1214 N HOLLY ST (2)Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD20222-06130
Issued: 12/28/2022
www.anaheim.neUbuilding
(714)765-4626
Quarter Section: 37
Site Address: 1214 N HOLLY ST, ANAHEIM, CA 92801
Legal Description: N TR 2197 BLK LOT 117
APN: 07230224
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
1714) 765.5153
Project Description: Reroof: Remove existing to install (22) squares of composition shingles over entire house. Re -sheath as
necessary.
Living Area: Number of Stories: 1 Valuation: 5,250.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony I Dedx Area: Fire Sprinklered:
Cool Roof: Total Feas paid for Permit: 340.07
People Associated with Project:
Permit Applicant Hayven Sault -Eli
Owner NAVARRO FERNANDO 1214 N HOLLY ST
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.
P�Pt1Ell14 Cq<
Cityof Anaheim o� io
Building Division
u >
�DDNDED
Do not occupy this buildinu 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)
COAIMigation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
sioned7
Building Final (714 765-5153)
Last Inspection-Final Only After Abo Compl ed
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECT ONS
Buildin Ins ecti s -
— – a IaTAMM
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Floor (Joist/Girders)
ig dHMOe
Underfloor Insulation (Raised Foundation Only)
Floor Nailing (Raised Foundation Only)
0VdAU
ImQ d Ki
2nd Floor (Floor Nailing)
�
Do not cover or conceal the work below until the following applicable items have
been sinned:
�^
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
25ESUSALUSI
(Sheathing/ aphragm/Frame)
einf./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 8, 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: BLD2022-06130
Issued:12/28/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 37
Site Address: 1214 N HOLLY ST, ANAHEIM, CA 92801
Legal Description: N TR 2197 BLK LOT 117
APN:07230224
WORKER'S COMPENSATION DECLARATION:
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765-5153
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 ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
1 have and will maintain a certificate of consent to self4nsure 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 COMPENSATION INSURANCE FUND Policy No.: 9310590 Expiration Date: 12#2812023
Name of Agent: aci—A I -e sc. U Phone No.: 60 6 rkj
Z`� t L(
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
worker's compensation laws of California, and agree that, if I should become subject to the workees compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
Ar
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:
Lender's 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.
zl�_4 _
Contractor Signature
NUMBER EXPIRATION DATE LICENSE TYPE ISt
1058455 09/30/2023 B. C39
IS Az a 171z -
Date