1234 Placentia
BUILDING PERMIT NO. BLD200S-Q2306
TYPE OF PERMIT CITY
Reroof
DATE: 7/21/2005
JOB ADDRESS: 1234 N PLACENTIA AVE
LEGAL DESCRIPTION: N TR 1353 LOT 96
APPLICANT: DA VESE GALLAR INI
OWNER INFORMATION:
RICHARD G FUHRMAN
10101 GROVELAND AVE
WHITTIER, CA 90603
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 111
CONTRACTOR INFORMATION:
MILES GALLA-RINI
346 E MEADOWBROOK AVE
ORANGE, CA 92865.0000
BUSINESS PHONE: (714) 974-6424
JOB DESCRIPTION:Tear off existing material, install 54 squares of composition shingles to house and detached garage.
VALUATION:
5,172.00
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ENO
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt rom the Contractor's License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, a tte r, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).
D I, as owner of property, or my employees with wages as their sole compersation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds or improves
thereon, and who does such work himse~ or herself or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale).
D I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law).
D I am exempt under Sec. , B & P .C. for this reason:
Date: ()wner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
o I have and will maintain a certificate of consent to self.insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
ihi permit is issued.
I have and will maintain worker's compensation insurance, as required by Section 3700 of
he Labor Code, for the performance of the work for which this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number: 285-00016!56
This section need not be completed if the pennit is for one hundred dollars ($100) cr less.
Kl-I certify that in the pertonnance of the work for which this permit is issued, I shall not
~oy any person in any manner so as to ecoll1e subject to the worker's compensation laws
of California, and agree that if Is ould b om subject the worker's compensation
provisions of Section 3700 of the L or Co I s forth ith comply with those provisions.
Date: 7/21/2005 Applicant:
WARNING: FAILURE TO SECUR ORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJ T AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE HUNDRE OUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATIOi'j AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST/AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is aconstruction lending agency for the
performance of the work for which this permit is issued (Sec. 3097.Civ.C):
Lender's Information:
~
Dale: 7/21/2005
Signature of Applicant or Agent
The permit hall 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 Dermit is required to commence or continue work.
LICENSED CONTRACTORS DECLARATION
I hereby affir under penalty of perjury that I am
licensed under rovis ns of chapter 9 (commencing
with Section 70 i I n 3 of the Business and
Prafes 'ons Code
Construcion Types:
VN, ,
Fire Sprinklered?
EXPIRATION DATE
2/28/2007
B
C39
NO
Fees paid for Permit:
Total:
459.51
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
SetbacklForms/Trenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable Items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough) /'"
2nd Floor Shear t I . \ ~
Roof (Sbeatl.ing/[)iaphragm/Frame) f1~ I~ .;!
Masonry (Reinf.lBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy) ,
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T-Bar Electrical
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Back1low
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-5194 I
Zoning 765-5139 ,
Building Final (last Inspection - Only rt5
After Above Complete) JA.~loc,)"iIL1
,
PARTIAL INSPECTIONS
Buildin9 InSDections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections