111 S HARDING AVEPermit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00425
Issued: 01/26/2023
www.anaheirnmet/building
(714)765-0626
Quarter Section: 9
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765-5153
Site Address: 111 S HARDING AVE A -C, ANAHEIM, CA 92804
Legal Description: N TR 403 BLK.LOT 26 TR 403 LOT 26 POR OF LOT
APN: 13528234
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f 41t.
Project Description: Reroof: Relay (3,950) sq ft of the over entire structure #A -C
Living Area: Number of Stories: 2 Valuation: 19,991.00
Garage Area: Construction Types: N/A
Carport Area: Occupancy Groups:
Balcony / Dedc Area: Fire SprinIdered:
Cool Roof: Total Fees paid for Permit: 710.60
People Associated with Project:
Contractor WILLIAM PRIEBE DBA S P CUSTOM ROOFING 23412 PACIFIC PARK DR UNIT 40H ALISO VIEJO, CA 92656
Owner GL WONG LLC 9555 NORMANDY WAY
Type Electrical Fixtures City Type Plumbing Fixtures City 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 building until the final inspections have been made.
FINAL INSPECTIONS
All applicable items below must be sigi
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (714) 766-4280
Engineering Final (714) 765-5126
DATE IINSPECTOR
before utilities are released
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/Migat' ures
Do not install subfloor or pour floor slab until the follwing applicable items have been
si ned:
nal 765-5153)
KLas�l�on-Final Only After A C mpleted
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 si ne
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd Floo ear
AgR (Sheathing/D' hragm/Frame) —
Masonry (Reint./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 hackfill unless Maned ofn
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00425 "
Issued: 01/26/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 9
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 111 S HARDING AVE A -C, ANAHEIM, CA 92804
Legal Description: N TR 403 BLK LOT 26 TR 403 LOT 26 POR OF LOT
APN:13528234 '.
WORK#S COMPENSATION DECLARATION:
WAR
ION
IS
NMA: FAILURE TO SECURE IVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS LARS ($100,000)EIN ADDITION ON TO THE COST OF COMPENSATION, DAMAGES AWFUL, AND SHALL SUBJECT AN EMPLOYER TO S PROVIDNAL ED AND
FOR PI�SECTION 3706 OR THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES.
I h y a 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 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: STATE COMoaSATION INSURANCE FUND Policy No.: 9021170 Expiration Date: 8@7@023
Name of Agent: Phone No.:
I certify that in a erfornance of the work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the
worker's co n tion Is of California, and agree that, if I should become subject to the worker's compensation provisions of Section 3700 of the
Labor Cod I sh rthwith comply with those provisions.
Signature of
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 CONTRj( TOR'S DECLARATION:
I hereby afBrtn under a ena of 13 rqury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code, a d my se is in full force and effect.
Contractor Signature
NUMBER
EXPIRATION DATE
LICENSE TYPE (S)
652641 08/31/2024 C39, C39, C39, C39
I/ zc �gj Z
Date