971 S. Sutter Creek Rd.
TYPE OF PERMIT CITY
Reroof
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECT/ON REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION:
BUILDING PERMIT NO. BLD2004-04469
DATE: 1212112004.
JOB ADDRESS: 971 S SUTTER CREEK RD 40
LEGAL DESCRIPTION:
APPLICANT: JIM POMEROY
OWNER INFORMATION: CONTRACTOR INFORMATION:
SUTIER CREEK HOA J P CONTRACTORS, INC.' .
17671 IRVINE BLVD SUITE 110 2484 N GLASSELL ST "
TUSTIN, CA 92780 ORANGE, CA 92865.0000 '
. BUSINESS PHONE: 714921'2370
JOB DESCRIPTION: Tear off exlstin9 and re-roof 4 squares of BUR on garage only; unit A.
VALUATION: . 1,200.00 . PROCESSED BY: ENO . .
I '. .... OWNER.BUlLDER 0ECLARATION '..
I hereby affirm under penalty of:perj.ury that I am exempt from the Contraclor';;Ucense Law.for the following reason (Sec. 7031.5 Business and
Professions Code: a.ny city.or county which requires a permit. to construct.altE~r,improve,_demoJish or repair any structure, prior 1('1 its issuance,. .alSo
requir!'ls the applicant for such permit to file a sign~d statement that he islice:~sed pursuant to the provisions of the Contractor's License Ll3w (Chapter
9)(commencing with Section 7000 of Division 3Df the Business and ProfessiC'lls 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 subjrctsthe applicant to a dvilpenalty of nO,t more than fiv!3 hundred dollars
($500). '. . ..J . .
o I, as owner of property, or my ~mployees with, wages as their sole com~\nsation, will do, the work, and the s1ructure is not intended or offeree! for'
sale {Sec. 7044 Business a lid ProfessionsCode:' The C.ontractor's License L~k.w does not apply to an own'er 0f property, who builds.or improves
thereon, and who does such work himself or herself o'r through his or her owr;employees, provided that such improvements are not intended or
offered for sale. If, hC?wever, the building or improvement is sold with oneYs.<:ir or completion, the owner-builder wiH have-'the burden of proving that he
did not buBd or improve for the purpose of sale}. . \, . .
D I, as the owner of the prQperty, am exdusivery conticlding with licensed I,;pntractors to constrLlct the project (Sec. 7044 BUsiness and professIOns
Code: The Contractor'"s licenSe Law does not apply to an owner of propeltywro builds ::Ir improves thereon, and who oontracts for.such projects with
flQontractor(~) licensed' pursu8f\t to the Contractor's uee~se La~). r '
W lamexemptu.nderSec. . ,B&P.C.forthlsreason: __~_
Date: Owner: _ 1
I WORKER'S COMPENSATION DECLARATION )
I hereby affinn under penalty of perjury one of the following declarations: . ~\
o 1 have and will maintain a certificate ot oonsent to self-insure for worker'~_~omp.ensatioll,
as provided for by Section 3700 of the labor Code, for the pe-rformance ofthrij;'-Jork. for which
this permit is issued. i
~have a nd wifl-maintain worker's compen~ation insurance, .as required b~/'Section 3700 of'
~bor Code, for the performance of the work for which this permit is issue.'t My worker's
.Compensation insurance carrier an'd pollCJf are:
Carrier: STATE FU NO
ARCHITECTIENGINEER INFORMATION:
I
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjul)/ that I am
license.d under provisi.ons o;..ch er g.(commencing
with Section 7000) of Di\!S1bp fthe Business and .
Professions Code." . /',/
/
1212112Q04.
Date:'
PoUcy Number. 046-02-OC6357
NUMBER/
594913
TYPE
TYPE
This section need not be .COmpleted if ~e pennit is for one hundred dollars ($1 OD} .O[ !ess.
o I certify "that in' the performance of the work for which this permit is issue(j,t~han not
employ any person in any manner so as to beco ubject to the worker's co~npensation laws
of Califomia, and agree that if lshould becor'!) ject the worker's compe~atiori
provisions of Section-3700 6fthe Labor Code,' sh hwith comply with th - provisions.
. /
'Date: 12121/2004 . Applicant: .
WARNING: FAILURE TO SECUR , ~ S
UNLAWFUL, AND SHALL SUBJE MPLOYER TO AL PENAL :lES AND CIVIL
FINES UP TO ONE HUNDRED ND DOLLARS ($100,000), IN ADDITION TO'THE
COST OF c;OMPENSATION, MA ES AS PROVIDED FOR IN SECTION ~706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury thaUhere is a construct[Qrl t'end.iog_aP-!~ntiYJor;Jhp...,
peofc.nnance of ille work for which tnis permit is issued (See: 3097.Civ.C):
Lender'5"information:
Construdon Types:
VN. , .
I certify that I have read this application and state that the above info'rmation is correct. J
agree to com pi ith all c' ordinances and state laws relating to building construction, and
herebyauth rep ntives of this city to enter upon the above mentioned property for
inspection -
Fees paid for Permit:
Total:
160.61
Signature of Applican
t shall expire by limit . n and become null and void if the building or
Ii s not passed final inspection 365 days from the date of permil issuance, A
new permit is required to commence or continue work.
Date: 12/21/2004
INSPECTION RECORD
INSPECTION' DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainNVaste Pipe) ,
Electrical Ground Electrode/uteI'
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 (UndergroundConduit)
Pre-slab (Compaction/Membrane .Rei nt.
Underpinning (Floor Joist/Girders) ,
Do not cover or conceal the work below until the ,
following applicable items have been signed: . ,
1st Floor Shear
Firesprinkler (Rough) , " .
2nd Floor Shflar ~
Roof (Sheathing/Diaphragm/Frame) I
Masonry (ReinfJBond BeamlPre-Grout)
Rough Ptumbing (Top Out) ,
Rough Mechanical
Rough BectrlCaI (Ory wall) .
Rqugh. Electrical . ' ,
Framing (On~ aherPlbg.', Elec.. Mech.. and Fire, " .
Insulation (Sou/'ldlEnergy)
l}o not tape or plaster until.the following applicable
items have been signed: , .
Drywall , ,
Penetrations (Fire Rated) Electrical
Penetrations (File Rated) Mechanical , ,
Penetrations (Fire Rated) Plumbing , ,
Interior Lath ,
Exterior Lath ,
. GENERAL ITEMS
Exterior Plaster (Brown Coal) .
T .Bar Electrical
T -Bar Mechanical ,
T.Bar Structural
Sewer , "
Water Engineering Backflow
Water Service
.... .
FINAL INSPECTIONS I' Date Inspector
Electrical Final ' ,
Plumbing Final ,
Mechanical Final ,
Gas Test ,
Engineering/Grading Final 765-5126 .., .
Fire Dept. Final ,7654040 . .
Water Engineering 765-5268
Sub List/BUsiness' License 765-519 .
Zoning .765.5139 ' , -
BUilding Final ~ast Inspection' Only I'u f3>Dl ~ I <:...:I ,... ~
fter Above, Complete)
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
-.
. PlumbinQ Inspections
Electrical Insoections