2130 W CRESCENT AVE (58)Permit Types
BLD ELE MEC PLM CITY OF ANAHEIM
X
BUILDING DIVISION
Permit Number: BLD2023-01967 200 S. ANAHEIM BLVD.
Issued: 04/27/2023 17141765.5153
www.anaheim.net/building
(714)765-0626
Quarter Section: 39
Site Address: 2130 W CRESCENT AVE 2162-2163, Anaheim, CA 92801
Legal Description: P BK 32 PG 24 PAR 1
APN:07207109
Project Description: Reroof: Relay (9) sq of existing tile, and remove existing to Install (13) sq of TPO over flat portions over units
#2162-2163
Living Area: Number of Stories: 1 Valuation: 1,800.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire Sprinkbred:
Cool Roof: Total Fess paid for Permit: 800.50
People Associated with Project:
Contractor MIDWEST ROOFING CO INC 1305 WEST 132ND STREET GARDENA, CA 90247
Permit Applicant Kevin Heineman
Owner TARA HILL OWNER LLC 2130 W CRESCENT AVE
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty 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 permit Is required to commence or continue work.
City of Anaheim
Building Division
Do not occupy this building until the final inspections have been made.
INSPECTION DATE INSPECTOR
Do not pour concrete until the following applicable items have been signed:
Plumbing (Ground/Underfloor Drain Waste)
Electrical Ground ElectrodelUfer
Setback/Forms/Trenches. (Footings)
Do not install subfloor or pour floor slab until the follwing applicable items have been
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
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
been sinnedi
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd Floor Shear
o (Sheath' iaphragm/Frame)7-14 2an
Masonry (Reinf./Bond Beam/Pre-Grout) IF
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation Measures
Framing (Only after Plbg., Ele., Mec. & Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable items have been signed:
Drywall
Drywall Penetrations (Ele, Mec & Plbg)
Interior Lath
Exterior Lath
Electrical Service Meter -(Meter will be set within 2-3
business days after approval) Excludes New
Construction
Exterior Plaster (Brown Coat)
T -Bar (Struct., Ele., or Mec.)
Grease Interceptor
Sewer
Water Engineering Backflow (Testable Only)
Water Service
FINAL INSPECTIONS DATE I 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
Fire Sprinkler (ONLY) (714) 765-5041
Fire Dept. Final (714) 765-5041
Water Engineering (714) 765-4591
Sub LisUBus. Lic. (714) 765-5194 (Allow 10 business days)
COA/Migation Measures
ileffin-Final
(714 765-5153)
Fst Only After Above Compleed —
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD202341967
Issued: 04/27/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 39
CITY OF ANAHEIM
BUILDING DMSION
200 S. ANAHEIM BLVD.
(714) 765 -5153
Site Address: 2130 W CRESCENT AVE 2162-2163, Anaheim, CA 92801
Legal Description: P BK 32 PG 24 PAR 1
APN:07207109
WORKER'S COMPENSATION DECLARATION:
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 self -insure 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.
1 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. AMERICAN ZURICH INSURANCE COMPANY Policy No.: WC169089101 Expiration Date: 1213112023
Name of Agent Phone No.:
1 certify that in the performance 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
bor Code hall forthwith comply with those provisions.
-4/27 %23
Signature of Applicant Date
DECLARATION REGARDING 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.Ctv.C):
Lenders Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATION:
I hereby affirm under the penalty of Perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code, and my license is in full force and effect.
Contractor Signature
NUMBER EXPIRATION DATE LICENSE TYPE (S)
769615 10/31/2023 C39, C39, D24, D24
`l 1 z -7 J -Z
Date