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2737 W. Stockton TYPE OF PERMIT CITY Reroof ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 19 BUILDING PERMIT NO. BLD200S-03022 DATE: 9/21/2005 JOB ADDRESS: 2737 W STOCKTON AVE LEGAL DESCRIPTION: N TR 3045 LOT 4 APPLICANT: ANDREW LEE OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION: ANDREWH LEE 6544 OAKHURST CIR HUNTINGTON BEACH, CA 92648 JOB DESCRIPTION:Tear off existing and reroof 35 squares with 30.year composition shingles VALUATION: 5,000.00 I OWNER-BUILDER t'ECLARATlON I hereby affirm under penalty of perjury that I am exempt from the Contractor's,Ucense Law for the following reason (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to construct, altsl, 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 licen~:;ed pursuant to the provisions of the Contractor's License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Professior.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 subje:;ts the applicant to a civil penalty of not more than five hundred dollars ($500). M. I, as owner of property, 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 Law 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 nmployees, 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 will 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 licensed contractors to construct the project (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of propertyw'ho builds or improves thereon, and who contracts for such projects with ~ontractor(s) licensed pursuant totheContractor's License Law). U I am exe pt nder Sec. -.4... B & .:. ..~ ~, fur this reason: Date: 4.21 D) Owner: ~/v~ WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of pe~ury one of the fallowing declarations: P I have and will maintain a certificate of consent to self~insure for worker's,)ompensation, as provided for by Section 3700 of the Labor Code, for the pertormance 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 issuec;. Myworker's Compensation insurance carrier and policy are: Carrier: Policy Number: This section need not be completed if the pennit is for one hundred dollars ($100) 1)( less. ::IJ I certify that in the perfonnance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the worker's compensation laws of California, and agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with tho:~e provisions. /-j..(.(.. PROCESSED BY: JNJ LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty perjury that am licensed under provisions of chapter 9 (commencing with Section 7000) of Divsion 3 of the Business and Professions Code. 9121/2005 Date: Contractor NUMBER EXPIRATION DATE TYPE Date: 9121/2005 Applicant: -,.= WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UPTO ONE HUNDRED lHOUSAND DOLLARS ($100,000), IN ADDI'nON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN 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 agency for the performance of the work for which this permit is issued (Sec. 3097.Civ.C): LSiidar':;; liiformation: Construcion Types: VN, , I certify that I have read this application and state that the above information is correct. I agree to comply with all city ordinances and state Jaws relating to building construction, and hereby authorize representives of this city to enter upon the above mentioned property for inspection purp~sr~/I '7 krr-::7 a..JY Date: 9/21/2005 Signature of Applicant or Agent The permit shall expire by limitation and become null and void if the building or work has not passed fi nal inspection 365 days from the date of permit iSSlIMCe. A new permit is required to commence or continue work. Fees paid lor Permit: Total: 319.54 City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbing (Drain/Waste Pipe) Electrical Ground Electrode/Ufer 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) I 2nd Floor Shear /I 'Ah Ill- JJ ."'''4iJ Roof (Sheathing/Diaphragm/Frame) IGY c..IL I, , _. I Masonry (Reinf./Bond Beam/Pre-Grout) I Y I Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical Framing (Only after Plbg.. Ete., Mec. 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 INSPECTOR Electrical Final Plumbing Final Mechanical Final Gas Test Engineering/Grading Final 765-S126 Fire Dept. Final 765-4040 Water Engineering 765-5268 Sub List/Business License 765-5194 I Zoning 765-5139 Building Final (Last Inspection - Only I;z/7/a !J Ill/t$ : After Above Complete) PARTIAL INSPECTIONS Building Inspections Mechanical Inspections Plumbing Inspections Electrical Inspections