8250 E LADYFERN LNPermit Types
• BLD ELE MEC PLM
X
Permit Number: BLD2023-00363
Issued: 01/24/2023
www.anaheim.neUbuilding
(714)765-0626
Quarter Section: 220
Site Address: 8250 E LADYFERN LN, ANAHEIM, CA 92808
Legal Description: N TR 12992 BLK LOT 49
AFN:35438220
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Project Description: Reroof: Relay (32) sq It of existing tile over the entire house
Living Area: Number of Stories: 1 Valuation: 13,650.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire Spdnklered:
Cool Root: Total Fees paid for Permit: 707.77
People Associated with Project:
Owner JACOBS DOUG C II & STEPHANIE A 8250 E LADYFERN LN
Type Electrical Fixtures Qty Type Plumbing Fixtures City Mechanical Fixtures City
The perrrrlt 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 buildina until the final inspections have been made.
INSPECTION DATE I INSPECTOR
Do not pour concrete until the following applicable items have been signed:
Plumbing (Ground/Underfloor Drain Waste)
Electrical Ground Electrode/Ufer
Setback/Forms/Trenches (Footings)
Do not install subfloor or pour floor slab until the follwing applicable items have been
sinned:
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre -slab (Compaction/Membrane Reinf.)
Floor (JoisUGirders)
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 sianed7
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COAIMitagation Measures
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 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
FINAL INSPECTIONS
DATE I 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
Fire Sprinkler (ONLY) (714) 765-5041
Fire Dept. Final (714) 765-5041
Water Engineering (714) 765-4591
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
COA/Migation Measures
Building Final (714 765-5153)
Last Inspection -Final Only After Above Completed
Q
80�ZIAH
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
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 A
FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. S PROVIDED
I hereby affirm under penalty of pedury one of the following declarations:
Permit Types
I have and will maintain a certificate of consent to selMnsure 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 I have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the
I ` this permit is issued. My workees Compensation insurance carrier and policy are. work for which
Cartier: STATE COMPENSATION INSUR C cUNp Policy No.: 9316111 Expiration Date:22103
Name of Agent
Phone No.:
I certify that in the performance of the work for which this permit is issued, I shall not employ an
worker's compensation I of California, and agree that, it I should become subject to the worker's compensation provisions of Section 3700 of the
P oy y person in any manner so as to become subject to the
Labor Code, II th comply with those provisions,
ure of Applicant
Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby afire 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 aft Code, and my liceunder the penalty of Perjury that I am licensed under provisions.o
Professions Code, 9 (commencing with Section 7000) of Division 3 of the Business and
nse is in force and efect._--
,.r
I Sign to I
Date
NUMBER EXPIRATION DATE _
LICENSE_ jP icy
1089382 04/30/2024
C39