1741 Stratford
TYPE OF PERMIT CITY,
Reroof
ElM
BUILDING DII,fISION;4,"
200 S, ANAHEIM'BLVP, '
.(714) 765 - 5153
INSPECTIONREQUESTLINE:
(714) 765~ 4626
CENSUS CODE: 434
QUARTER SECTION: 138
BUILDING PERMIT NO. BLD2003-04464
DATE: 11/17/2003
,JOB ADDRESS: 1741 N STRATFORD CIR
LEGAL DESCR1PTION: N TR 5482 LOT 46
CONTRACTOR INFORrlATION:'
SO CAL ROOFING COi/,PANY .
. .23881 VIA FAVRICANTE ~'52i
MISSION VIEJO, CA 92E91
BUSINESS PHONE:. 949 ,60-0670
. JOB DESCRlpTION:rear off existing shake and inslaU34 squares of 30 yea,lEolk compo
VALUATION: 8,500.00
1 OWNER-BUILDE.f~ DECLARATION
I hereby affirm under penalty of perjury that! am exemptfrom the Contracti)r's License Law for the.f~llowjng,reason'(Sec. 7031.5 Business:and
Professions Code: any dty or countywhichrequiras a permit to construqt, :-.lter, improve, demOlish- or repair anystru.c;.tL're.. prior to its issuance, also
requ.ires the.applicant for such 'perr:nit.to file.a signed statement that he is li::ensed pursuan~ to the proVisions of the C?ntractor's License Law (~hapter .
9)(commencing with Section 7000 of Division 3 of the Businessand Profec \ions Code) or that he is exempt therefrom and the basis for the alieged
exemption. Any, violation'of Sectio~ 70;31.5 ,by any, applicant for a 'permit sl;hjects the applicant to a evil ~nattyof not more,~han five hundred dollars
($500). '.. " ..' i' . .'. ." '.
01, as owner 6fproperty~ or my empl~yees with wages as their sole corrpensfltion, will do the wor~, and the-$;~ructure is not intenc;ted or offered. for. .
sale (Sec. 7044 Business and P,rofessions Code: The .contractor's peens$-4 :"a~_ does not apply to an owner of property who b~i~s or improy.es
thereon, and who does such work himself or herself or through his or her O'-iin employees, provided that such imprm;'3nients are not intendetl or
offered for sale. If, however, ~he buildin'g or improvement.is sold with on~ ~?3ai of completion, thE!.owner-builder will have the b~rden of proving that he
. did -not build or improve for the purpose ofaale). . . _1 " "',' ""'" . , :
o I" as the owner of the property, am exdusively contracting withli~en::;~1 contraCtors to construct theproj,ect (Sec. 7044 Business ~nd Professions
Code: ,The Contractor's License Law does not apply to an owner of prope~:'who builds or improves thereon, and who-contracts for such projects with
~ntractor{s) licenSed pursuant to th~ COIltractor's. License Law). " :r. .'.
U I am exempt under Sec. . ,B&,P.C.forttlis reason:, t
Date: Owner: __.1
'1 . WORKER'S COMPENSATION DECLARATION -l
I hereby affirm under penalty of perjury one of the following ~eclarations: :, .
o I, ha'veal'\d Will maintain a certificate' of consent to self~insurefcr.wor:-~?J compensation,
, as'provided for by Section 3700 'of the Labor Code, for the performance o:;:)ework for which'
this permit is issued. , ,; . _ . "
r\9 Ihav.e and Will. maintain ~orker's c.ompensation insurance, as reql,Jired -',y SectiOn 3700 of 11/17/2003
a labor Code, for the performance of, the wOrk' for which this permit is iss,:.:ed, My worker's Date:
, Compensation insurance earner and policy are: .
Carrier: STATE.FUND Pqlicy Number. 265-02;'34:03
APPLICANT: MiCHAEL HOLLEY
OWNER INFORMATION:
2000 T Utter
301 N Bluerock St
Anaheim, CA 92807
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: AEM
LICENSED CONTRACTORS DECLARATION
I hereby affirm .l,mderpenalty_ofperjury t~at I am
" licensed under' provisions of chapter ncing
with_Section '7000) of Divsion he Su' sa
Professions C0ge.
~
." -- ,,- .
. , '. " , ,,--.,\-
This section,need not be completed if the pennit is for one hundred dollars ($:1C}) '~,ress. '.
D " 'Icertify:that in th.e performarice of the work for which this permit is'JSsl<~d, l.-'sh~l! not
employ.any '~rson. inany manr~er so as to become subject to.the worker's C"Prnpen~~tion laws
of Califomia, and agree that if I should become subject to tjle r's, com~-:eri~:ati.bn, _'
provisions o~ Sectior;'3700 of the labor Code shall ~ Ith c pi -. t::l)3~{:irovisio~~._'
Date: 11/17/2003 Applicant:
WARNING: FAILURE.TOSEC E ORKER'S COM N ATIO C . ...
UNLAWFUL, AND. SHALL SUBJECT AN EMPLOYER TO CRIM PENI'.~TIES ;<\ND CIVIL
FINES UPTOONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADr;:rfON)TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIOt' ~706...0F THE
. LABOR CODE, INTEREST .AND ATTORNEY'S FEES. '.;' . ,0
I CONSTRUCTION LENDING AGENCY .~"A€j;.;:.'
I h~reQY affirm under penalty'of perjury tha~ ther~isa.:con.structi~n'lend ir.g ~:Jl,9riCY for the.
- '-0;;,r~fl;.ui l~ uri.h~'__\.6rk-fvl.wjllGl-r tnlsp"errnlL'iS-iSsuiHf{Sec.3097 .Civ.C):
Lender's Information:' ' , .
NUMBER
797707
TYPE .
C39
Construcion Types:
VN., ",
Fire Sprinkle red?
NO
-,-:>'-
I certify that I h~ve read this applicatio~ and state that the aboVe information is correct. I
agree to complywith all city or-din a state laws,(eJating to bLl.~ding construction, and
hereby authorize represent" of this ' to ent upon the above mentioned property for
inspectio
Fees paid for Permit:
Total:
195.60
Date: 11/17/2003
null and void if the building or
INSPECTION RECORD
INSPECTION . DATE INSPECTOR .
Temporary Power Po'e .
Plumbing (DrainIWa$le Pipe) . .
Electrical Ground Electrode/uter
SetbacklForlTlSlTrenches (Footings) .
Do not install subf.loor or pour floor slab unti Ithe
following applicable ilems have been signed: .
plumbing (Water Pipe.Sprinkler Valves)
Mech3nlcal (Groundwork) . .
Electrical (Underground Conduit)
Pre-slab (CompactionlMembrane.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
Firesi,,;nkler (Rough)
2nd Floor. Shear .... . . .
Roof (Sheathing/Diaphragm/Frame) .
Masonry (ReinfJBond Beaini'Pnl-Grout) .'
Rough Plumbing (Top Out)
Rough Mechanical
Rough Bectncal (Dry Walll
Rough Electricai ..' ".
Framing (Only after Plbg.. Elec.. t.'lech. a!')d Fire)
Insulation (SoundlEnergy)
Do not tape Dr plasteruntii-the following applicable
items have been signed: ..' .
Drywall .
Penetrations (Fire Rated) Electrical
Penetrations .(Fire Rated) Mechanical.
Penetrations (Fire Rated) Plumbing
Interior Lath . .
Exter.iOr 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 765.012.6 .
Fire Dept. Final 765-4040 . .
Water Engineering 765-5268 . .
,
Sub List/Business License 765'519
Zoning 765.5139 .
Building Final *ast Inspection- Only
fler Above Complete) .
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
( J)
\-:...~.
"
,',
Plumbinalnspections.
Electrical Inspections
'PERMIT EXPIREQ
INSPECTION
NOT C MPLETE.()
;/
'j
DATE: