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5310 E. Suncrest TYPE OF PERMIT CITY Reroof ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 434 QUARTER SECTION: 179 BUILDING PERMIT NO. BLD2005-03637 DATE: 11/15/2005 JOB ADDRESS: 5310 E SUNCREST RD LEGAL DESCRIPTION: N TR 8783 LOT 139 CONTRACTOR INFORMAT'ON: PLATINUM BEST VALUE ROOFING CO 22365 EL TORO RD #297 LAKE FOREST, CA 92630 0000 BUSINESS PHONE: 949770-7663 JOB DESCRIPTION:Tear off existing material, install 7/16" OSB and 28 squares of Eaglelite tile 5.7 psf to house and attached garage. (ICBO #4660) VALUATION: 8,000.00 PROCESSED BY: ENO APPLICANT: MIGUEL ENRIQUEZ OWNER INFORMATION: JOHN BRIDGMAN 5310 E SUNCREST RD ANAHEIM, CA 92807 ARCHITECT/ENGINEER INFORMATION: OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that 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, alter, 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 Profession-s 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 subjedts the applicant to a civil penalty of not more than five hundred doUars ($500). o I, as owner of property, or my employees with wages as their sole comper.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 hefSelf 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 wUl 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 leansed CCotractors to construct the project (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of propertywlro builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law). o 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 cpmpensation, as provided for by Section 3700 of the Labor Code, for the pertormance of the Work for which his ermit is issued, ' I ve and will maintain worker's compensation insurance, as required by S,ection 3700 of the lor Code, for the periormance of the work for which this permit is Issued. tMy worker's Compensation insurance carrier and polley are: ~ Carrier: STATE FUND Policy Number. 1733177-2(,04 ~ This section need not be completed if the pennit is for one hundred doIlars{$100) o$..less. I certify that in the performance of the work for which this permit is issued, 'fshall not mp any person in any manner so as to become subject to the worker's compensation laws of Califomla, and agree that if I should become subject to the worker's compenlation provisions of Section 3700 of the Labor C ,sbaU forthwith comply with thos~ provisions. t 1~ LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Seef n 7000) of Oivsion 3 of the Business arid Prafessio Code. NUMBER 753512 TYPE TYPE EXPIRATiON DATE 8/31/2006 C39 HIC Date: 11/15/2005 Applicant: WARNING: FAILURE TO SECU WORKE COMPENS AGE IS UNLAWFUL, AND SHALL SUB CT AN EMPLOYER TO CRIMINAL PENALTiES AND CIVIL FINESUPTO ONE HUNDRE THOUSAND DOLLARS ($100,000), IN ADDITI,oN TO THE COST OF COMPENSATION AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST ND ATTORNEY'S FEES. ONSTRUCTlON LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending age",cyfor the performance of the work for which this permit is issued (Sec.3097.Civ.C): Lender's Information: Construcion Tvpes: VN, , Fire Sprinklered? NO I certif that I have read this application and state that the above information is correct. I agree oomply wit all city ordinances and state laws relating to building construction, and hereby uthor" repre ntives of this city to enter upon the above mentioned property for inspectio oses. Date: 11/15/2005 Fees paid for Permit: Total: 245.17 Signature pplicant or Age The per it shall expire by limitation and become null and void if the building or work h s not passed final inspection 365 days from the date of permit issuance. A new p mit is required to commence or continue work. City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE Tempora Power Pole Plumbin DrainlWaste Pipe Electrical Ground Electrode/Ufer SetbacklForms/Trenches Footings) Do not install subfloor or pour floor slab until the following applicable items have been signed: Plumbing Water Pipe/S rinkler Valves Mechanical Groundwork} Electrical Under round Conduit Pre-slab Compaction/Membrane Reinf.} Underpinning (Floor Joist/Girders) Do not cover or conce,II the work below until the following applicable items have been signed: 1 st Floor Shear Firesprinkler (Rough) 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) Mason (Reinf./Bond Beam/Pre-Grout Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical Framing (Only after Plbg., Ele., Mec. And Fire) INSPECTOR 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 7654040 Water Engineering 765-5268 Sub List/Business License 765-5194 / ? Zoning 765-5139 . /.// Building Final (Last Inspection - Only 117' 'ill ~ After Above Complete) vlb"'5 PARTIAL INSPECTIONS BuildinQ Insoections Mechanicallnsoections PlumbinQ Insoections Electricallnsoections