725 N. Sabina
CONTRACTOR INFORM('TION:
A-OK ROOFING & RENOVATIONS
22022 BALBOA CIR
HUNTINGTON BEACH, CA 926460000
BUSINESS PHONE: 714891-3754
JOB DESCRIPTION:. Tear off and re-roof 17 squares of composiiion shingles.
VALUATION: 3,500.00
I OWNER-BUILDERPECLARATlON
J hereby affirm uDder penalty of perjury that I am exemptfrom the Contractor!~ License Law for'the following reason (Sec. 7031.5 Busjn~ss and
Professions Code: any dty or county which requires a permit to construct. alhw, improve, demolish orrepair.any structure. prior to its issuanqe. also, _
requires the applIcant for such permit to file a signed statement that he is iic~r.,sed pursuant to the provisions ofth"e Contractor's L1cense'Law'(~hapter
9J<comr:nencin9_:With Section 7000 of Division 3 of the-Business and Professicns 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 su!jj:}"cts the applicant to a civu penalty o{ not mere than five hundreQ dollars
($500). . ..,'. . . - ...
o I, as owner of property, or my employees with wages as their sole comp~nsation, '.viii do the work, and the structure is not intended or offered for
sale (Sec',7044 Business and Profession,s Code: The Contractor's License L:~w does not apply to an owner of proper.:.: who builds or imp'rOves. '"
thereon, and 'who does such work himself Or herself or through his or her OVi,~,I::!:mp!oYE:'!es, provided that such improveme;1ts are not intended or:,: .':.':~ .,
offered f,or Sa!e. If, however, the building or improvement is sold with one yer; of completIon, the owner-builder Will have the burden of pr()ving that he
did notbuil,d or improve for the pu rpose of sale)_ . ,', . _ ,:./:
o 'I, as ti1e'- owner of the propeny, am exdusively contracting wttn Hcen!"l::!d,~.r:.:1tractors to construct the projer::t (S~c: 7044' Busines& and Profesr_ions
Code: The Contractor's Ucense Law does not apply to an owner of property\i::p.n bu.:d~ or irnproves thereon; :1l1d.who contracts for SiJ~.h projectS with
. ~ontracto~(s) licensed pursuantto th~ Contractor's License, La...y). '\ '
U I am exempt under Sec. . '-,.\--:.:< , B & P.C. for this reason: ' ^ ___~,' .".
Date: Owne'r;,~:;., /~. ..
I WORKER'S COMPENSATION DECLARATION _:__._--.-1 LICENSED CONTRACTORS DECLARATIOf'!..j
I hereby affirm under penalty of perjury one of the following declarations: _ I'hereby affirm under pen<:llty,of.perjury that l;Jm
o I have and will maintain a certificate of cpnsent to self..insure for worker'~,: com~nsat!on, lict;nsed u!1der provisions of ('.hapter 9 (corhmel1cing
as provided for-by Sedion 3700 of.t,he Labor Code,_ for the perfor:na.noo ofth~ work leI' Which. I with Section -rOOD) of Divsinn 3 oft Business and
this permit is issued. . . . .' J ..~, Professjo C e.
~. have and will maintain worker's compensation insurance, as re'quired oy\f,8Ction 3700 of I
t , abor Code, for the pedo'rmance.' of.the work for Which this permit is iSSIJC"}. M~iworKer'g.
. ,pensation insurance carrier and policy are:' ;~
Carrier: INS CO STATE OF PENN, . Policy Number. 52.'1e33'
This section ne~ not be completed if the permit is; for 000 hundred dollars ($1 ~OJ.orie5s.
o I certify that in !he .perfonnance of the work for which this -permit is iSSl~~h~: li;;hallllot
employ any person In any manner so as to beco.me subject to.the worker's cC':!_~p-~nsation laws
of Califpmia, and agree th.atif' I should become bjed to the worker's compensation
provisions of Section 3700-ofthe La !:>or Code, I an fo WI comp' ~ith;; 0se provisions.
BUILDING PERMIT NO. BLD2004-04408
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. iOiilr-,/. >.~<;;~..
CITY ~"tl~ ElM
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TYPE OF PERMIT
Reroof
DATE: 12/13/2004
JOB ADDRESS: 725 N SABINA ST
LEGAL DESCRIPTION: N TR 247 BLK A LOT 26
APPLICANT: KEN SMITH
OWNER INFORMATION:
Theresia T Gunther
10562 Tampion Ave
.Garden Grove, CA 92843
BUILDING DIVISION
200 $. ANAHEIM BLVD.
(714) 765 - 5153.
INSPECTION REQUEST LINE:
(714) 765 - "626 .
CENSUS CODE: 555
QUARTER SECTION: 82
ARCHITECT/ENGINEER INFORMATION: '
PROCESSED BY: .SAM
NUMBER
639447
TYPE
TYPE
TYPE
Construcion Types:
\IN, ,
Date: 12/13/2004 Appll
WARNING: FAILURE TO SEC KER'S COMPENSATION COVERf,Gt; IS.
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAl PENALnES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. .
I CONSTRUCTION LENDING AGENCY
I hereby aff.irm l:nd-"!" penalty of per!ury ~!-lst th':!re ~ ~ constwct!0n le(\l:iing,~~y.f0r-H"'_,,;,
performance of the work for whim.this permit is issued (Se9-3097,Civ,C):.
Lender's Information:
I certify that I have' read this apPlication and state that the above informationt3 correct. I
agree to comply with all city. ordinances and state laws relating to building cor.struction, and
hereby author' e n3presentive 0 this city to enter' upon the 'above mentioned property for
inspection 5.. _ fl.
. ~ Dal;,:1211312004
ignaturepf Applicant or Agent
The perr'nitshall 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.
Cohtractor
EXPiRATION DATE
3/31/2006
Hie
B
C39
Fees paid for Permit:
Total: .
160.61
INSPECTION RECORD
INSPECTION , DATE INSPECTOR
" , ,
Temporary Power Pole ,
Plumbi ng (DrainlWaste Pipe) , . ,
Electrical Ground ElectrodelUfer
SelbacklFormsfTrenches '(Footings) , , '
Do not install subfloor or pour floor slab until the
lollowing applicable items have been signed: '
Plumbing (Water Plpe.Sprinkler Valves) I
Mechanical (GroundwOrk) , ,
Electrical (Underground Conduit)
Pre-slab (CompactionlMembrane.Relnt
Underpinning (Floor Joist/Girders)
Do not cover or con,ceal the wor1<, below until the,
, following applicable items have been signed: ,
1st Floor Shear ..
Firesprinkler (Rough)
2nd Fi,oor Shear
Roof (Sheathing/Diaphraam'Frarne) ~"70"1."" tf- .u~.
Masonry (RelnfJBond BeamlPre-Grout) .
Rough Plumbing (Top Out) " , ,
ROlJgh Mechanical
KOugh l:Iectncal (ury vvall) ,
Rough Electrical ' "
Framing (Only after Plbg. Elec..,Mech, and Fire) , '
Insulation (Sound!Energy)
Do not tape or plaster 'until the following applicable
item~ have been signed:
Drywall " ' , , ,
Penelratlons(FireRated) Electrical ,
Penelratloni; (Fim Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath " "
Exterior Lath
GENERAL fTEMS ..
Exterior Plaster (Brown Coat)
T -Bar Electrical
T -Bar Mechanital ' ' ,
T -Bar Structural
Sewer, ,
Water Engineering E!ackflow
Water Service "
FINAL INSPECTIONS Date Inspector'
Electrical Final I ,
Plumbing Final ..
Mechanical Final ,
Gas Test ,
" "
Engineeriilg/GradingFinaI765~126 , I
Fire Dept. Final 765-4040 ,
Water Engineering 765-5268
Sub List/Business License 765-519 ' ,
" ,
Zoning 765-5139 ' ,
Building Final\1:ast Inspection. Only Ir-Z(?4f !a y :. ,il, ,
, , fter AboveCompletej
PARTIALlNSPECTIONS /
C
.
BUlldmQ'lnspectlons
.*--14 d~-- d f
Mechanical Inspections
Plumbina Inspections
Electrical Inspections