1421 W BALL RD (8)Permit Types
BLD ELE MEC PLM
X
Pe:%Mt Number. fb202341235
Issued: 03/14/2023
www.anaheim.net/building
(714)765.4626
Quarter Section: 64
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Site Address: 1421 W BALL RD, ANAHEIM, CA 92802
.Legal Description: A TR ANAHEIM INVESTMENT CO TR BLK LOT 19 ANAHEIM I
5.
APN'03607227
Project Description: Reroof: Remove existing to install (99) sq. of composition shingles over building.
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Living Area: Number of stories: 1 Valuadon: 65,000.00
Garage Area: Construction Types: N/A
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinklered:
Cool Root. Total Fees paid for Permit: 513.20
People Associated with Project:
Contractor HOYT ROOFS INC 1809 N ORANGETHORPE PARKABCDE11140254 ANAHEIM, CA 92801
Owner CHURCH PRINCE OF PEACE LUTHERAN OF A 1421 W BALL RD
Type Electrical Fixtures City Type Plumbing Fixtures Oly Mechanical Fixtures City
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�PNEIM cq<
Cityof Anaheim D� �o
Building Division F z
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�DGNDED �6y�
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 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 List/Bus. 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
e .
Building Final (714 765-5153)
Last Inspection -Final Only After Above Completed
• ,�
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre -slab (Compaction/Membrane Reinf.)
PARTIAL INSPECTIONS
Buildinq Inspections
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 e•
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd Flo ear
Mechanical Inspections
eathing/Dia gm/Frame)
Masonry Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation Measures
Framing (Only after Plbg., Ele., Mec. & Fire)
Plumbing Inspections
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
Perrmli Number:
Issued: 03/14/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 64
CITY OF ANAHEIM
BUILDING DMSION
200 S. ANAHEIM BLVD. a�
(714) 765 - 5153
Site Address: 1421 W BALL RD, ANAHEIM, CA 92802
Legal Description: A TR ANAHEIM INVESTMENT CO TR BLK LOT 19 ANAHEIM I
APN:03607227
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.
t=Q( 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: AMERICAN ZURICH INSURANCE COMPANY Policy No.: WC112680504 Expiration Date: 12/31/2023
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, it I should become subject to the worker's compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
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:
Lender's 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 IS
606111 12/31@022 C39, D24, C-2
Date