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1435 E. Willow St. ,BUILDING PERMIT NO. BLD2005-01711 ;,..:- 4:;:;' TYPE OF PERMIT CITY Repair DATE: 6f112005 JOB ADDRESS: 1435 E WILLOW ST LEGAL DESCRIPTION: N TR 1770 LOT 109 / BUILDING DIVISION 200 S. ANAHEIM BLVD. (714F65- 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 434 QUARTER SECTION: 103 APPLICANT: MIGUEL LUA ! >/ OWNER INFORMATION: CONTRACTOR INFORMi\TIQN: ARCHITECT/ENGINEER INFORMATION: Fernando Diaz CALIFORNIA CONSTRUCTION & R RE REs:lONALD J INMAN 1435 E Willow St 3104 E GARVEY AVE SOUTH #5 5131 FOX HILLS 'AVE. . Anaheim.CA 92805 WEST COVINA, CA 91791 OOQO BUENA PARK, CA 90821 . BUSINESS PHONE: 626919-5:j53 . JOB DESCRIPTION: Rebuild garage, bedroom waU,and miscellaneous roof repaifs including reroot-of 18 squares with comwsition shingles due to fire VALUATION: da"lilP,800.00 PROCESSED BY: JNJ OWNER-BUILDER DECLARATION I eteby affirm under penalty of perjury that I am exempt from the Gon-tractorsicense Law for the followIng reason (Sec. 703 ..5 BusuJes$ an Professions Code: any city or county which req"uires a permit to construct, atter,,:lmpr9Ve, demolish or repair any structure, prior to its-issuance, also requires the appli~nt for such permit to file a-signed statement that he is licensEl'd pur~uant to the provision,s of the Contractor's License Law (Chapter 9)(coml'"(lencing with Section 7000 of Divi,$ion 3 of the Business a!:)d Profession~,9ode) or that he is ~xempt therefrom and the basis for the.alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjec!:S the applicant to a civil penalty of not more than five hundred"dollars ($500). ' . ' ,1 . . , . , o '>,as.own~r 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 LaV:~does not apply-to an'owner of property who builds or improves thereon, and whod6es such work himself or herself or through his or her own e,;:1pJoyees. provided that Such"improvements are noHntemded.or offeredJor sale. If, however, the building or improvement is sold with one.yea'r ~rCompletion.. t!1e owner~builder will have the burden of proving that he did.notbu>>d.orimprqve~orthepurpose,bfsale). ~;'-'" , " . ..,. o I, as the owner, of the property, amexclusiv~Iy' contra-cUng wit.~ licensed coiitractors to c,:mstruct the project (Sec. .7044 Business and Professions Code: The Contractor's License Law d06S.not apply'to an owner of propertyw~p buUds or improves thereon, and who contracts for such projects with ~ont~~ctor(s) Ucensed pursuantt~ the Contractor's license Law). . ~ . ,', . -" ,- . . " ~ - " ' , U I am exempt under Sec. ,6& P.C. fqr this reason: l' . , '. .. . . Date: Owner: - . . . ,~i' . . I WORKER'S COMPENSATION DECLARATION, t LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjurY one of th~ following declarations: .. ~. I hereby afffrmunder penalty of perjury that I am o I have and wilt maintairl a certificate of consent to se)f~insure for wcirker'scompensation, licensed under proVisions of. chapter 9 (commencing as provick?d for by Sect~~n 3700 of the- Labor Code. for the performance of the ~urk for'which with. Section 7000) of Divsion 30t the' Business and this permit is issued. .. . l!. Professions Code. . ~l- have and will maintain worker's cOfTlpensation,insurance, as required by Section 3700 of 6i7/~'" ~ ~ ~~r:rr'. -, . the Labor Code, for the performance ot the work for which this permit is iss'ued.tMyworket's Date: .~ Contractor Compensation insurance carrier and policy are: '. ;V,' Carrier: STATE FUND . Policy Number. 0008811-2094' . ~ This section need not be completed if the pennit i$ for one hundred dol/ars ($1'00) Oii less. .' ) o I certify that in the performance of the work for w~ich-this permit Is. issued, I shaH not employ any' person in any manner so 'as to become subject to the workers compensation laws ot Califomia, and agree that if I should become subject to the worker'!;> compen~ation provisions of Seciion.~70(j at the Labor Code, I shall forthwith comply with thos~ provisions. NUMBER 800231 TYPE Construcion Tvpes: VN, , Dale: 617/2005 Applica . WARNING: FAILURE TO SECUREWORKE PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINESUPTO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDll1pN TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3\06 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. ' CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of p~rlury that there is a cO!'l'struction lending.2.ge:-i.)y for the' petiormance' of the work far whlch this permit is issued (Sec.3097.Civ.C): Lender's Information: I certify that I have read this application and state that the above information is correct. I 'agree ta comply with all city ordinances and state laws relating ta building construction, and hereby autnorize representives ot this city to enter upon the above mentioned _property for i1sp~ion ~r:~~Ses, . _' . . '. '. , . ~ - "".~~ Date:6f712005 . g - . of Applicant or Agent ,The permit shall expire by limitation and become null and void if the building or work has not passed final inspection 365 days from the date of permit issuance. A new permit is required to commence or continue work. ' EXPIRATION DATE 1013112005 B ---.------"'>-- Fees paid for Permit: Total: 890.91 INSPECTION RECORD INSPECTION '. . .[lATE . INSPECTOR ., . ,.'" T ell'lporary Power Pole .' . Plumbing (Ora/nlWaste Pipe) Electrical Ground Electrode/uter I. . . SetbackfFormslTrenches (FootinQ$) Do not install sUblloor or pourfloor sl.abuntillhe following applicable items havebee~ signed: Plulllbing (Water Pipe.Sprinkler Valves) Mechanical (Groundwork) . '. .' . E\edrieal (Underground Conduit) . , Pnl-5/ab (CompactionlMembrane.Reim. ; Underpinning (Floor Joist/Girders). . I lJO not cover or conceal the work belOW until the I . following applicable items have been signed: . . 1st Floor Shear '. . I FinlsPrinkler(Rough) . . . , 2nd Floor Shear . . . i Roof (Sheilthlng/D1aPhragmlFrame) J -3.(;;"'- / Masonry (RelnfJBond BeamlPre-Grout) . ~ Rough Plumbing (Top Out) -'(~ rp-. ; Rough Mechllnical . . . .~ ~-'t~ ,. I Rough Electrical (Dry Wail) '..1 ~ ,.. +. Rough Electrical . -~ Fr.aming (Only after Plbg.. Elec.. Mach:'and F'm . Insulation (SoundlEnergy)' . . - po not tape or pia,,,,, until the following. applicable \.. I Items have been SIgned: . Orywllil . '7f I(.IN A ! Penetrations (Fire Rated) Electric;ol . I Penetrations. (Fhe Rated) Mechanical I. Penetrations (Finl Rated) Plumbing . . 1 Interior Lath ..' . I Exterior Lath ~.Ii!"'- "'I GENERAL I MS' ..' . i Exterior Plaster (Brown Coal) . . I.' T -Bar Electrical . 1 T-Bar Mechanical I T -Bar Structural' I Sewer i Water Engineering Backflow . , Water Service , I i 1 FINAL INSPECTIONS Electrical Final Plumbing Final. Mechanical Fin~1 . Gas Test EngineeringlGrlldingFin;oI765-5126 'Dale . Insp-ector erS . " Fire Oept. Final 765-4040 Water Engineering 765.5268 Sub List/Business Ljcens~ 765-519 Zoning 765-5139 Building Final' fla.t Inspection- Only' ()-(Q .. . . Aller Above Complete) ./ PARTIAL INSPECTIONS. Buildina Insl'lections Mechanical Inspections . Plumbina Inspections. Electricallrispections