912 S ANAHEIM BLVDPermit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-05152
Issued: 10/28/2022
www.anaheim.net/building
(714)765.4626
Quarter Section: 86
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765.5159
Site Address: 912 S ANAHEIM BLVD, ANAHEIM, CA 92805
Legal Description: N TR 1245 BLK-LOT 1 TR 1245 LOT 1 ALL -EX NWLY 56.
23341`3103
Project Description: Residential Addition: Replacing (12) retrofit windows, like for like
Living Area: Number of Stories: 1 Valuation: 15,090.00
Garage Area: Conslrucdon Types: NIA
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinidered:
Cool Roof: Total Fees paid for Permit: 276.96
People Associated with Project:
Owner SCHWARCZ KIM TR MARGARET 22 SEAWOLF PASSAGE
Type Electrical Fixtures City Type Plumbing Fixtures Qty Mechanical Fixtures Qty
The permit shall expire by [Imitation and become null and void K the building or work has not passed final Inspection 965 days from the
date of permit Issuance. A new permit Is required to commence or continue work.
P�PHEIM Cq<
City of Anaheim 04 io
Building Division
u >
DED
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)
COAIMigation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
si ned:
Building Final (714 765-5153)
Last Inspection-Final Only After Above Completed
IIe1
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Building Inspections
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 slanedi
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation Measures
Plumbing Inspections
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 Inspections
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
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-05152
Issued: 10/28/2022
www.anaheim.net/buiiding
(714)765-0626
Quarter Section: 85
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 -5153
Site Address: 912 S ANAHEIM BLVD, ANAHEIM, CA 92805
Legal Description: N TR 1245 BLK LOT 1 TR 1245 LOT 1 ALL -EX NWLY 56.
APN: 23413103
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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to selfeinsure for worker's compensation, Issued by the Director of Industrial Relations as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
1 have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued. My worker's Compensation insurance carrier end policy are:
Cartier. NORGUARD INSURANCE COMPANY Policy No.: PVWC338561 Expiration Date: 6/30/2023
Name of Agent:. Phone No.:
I that 1n the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the
rker'$ pompe tion laws of California, and agree that, if I should become subject to the worker's compensation provisions of Section 3700 of the
Labo ode, I hal forthwith comply with thoseLA J
sions.
Signa of Applicant Date I.
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.Civ.C):
Lenders Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATION:
1 hereby rntand
penalty of Perjury that I am licensed under pro slons o1 chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professio s Cy license isfull force and effect.
(o 2
Contrackilawfure Date
NUMBER EXPIRATION DATE LICENSE TYPE (S)
1065570 04/30/2024 B. B. B. C17, C17, C17