1429 Sherrill St.
. DATE: 5/24/2004
JOBADDRESS: 1429 S SHERRILL ST
,.
CITY ~fl~\~~HEIM
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BU1LDING DIVISION
200 s. ;'.:,AHEIM BLVD.
(714) 765 - '\153
iNSPECTION REQUESTLINE:
(714) 765:4626
CENSUS CODE: 434
QUARTER SECTION: 22
BUILDING PERMIT NO.. 8LD2004-01927
TYPE OF PERMIT.
Reroof
LEGAL DESCRIPTION: N TR 2715 LOT 41
APPLICANT: STEVEN STERNBERG.
OWNER INFORMATION: CONTRACTOR INFORM!, nON:
. JamesA Holliday CENTURY ROOFING Co.
1429 S Sherrill $t . 8662 DOLPHIN DR
Anaheim. CA92804 .. . . HUNTINGTON BEACH, C;. 926460000
JOB DESCRIPTIONRe-roof - o.verlay of 23 sq. of comp shingles over (1) exi<:ing layer of compo (HIH).
VALUATION: 2,530.00 PROCESSED BY: PMK
I OWNER.BUILDERp~_CtARATION
I hereby affirm under penatty of perjury that I am exemptfrom the ContractOl $. License Law for the fQllowing reason .(Sec. 7031.5 Business and
Professions Code: any dty or countywtJich'requires a permit to con~tru.ct, att~r, mprove, d-emolishonepair anys.tructure, prior to its issllance,,"also
requires the applicant for such Permit to-fire a signed statement ttiat he is lic{~nsed .pursuant to the provisions of the Contractor's License Law (Chapter
9){comme!lGing with Sp.ction 7000 of Divis;on 3 of the Busi,ness and Profess_i0'1:S Code) ortha~ he is exempt therefrom _and thebasis tor the al'leged"
exempticn. Anyviolation.of $ecti.on 7031.5 by any applicant fora permit sub~eds the applicant to a civil penalty of not niore than five hundred dollars
.~~ ... ..... .. . . ..
o J, as owner. of property, or my employees with wages as their sole COmi{~n.."'ation,.wilJ do the work,. and the str'-:lcture i~ n9t intended or offered for
sale (Sec; 7044 Business a nd Professions Code; The Contractor'~, License i'f~W does not _apply to an owner of property who builds pr improves
thereon, and who does such work himself or herself or through his or her OWJ~I employees,_ provided that such ir:nprovements are' not intended or
. offered for sale. If, however, the build;ng.orimprovement is sold with one Yc-:ti of completion, the owner~bLiilder will have the burden of proving thathe
dfdnofbuiJdorimproveforthepurposeofsale). ", .". . '
o I; as the owner of the property, am eXdusively contracting w~th Ilcensed-::.Cntractors toconstrLict the proj~ct(Sec. 7044 Business and PrOfessions
Code: The Contractor's License Law does not apply" to an owner of properfy Who builds or irnproves thereon, and who contracts-for such projects with.
~ontractor(s) licensed pursu<;Int to ~he Contra~tbr's License Law).. J . -, ". _' . . .
U '-1 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 maintai'n acertiflcate of oonsent to self-insure for workej"::~compensation,
as provided for by Section 3700 of the LaborCode, for the performance. of th,3 work for whLCh
this permit is issued. . .. . :,~. - ' ,
o 'haveand will maintain worker's compensation insuran(::e, as requi~(l"b;i' S~ction 3700 of '
. the Labor Code, for the performance of the work for which this permit is issIY~d:._ Myworker's
CompenSation inSurance carrier and ,policy are; . "
Carrier; STATE FUND PolieyNumber. ,1462890.2003
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
. , I hereby'affirm under penalty of perjury that I am
licensed und r proVislons Qf chapter 9'(c6mm-encing
with Secti ,. f 'vsion 3 of the Business and
PlOfess~~
!j/24/20
Date:.
Contractor
This section need not be completed if the pennit is for one hundred dollars '($10(: or less.
o I certitYtha,t irlthe performance ofthe wo-rk for ~hjch thi~ permit is issuei, I shaff not
employ any person in a'ny man ner, so as to become subject to the worker's'c,:;:npensation laws
of"Califomja,.and agree that jf I shoul pecome subject tp nie worker's compl<nsation
provlsions of Section 3706 of the La shall forthwith comply with O-')se provisions."
Date: 5124/2004 - APPlican0'
WARNING: .FAILURE TO. SECUREWo.RKER'S Co.MPENSATlo.N COVER~GE IS
UNLAWFUL,AND SHALL SUBJECT AN EMPLo.YER TO. CRIMINAl PEN''';.TiES AND CIVIL
FINES UPTo. o.NE HUNDRED THo.USAND DOLLARS ($100,000), IN AD.C:TtON To.THE
COST o.F Co.MPENSATlo.N, DAMAGES AS PRo.VIDED Fo.R IN SECTIOK :)706 o.F THE
LABo.R Co.DE, INTEREST AND ATTo.RNEY'S FEES. ..,.
, CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of peri.uiy that there is a construction. lending a~-~e'bcyfor the
performance of the, work far whictl this permit is issued (Sey.3097 .Civ .C): "
Lender's Information:' . . . .". ..
NUMBER
.674019 .
TYPE
TYPE
EXPIRATlo.N DATE
7/31/2005
C39
Hie
Constructon Tvpes:
VN, ,
Fire Sprinklered?
NO.
""j-C6i1f1y'-tna.i i i-ia'le read -tnlsappilcatiar,'and state that the above Itl'tcrmat{.)i{~5co!"re~...t. I
agree to comply with all city ordinanceS and. state laws relating to building, cons'truction, arid
he y authorize representivesof this cit{to.enterupon the above mentioned property for
I pur
Fees- paid for Perm!t:
Total:
.0.50
Date: !5I24/2004
Signature of Applicant or Agent
. The permit shall expire by limitation and becomenuU 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.
INSPECTION RECORD
.' . INSI'ECTlON. '. . .: . DATE . INSPECTOR
. .... .' .
Temporary Power Pole . . . . .
. PJumbing(DrainlWastePipe) .--:. . . ': .
Electrical GrOund. EhlCtrodellJfer .'
SetbacklFormsrrrendles (Footings) .'. . ....
00 not installslIbflOor or pour floor sl.ab until the'. . .
folldwing. applicable items have been signed: . ".
Plumbing (Water Plpe.Sprinkler Valves) '. .
Mechanical (GroundwOrk) . .
Eledtical' (Underground Conduit)
I"re-slab (\;ompac:tlonlM!lI1tbrane.Reinf. ". .
Underpinning (FJOorJoistlGlrders) .. . .
.!Xl nlltcover.or conc::eal the\Nork. bel.ow until the . . '.
.following applicable Items have been signed: '. .... .
1st Floor Shear. . :' . . '.
.
Firesprinkler (Rough) . '. . . .
. .
2nd Fioor Shear .' . . " I. I
ROQf (Sheathing/DiaPhragrn'Framel 'i:)<. ,fP\i;(' ~.'.
Masonry (ReinfJBond Beanl/Pre-GlOllt) . .
Rj)ugbPlumbing (Top Out) . ::
ROUsb Mechanical . .' . .. .' ,.
Rough l:Iectrical (UFy WaD) . . :
. Rciugh Electrical . .
Framing (Only after. Plbg.. Elec~. Mecl'l . and Fire) . .
In.lWlatlon'(SlIUndlEnergy) . . . . .'. . .... .
po not t;>P'f pr pl;>~ter'" until tne IpUowing applicljble
I.tems have been Signed: . '. .'. .
DrYwall'" '., .'. .'. . . . : . ....
i PenetrationS (Fire Rated) Electrical
I Penetralio$ (Fire Rated).MeChanical
L Penetfations (Fire Rated).P.lumblng . .'.
: Interior Lath '. .' . ..' .
I Exterior Lath ..... ' .'
.. , . GENERAL ITEMS .
Exterior Plaster (Brown COat)' . '.
,:r.Bar Electrical: .. .' '.
.T .BarMechanical. . , . . " . .
I T'Bar Structural . '. .
: Sewer . . .'. . .
water .EngineeringBackflolN . " .
',Water Service . .
FINAL INSPECTIONS Date Inspector
Electrical Final' '. .... .... I '.
Plumbing Final .. '. -: . .' .. . "
....
Mechanical Final. ~'. . .
..... '. ."""'.
Gas Test . " ................ .
. .'
Engineering/Grading Final 765-5116 ....:... : .
Fire Dept. Final 765-4!l40 .... . . , .
Waiei' Engineering 765.5268 ,.' , . , .
.SubLlstlBuSinessLicense 765-5.19 .. ... .'
Zcining 765-51.39 .. '. ...
, .. .
Building Finiir ~ast In'spectidn~ Only .. .. ..
. ' ',' '. fter Abov.e Complete)
'., PARTIAL INSPlOCTIONS
BuildinalllSDections .
, '. Mechanical" In.sDections
Phimbina InsDections
Electrical insD6ctions
prpl\."IT.. 'E'/P'"'C'''Q'''
t. I. \ (Ill .~A" I U"i .
LNSPtCTION'
I'It'OT 'CO~f1D"i:~'.:,.jch
1\' '. !\itjJ'1 ;<-., '- tJ:
. . ,...... .,:~r '~.,~ .'. ~-, l.
DATE:
'--""~;.: ......,...
..., .