628 S BARNETT ST (3)Permit Types
BLD
lkE MECPLM
X
Permit Number: BLD2022-05160
Issued: 10/3112022
www.anaheim.neUbuilding
(714)765-4626
Quarter Section: 104
Site Address: 628 S BARNETT ST, ANAHEIM, CA 92805
Legal Description: N TR 3392 BLK LOT 53
APN:08253209
Project Description: Main Electric Service Size: 200 Amps
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765-5153
Living Area: Number of Stories: Valuation: 0.00
Garage Area: C and D: Option 2 construction Types:
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinldered:
Cool Roof: Total Fees paid for Permit: 167.00
People Associated with Project:
Permit Applicant Brittany Miles
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty
Meter/Disc Sw - Under 600 V, up to 200 1
amps
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.
P�PHEIM Cq<
Cityof Anaheim o� io
Building Division
u >
DED �$y�
Do not occupy this building until the final inspections have been made.
FINAL INSPECTIONS DATA ,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
s
Do not install subfloor or pour floor slab until the follwing applicable items have been
smoned7
Building Final (714 765-5153)
Last Inspection -Final Only After Above Completed
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas I'
PARTIAL INSPECTIONS
Buildinq Inspections
q
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre -slab (Compaction/Membrane Reint)
Floor (Joist/Girders)
Underfloor Insulation (Raised Foundation Only)
ra b d 1U Ar U 11tom
Floor Nailing (Raised Foundation Only)
2nd Floor (Floor Nailing)
Do not cover or conceal the work below until the following applicable items have
been sinned�
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., 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
Constructoo
Exterior Plaster (Brown Coat)
T -Bar (Struct., Ele., or Mec.)
Grease Interceptor
(Do not backfill unless sinned ofl)
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD `ELE I MEC PLM
X
Permit Number. BLD2022-05160
Issued: 10/31/2022
www.anaheim.net(building
(714)765-0626
Quarter Section: 104
Site Address: 628 S BARNETT ST, ANAHEIM, CA 92805
Legal Description: N TR 3392 BLK LOT 53
APN:08253209
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 -5153
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.
1 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
BM 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 worker's Compensation insurance carrier and policy are:
Cartier: MIDWEST EMPLOYERS CASUALTY COMPANY Policy No.: BNUWC0157971 Expiration Date: 10/10/2023
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 laws of California; and agree that, If I should become subject to the worker's compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
Brittany Miles 10/31/2022
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.Civ.C):
Lender's 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
SEMPER SOLARIS 10/31/2022
Contractor Signature Date
NUMBER EXPIRATION DATE LICENSE TYPE fSl
978152 10/3112022 B. C10, C46, C39, C20