920 S BEACH BLVD (3)Permit Number: SW12022-00024
Issued: 03/14/2022
www.anaheim.net/building
(714)7654626
Quarter Section: 14
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765-5153
Site Address: .920 S BEACH BLVD, ANAHEIM, CA 92804
•Legal:Dascrj) tlork S TWP 4 RGE 11 SEC 13 SEC 13 T 4 R 11 W 464.20 FT
APN 12626118
Project Description: Demolition: 200 sq It inground pool and shell to be removed.
People Associated with Project:
Permit Applicant Pravin Ahir
Owner
NIOMI HOSPITALITY INC
920 S BEACH BLVD
OWNER - BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractor's License State Law for the following reason(s) Indicated below by the
eheekmark(s) I have placed next to the applicable Item(s) (See. 7031.5 Business and Professions Code: any city or county which requires a permit to
construct, alter, Improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for the permit to file a signed statement that he
or she Is licensed pursuant to the provisions of the Contractors' State License Law Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she Is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any
.app11 nt for a permit subjects the applicant to a civil penalty of not more than five hundred dolls ($500).
to 1, as owner of property, or my employees with wages as their sole compensation, will do,(�a I or I portions of the work, and the air ucture Is not
intended o, offered for sale (Sec. 7044 Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through
employees' or personal efforts, builds or Improves the property, provided that the Improvements are not Intended or offered for sale. If, however, the building or
13 I, as the owner of the property, am exclusively contracting with licensed Contractors to construct the project (Sec. 7044 Business and Professions Code:
The Contractors' State License Law does not apply to an owner of properly whyAVilds or improves thereon, and who contracts for the projects with a licensed
Contractor pursuant to the Contractors State License Law).
I am exempt from licensure under the Contractors, State Lic
2-hA-7_Z.—
reason:
Date Signature of PropprtylOWhil &/Authorized Agent
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self -Insure for workers 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:
Carder. Policy No.: Expiration Date:
This section need not be completed ff the permit Is for one hundred dollars ($100) or less.
Q 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
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.
Date
Signature of Applicant
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 CONSTRUCTION LENDING AGENCY II - LICENSED CONTRACTORS DECLARATION I
I hereby affirm under penalty of perl'ury that there is a construction lending agency for the performance
Lenders Information:
I hereby certify that I have read this application and state that the Information above is correct. I agree
to comply with all city ordinances and state laws relating building construction, and hereby authorize
representives of this city to enter upon the above mentioned property for inspection purposes.
Date Signature of Applicant or Agen
The premit 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.
I hereby affirm under.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.
Date: 03/14/2022
Contractor:
Number. SWI2022-00024 Expiration Date
TYPE:
Fees paid for Permit: $171.00
City of Anaheim
BUILDING DIVISION
INSPECTION RECORD
SWIMMING POOL
ADDRESS:
920 S BEACH BLVD, ANAHEIM, CA 92804
OWNER:
NIOMI HOSPITALITY INC
PERMIT #.
SWI2022-00024
DATE ISSUED:
03/14/2022
DESCRIPTION:
Demolition: 200 sq It inground pool and shell to be
DO NOT GUNITE ROCK STRUCTURE
ter feature, rock slide, fountain, waterfall, grotto etc.) until the above inspection has
been signed.
removed.
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE ON THE JOB SITE
nspection Code Date Inspector
rain 504
c Bonding 506
508
al to Gunite 510
FAppmval
DO NOT GUNITE POOUSPA
until all the above Inspections have been signed.
teel and Electric boctures,Slides Etc)
508
DO NOT GUNITE ROCK STRUCTURE
ter feature, rock slide, fountain, waterfall, grotto etc.) until the above inspection has
been signed.
ground Electric
512
7. Gas Piping Test
514
8. P -Trap Receptor
516
9. Backflow
518
10. Deck, Deck Drains,
Equipotential & Accessory
Bonding
520
DO NOT POUR FLATWORK
until all the above inspections have been signed.
11. Rough Electrical 522
12. Fencing/Door Alarms 524
13. Plaster approval 526
DO NOT PLASTER
until all the above Inspections have been signed.
14. Final Electric 1 528
Sub -Contractors List MUST be approved and pool cover on site
PRIOR to Pool Final Inspection request
FINAL INSPECTION CODE DATE INSPECTOR
15. Rough Demo 527
16. Final 599
MISC. INSPECTIONS Date Inspector
fbldjobcards
Inspections 1.5: 4
1. All Plumbing to be completed and the system pressurized to 35 lbs. with waters
or house pressure.
2. All metal within 5 feet of pool water, and all pod equipment, must be bounded
to pod reinforcing steel with 08 solid copper wire. Niche light shell, deck Inserts,
etc. shall be bonded to pool reber.
3. Pool equipment is not iequirod to be set at this time.
Inspections 6.10:
1. Underground electric Inspected prior to baddlling.
2. Gas line tat at 100 for 15 minutes with 150 gauge.
3. When polyethylene gas piping Is used, a certificate from a certified Installer
and tracer wire shell be provided per CPC 1210.1.7.2 APPENDIX I.
Inspections 11.13:
1. Rough electric Inspection when all widng is completed and ready prior to the
plastering of poollaps. Potft compound In place at plastic tight niche.
2. Current Code requires that any pool, spa or water feature
contacting water 16 inches or more in depth shall be enclosed by a barrier
adequate to prevent entry of smell children. The banter shell comply with
Section 3109 of current CBC and CRC APPOENDIX V spedfying the height of
any fence provided as bander to the pod d- shall be 60' above grade on the
outside of the fence.
3. Does from a gorge &hal meet the requirements for a gate. Glass
windows within F of pool water shag be tempered glass.
4. Prior to pre -plaster inspection, streets, curbs and city sidewalks will be
Inspected for any damage due to construction of pod or spas.
5. Grading complete with positive drainage to street or public way. All
exposed plastic pipe shall be painted to protect from sunlight
Inspections 14.16:
1. Gas and Electrical completely removed and 2x2 holes at bottom of pod
and/or Isolated elements.
2. Pod bacldiled:
A.) With future build - sellw ompectkng sand 95% with receipt
S.) No future build - any 01.
3. After pool Is operating and In working condition with approved pod cover on
site.
IL,Iio
Inspection requests made prior to 5:00 pm Monday - Friday
will be scheduled on the following workday.
To schedule your building inspection online, please go to
https://aca.anaheim.neUCifizenAccess
Inspection can normally be reached between
7:30 - 8:00 A.M.
(7141765.5153 + 0
To access your inspection timeframe:
Please go to www.anahedm.netlbullding after T30am on the day of your
Inspection. Under online Services, dick on the link 'Inspection
Timeframes' or call (714) 765.5153 + 0