1974 W HARRIET LNCity of Anaheim
BUILDING DIVISION
INSPECTION RECORD
SWIMMING POOL
ADDRESS:
1974 W HARRIET LN, ANAHEIM, CA 92804
OWNER:
NGO NGOC TUONG QUYEN
PERMIT#:
SWI2022-00108
DATE ISSUED:
09/22/2022
DESCRIPTION:
Demolition: 612 sq ft pool with shell to remain with (2)
DO NOT GUNITE ROCK STRUCTURE
(water feature, rock slide, fountain, waterfall, grotto etc.) until the above Inspection has
been signed.
3X3 holes
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE ON THE JOB SITE
Inspection Code Date Inspector
1. Main Drain 504
2. Electric Bonding 506 '
3. Steel 508
4. Approval to Gunite 510
DO NOT GUNITE POOUSPA
until ell the above Inspections have been signed.
S. BLD -Steel and Electric bonding
(Rock Structures,Slides Etc)
508
DO NOT GUNITE ROCK STRUCTURE
(water feature, rock slide, fountain, waterfall, grotto etc.) until the above Inspection has
been signed.
6: Underground Electric -
512
- - - - -
7. Gas Piping Test
514
8. P -Trap Receptor
516
9. Backflow
518
10. Deck, Deck Drains,
Equipotential & Accessory
Bondina
520
DO NOT POUR FLATWORK
until all the above Inspections have been signed.
11. Rough Electrical 522
12. Fencing/Door Alarms 524
13. Plaster approval 526
DO NOT PLASTER
until all the above inspections have been signed.
14. Final Electric 528
Sub -Contractors List MUST be approved and pool cover on site
PRIOR to Pool Final inspection request
FINAL INSPECTION CODE DATE
HECTOR15. Rough Demo 5Z716. Final 599��-2. /
MISC. INSPECTIONS Date Inspector
fbldjobcards
Inspecdona 14•
1. All plumbing to be completed and the system pressurized to 35 lbs. with water
or house pressure.
2. All metal within 5 feet of pool water, and all pool equipment, must be bounded
to pool reinforcing steel with #8 solid copper wire. Niche light shell, deck Inserts,
etc. shall be bonded to pool rebar.
3. Pool equipment is not required to be set at this time.
Inspections 6.10:
1. Underground electric inspected prior to bacidilling.
2. Gas line test at 10# for 15 minutes with 15111 gauge.
3. When polyethylene gas piping is used, a certificate from a certified Installer
and tracer wire shell be provided per CPC 1210.1.7.2 APPENDIX I.
In3peetlons 1143-
1. Rough electric Inspection when all wiring N completed and ready prior to the
plastering of pool/spa. Potting compound In place at plastic tight niche.
2. Current Code requires that any pod, spa or water feature
contacting water 18 inches or more in depth shell be enclosed by a bonier
adequate to prevent entry of small children. The bonier shall comply with
Section 3109 of current CBC and CRC APPOENDIX V speWng the height of
any fence provided as barrier to the pod 6- shall be 6V above grade on the
outside of the fence.
3. Doom from a garage shall meet the requirements for a gate. Glass
windows within F of pool water shall be tempered glass.
4. Prior to pre -plaster Inspection, streets, curbs and city sidewalks will be
inspected for any damage due to construction of pod or spas.
5. Grading Complete with positive drainage to street or public way. All
exposed plastic pipe shall be painted to protect from sunlight
Inspections 14.18:
1. Gas and Electrical completely removed and 2x2 holes at bottom of pod
and/or Isolated elements.
2. Pool backfilled:
A.) With future build - selfeompadbp send 95% with receipt.
S.) No future build - any fill.
3. After pod is operating and In working condition with approved pool cover on
site.
INSPECTION REQUESTS
Inspection requests made prior to 5:00 pm Monday -Friday
will be scheduled on the following workday.
To schedule your building inspection online, please go to
httpsJ/aca.anaheim.neUCitizenAccess
Inspection can normally be reached between
7:30 - 8:00 A.M.
(714)765.5153 t 0
To access your inspection timeframe:
Please go to www.anaheim.net/building after 7:30am on the day of your
Inspection. Under Online Services, dick on the link "Inspection
Timeframes' or call (714) 765-5153 + 0
Permit Number: SWI2022-00108
Issued: 09/22/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 42
Site Address: 1974 W HARRIET LN, ANAHEIM, CA 92804
Legal Description: N TR 2031 BLK LOT 16
APN: 12844301
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765.5153
Project Description: Demolition: 612 sq ft pool with shell to remain with (2) 3X3 holes
People Associated with Project:
Permit Applicant KHANH HNGUYEN
Owner
NGO NGOC TUONG QUYEN
1974 W HARRIET LN
OWNER - BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License State Law for the following reason(s) Indicated below by the
checkmark(s) I have placed next to the applicable Item(s) (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to
construct, alter, Improve, demolish or repair any structure, prior to Its Issuance, also requires the applicant for the permit to file a signed statement that he
or she is licensed pursuant to the provisions of the Contractors' State License Law Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she Is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
E3 I, as owner of property, or my employees with wages as their sole compensation, will do (_) all or I` I portions of the work, and the structure is not
intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through
employees' or personal efforts, builds or Improves the property, provided that the Improvements are not Intended or offered for sale. If, however, the building or
13 I, as the owner of the property, am exclusively contracting with licensed Contractors to construct the project (Sec. 7044 Business and Professions Code:
The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for the projects with a licensed
Contractor pursuant to the Contractor's State License Lav$1.
1 am exempt from. licensurs under the Contractors, State License Law for the following reason:
Date Signature of Property Owner or Authorized Agent
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
0 1 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.
Q 1 have and will maintain workers compensation insurance, as required by Section 3700 of the tabor Code, for the performance of the work for which this
permit is issued. My workers Compensation insurance carder and policy are:
Cartier: Policy No.: Expiration Date:
Thi sctlon need not be completed If the permit Is for one hundred dollars ($100) or less.
I certify that in the performance of the work for which this pe rt 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, ifI scome subject to the workers compensation provisions of Section 3700 of the
LaborGodeJ abelllorthwith comply with those orovisions.
Date " r Signature of Applicant
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 CONSTRUCTION LENDING AGENCY 11 LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance
Lenders Information:
I hereby certify that I have read this application and state that the information above is correct. I agree
to comply with all city ordinances and state laws relating building construction, and hereby authorize
representives of this city to enter upon the above mentioned property for Inspection purposes.
Date Signature of Applicant or Agen
The premit 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.
I hereby afire under penalty of penury that I am
licensed under provisions of chapter 9 (commencing with
Section 7000)
io 3 of Divisof the Business and
Professions Code
Date: 9/22/2022
Contractor:
Number: SW12022-00108 Expiration Date
TYPE: B
Fees paid for Permit: $170.00