127 S CAMPHOR STPermit Types
BLD ELE MEC
X
!LM—
Permit Number: BLD2022-05217
Issued: 11/02/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 93
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
17141 765 -5153
Project Description: Reroof: Remove existing to Install (21) sq of composition shingles over entire house and attached garage
Living Area: Number of Stories: 1 Valuation: 12,500.00
Garage Area: Construction Types: N/A
Carport Area: Occupancy Groups:
Balcony / Dock Area: Fire Spdnidered:
Cool Root Total Fees paid for Permit: 340.63
People Associated with Project:
Permit Applicant Takeo Tokillas
Owner RAMOS SENECA A TR 127 S CAMPHOR ST
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty
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 buildinq 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 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
sinned:
' mg Final (7 765-5153)
La`sf7nspection-Final Only After AbovC let
I
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Buildinq 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 s' ne •
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
(Do not backfill unless smanad ofn
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE MEWa-
Permit
X Number: BLD2022-05217
Issued: 11/02/2022
www.anaheim.neUbuilding
(714)765-4626
Quarter Section: 93
Site Address: 127 S CAMPHOR ST, ANAHEIM, CA 92805
Legal .Do criptloe: N TR :14866 BLK LOT 50
APN: 03715469 1
CITY OF ANAHEIM
BUILDING DIVISION
2011 S. ANAHEIM BLVD.
(714) 765 - 5153
Project Description: Reroof: Remove existing to install (21) sq of composition shingles over entire house and attached garage
Living Area: Number of Stories: 1 Valuation: 12,500.00
Garage Area: Construction Types: N/A
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinklered:
Cool Roof: Total Fees paid for Permit: 340.63
People Associated with Project:
Permit Applicant Takeo Tokillas
Owner RAMOS SENECA A TR 127 S CAMPHOR ST
Type Electrical Fixtures City Type Plumbing Fixtures Qty Mechanical Fixtures Qty
0
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< FINAL INSPECTIONS DATE INSPECTOR'
Cityof Anaheim o� io All applicable items below must be signed before utilities are released
Building Division F i Final Gas Test
a Electrical Final
Plumbing Final
�DVNDED 'k Mechanical Final
Cross Connection Control (714) 765-4280
Do not occupy this building until the final inspections have been made. Engineering Final (714) 765-5126
INSPECTION 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
Do not install subfloor or pour floor slab until the follwing applicable items have been
sinned:
Bu' ding Final 4 765-5153)'
ion-Final Only After Above Cfmp-lbete�
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 smanedo
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd Floor Shear
oof (Sheathin iaphragm/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
Construction
Exterior Plaster (Brown Coat)
T-Bar (Struct., Ele., or Mec.)
Grease Interceptor
(Do no
Sewer
Water Engineering Backflow (Testable Only)
Water Service
BUILDING DIVISION
CITY OF ANAHEIM
BUILDING DEPARTMENT 2016 CALIFORNIA CODES
CODCYCLE
200 S. Anaheim Blvd., Suite 145
Anaheim, CA 92805 01/001/1/ 2001717
714 765-5153 EFFECTIVE DATE
www.anaheim.net/building
SMOKE DETECTORS AND CARBON MONOXIDE SELF CERTIFICATION
• Final inspection approval will require this completed form to be on site along with the job card.
Permit Number: Q () 243. — 05 Date:
Project address:
Property Owner: 1" !n6t h L&L j1)
The undersigned does hereby certify that I am the property owner of the
property. I further certify that smoke alarms and carbon monoxide alarms
functional in all the following locations. All boxes must be checked below
above referenced
are present and
pro"Smoke Alarms and Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
sleeping area in the immediate vicinity of bedroom/s or in each hallway outside of the rooms.
Smoke Alarms: In each room used for sleeping purposes.
Smoke Alarm and Carbon Monoxide Alarm: In each story, including any habitable basement;
(Note: in dwellings or dwelling units with split levels and without an intervening door between
the adjacent levels, a smoke alarm and a carbon monoxide detector installed on the upper level
shall suffice for the adjacent lower level provided that the lower level is less than one full story
below the upper level.)
All dwelling units with attached garages require carbon monoxide detectors.
Signature: &neiz di�a •LDate: 110,002—
California Residential Code (CRC) Sdction R314.6.2,CRC R315.2 states in part that existing dwellings be
"retrofitted with smoke detectors and carbon monoxide detectors when a building permit is issued for work on or
in a building that is valued at $1,000 or more." CRC Section R314.3, CRC R315.2 defines required locations as
indicted above.
NOTE: This certification is only used when normal access to the interior of the dwelling by the City of Anaheim
Inspector is not achieved during the course of project construction. It is normally used for exterior projects such
as re -roofing, re -siding, patio covers, solar photovoltaic installations, and similar exterior construction work.
200 S. Anaheim Blvd., Suite 145 Anaheim, California 92805 (714)765-5153 Phone (714)765-4607 Fax FEB 2018
www.anaheim.net/building 8842
SMOKE/ CO ALARM REQUIRED LOCATIONS
Bedroom Bedroom
6
Bath
OBedroom
0
Kitchen
Living Room
Figure 1
Family Room Bedroom
Dining
Living Room
Kitchen
Bedroom Bedroom
Figure 2
/ Attic \
Bedroom Hall Bedroom
Living Room Hall Kitchen
Basement —/
Figure 3
REQUIRED SMOKE ALARM LOCATION
REQUIRED CARBON MONOXIDE ALARM LOCATION
Calling -
`I
_,' I_
Acceptable S
Here Never
Here T".
Top of Detector
Acceptable Here
Well
Figure 4
Garage
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-05217
Issued: 11/02/2022
www.anaheim.netlbuilding
(714)765-0626
Quarter Section: 93
Site Address: 127 S CAMPHOR ST, ANAHEIM, CA 92805
Legal Description: N TR 14866 BLK LOT 50
APN: 03715469
WORKER'S COMPENSATION DECLARATION:
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 -5153
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 ($700,000), 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 tabor 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 workers Compensation insurance carder and policy are:
Cartier. ZURICH AMERICAN INSURANCE COMPANY Policy No.: WC112580503 Expiration Date: 12131=22
Name of Agent: Phone No.:
1 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 1 should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, I s forthwith comply with thasammulsions.
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 perm 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 licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code, and my IIInse is in full force and effect.
l� Z
Contractor Signature Date
NUMBER EXPIRATION DATE LICENSE TYPE (S)
606111 12/31/2022 C39, D24, C-2