970 S AMHERST CIRPermit Types
BLD EW MEC PLM
'X
Permit Number: BLD2023-00410 Q0
Issued: 01/26/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 286
Site Address: 970 S AMHERST CIR, ANAHEIM, CA 92807
Legal Dascription.N TR 8375 BLK LOT 16
APN: 365061/4
Project Description: Residential for EV charger level 2
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765-5153
Living Area: Number of Stories: 1 Valuation: 0.00
Garage Area: Construction Types: N/A
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire SprinMered:
Cool Roof: Total Fees paid for Permit: 0.00
People Associated with Project:
Permit Applicant RAYMOND LEZAMA (PRES)
Owner NGUYEN HIEN V & TU DIEN 970 S AMHERST CIR
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty
EV Charger 1
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 commence or continue work.
City of Anaheim
Building Division
Do not occupy this building until the final inspections have been made.
Engineering Final (714) 765-5126
INSPECTION DATE I 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 LisUBus. 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
si ned:
Building Final (714 765-5153)
last Inspection -Final Only After Above Completed
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Buildinq Inspections
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre -slab (Compaction/Membrane Reinf.)
Floor (Joist/Girdem)
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 sinned7
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
Plumbinq 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
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: BLD2023-00410
Issued: 01/26/2023
www.anaheim.nef/building
(714)765-0626
Quarter Section: 286
143kfI.1J_1zT_1lig 1:41i11
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 970 S AMHERST CIR, ANAHEIM, CA 92807
Legal Description: N TR 8375 BLK LOT 16 4.
APN: 36506114
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 self4nsure 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 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 and policy are:
Cartier: STATE COMPENSATION INSURANCE FUND Policy No.: 9303073 Expiration Date: 8/3/2023
Name of Agent Phone No.:
I 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 I we of Ca' Is, and agree that, it I should become subject to the worker's compensation provisions of Section 3700 of the
Labor de, I shall fo th co ly with those provisions.
Signatu pti 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.Civ.C):
Lender's Name:
Lender's Address:
LICENSED CONTRACTOR'S DECLARATION:
1 hereby affirm under the penalty of Perjury that I am li!pdnsed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code, and my cense is in rce a effect.
23
Contractor Date ure Date
NUMBER EXPIRATION DATE LICENSE TYPE (SI
977779 10/31/2024 C10