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882 S. Philadelphia St. TYPE OF PERMIT C.ITY Reroof. DATE: 1/24/2005 JOB ADDRESS: 882 S PHILADELPHIA ST LEGAL DESCRIPTION: N TR 1871 LOT 12 ElM BUIL9INGDIVISION . 200 S. ANAHEIM BLVD. (714) 765 - 5153, INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 85 BUILDING PERMIT NO. BLD2005.o0192 , , APPLICANT: JOHN SHEATZ i OWNER INFORMATION: CONTRACTOR INFORMATION: Monarch Mano' THE ROOF GUY " li ,989 Scott SI 9781 EAS1WOOD CIRCLE ~ ' San Diego, CA 92106 VILLA PARK, CA 92861 oqoo BUSINESS PHONE: 7149';n-1500 ' JOB DESCRIPTION:Re-roof - Overlay 38 sq. of 20 yr. composition shingle 01:' (1) existing layer of compo VALUATION: 3,300.00' , l.. . PROCESSED BY: ENO , I ., .. . . OWNER-BUILDE~DECLARATION . , . ..' ' . Lhereby affirm under penalty of perjury that I am exempt from the ContractQfs! icense Law for the following reason (Sec. 7031..5 Business and Professions Code: any dty" ot county which requiresa permit to construct, ~~er, 'improve,'demo'.ish or repair any structure, prior to it.s issuange. -also requires the applicant for such permit to file-s signed. statement that he i$IiQ~l}sed- pursuant to the provisions of the Contrador's. License Law (Chapter 9}(commencing with Section 7000 of DiVision 3 of the Business and Profess1bhs Code) brthat he is exempt therefrom and the basis for the alleged . . e~em'ption. Any vi?iation of Section 703'1.5 by any applicant for a permit su~ects the a'pplicant to a dvU nenalty of not ~re than ~ve hundred dollars ffiiOO). " 1 ' , , U 1', as owner of property, or my employees with wages as their sole comHmsatjon,'wlll do the work, and the structure is 'not intended or ~ffered for. sale (Sec. 7044 Business and Professions Code:, The Contractor's Llcense';_&~'/I doe~ not apply to ~n '<;Jwner of property who buikfs or imprbv,*, thereon, and who does such worJ.<. himself or hecs.elf'-~r through his or her oVl:~.empJoyees;, pro\(ided that s,!ch improvements are not intended or . offered:f6r sale. If, however, the building or impro~ement ~ sold with one yi}r of completion, the owne,--bui'der will have the burden of provlngthat h~ did not build or imp.rove for the purpose of sale). . . . . .t." , " 0' I, as- the C?wner.of the ,property, am ex'dusively cont.. raeting ,with Iicense~tCo. ritractors to construct the project '(See. 7044 Business. and Professions Code: The Contractor's License Law does.not apply to an owner of propert~tvho builds or improves th~reon, and who'contrac~s. for:such projects with . ~ontractor{s) licensed pursuant to the Contractor's:Ucense Law)~ -~. , . U I am exempt under S~c. " B & P.C. forthj~ reason: . . _t~ Date: Owner: . ~ I WORKER'S COMPENSATION DECLARATION .1 l hereby affirm under penalty of 'perjl!'Y Qne of tl"!e following declarations:.., ' D. . I haVe a'nd willmainta-in a certiJiGate of con 'sent to self-insure for w()rkerl~_:cQmpensation, as provided for by SectiO" 3700. of the Labor Code. for the performance of t~;t' work. for which this permit is iss'ued. . . .-". . I . :;JII have and will maintain worker's compensation insurance, as required i:;,:Section 3700 of ~labor Code, for the performance of the work for which this permit is iSSU~ld. My wprker's . Compensation insurance carrier and policy are:. .~. Carrier: STATE COMPENSATION FUND Policy Number. 17137931 , 1 ' This section need nol be completed if the pennil is for one hundred dollars ($10Qi or less. ' . 0 .' certify that in the performance of the work for which this permifis issu~d>.! sha'l! not. employ any Person in_any manner 5:0 as to become subject to the workets:~_pr~pensatjon raws of .Califomia, 'and agree that if I should become subject to the worker's comt.kmsation . . . provisions of-Section 3700.ofthe Labor Code.. shall forthwith comply withJh~::~ avisions. > Construc;on Types: VN, ARCHITECT/ENGINEER .INFORMA TION: LICENSED CONTRACTORS DECLARATION I I hereby affirm under penalty of perjury that I'am. _ licensed under provisionS-of chapter 9 (coa:im~hci1j,g-// with Section 7 00). of Divsion 3 of th sine$.S-1!l1d Professio e. 1/2412005 Date: Contractor NUMBER 638593 TYPE EXPIRATION DATE 2/2812006 C39 Date' 1/24/2005 Applicant: WARN ING: FAILURE TO SECUR ' ORKER'S COMP A TION COVER<\GE IS UNLAWFUL, AND SHALL SUBJE T AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UPTO ONE HUNDRED 1HQUSAND DOLLARS ($100,000), IN ADD:T10N TO THE, COST OF COMf>ENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE , LABOR CODE, INTEREST AND ATTORNEY'S FEES, I' I CONSTRUCTION LENDING AGENCY I hereby'affirl1' under.penalty of perjury that there is a construction lending agency for the . performance of the work for which this permit is issued (5eo.3097 .Civ .C): ( -,__ Lende-~slnformation; L~;~. , ''=.:.._'.:;;_-'----.'__:~__'''_~~__.,_,_._,__ ":._____'-""'-_..:.-....-.L-'c--'-'---_;,'"'-,_,_., I. certify that I have read this application and state that the above information is correct. I .i;igree to comply with all city ordinances and state laws relating to building construction, and ~ere authoriZe representives_ of'this city to enter upon the above mentioned property for i sp Ion pur~ses. Signature Appli r Agent The permit shall expire by limitation and become null and void if the building or work has not passed final inspection 365 days from the date of permit issuance. A new permit is required to commence or continue work. . Date: 1/24/2005 Fees paid for Permit: Total: 310.05 , , INSPECTION RECORD' INSPECTION , DATE INSPECTOR TElmporary PowElr,"ole ' " , 'Plumbing (DrainNVaste Pipe) " ' Electrical GroundElectrodelUfer , SetbacklFormsfTrenches (Footings) " Do' noUnstall !>ubfl06r or pour floor slab' until the folloWing applicable items have been,signed: Plumbing !Water Pipe.Sprinkler Valves) MechaniCal (Groundwork) Electrical (Uoderground Conduit) , . Pre-slab (Compaction/Membrane.Reinf.j , Underpinning (Floor Joist/Girders) , , ' Do not cover or conceal the work be,low until the ,', , following applicable items have been signed: 1st Floor Shellr , , ' F1resprfnkler' (Rough), 2nd Floor ShElllr " ,~ / Roof (Sh8athIng/DiaphragIiv'Frame) '1- <>{\ Masonry (ReinfJBond BeamlPre-Grout) , /, Rough Plumbing (Top Out) l'../ Rough MechllniclIl , " . , , Rough f1eetrie ,..all) , Rough Electrical ' , - Framing , (Only after Plbg, Elee.. Meth, and Fire) Illsulatlon, (SoundlEnergy) , po not tllpe or plll~ter until the following applicable' , Items hav.e been signed: " ' , Drywall ' ' ", " ' ' Penetrations (Fire Rated) Electrical PenEltrallons (Fire Rated) MElchanical Penetrations (Fire Rllled) plumbing , ' Interior Lath ' , , , , exterior Lath' , " , GENERAL ITEMS Exterior Plaster (Brown Coat) " , " , ' :r -Bat Electrical , , T -Bar Mechanical , T -Bar Structural , Sewer Water Engineering Backflow " . Water Service . ' FINAL INSPECTIONS Date' , Inspector ' Electrical Final . , Plumbing Finai ' ' ' " " , , ' Mechanical Final " , Gas Test " , , Engineering/Grading Final 7,65-5126 , " FireDept. Final 765-4040 , , , Wllitir Engineerlnll 765.5268, , " Sub List/BusiMss, LicensEl765.51 9< , , Zoning ,765-5139 , ' , " Building Final \l:"st Inspection- Only Z..7-~ V/t- 1/ fter A~ove Comp/ete)' PARTiAl INSPECTIONS f/ . . . Buddma InspectIons Mechal'licallnspections Plumbina Inspections Electrical Inspections '.