Loading...
221 N. Shakespeare BUILDING PERMIT NO. BLD2005.03677 . . /;;;'0c'> / ""---,.,,':.-:-.;,.<;':"'- / ~..." ." "'00,\ /)..o>~ ~. _:-----;,~~>~(~\ CITY QF~J1:NAHEIM \ \;,230f~~;f~92_::,;J / ',",'" ""i-'..!I '~",:/ ~.~;-,....:::>".,)/<-.-'\ " (",;--"'-""->>--, '~ ~~_~.~~n.\.;"/ TYPE OF PERMIT Reroof DATE: 11/17/2005 JOB ADDRESS, 221 N SHAKESPEARE ST LEGAL DESCRIPTION: N TR 2767 LOT 61 APPLICANT: DUKE HANSEN OWNER INFORMATION: ELIZABETH G REBICH 221 N SHAKESPEARE ST ANAHEIM, CA 92806 BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUESTLINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 122 ARCHITECT/ENGINEER INFORMATION: CONTRACTOR INFORMATION: ROSS & BARROWS INC 260 E ALTON ST SANTA ANA, CA 927070001) BUSINESS PHONE: 714 557 '7440 JOB DESCRIPTION:Tear off existing roof and replace with 30 squares of 50 year composition shingles ICBO# 5443. VALUATION: 8,326.00 PROCESSED BY: MSM 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 permi!: to construct, alte"', 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 penalty of not more than fjve hundred donars ($500). o l, as owner of property, or my employees with wages as their soJe 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 Law 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 her own employees, 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). o I, as the owner of the property, am exclusively contracting with licensed Clmtractors 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 ~ontractor(s) licensed pursuant to the Contractor's License Law). U I am exempt under Sec. ,8 & P.C. for this reason: _ Date: Owner: I WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following 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 ~th' permit is issued. ' I have and will maintain worker's compensation insurance, as required by Section 3700 of he Labor Code, for the performance of the work for which this permit is issued,": Myworker's ompensation insurance carrier and policy are: ( Carrier: STATE COMP Policy Number. 046-02 UNiT 0010815 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000 'ygion 3 of the Business and Professions C e.. 11/17/200. Date: This section need not be completed if the pennit is for one hundred dollars ($1 00) ~w less. o I certify that in the performance 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 cO'1lpensation laws of Califomia, and agree that if I should becom subject to the worker's compel1sation provisions of Section 3700 of the La e, I all forthwith mply with thov>e provisions. NUMBER 327802 TYPE Construcion Tvpes: VN. , Fire Sprinklered? Date: 11/17/2005 Applicant: WARNING: FAILURE TO SECUR WORKER'S COM ENSATIO COVERAGE IS UNLAWFUL, AND SHALL SUBJ. CT AN EMPLOYER TO CRIMINAL PENAL1IES AND CIVIL FiNES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDll10N TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 4106 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 perfor~ance 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 building construction, and hereby tho' resentives of this city to enter upon the above mentioned property for i eet' urposes. Date: 11/17/2005 81 ature of Appliea 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 Dermit is reauired to commence or continue work. EXPIRATiON DATE 10/31/2006 C39 NO Fees paid for Permit: Total: 245.20 City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbing (Drain/Waste Pipe) Electrical Ground Electrode/Ufer SetbacklFormsrrrenches (Footings) Do not install subfloor or pour floor slab until the following applicable items have been signed: Plumbing (Water Pipe/Sprinkler Valvesl Mechanical (Groundwork) Electrical (Underground Conduit) Pre-slab (Compaction/Membrane Reinf.) 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 Shear / Roof (Sheathing/Diaphragm/Frame) VII.lp.-& y~ Masonry (Reinf./Bond Beam/Pre-Grout) II Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical Framing (Only after Plbg., Ele'l Mac. 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) 765-4280 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 11'tt ~I(J{ '-i\\. \ tilL After Above Complete) PARTIAL INSPECTIONS Buildina Inspections Mechanical Inspections Plumbina Inspections Electrical Inspections