5985 E. Settler Ct.
TYPE OF PERMIT CITY
Reroof
DATE: 8/24/2005
JOB ADDRESS: 5985 E SETTLER CT
LEGAL DESCRIPTION: N TR 9750 LOT 59
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765 - 5153
INSPECTION REOUESTLINE:
(714) 765- 4626
CENSUS CODE: 555
QUARTER SECTION: 192
BUILDING PERMIT NO. BLD200S-02643
CONTRACTOR INFORMATION:
HOYT ROOFS INC
1809 N ORANGETHORPE PARK
ANAHEIM, CA 92801 0000
BUSINESS PHONE: 714773.1820
JOB DESCRIPTION: Tear off existing roof and replace with 26 squares of 7.2 lb. eaglelite tile ICBO# 4660.
VALUATION: 13,500.00 PROCESSED BY: MSM
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's,Ucense Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or cOl.lntywhich requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also
requires the appllcant 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 five hundred dollars
($500). :
o /, as owner of property, or my employees with wages as their sole compel)sation, 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 helBelf or through his or her own employees, provided that such implOvementsare 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 contractors 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
a contractor(s) licensed pursuant to the Contractor's License Law}. i
D 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 se/f~insure {or worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
~i permit is issued.
I have and will maintain worker's compensation insurance, as required by Section 3700 of
Labor Code, for the performance of the work for which this permit is issued. Myworker's
ompensation insurance cartier and poflcy are:
Carrier: STATE FUND Policy Number. 1700471-02
This section need not be completed If the pennit is for one hundred dollars ($100) or less.
o I certify that in the pertormance 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 compensation laws
of Califomia, and agree that if I should become subject tothewotker's compensation
provisions of Section 3700 of the Labor Code all forthwith comply with those provisions.
Date: 8/24/2005 Applicant
WARNING: FAILURE TO SECUR K 'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJE EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE HUNDRED USAND DOLLARS ($100,000), IN ADDIllON TO THE
COST OF COMPENSATION, MAGES AS PROViDED FOR IN SECTION 3706 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
performance of the work for which this permit is issued (Sec. 3097.Civ.C):
Lender's Information:
APPLICANT: JOE GILLIS
OWNER INFORMATION:
BRIAN LIPSCOMB
5985 E SETTLER CT
ANAHEIM, CA 92807
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
r ereby affirm under penalty of perjury that' am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Oi ion 3 of the Business and
Professio s e.
Contractor
EXPIRATION DATE
12/3112006
C39
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 repro ntives of this city to enter upon the above mentioned property for
in ion purpo
Date: 8124/2005
Fees paid for Permit:
Total:
332.21
nature of Applicant or Agent
mit shall expire by limitation and become null and void if the building or
has not passed final inspection 365 days from the date of permit issuance. A
permit is required to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/uter
SelbacklFormsrrrenches (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 (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:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear I I
Roof (Sheathing/Diaphragm/Frame) 'fSh1iY'i .\AtJ'tLcl"St<:.1
Masonry (Reinf./Bond Beam/Pre-Grout) , I
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetralions (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 (Lasllnspecllon - Only E5" -7t?~{J :--" Ii. Lt y
After Above Complete)
~
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections