4170 E. Summer Creek Ln.
TYPE OF PERMIT CITY
Patio Cover
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153 .
INSPECT/ON REQUEST liNE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 156
BUILDING PERMIT NO. BLD2005-00350
DATE: 21812005
JOB ADDRESS: 4170 E SUMMER CREEK LN
LEGAL DESCRIPTION: TRACT 15961 LOT 26
APPLICANT: DAVID BOYANER
OWNER INFORMATION:
CONTRACTOR INFORMATION:
GALKOS CONSTRUCTION INC
.SUMMER CREEK HOLLOW L.P. 5412 BOLSAAVE #G
22974 EL TORO RD HUNTINGTON BEACH, CA'92649 1056
LAKE FOREST, CA 92630 ,BUSINESS PHONE: 71437t-8545
JOB DESCRIPTION:lns!all patio cover 240 square feet of solid roof, 360 squa:'''' ioot oflalllce. ICBO #2228-P
ARCHITECTIENGINEER INFORMATION:
VALUATION: 5,000,00
I OWNER-BUILDEROECLARATION
I hereby affirm under pena~ of perjury that I am exempt from the ContradQr:~' Lice~e law for the fallowing rea~cn (Sec. 7031.5 Business and
Professions Code: any dty or county which requires a p~rmit to construct,ar:er, improve, demolish or repair any structure, prior to its issuance, al$o
requires the -applicant for such permit to ~Ie 'a Signed statement that he is Jici:'hsed pursuant tothe provisions of the Contractor's License Law (Chapter
9){commencing with Section 7000 of Division 3 of the Business a nd ProfeSGi,jnsCode) or that he is exempt theref~om and the basis fer the alleged
exemption. ,Any violation of Section 7031.5 by any-applicant for. a permit sUbjects the applicant to aciv" penalty of not more than five hundred dollars
($500). . .' ." .'. .
o I, as owner of property, or my employees w.ith wages 'a$ their sole COnlp~fl.sation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 BUSIness and Professions Code: The Contractor's Licern.;~}\flYldoes not applytb an owner of pr9perty who builds or improves.
thereon, and who does such work,himself or herself or through his,or her Owbehlployees, provided that such improvements are not intended or
offered f.or sale. If, however, the building or improvement is sold with one ye~r (If rompletion, the owner~builder will have the burden of proving that he
did 1j1ot buRd or improve for the purpose of sale) . . , .' ,:~~ ,':_ . '. . , '
o I, as the owner ~fthe property, am. exclusively contractiog with Iic.ensed;~r:trad:brs to construct the project (See. 7044 Business and Professions
Code: The Contractor's License law does nohlpPty to an_owner of propeltY?Nho builds or improves thereon, and who contracts for such projects with
. }!J(ontractor(s) licensed pursuant to the Contractor's License Law)~ ':1
U I am exempt uncter See, . .' , B & ~.C. for this r~ason: ~:~
Date: Owner: ' .,~.
~ WORKER'S COMPENSATION DECLARATION:~
I hereby affirm under peo?lty of perjury one oithe following declarations: .'. ."".:
o i have ahd WiU 'maintain a certificate of consent to self~ins~re fOI workef.~{t:hmpensation,
as provided for by Sectlon 3700 of th~ Labor Code, ,for the performance 6f~~'::wOrl< for which'
this permit is issued._:jf.,: .'
,~ ., !"lave and will maintain worker's' compensation insurance, as requireci-f~r-.Secticrl3700 of
4he't.abor Code, for the performance of the work for which this permit is issu<d. My worker's
CompensatiOn insurance carrier and panty :are:
Carrier: STATE FUND
PROCESSED BY:. ENO
LICENSED CONTRAc:.TORSDECLARATION.J
I hereby aft;rm under penalty of perjury that J am
licensed under provisioilS f chapter 9 (commencing
wit ection Z 0) of Divs n 3'ofthe Business and
Pro~e ions ..
Policy Number. 046-04 :!N IT 0009439
Contractor
~7-
This section ne~ not be co":,pleted if the pennit is for one hundred 'dollars t$1 Op, or lesS.
"NT I certify that in the perfonnanceofthe work for whIch this permit is'is..C:;U60, , shall not
~itploY any person in any manner so as to become subject to the worker's :co,mpensationlaws
of California, and agree that if Ishou be subje to the worker's Goni;xr.sati.on
provisions of Section 3700 of the Labo ~Sh~1 j h~;O,' ~j~witihose provisions.
Date;, 21812005 \. ~ - ,.'
WARNING: FAILURE TO SECU WOR.KER'S COMPENSATION CQVERAGE IS .
UNLAWFUL, AND SHALL SUBJ CT AN EMPLOYER TO CRIMINAL'PENJl,i:fIES AND CIVIL
FINESUPTO ONE HUNDRED OUSAND DOLLARS ($100,000), iN AlJDIT10N TO THE
. COST OF COMPENSATlON:( AMAGES AS PROVIDED FOR IN SECTI()!.: 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . :
I . '., .CONSTRUCTIO~ LENDING AGENCY .
.~J..j1.l?r..o/.JY..."v.f.irm_t'nljet:~~,.of.~..rJur:~d:h~,U:~~'l-..<=t!"..<djonJz::;.:iif.:.g~1)Cy_f:Jr.~ ,
performance of the work forwhidl this permit is issued (Sec.3097.Civ.C):
Lender's Information:
EXPIRATION DATE
1113012005
C17
B
HIC
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 oomply with all city ordinanpes and state laws reiating to building cortStruction, and
er y authorize r resentives of this city to,enter upon the above mentioned property for
i eel' urpa~s h___~"
rr/~ .::.-- Date: 218/2005
Sign"lure of Applicant or Agent
The permit shall 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 commeru:;e or continue work.
Fees paid for Permit:
.Total: .
626.27
INSPECTION RECORD
INSPECTION . DATE INSPECTOR
Temporary Power Pole .-
Plumbing (OrainlWaste Pipe) .
Electrical Ground Electrode/Ufer .
SelbacklFormstrrenches (Footings) ..
Donat install subfloor or pour floor slab untH the . .
fallowing applicable Items have been signed:,
Plumbing (Water Plpe.Sprinkler Valves)
MechanicaJ (GroUndwork) . .
Electrical. (Underground Conduit) .
Pre-slab (\;ompactionlMembrane.Remf. .
Underpinning (Floor Joist/Girders) .
Do not cover or conceal the work below until the .
following applicable items have been sighed:,
,1 st Floor Shear , .
FiresprinkJer (Rough)
2nd Floor Shear'
Roof (Sheathing/Diaphragm/Frame) .' , .
Masonry (ReinfJBond BeamlPre-Gmut)
Rough Plumbing (Top Out)
Rough Mechanicai . .
ROugh l:Iec:trlCaI all)
Rough Electrical .
Framing (Only after Plbg.. Elec:. Mech.. and Fire) ,. ,
Insulation {SoundlEner!IV) .
po ntit tape or pla~ter until the tollowing applicable
items have been Signed: . ... .-.
DryWall . .
, Penetrations {Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumj)ing
Interior Lath . . ,
Exterior Lath
, , GENERAL ITEMS
Exterior Plaster (Brown Coat) . , .
T .Bar Electrical' . .
T .Bar Mechanical ' .
T ..sar ,Structural . . .
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS . Date Inspector
Electrical Final . .' q/t;-rt6~ /CU_JL
Plumbing Final . W .
Mechanical Final
Gas Test . .
Engineering/Grading Final 765-5126 ~-
'. .
Fire Dept. Final 765-4040 . , .
Water Engineering 765.5268 '. : ...
Sub .ListlBusiness License 765.M9 .
Zoning 765.5139 , .
Bullding'Final ~astlnspection. Only / ~$ /l )A".u '0
fter Above Completel
PARTIALINSPEC IONS it
BuildinQ ,Inspections
Mechanical 'Inspections
PlumbinQ Inspections
Electricallnsoections