1434 W. Westmont Dr.
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CITY ()l;:;tAN~HEIM
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BUILDING PERMIT NO, BLD2005-03676
TYPE OF PERMIT
Reroof.
DATE: 11/17/2005
JOB ADDRESS: 1434 W WESTMONT DR
LEGAL DESCRIPTION: ANAHEIM HOMESTEAD TR LOT 6 POR OF
APPLICANT: RHONDA CRESS
OWNER INFORMATION:
BUILDING DIVISION
200 S. ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 53
CONTRACTOR INFORMATION:
DENNIS GROUP INC
17903 EVELYN AVE
GARD ENA, CA 90248 0000
BUSINESS PHONE: 310516-7935
JOB DESCRIPTJON:Tear off existing roof, resheath with osb and replace with 21 squares of 30 year composition shingles.
ARCHITECT/ENGINEER INFORMATION:
VALUATION: 8,500.00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from 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, alter, 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 pena~y 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 notiJitended 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 himself or helSelf or through his or her own (~mployees, 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 c(mtractors 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 ~xempt under Sec. , B & P .C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the fallowing 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
~i permit is issued.
;1 have and will maintain worker's compensation insurance, as required by Section 3700 of
e Labor Code, for the performance of the work for which this permit is issued. Myworker's
ompensation insurance cartier and policy are:
Carrier: STATE FUND Policy Number. 1585581-2D05
PROCESSED BY: MSM
This section need not be completed if the pennit is for one hundred dollars ($100) Qr less.
D I certify that in the perfonnance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the l bor e sh orth~CIY with those provisions.
Date: 11/17/2005 Applicant:
WARNING: FAILURE TO SECLiR WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJE, T AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED 'THOUSAND DOLLARS ($100,000), IN ADDIllON TO THE
COST OF COMPENSATION, DAMAGES AS PROVI DED 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 agency for the
performance of the work for which this permit is issued (Sec.'3097.Civ.C):
lender's Information:
I certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to bu i1ding construction, and
~ereby author' repre58ttf e s of this city to enter upon the above mentioned property for
msp np 58. L-
Date: 11/17/2005
Signature of Applicant or Agent
The per it 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.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penatty of perjury that am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Di n 3 of th usi~~s and
Profession e. r .
11/17/2005
Date:
NUMBER
699237
TYPE
Construcion Types:
V N, ,
Fire Sprinklered?
EXPIRATION DATE
11130/2006
B
NO
Fees paid for Permit:
Total:
245,22
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporarv Power Pole
Plumbina (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
SetbacklFormslTrenches (Footingsl
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbina (Water Pipe/Sprinkler Valves)
Mechanical {Groundworkl
Electrical (Underground Conduit)
Pre-slab ICompaction/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 ,
Roof (Sheathing/Diaphragm/Frame) ~ Y(/}:;; v:il
Masonry IReinf.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 Backflow
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Cross Connection Control (714) 165-4280
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 (Last Inspection - Only r/ik ~1tU,"'>S~l
After Above Complete)
'/
PARTIAL INSPECTIONS
Buildinq Inspections
Mechanical Inspections
Plumbinq Inspections
Electrical Inspections