231 S. Summertree Rd.
TYPE OF PERMIT CITY
Reroof
DATE: 8/10/2005
JOB ADDRESS: 231 S SUMMERTREE RD
LEGAL DESCRIPTION: TR 8905 LOT 4 AND POR LOT A
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 191
BUILDING PERMIT NO. BLD2005-02497
CONTRACTOR INFORMATION:
WESTERN ROOFING SYSTEMS
2031 E CERRITOS AVE #7E
ANAHEIM, CA 92806-0000
BUSINESS PHONE: 714/778-6294
JOB DESCRIPTION:Tear off existing material, install 20 squares of metro metal shingles ICBO#5626 to house and attached garage.
VALUATION: 3,000.00 PROCESSED BY: FAN
APPLICANT: SCOTT JOHNSON
OWNER INFORMATION:
PAUL J SHEPPARD
231 S SUMMERTREE RO
ANAHEIM, CA 92807
ARCHITECT/ENGINEER INFORMATION:
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason ( ec. 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 Professions 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 subjocts the applicant to a civil penalty of not more than five hundred dollars
($500).
o 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 Ucense 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 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 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 property who builds or improves thereon, and who contracts for such projects with
,a.Qontractor(s) licensed pursuant to the Contractor's License Law).
U I 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 01 the following declarations:
D 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 periormance of the work for which
this permit is issued.
ti{ J have and will maintain worker's compensation insurance, as required by Section 3700 of
f!1e Labor Code, for the performance of the work for which this permit is issued. Myworker's
Compensation insurance carrier and poliey are:
Carrier: STATE FUND Policy Number. 1579948-2003
L1CENS D CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Oi 10 3 of the Business and
Profess s Code
Contractor
~.s section need not be completed if the pennit is for one hundred dollars ($1 00) 01' less.
I certify that in the performance of the work for which this permit is issued, ! shaH not
mploy any parson 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 01 the Labor Code h f wi mply with those provisions.
NUMB
675902
TYPE
EXPI RATION DATE
813112005
C39
Date: 8/10/2005 Applicant:
WARNING: FAILURE TO SECURE
UNLAWFUL, AND SHALL SUBJE AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDITlON TO THE
COST OF COMPENSATION, D AGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST A ATTORNEY'S FEES.
C.. NSTRUCTION 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):
Lender's Information:
Construcion Types:
VN, ,
Fire Sprinklered?
NO
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 laws relating to building construction, and
hereby authorize represe tives of this city to enter upon the above mentioned property for
in i pu pses.
Date: 8/10/2005
Fees paid for Permit:
Total:
160.61
Signature of Applicant or Agent
The permit shall expire by limitation and become null and void if the building or
w has not passed final inspection 365 days from the date of permit issuance. A
new Dermit is reauired to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/Ufer
SetbackIForms/Trenches (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 f /
Roof (Sheathing/Diaphragm/Frame) f?/rr/". _\AIJ~
Masonry (ReinfJBond Beam/Pre-Grout) f (
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele" 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
Ex1erior 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 765-5126
Fire Dept. Final 765.4040
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765-5139 T I
Building Final (Last Inspection - Only ?/7~5
After Above Complete) 1,\A-lJr...'SlI._1
/
PARTIAL INSPECTIONS
Buildina Inspections
MechanicallnSDections
Plumbing Inspections
ElectricallnSDections