708 S. Westvale Dr.
~:O~?F PERMIT . CITY
DATE: 1/18/2005
JOB ADDRESS: 708 S WESTV ALE DR
LEGAL DESCRIPTION: NTR 1646 LOT 41
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
. (714) 765 - 5153
INSPECTION REQUESTLlNE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 6
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BUILDING PERMIT NO. BLD2005.00126
APPLICANT: FRED FARMER
OWNERINFORMATION: CONTRACTOR INFORMI',TION: ARCHITECTJENGINEER INFORMATION:
Paul H Juarez CHRISTOPHER ROOFiNG CO, INC
5245 Glen Verde Dr 1240 N ANAHEIM BLVD'
Boniw, CA 91902 ANAHEIM; CA 92801 0000 ,
BUSINESS PHONE; 714997-4541 .
.JOB DESCRIPTION: Tear off. existing and re.roof 24 squares of 50 year' compc,sition shingles. .
VALUATION: 4,600.00
I OWNER.BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contracf.or~s License law for the following reason (Sec. 7031.5 Bl!siness and
Professions Code: any city or countywhich.requires a permit to construct, aItQr, improve, demolish or repair any structure, priorto its issuance, also~
requi~e:s the applicantfor such permit to file '8 si9:ned statement that he '$Iic~:_\sed purs-u~n~ to the plOyisions of the Contractor's UcenseLqw (Chapter
9)(commencing with Section 7000 of Division 3 of the Susiness and Prof,eSSlc:1S Code) or that he is exempt therefrom and the basis for the alleged ,
exemption. Any violation of Section 7031.5 by any applicant fOT a permit ~ubJ.::tCts the a pplicant to a'~vil penalty of nat more than five _hundred dollars
($500).. . '. J': .
o ,I, as owner of property, or my emptaye~ with wages as their sole ccmp~nsation, will do the work, and the structure is not intended or offered for
sale (See; 7044 Business and Professions Code: The Contractor'!? License L~:...v 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 her0w/(:,-;:mployees, provided that such impJ:OvelTJants are, not intended or
offered for sale. If, however, the buifding or-.improvement issold with one ye-2:i of completion, the owner-b,uilder will have the,burden of proving that he
did not bu"dor improve for the purpose of sale). 'i >' " . '
. 0 I, as the owner.ofthe property, am exdusively~contra9ting with licensed for>tractors to construqt the project (Sec. '1044 Business and Prcife&sions
Code:, The <:;ontractor's License LaW'does~hot apply to'an 9wner,ot. property'~ho builds .or improves thereon, and who c:ontr~cts for such proje~ with
. ~ontraCtor(s) lice-ns:ed pursuant to the Contractor's License Law). '
U I am exempt under Sec. , ' , B & P.C. for this reason:
Date: :: Owner:
.1 WORKER'S COMPENSATION DECLARATION
I hereby affirm unde~,p,enalty of pa~jury .one of the following declarations: C
q,'-' have andwili h,ail"!t.aj~ a certifr~ate '.of co'nrent t.o, self-insure forworl<e{iri'.;orepensation,
as provided f.or by Section _3700 of the Labor Code~ f.or the performance oft!}€. wolk fer which
~.spermitls'lssued. . '"
. have' and will main!ai.n worker's comp e~sation insurance, as required by Section 3700 qf
bar ,Code; for the performance of the work for which this permit, is iSStled, Myworker's
Compensation insurance carrier and poliqy are: ' !. '
Carrier: STATE FuND . Policy Number. 28500000(l625 .
....,\ /.
This section need not be compl.eted if the pennit is for one hundred dollars ($1Q~) pr leSs.
o 'cer1ify that in the perfdrrnance of the work for which this perrnit is issues~ { shetH not
employ any person in any manner so as to become subject to the worker's'qoMpensation laWs
of Califomia, and agre'e that ifl should become 'subject to the worker's cO~;1sa:tion
. prOVisions of Section 3700 of the Labor Code, II forthwit mply with thoi>epr~visions.
PROCESSED BY: SAM
~
~L
~
UCENSED CONTRACTORS DECLARATION
, hereby aff,irm under penalty of perjury that I am
licensed under provisions of ch~pter 9 (commenc:ing
with Sectio'n 7000) of Divsion 3 of the Business and'
profeSSiO~ode. . -' //. '.
1/18/Zoo5 r!:! -~..---....-
Date:' : " .' " Co'~tractor'" ' .
'NUMBER EXPIRATION DATE
624118 813112005
TYPE C39
Date: 1/1812005 Applicant
WARNING: FAILURE TO SECURE .... ..
. UNLAWFUL, AND SHALL SUBJEC AN EMP/-OYER TO CRIM INAL PENAL TIE;S'.AND CIVIL .
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDrnON'TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABORC.ODE,.INTEREST AND ATTORNEY'S FEES. . .
CONSTRUCTION LENDING AGENCY
Construcion Types:
VN, , .
Fire Sprinklered?
NO
. ~,~
I ~ereby affirm under penalty of perjUry that there is a cQnstruction lending tlge.,'~G-yfor the
pe:riormance of the work for which this permit is issued (Sao.3097 .CIV.C):
Lender's ll)formatioh:
.
.'I'.t "."""".,','
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f certify that I have read this application and state-that the above information IS correct. I
agree tacompl.Y,with. a/l city ordinances and ,state laws relating to building cOniStructlon, and
hereby authoriZe representives of this city to enter upon the above mentioped property for
inspecti~n purposes.' '- , .' ~ ," ,. Date: 1/18/2005
'{(. ~~~re~PPlica~-
The permit shall. expire by limitation and become null and void if the building or
. w'orkhas not passed final inspectioll 365 days from the date of permit issuance. A
new permit is required'to commence or continue work.
Fees paid for Permit:
Totill:
235.33
INSPECTION RECORD
, INSPECTION , DATE INSPECTOR,
Temporary Power Pole
Plumbing (Drain/Waste Pipe) ,
Electrical Ground Electrode/uter, "
SelbacklFormsfTrenChes (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical, (Grouriclwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Reinf. "
Underpilming (Floor Jolst/Gitdersf , .
Po. not cover or conceal the work below until the .'
, following applicable items have been signed: .
1st Floor Shear, .
FireSprinkler (Rough) " .
2nd Floor Shear . . In u .
Roof'(Sheathina/Diaohraam'Framel J-i"!-tJ ./
Masonry (ReinfJBond BeamlPre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
I KOugn t:lectrlClIlury wall) ,
Rough Electri,cal .
Framing (OlllyafterPlbg., Elec.. Mech.. and Fire) .
Insulation (Sou!1d/Energyj ,',
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 (Bl'O\Nn Coat)
T .Bar Eleetrical ' .
T .Bar Mechanical " ' . . .
T -Bar ,Structural . .
Sewer
Water Engineering Backflow .
Water Servil'J>
FINAL INSPECTIONS , Daie Inspector
Electrical Final '. " ,
PIl!mbing Final ,
Mechanical Final
Gas Test . .
EngineeringlGracling Final 765.0126 .
Fire Oept. Final 765-4040 ..
Water Engineering 765-5268,
Sub List/Busine'ss License 765-519
Zoning 765-5139 .' , ,
Building Final, ~.st Inspection- Only IJ--)I-t)!J r;';lu"t6
" fter Above Complete)'
PARTIAL INSPECTIONS
. Buildina Inspections .
Mechanical Inspections
. 'Plumbina Inspections
Electrical Inspections ,