1243 N DRESDEN PL 1, 7Permit Types
BLD ELE MEC PLM
X
kbit Nudnber. BLD2023-01191
Issued: 03/13/2023
www.anaheim.net/building
(714)765-0626
Quarter Section: 51
CITY OF ANAHEIM
Site Address: 1243 N DRESDEN PL 1-7, ANAHEIM, CA 92801
Legal Description: N TR 3396 BLK LOT 13
APN:07338427
BUILDING DIVISION
4 20U S�A��iE1M BLVD.
(714) 765 -5153
WORKEWS,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 selfansure 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 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. FALLS LAKE FIRE AND CASUALTY COMPANY Policy No.: FLA020269 Expiration Date: 1/15/2024
Name of Agent:
Phone No.:
Ice ' at 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
rk is corn nation laws of California, and agree that, if I should become subject to the worker's compensation provisions of Section 3700 of the
Ls11"Code, I shall forthwith comply with those provisions.
a
Sffnature 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 D LARATION:
I hereby affirm under tj a penalty of P rjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
my license I& full force and effect.
NUMBER EXPIRATION DATE
1054542 06/30/2023
LICENSE TYPE (S)
C17, C17, C17
"7 1'7 2
Date
^t. f N
�� _.
BUILDING DIVISION
CITY OF ANAHEIM
BUILDING DEPARTMENT 2016 CALIFORNIA CODES
200 S. Anaheim Blvd., Suite 145 CODE CYCLE
Anaheim, CA 92805 01/01/2017
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: '3t O Z4c>23 — oft 9 ( Date: s_24,—Z 3
A'Pf
Project address: 12 -1zfs t
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
l7/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 unitswith hed arages require carbon monoxide detectors.
Signature: Date: is 3
California Residential Code (CRC) Section 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.
200S. Anaheim Blvd., Suite 145 Anaheim, California 92805 (714)765-5153 Phone (714)765-4607 Fax FEB 2018
www.anaheim.ne9building B842
LJ
''. BUILDING DIVISION
CITY OF ANAHEIM
BUILDING DEPARTMENT 2016 CALIFORNIA CODES
200 S. Anaheim Blvd., Suite 145 CODE CYCLE
Anaheim, CA 92805 01/01/2017
714 765-5153 EFFECT/VEDATE
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: k1L T> ZoZ3 — b I 1 `1 l Date:
S —Z6 — z3
Project address: t?, Q M• IPL ArFT— 01 /moo-Ne.4 9zbo %
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
0' 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.
Cd' Smoke Alarms: In each room used for sleeping purposes.
2r 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 wit ed s require carbon monoxide detectors.
Signature: Date: — Z 3
California Residential Code (CRC) Section 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.netlbuilding B842