1684 Sallie Ln.
BUILDING PERMIT NO. BLD2005-03095
TYPE OF PERMIT CITY
Reroof
DATE: 9/27/2005
JOB ADDRESS: 1684 W SALLIE LN
LEGAL DESCRIPTION: N TR 6585 LOT 111
APPLICANT: RICK HURLEY
OWNER INFORMATION:
IRVING HECHT
1684 W SALLIE LN
ANAHEIM, CA 92802
CONTRACTOR INFORMATION:
HURLEY ENTERPRISES
23251 PERALTA #R
LAGUNA HILLS, CA 92653,JOOO
BUSINESS PHONE: 949/951.6724
JOB DESCRIPTION: Tear Dff existing and reroof 28 sq with 40 yr composition shingles.
VALUATION:
9,735.00
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 57
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: MJF
OWNER-BUILDER I)ECLARATION
I hereby affirm under penalty of perjury that am exempt from the Contractor'~; 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 Professio)1S 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 subj(~ts the applicant to a civil penalty of not more than five hundred dollars
($500).
o J, as owner of propertYl or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License L,\w 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-bullder will have the burden of proving that he
did not build or improve for the purpose of sale).
D 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
i!-Qontractor(s) licensed pursuant to the Contractor's License Law).
U I am exempt under Sec. , B & P .C. for this rea.son:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
r 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 compensation,
as provided for by Section 3700 of the Labor Code, for the perrormance of the work for which
this permit is issued.
o I 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 FUND PoUcy Number. 120099-21>05
This section need not be completed if the pennit is for one hundred dollars ($1 00) or less.
o I certify that in the perfol111ance of the work for which this permit is issueo~ I shaH not
employ any person in any manner so as to beco subject to the worker's compensation laws
of Califomia, and agree that if I should beco sub' ct to the w r'$ co pensation
provisions of Section 3700 of the Labor Co s n fo with c ply wi those provisions.
Date: 9/27/2005 Applicant:
WARNING: FAILURE TO SECURE WORKER' COMPENSAT
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CR INA PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED "THOUSAND DOLLARS ($1 ,00 ,IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FO 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 age.ncyfor the
performance of the work for which this permit is issued (Sec.3097.Civ.C):
Lender's Information:
I certify that I have read this application and state that the above information is correct. I
agree to co ith all city ordinanc s and state laws relating to building construction, and
hereby au orize epresentives cl-j:hi city to ter upon the above mentioned property for
inspectio purp s.
Date: 9/27/2005
ent
d become null and void if the building or
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provi' of chapter 9 (co mencing
with Section 7000 f D" ion of the Bess d
Professions Cod
9/27/2005
Date:
NUMBER
314183
TYPE
TYPE
TYPE
Contract
EXPIRATION DII
11130/2005
B
C39
051
Construcion Tvpes:
VN, ,
Fees paid for Permit:
Total:
245.34
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Uter
SetbacklFormslTrenches (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 .
Roof (Sheathing/Diaphragm/Frame) ld. /. ~
Masonry (ReintJBond Beam/Pr....Grout) 1/ /
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., M~. And Fire)
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
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765.5266
Sub List/Business License 765.5194
Zoning 765.5139
Building Final (La.tln.pectlon - Only
Alter Above Complete)
INSPECTOR
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections