1006 S. Philadelphia
~~O~?FPERMIT . CITY
DATE: 4/5/2005
JOB ADDRESS: 1006 S PHILADELPHIA ST
LEGAL DESCRIPTION: .N TR 1379 LOT 51
':~ ( ,".
~'::i~~'i:
. J.~HEIM
\v;,~~~if~aVJ/
.BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714} 765.5153
INSpECTION REOUESTlINE:
(714) 765.4626
CENSUS. CODE: 555
QUARTER SECTION:e5
SU!LD1NG PERMIT NO. BLP2005-00914
CONTRACTOR INFORMATION:
HOYT ROOFS
1809 N ORANGETHORPE f'ARK
ANAHEIM, CA 92801000" .
BUSINESS PHONE: 714 1',"3.1820
JOB DESCRI?TION:Tear off existing roof and replace with 15 squar~ of 30 y.ar composition Shingles (House Only).
VALUATION: 4,500.00 PROCESSED BY: MSM
I OWNER-BUlLPEn DECLARATION
Ihereby affirm under penalty. of perjury that I am exempt from the'Contract(r:s license Law for the following reason (Sec. 70.31.5 Business and
Professions Cod.e: any dty or county which requires a permit to construct, a:;er, improve, demolish or repair any structure, prior to its. issuance, also'
. (Elquires the applicant for such permit to file a" signed statement that.he is Ifc~:nsed pursuant to the prov1sions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Busine3s and Profes~;ons ~ode) or that he is exempt therefrom and the basis for the alleged
exemption., Any violation' of Section703t.5 by any applicant for a permit sU:)jects the a pplicant to a dvfl penalty of not more than five hundred dollars
~OO), . . .' '. . .
LJ I, as owner of properW; or n1Y employees with wages as their sole cOioliensation; will do the work,. and the structure is not intended or offered for",
'sale (Sec. 7044 Business and Professions Code: The Contractor's Ucense'.aw does not apply to an owner of property who 'builds or improves
'hereon, and who does such work himself or hersf'..If or through his or her'o"~i1 emDJoyees, orovided that such improvements are not intended or "
offered torsale. If;. howeller. the bUilding or improvement is sold with one y\~!" or 'completion, the owner-builder will have ,the burden of proving that he
did not buUd 0;" improve for the purpose or sale), ': "
O!" as: the_ owner of the property, ani exdusivlSly contracting with,liCGnseli cuntrac1:ors to constnJpt the project (Sec. ,7044 Busines~ 8(ld professions .
.Gode:, The Contractor's license Law does not apply to an owner of propert~- who builds or improves thereon; and who contracts for such projects with
-~ontract~r(s) licensed pursuant totheContractor's license Law/..- f .
U lal1]..~xe!'l1pt under Sec.," " B & P.C. for this reason:
Date: . ..~;:-:. '~ ' Owner:
I ,WORKER'S COMPENSATION DECLARATIOt.
,. hereby afflnn under penalty of perjury one of the following declarations:
" D... I have, and will maintain 'a certific'ate of consent to ~lf-in$ur~ for \...'ork,...r:s compens:;ation,
a:s provided for by Section 3700 of the Labor C9de, for the parformance of j>~ work to'r which
tf'!is'~ t is issued. .
have'and will maintain worker's compensation insurance, as required t'y SecHem 3700 of
the: Labor Code. for the performance of the work for which this peiTnit is is~u3d" My,v.'orker's
Compensation insurance eanier and policy are:
Carrier: STATE FUND -' Policy Number. 1700471-02
,This seCtion need not be comPieted if the permit is for one hundred dollars ($10q or less.
o I certify that in the perfomiance of the work for which"this permifis iss:uf;d, J shaJi not
employ any person inany manner so as tq' become subject to the worker's compensation laws
of Califomia, and agree that if I should become subject to the worker's comp~nsation
provisions of 'Sectio:1 3700 of the labor Code; I shall forthwith comply with 1rose provisions.
Date: 4/512005 APPlicant:' ~ .
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVEF<A<1E IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAl PENA,-TIES AND CIVIL
FINES UP TO ONE.HUNDRED THOUSAND DOLLARS ($100,000), IN APemON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTlor, 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm unde r penalty. of perjury that there is a. construction -lend lng a-F'ncy for the:
performance of the work for which this permit is issued (Sec.3097 .Civ.C):
Lerlder's-lnformation: ,
APPLICANT: BRIAN HOYT
OWNER INFORMATION:
Norma Garcia
1006 S Philadelphia SI
Anaheim, CA .92805
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury t at I am
licBnsed u(1der provisions of chapter 9 (commencbg
with.Section 7000) of Divsiqn 3 of the Business and'
Professions Code.
4/5/2005
bate: .
V-'~
Contractor
NUMBER
606111 .
TYPE
EXPIRAT:ON DATE
12/31/2006
C39
Construcion Tvpes:
VN, ,
Fire Sorinklered?,
NO
"
I certify tha,t' have read this application and s1ate that the above information is correct. J
agree to oomplywith all city ordinances and state laws re/ar to building construction, and
hereby authorize representives of this city to enter.uQ above ment;one'.1 property for-
inspection purPoses. . "
Fees paid for Permit:
Total:
160;61
. Oat<,; 415/2005 .
. Signature of Applicant or Agent. , - .
The. perinit 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.
_/
INSPECTION RECORD
'.' .
INSPECTION . DATE INSPECToR
'temporary Power. Pole
Plumbing (DralnlWasle Pipe)
EledricalGround Electrode/uter . .
SetbacklFornisrrrenches (Footings)
Do'not install subfloor or pour floor slab until the
following applicable items have been signed: .
Plumbing (Water Plpe.Sprinkler Valves) .
Mechanical (Groundwork) . .
Electrical (Underground Conduit) .
Pre-slab (Compaction/Membrane.Reinf.
Underpinning (Floor Joist/Girders) .
Do not cover or conceal the work below until tne
followjngapplicable items have been signed: .
1st Floor Shear .
Firespri!lkler (Rough) .
. 20dFloor Shear "
Roof (Sheathing/Diaphragm/Frame) .''; ...........
. Masom'y .(ReinfJBond BeamlPre-GlOI1t) '.
: Rough Plumbiog (Top Out) . . .
Rough Mechanical. . . . .
RoUgh eJectr ' ....11).
'Rough Electrical . . . . .'
Framing {Only after Plbg,. ElK: Mec~.. and Fire) .
Insulation (SoundlEnergy) . .'
po not tap'" or plaster until the following applicable ,
,tems 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 Coa:!) '. . .
. T -Bar Electrical . ,
T .Bar Mechanical . . .
T .Bar Structural . .
Sewer
Water Engineering Backflow
Water Service .c. .
Plumbing Final .
Mechanical Final
Gas Test . .
Engineitring/Grading Final 765-5126
Fire Dep!. Final 7654040
Water Engineering 765-5268 . ....
. Sub List/Business License 765-519
Zoning 765-5139 .
Blillding Final . I~asllnspeclion. Only .' ,
After Above Complete) <;-/1'''J
PARTIAL'INSPECTIONS
Buildina Inspections
FINAL INSPECTIONS
Electrical Final
Date . Inspector
.
.
'::/1. (
.I.
. Mechanical Inspections .'
Plumblna Inspections
Electrical Inspections .