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615 S. Scout Trail TYPE OF PERMIT C AccessOlY Building (Shed, Garage...) ITV DATE: 6/1312005 JOB ADDRESS: 615 S SCOUT TRL LEGAL DESCRIPTION: N TR 9750 LOT 6 ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714)765 - 5153 INSPECTION REQUESTLINE: (714) 765 - 4626 CENSUS CODE: 434 QUARTER SECTION: 186 BUILDING PERMIT NO. BlD2005-01793 CONTRACTOR INFORMATION: PARAGON ROOFING 16542 POTTER CIR HUNTl NGTON BEACH, CA 926470000 BUSINESS PHONE: 7148431950 JOB DESCRIPTION:Tear off existing material, install Hanson Tile at 9.9Jbs per square to 32 squares of roof leBO #ER3748. APPLICANT: CHRISTINE BRYAN OWNER INFORMATION: Steven C Reiner 615 S Scout rr' Anaheim, CA 92807 ARCHITECT/ENGINEER INFORMATION: VALUATION: 11,000.00 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, after, 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 subj81;ts the applicant to a civil penalty of not more than five hundred dollars ($500). D I, as owner of property, or my employees with wages as their sole compeflSation, 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~buHder will have the burden of proviftg-that he did not bu~d or improve for the pU!pose of sale). o I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of propertyw;1o 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. , B & 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 selt-insure for worker's compensation, as provided for by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. ~ have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Myworker's Compensation insurance carrier and policy are: Carrier: STATE COMP PROCESSED BY: ENO LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commenCing with Section 7000) of Di n 3 the Business and Professi ns Code. 6/13/2005 Date: Contractor Policy Number. 1570328-99 NUMBER 726753 TYPE TYPE EXPIRATION DATE 9130/2006 This section need not be completed if the pennit is for one hundred dollars ($100) or less. ~certify that in the performance of the work for which this perrnit is issued, I shall not employ any person in any manner so as to become subject to the worker's compensation laws oj Calffomia, and agree that if I should become subject to the worker's compensation provisions of section 3700 of the Labor Code, I shall fa 'th comply with those ro. 'ons. C39 HIC Date: 6/1312005 Applicant: WARNING: FAILURE TO SECU EWER OMPENSAT N COVERAGE IS UNLAWFUL, AND SHALL SUBJ CT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDIl10N TO THE COST OF COMPENSATION, AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST A 0 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: Construcion Types: VN, , Fire Sprinklered? NO 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 authorize pre ntives of this ci to enter upon the above mentioned property for 'on pu s. Date: 6/1312005 Fees paid for Permit: Total: 609,69 Signature of Applicant or Agent 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. City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbing (DrainJWaste Pipe) Electrical Ground Electrode/Uter SetbackfFormsfTrenches (Footings) Do not install subfloor or pour floor slab until the following aDplicable items have been signed: Plumbing (Water Pipe/SDrinkler Valves) Mechanical (Groundwork) Electrical (Underground Conduitl 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: 1 st Floor Shear Firesprinkler (Rough) 2nd Floor Shear I Roof (Sheathing/Diaphragm/Framel h-. ';~.H III. A/ Masonry (Reint JBond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical I Framing (Only after ~Ibg., Ele., Mec. And Fire) I;'. J(.fJ'" Mg, ./> 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 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 fs;;7.l\ t:J1 I'.r ~ After Above Complele) PARTIAL INSPECTIONS Building Inspections Mechanical Inspections Plumbing Inspections ElectricallnSDections