2141 W FALMOUTH AVEPermit Types
BLD ELE MEC PLM CITY OF ANAHEIM
X
BUILDING DIVISION
Permit Number: OLD2023-01744 200 S. ANAHEIM BLVD.
Issued: 04/13/2023 (714) 765.5153
www.anaheim.net(building
(714)765.4626
Quarter Section: 37
Site Address: 2141 W FALMOUTH AVE, ANAHEIM, CA 92801
Legal Description: N TR 2093 BLK LOT 46
APN: 07241306
Project Description: Reroof: Tear off existing and install 24 squares of shingles on house and detached garage.
Living Area: Number of Stories: 0 Valuation: 12,000.00
Game Area: Construction Types: VB
Carport Area: Occupancy Groups.
Balcony / Dedc Area: Fire Sprinklered:
Cool Roof: Total Fns paid for Permit: 340.56
People Associated with Project:
Contractor BREA ROOFING 171 GEMINI AVENUE BREA, CA 92821
Permit Applicant Reece Shirley
Owner RINCON ALBERT L TR 2141 W FALMOUTH AVE
Type Electrical Fixtures Qty Type Plumbing Fixtures ally 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.
P�PNEIM CSC
City of Anaheim D� �o
Building Division z
u >
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
Plumbing Final
Mechanical Final
Cross Connection Control (714) 765-4280
Engineering Final (714) 765-5126
INSPECTION I 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
Building Final (714 765-5153) r
Last Inspection-Final Only After Above Completed 10
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 secine&
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame) 0�3 �3 J G
Masonry (Reinf.lBond Beafn/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
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
,BLD ELE MEC PLM
X
Permit Number: BLD2023-01744
Issued: 04/13/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 37
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 2141 W FALMOUTH AVE, ANAHEIM, CA 92801
Legal Description: N TR 2093 BLK LOT 46 i
APN: 07241306
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 carrier and policy are:
Cartier.
Policy No.: FORWC0000001931 Expiration Date: 1/1/2024
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, if I should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
4*U Atlaw —
12%Z�Z3
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:
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 Cade, and my license is in full force and effect.
6" RAAdu-71
Contractor S gnature
NUMBER EXPIRATION DATE LICENSE TYPE ISl
818684 04/30/2023 C39, B
02. 2.1-zam
Date