512 S CIRCULO LAZO (4)Permit Types
BLD ELE MEC PLM
X X
Permit Number: BLD2022-05211
Issued: 12/20/2022
www.anaheim.neUbuilding
(714)765.4626
Quarter Section: 198
Site Address: 512 S CIRCULO LAZOANAHEIM, CA 92807
Legal Description: N TR 8215 BLK LOT 4
APN:36503104
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Project Description: Photovoltaic System: Install new residential roof mounted solar system with (23) modules, (23) micro -inverters,
125amp combiner box, and 200A main service.
Living Area: Number of Stories: 2 Valuallon: 23,000.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony I Dock Area: Fire SprinMered:
Cool Roof. Total Fess paid for Permit: 1,139.99
People Associated with Project:
Permit Applicant Addana Acosta
Owner ADRYANTO HENGKY 512 CIRCULO LAZO
Type Electrical Fixtures Qty Type Plumbing Fbdures Qty Mechanical Fixtures Qty
Meter/Disc Sw - Under 600 V, up to 200 1
amps
Microinverter 23
Sub PaneVTemp Pwr - Under 600 V, up to 1
200 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�pNEH4 �q(
City of Anaheim D� io
Building Division F y
DED
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 $ (S
Plumbing Final
Mechanical Final
Cross Connection Control (714) 7654280
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) 7654591
Electrical Ground Electrode/Ufer
Sub ListlBus. 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 foliwing applicable items have beension
e .
Building Final (714 765-5153)
Last Inspection-Final Only After Above Completed
/ /S
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 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., 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
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLDALE MEC PLM
X I X
Permit Number: BLD2022-05211
Issued: 12/20/2022
warmanaheim.nellbuilding
(714)765-0626
Quarter Section: 198
Site Address: 512 S CIRCULO LAZOANAHEIM, CA 92807
Legal Description: N TR 8215 BLK LOT 4
APN:36503104
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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self4risure 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.
�L7-% 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. NATIONAL CASUALTY COMPANY Policy No.: WCC336206A Expiration Date: 11/16/2023
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
workers compensation laws of California, and agree that, it I should become subject to the workers compensation provisions of section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
,�� 12.2 .
Sig ure o 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):
Lenders 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.
Contractor S I —gn atb r
NUMBER EXPIRATION DATE LICENSE TYPE (S)
1062299 01/31@022 C10
111 22
Date