1769 S CAROLEEN LNPermit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-02265
Issued: 05/09/2023
www.anaheim.net/building
(714)765.4626
Quarter Section: 36
Site Address: 1769 S CAROLEEN LN, Anaheim, CA 92804
Legal Description: N TR 2319 SLK LOT 47
APN: 12761237
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765-6153
Project Description: Re -roof: tear -off existing and Install (31) sq of torch down on entire house and attached garage.
LMng Area: Number of Stories: 1 Valuation: 1000.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire SpfinNered:
Cool Root Total Fns paid for Permit: 361 AI
People Associated with Project:
Contractor BRIZUELA'S ROOFING SYSTEMS 3930 2ND AVE201912061606129258 LOS ANGELES, CA 90008
Permit Applicant Carlos Br[zuela
Owner DELFIN, ISABEL & LARRY 1769 S CAROLEEN LN
Type Electrical Fbdures Qty Type Plumbing Fixtures Gly Mechanical Fixtures Qty
The permit shall expire by [Imitation 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 penult Is required to commence or continue work.
P�PNEIM C'<
City of Anaheim c� .o
Building Division i
u '
�DVNDED
Do not occupy this building until the final Inspections have been made.
FINAL INSPECTIONS DATE INSPECTOR
All applicable Items below must be signed before utilities are released
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (714) 765-4280
Engineering Final (714) 765-5126
INSPECTION I DATE INSPECTOR
Fire Sprinkler (ONLY) (714) 765-5041
Do not pour concrete until the following applicable items have been signed:
Fire Dept. Final (714) 765-5041
Plumbing (Ground/Underfloor Drain Waste)
Water Engineering (714) 765-4591
Electrical Ground Electrode/Ufer
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
Setback/Forms/Trenches (Footings)
COA/Migation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
Building Final (714 765-5153)
Last Inspection-Final Only After Above Completed
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Buildina Insactions
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Floor (Joist/Girders)
Underfloor Insulation (Raised Foundation Only)
Floor Nailing (Raised Foundation Only)
2nd Floor (Floor Nailing)
Do not cover or conceal the work below until the following applicable items have
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd Floor
( h iaphragm/Frame)
asonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COAIMitagation Measures
Plumbing Inspections
Framing (Only after Plbg., Ele., Mac. & Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable items have been signed:
Drywall
Drywall Penetrations (Ele, Mac & Plbg)
Interior Lath
Exterior Lath
Electrical Inspections
Electrical Service Meter-(Meter will be set within 2-3
business days after approval) Excludes New
struction
Exterior Plaster (Brown Coat)
T-Bar (Strutt., Ele., or Mec.)
Grease Interceptor
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
X
Permit Number. BLD2023-02265
Issued: 05/09/2023
www.anaheim.net/building
(714)7654626
Quarter Section: 36
Site Address: 1769 S CAROLEEN LN, Anaheim, CA 92804
Legal Description: N TR 2319 BLK LOT 47
APN:12761237
WORKER'S COMPENSATION DECLARATION:
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
17141765 - 5153
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to selfansure for worker's compensation. Issued by the Director of industrial Relations as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
I have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code. for the performance of the work for which
this permit is issued. My workers Compensation Insurance carrier and policy are:
Cartier. STATE COMPENSATION INSURANCE FUND Policy No.: 9298072 Expiration Date: 5/12/2024
Name of Agent: Phone No.:
I certify that in the performance of the work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the
workers compensation laws of California, and agree that, If I should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions. r
J
' a nt Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
1 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):
Lenders Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATION:
1 hereby affirm under the penalty of Perjury that I am licensed under provisions of chapter 9 (commencing with Section 7007slon 3 of the Business and
Professions Code, and my license Is in full force and effect.
--
Contracto re Date
NUMBER EXPIRATION DATE LICENSE TYPE (S)
919282 07/31/2022 C39,024