315-341 S. Magnolia Ave.
BUILDING PERMIT NO.
BLD2004,03755
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CITY A~';!A,,'kf~W.;H ElM'
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BUILDING DIVISION
200 S ANAHEIM BLVD.
(714) 7135 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 20
CONTRACTOR INFORMi"T10N:
JEONG WOO'j..EE !
1113MGNOUi>.AVE#4 !
GARDENA, CA 90247 OOC~
BUSINESS PHONE: 310 51~.55QO
~OB DESCRIPTION:Tear off existing roof and replace with 140squ",es of sur.
VALUATION: 18,000.00., .f PROCESSED BY: MSM
I . OWNER-aUILDEHIDECLARATION . .
! hereby affirm under penatty of perjury that I am exempt from the Con'tracto1s License Law for the following reason (Sec. 7031.5 BUsiness and
Professions Code: any dty orcountywhich requires a 'permit to construct, ;::d!~r, improve, derriolish or repair any structure,_ prior to its iSsuance, also
requires the. applicant for such permit to file a signed'stafement that he is l:c~;nsed pursuant to the provisions of the Contractor's license Law (Chapter
9)(commencing with Section 7000 of Division 3 of t~e Business and Profess:Llls Code) or that he is ax~rnpt therefrom and the basis for th~atleged'
exemption. Any violation of Sedion 7031.5 by any applicant for a permit sui:.;~cts the spplicant to a dv~ pe>nalty of not ,mOl"e than five hundred dollars
($500). . . i. .
o I, as owner of property, or-my.employees with wages as their sole corr;r~msalion, will-do the work, and the structure is no! intended 9r offered for
sale (Sec. 7044 Business a nd Professions Code: The c.ontrnctor's License ltaw dees not aoply to an owner of property who builds of'improves
thereon, and who.does.such work himself or herself or through hi$ or he!'" ow~ ernpIOy"eI:'!S, p'rovided that $uch imp!Ov~ments are not intended o"r
offered for sale. If, however, the buildlrg or improvement is sold with Drl€ Y.f..rr of compleiion. theowner-D'Jilder will have the burden 6f proving thrl1 he
did not puUd orirnprove for the purpose of sale). l~. . ,
o ~,as the owner 'of the pr9perty, am exclusively contracting with lice/"lsed j::ontractors to construct the project (Sec. 7044 Business and Profe-ss;ons
Gode: The'Contractor's license Law does nqt apply to an owner of propF;rt~'INho bujld~ or improves thereon" and who contracts for sudl projects with
~ontractor(~) licensed pursuant to the Contr.?ctor's License Law). .
U I am exempt under Sec. ,B & p.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATIOi~ 'i
I hereby affirm under penalty of perjury .one of the following declarations: .1
o I have and will maintain a certificate of oonSent to self-insure for WNk(~;"~ :;l)mrens~i:jon,
~s rovided for by Section 3700 of the Labor Code, for the perforrn8:100 of th;~ work fer whiCh
.th. permit is issued. ,,(. ,
, . I h~ve andwin maintain worker's compensation insurance, as required 0;' :Secti(),~ 37C.,O o~
he. abor Code. for the performance of the work for which this permit is issu~)Q. Myworker's
Compensation insurance carrier and policy are: ':. .
Carrier: STATE COMPENSATION INS FUND PoliCf Number. 1704357'W.
This seCtion need not be completed if the pennit is for on~ hundred dol1ars ($,1~~i or'~es's.
o 'l certify that in the perfonnance o~the work for which this permit isi&U~?, I shall not
employ any person in any manner so as tQ. become.subject to the wQlker's cq,mp.en.satiOr. laws
of Califomia, and agree that if I should become subject to the worker's cOmf)qnsation
provisions of Section 3700 ofth~ Labor Code, I shall forthwith comply w.ith th~se'provisions..
TYPE OF PERMIT
Reroof
DATE: 10/7/2004
JOB ADDRESS: 315341 SMAGNOLlAAVE
LEGAL DESCRIPTION: SEe 13 T 4 R 1.1 E 200 FT $312 FT N
APPLICANT: JEONG LEE
OWNER INFORMATION':
Aprtments Pomona
2325 Camono Recondito
Fullerton, CA
ARCHITECT/ENGINEER INFORMATION:
Dale: 101712004
<-J'~
WARNING: FAILURE TO SECURE ORKER'S COMPENSATION COV~R/I(iEIS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN;.ttiss. AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,00G), IN ADO[ffo,'l TOTHE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION'37P<;.9F THE'
LABOR CODE. INTEREST AND ATTORNEY'S FEES. . .
I CONSTRUCTION .LENDlNG AGENCY }:
Lher:~!;i)tgff.iLl1}_\Jf!9_~LNtW_~Y.Qf per:illryJ!'l,:tUher~ is a construction ~end irlJ~4~jc~_fo(1/o:l_e-
... perf(Jrmance _oftneW()rk for which thi$-permit is issued (See. 3:097 .Civ .C). .. .
Lender's Informatjon~
Applicant:
I certify that I have r~ad this application and state that the above information;s correct. I
agree to comply with all city ordinances and state laws relating to bu ilding construction, and
her y authorize representives of this city to enter upon the abov~ mentloneo property for'-
i ion purpo~s. . ~
I ~ <-V .0----- Dale. 10/7/2004
Signature "of Applicant or Agent
The permit shall expire by limitation and become null and void if the building o(
work has not passed final inspection 365 days from the date of pern:it issuance. A
new permit is required to commence or continue work. :
~
I
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that J (:!m
Iicensed'under provisions 6f chapter 9 (commemcli1g
with sec~ooo) of DivsiO.n 3 o. fthe B.US iness'and
Professl . sode. 7' """-.J' /--
10/~/2004 ; _,.... . ~
Date: . .: . - ,." Contractor"
.../
NUMBER
812026
TYPE
EXPIRATION DATE
8/3112006
C39
C.onstrucion Types:
VN, ,
Fire. Sprinklered?
NO
,,- ,"-...t.,-,,'.
Fees paid for Permit:.
Total:
804.33
, INSPECTION RECORD
, " INSPECTIOtol ' 'DATE INSPECTOR:
,
Temporary Power Pole , ,
Plumbing (OrainlWaste Pipe) "
Electrical Ground Electrode/Ufer
SetbackfFormsrrrenches (Footings)' ,
Do not install sub floor or pour floor slab unWlhe
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) , , , ,
Mechanical (Groundwork)
Electrical (Undergrollr\d Conduit)
Pre~slab (CompactionlMembrane.Reinf. , ,
Underpinning (Floor Joist/Girders)
:, ,Do nol cover or conceallhe work below until the
following applicable items have been $igned: ",
1st Floor Shear
FireSprinkler(ROugh) "
2nd Floor Shear
RQot.!Sheathinall;liaphragmlFramej I,~A.I. ~"'r,q-~
Masonry '....'mJBonel Beam/Pr&-Gl'O\It) , ,
Rough PllImbing(Top Ollt) ,
, Rough Mechaoical '
Rough t:lectrlCaI II)
Rough Electrical ' ,
Framing (Only aher Plbg, Elec.. Mech and F,trel ' ,
Insulation (SoundlEnergyl , " "
00 n,ot i"pe or' plaster until the following applicable
item~ have been signed: '
Drywall
Penetrations (Fire Rated) Electrical ' ,
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) P1umbil19
Interior Lath , , '
Exterior Lath
GENERAL ITEMS
Exterior Plaster (BlWlnCoat) ,
T -Bar Electrical "
T-Bar MechanIcal , ,
T -Bar Structural
Sewer ,
Water Engineering Backflow
Water Service , ,
FINAL INSPECTIONS' Date Inspector
Electrical Final ' , "
Plumbing Final
Mechanical Final I
Gas Test ,
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040 ,
Water Enginee,ring 765.5268
Sub List/Business License 765-519 "
,
Zoning 765-5139 ,
Building Final *.sllnspection" Only ,
, fie' Above Complete)
PARTIAL INSPECTIONS
Buildina Insrlections
Mechanical Inspections
PJumbina Inspections
Electricallnspec.tions
ro'\~\T ,EVPIREIJ
~-\\\~\ I, ^,
\ L ,,'
.\NSPECTION
'NOT COMPLETED
',.1-- 7;70 ..-Os
DATE.: ' ,