447 S. Westridge Cir.
BUILDING PERMIT NO. BLD2005-02488
TYPE OF PERMIT CITY
Reroof
DATE: 819/2005
JOB ADDRESS: 447 S WESTRIDGE CIR
LEGAL DESCRIPTION: N TR 7569 LOT 92
APPLICANT: RAYMOND CAUCHOIS
OWNER INFORMATION:
MARK C SALIBA
447 S WESTRIDGE CIR
ANAHEIM, CA 92807
CONTRACTOR INFORMATION:
ACCURATE ROOFING
19732 PROVIDENCE LN
HUNT I NGTON BEACH, CA 926460000
BUSINESS PHONE: 714962,4250
JOB DESCRIPTION:Tear off existing and r.ro0139 squares with Ea91e tile ICBO # 4660 # 6.5Ib/sf
VALUATION: 15,800.00
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 180
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: JNJ
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the tractor's. License Law for the following reason ( eG. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter, Improve, demolish orrepair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is licen~d 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 penatty of not more than five hundred dollars
($500).
o I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License La~does not apply to an owner of property who builds or improves
thereon, and who does such work himself 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 yea(of completion, the owner-builder will have the burden of proving that he
did not bu"d or improve for the purpose of sare).
o \, 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 propertyw.ho builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law).
o I am exempt under Sec. ,8& P.C. for this reason:
Date: Owner:
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 dompensation,
as provided for by Section 3700 of the Labor Code, for the perlormance of the work for which
this permit is issued. .
~ have and will maintain worker's compensation insurance, as required by Section 3700 of
'the Labor Code, for the performance of the work for which this permit is issued.: My worker's
Compensation insurance carrier and policy are: .
Carrier: Policy Number: EXEMPT
This section need not be completed if !he penni! is for one hundred dollars ($1 00) or Jess.
o 1 certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become sub' ct to the worker's compensation laws
of Califomia, and agree that if I should becryf;m bje 0 the w. er's compensation
provisions of section 3700 of the Labor C , I al prthwit omply with those provisions.
Date: 8/9/2005 Applicant:
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED ll-l OU SAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES 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 a construction lending a(le~vfor.the
performance oj the work for whidl this permit is issued (Sec.3097.Civ.C):
Lender's Information:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of vsion of t Business and
Professions Code.
8/9/2005
Date:
NUMBER
726093
TYPE
Contractor
EXPIRATION DATE
8/3112006
C39.
Construcion Types:
VN, ,
I certify that I have read this application and state that the above information is correct. I
agree tO~IY w. all city ordinances and state laws relating to building construction, and
hereby a rize prese as of this city to enter upon the above mentioned property for
inspectio IrjlO: s.
( J" Date: 8/9/2005
Signature of Applicant or 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 Dermit is reauired to commence or continue work.
Fees paid for Permit:
Total:
607.92
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainJWaste Pipe)
Electrical Ground Electrode/Uter
SetbacklFormslTrenches (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 (CompactionlMembrane Relnf.)
Underpinning (Floor JoisUGirders)
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 f I
Roof (Sheathing/Diaphragm/Frame) 't:/Zl.L. ,\A-\hW~~
Masonry (Reinf./Bond Beam/Pre-Grout) ,I I
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ete.,Mec. And Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetrallons (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 Backflow
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
ZonIng 765-5139
Building Final (Lasllnspectlon - Only ~~
After Above Complete) ,'\J\tJcW"'9vL \
I
PARTIAL INSPECTIONS
B~~i~'nspections
f': t-_i_< ic,",<.o",. f.....k.l10 ~
I tV( J,~~ ol\UcrJSV--l
Mechanical Inspections
Plumbina Inspections
Electrical Inspections