3430 E LA PALMA AVE (21)Permit Types
BLD ELE MEC PLM
X X X X
Permit Number: BLD2022-04925
Issued: 01/11/2023
www.anaheim..net/building
(714)765-0626 . '
Quarter Section: 150
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
17141 765-5153
Site Address: 3430 E LA PALMA AVE, ANAHEIM, CA 92806
Legal Description: P BK 363 PG 13 PAR 1 PM 363-13 PAR 1 AND POR ABAND
APN 34512126
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Project Description: Tenant Improvement: 204 sq. ft. to remodel existing medical biopsy room #1810 with new equipment and updated
electrical and plumbing fixtures on first floor for "Kaiser Permanente".
Living Area: Number of Stories: 6 Valuation: 45,000.00
Garage Area: Construction Types: IA
Carport Area: Occupancy Groups: B
Balcony/ Deck Area: Fire Sprinklered:
Cool Roof- Total Fees paid for Permit: 1,877.10
People Associated with Project:
Owner KAISER FOUNDATION HOSPITALS 1 KAISER PLZ 15TH FL
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty
Receptacle, switches, lights 12 Lavatory 1 Commercial System per 1,000 sq. ft. 1
P�Pt1EIM CqC
Cityof Anaheim o� �o
Building Division F i
�DGNDED �$y^
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 I _X11,010�
Mechanical Final
Cross Connection Control (714) 765-4280
Engineering Final (714) 765-5126
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/Migation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
si ne •
Building Final (714 765-5153)
Last Inspection-Final Only After Above Completed
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 sionede
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical 11q
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 X X X
Permit Number: BLD2022-04925
Issued: 01/11/2023
www.anaheim.net/building
(714)765-0626
Quarter Section: 150
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 3430 E LA PALMA AVE, ANAHEIM, CA 92806
Legal Description: P BK 363 PG 13 PAR 1 PM 363-13 PAR 1 AND POR ABAND
APN:34512126
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 selfoinsure for worker's compensation, issued by the Director of Industrial Relations as provided for by
Section 3700 of the tabor 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. DEPARTMENT rOF INDUSTRIAL RELATIONS Policy No.: 1053 Expiration Date:
Name of Agent: Phone No.:
I certify that In the performance 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 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.
Signature of Applicant
Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penalty of.pedury that there is a construction lending agency for the performance of the work for which this permit is Issued
(Sec.3097.Civ.C):
Lenders Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATI N-
I hereby affirm under the penalty of Perjury that I m licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code, an�license is in full fo and effect.
Date
NUMBER EXPIRATION DATE LICENSE TYPE (S)
370871 03/31/2023