2130 W CRESCENT AVE (45)H
•. � _ _ mow.
BUILDING DIVISION
CITY OF ANAHEIM - r
BUILDING DEPARTMENT 2016 CALIFORNIA CODES
200 S Anaheim Blvd., Suite 145 -01/01/2017
Anaheim, CA 92805 01/01/2017
714 765-5153 EFFECTlVEDd1E
vw manabeim net/building
SMOKE DETECTORS AND CARBON MONOXIDE SELF CERTIFICATION
' Final Inspection approval will require this completed form to be on alto Along with the job card.
Permit Number.. Date:
Project address:
Property Owner:
The undersigned does hereby certify that I am the property owner of the above referenced
property. I further_ certify- that smoke alarms -and _carbon monoxide alarms are present and
functional in all.the following locations. All boxes must be checked below
m- Smoke Alarms and Carbon Monoxide Alarm: On the ceiling or will outside of each separate
sleeping area in the immediate vicinity of bedroom/s or in each hallway outside of the rooms.
EL Smoke Alarms: In each room used for sleeping purposes.
11 Smoke Alarm and Carbon Monoxide Alarm: In each story, including any habitable basement;
(Note: in dwellings or `dwelling units with split le' s and without an intervening door between
the adjacent levels, a smoke alarm and a car n monoxide detector installed on the upper level
shall suffice for the, adjacent lower level p vided that the lower level is less than one full story
below the upper level.)
All dwelling units with attach es require carbon monoxide detectors.
Signature: Date: V 7-11
California Residential Code (CRCecarbon
tion R314.6.2,CRC R315.2 states in part that existing dwellings be
°retrofitted with smoke detectors a monoxide detectors when a building permit is issued for work on or
in a building that is valued at $1,06ore.° 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, CallIbmia 92805 (714)765-5153 Phone (714)765-4607 Fax FEB 2018
www.anaheim.net/building 8842
Permit Types
k8LD 1, ELE MEC PLM
'
X It
Permit Number: BLD2022-04922
,
Issued: 10/17/2022
1
ww.anaheim.net/building
rl4)765-4626
Quarter Section: 39
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765-5153
Site Address: 2130. W CRESCENT AVE 2002-2005, ANAHEIM, CA 92801
Legal'Descr16tlo6 0,131<42:P6 24 PAR 1
"APN
: 07207109
Project Description: Reroof: Remove existing to install (19) squares of heavy weight tile (ICC#1900), and (25) squares of flat roof over
BLDs #2002-2005.'
Living Area: Number of Stories: 2 Valuation: 36,263.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire Sprinklered:
Cool Roof: Total Fees paid for Permit: 611.15
People Associated with Project:
Permit Applicant Breanna Yankin
Owner TARA HILL OWNER LLC 2130 W CRESCENT AVE
Type Electrical Fixtures Oty 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.
FINAL INSPECTIONS I DATE
All applicable items below must be signed before utilities are released
I Gas Test
trical Final
Plumbing Final
Mechanical Final
(Cross Connection Control (714) 765-4280 1 1 1
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/M' io Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
s' a
Building Final 14 765-5153)
bastlaWm0wInal Only After Abo Compete
._
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 Manedo
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
oofof V2ndF(
heathiaphragm/Frame)
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., Mac. & 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
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
Permit Number: BLD2022-04922
Issued: 10/17/2022
www.anaheim.net/building
(714)765-0626
Quarter Section: 39
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
Site Address: 2130 W CRESCENT AVE 2002-2005, ANAHEIM, CA 92801
Legal Description: P BK 32 PG 24 PAR 1
APN:07207109
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.
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.: WC169089100 Expiration Date: 12/31@022
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 I should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, l shall forthwith comply with those provisions.
Signature of Applicant Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
1 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:
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 license Is in full force and effect.
!U-1? ` ZZ
Contractor Signature Date
NUMBER EXPIRATION DATE
769615 10/31/2023
LICENSE TYPE (S1
C39, C39, C39, C39, C39, D24, D24, D24, D24, D24