1711 W. Sumac Ln.
TYPE OF PERMIT CITY
Reroof
DATE: 8/3/2005
JOB ADDRESS: 1711 W SUMAC LN
LEGAL DESCRIPTION: N TR 2176 LOT 15
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 50
BUILDING PERMIT NO. BLD2005-02429
APPLICANT:
OWNER INFORMATION: CONTRACTOR INFORMATION:
TSUN-TSAI L1U ALL TOPS INC
200 N 8TH ST 1511 S BAYLESS ST
ROGERS, AR 72756 ,,". ".' ANAHEIM CA 928020000
'Ifft '
.{.:! BUSINESS PHONE: 888525-5867
JOB DESCRIPTION:Tear Off'&xii.~ing material, install 18 squares of shingles to pitched roof and 5 squares of torch down to flat area.
VALUATION: 5,200.00 .f;> PROCESSED BY: JNJ
I OWNER-BUltDER DECLARATION
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 , or county which requires a permit to construct, atter, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant f 'uch permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with 'n 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any vio Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).
o I, as owner of or my employees with wages as their ~Ie compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 B d ProfeSSIons Code: The Contractor's license Law does not apply to an owner of property who bUilds or Improves
thereon, and who doess ____work himself or herself or throug~,~is:'or her own employees, provided that such improvements are not intended or
offered for sale. If, howe~the building or improvement is ~q1d;.~ith one year of completion, the owner-builder will have the burden of proving that he
did not build or improve fdftl1e purp~~! sale). p.lI'
D I, as the owner of th:~1JfOpertY:"8~lusive]y contracti~~ith licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law hoes not apply to an oWner of property who builds or improves thereon, and who oontracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law).
D 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 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 at the Labor Code, for the pertormance of the work for which
this permit is issued. .~ "
~ave and will maintain worker's compensation insurance, as required by Section 3700 of
t bor Code, for the performance of the work for which this permit is issued. Myworker's
ompensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number. 285-03 UNIT 0001950
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penatty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Prafes 'ons ~
~
Contractor
This section need not be completed if the pennit is for one hundred dollars ($100) or less.
~rtify that in the performance of the work for which this permit is issued, I shall not
~ any person in any manner so as to become subject to the worker's ca"tnpensation laws
of Califomia, and agree that if I should become subject to the wo er's compensation
provisions of Section 3700 of the Labor Co e, I?W rthwith c. p~ with thOse provisions.
Date: 8/3/2005 Applicant: //f?: - :A.
WARNING: FAILURE TO SECURE ORKE S COMPEN ION C ERAGE IS
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. 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 (8ec.3097 .Civ.C):
Lender's Information:
EXPIRATION DATE
5/31/2006
C39
Construcion Types:
V N, ,
Fire Sprinklered?
NO
I certify that I have read this application and state that the above information is correct. I
agree co ly with all city ordinances and state laws relating to building construction, and
hereby a rize representives of this city t enter upon the above mentioned property for
inspection oses. /;
~ C2"j Date: 8/3/2005
Signature of App iean r Agen!
The permi shalf 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.
Fees paid for Permit:
Total:
213.90
City of Anaheim
Building Division
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 ListlBusiness License 765-5194
Zoning 765-5139 /
Building Final (Last Inspection. Only ~
After Above Complete) ~N.lo0SH
I
INSPECTION RECORD
DATE
INSPECTOR
INSPECTION
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
Setback/Forms/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
/l j
I , /,) ~ J
Roof~eatliil)gta'iaphragm/Frame) 3/>/6.~ d. :{~
Masonry (Reint./Bond Beam/Pre-Grout) .
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Firesprinkler (Rough)
2nd Floo. "h
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy)
Do not tape or plaster unlilthe 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
PARTIAL INSPECTIONS
Building Inspections
Mechanicallnsoections
Plumbim;llnsoections
Electrical Inspections