920 S MICHAEL WAY,._
,(
CITY OF ANAHEIM
_ _L.DING DIVISION
BUILDING DEPARTMENT 2013 CALIFORNIA CODES
200 S. Anaheim Blvd., Suite 1.45 CODEC)'CLE
Anaheim, CA 92805 01/01/2014
714 765-5153 EFFFMIS 2ATF.
www.anaheim.net/building
SMOKE DETECTORS AND CARBON MONOXIDE SELF CERTIFICATION
• Final Inspection approval will require this completed form to be on site along with the job card.
Permit Number: &D -LQ 2-
1-0422-1 Date: —
Project address: q 2 n. s- M I c H �-1P L WPM
Property Owner: I V I I U 1111 t L JOWL -3
The undersigned does hereby certify that I am the property owner of the
property. I further certify that smoke alarms and carbon monoxide alarms
functional in all the following locations. All boxes must be checked below
above referenced
are present and
qd Smoke Alarms and Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
sleeping area in the immediate vicinity of bedroom/s or in each hallway outside of the rooms.
IR/Smoke Alarms: In each room used for sleeping purposes.
Ig Smoke Alarm and Carbon Monoxide Alarm: In each story, including any habitable basement;
(Note: in dwellings or dwelling units with split levels and without an intervening door be
the adjacent levels, a smoke alarm and a carbon monoxide detector installed on the upper level
shall suffice for the adjacent lower level provided that the lower level is less than one full story
below the upper level.)
All dwelling units with attached garages require carbon monoxide detectors.
Signature:
California Residential Code (CRC) Section R314.6.2,CRC R315.2 States in part that existing dwellings be
"retrofitted with smoke detectors and carbon monoxide detectors when a building permit is issued for work on or
in a building that is valued at $1,000 or more." CRC Section R314.3, CRC R315.2 defines required locations as
indicted above.
NOTE: This certification is only used when normal access to the interior of the dwelling by the City of Anaheim
Inspector is not achieved during the course of project construction. It is normally used for exterior projects such
as re -roofing, re -siding, patio covers, solar photovoltaic installations, and similar exterior construction work.
200 S. Anaheim Blvd., Suite 145 Anaheim, California 92805 (714)765-5153 Phone (714)765-4607 Fax SEPT 2015
www.anaheim.net/building B842
i
SMOKE/ CO ALARM REQUIRED LOCATIONS
Figure 1
6
Bedroom
Attic
N(1
mvc-e
Living Room "t
Basement
Family Room Bedroom
Dining
Living Room
I Kitchen
BedroomBedroom
I ff
Figure 2
6)
Bedroom
Kitchen
Figure 3
REQUIRED SMOKE ALARM LOCATION
REQUIRED CARBON MONOXIDE ALARM LOCATION
�a•
Ceiling
1
- Q
Acceptable 1 4•
Never
Here Here T
Top of Detector
Acceptable Here
Wall
Garage
Figure 4
Permit Types
BLD 9LE MEC PLM
X
Permit Number: BLD202244821
Issued: 10/11/2022
www.anaheim.net/building
(714)76511626
Quarter Section: 96
Site Address: 920 S MICHAEL WAY, ANAHEIM, CA 92805
Legal 'Description: N TR 8758 BLK LOT 4
APN: 23401204
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD
(714) 765 - 5163'
1
M
Project Description: Reroof: Remove existing to install (21) sq of composition shingles over entire house and attached garage
Living Area: Number of Stories: 1 Valuation: 28,000.00
Garage Area: Constnkdon Types: VB
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Spdnklered:
Cool Roof Total Fees paid for Permit: 343.64
People Associated with Project:
Permit Applicant Joel Ortiz
Owner JONES NORMA SUE TR PO BOX 11668
Type Electrical Fixtures Qty 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.
City of Anaheim
Building Division
Do not occupy this buildinq until the final inspections have been made.
INSPECTION DATE 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
si ned:
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
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.)
2nd Floor Shear
oof (S eathing)iaphragmlFrame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation 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 I DATE 'INSP9CTOR
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)
Inspection -Final Only After Above Completed
+ 1 Ax
lJ'
�1Last U�Iw.
PARTIAL INSPECTIONS
Buildinq Inspections
Mechanical Inspections
Plumbinq Inspections
Electrical Inspections
Permit Types _
BLD ELE MEC PLM
X
Permit Number: BLD2022-048.21
Issued: 10/11/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 95
Site Address: 920 S MICHAEL WAY, ANAHEIM, CA 92805
Legal Description: N TR 8758 BLK LOT 4
APN:23401204
CITY OF ANAHEIM
BUILDING DMSION
200 S. ANAHEIM BLVD.
(7141 765 - 5153
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 ($700,000), 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 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 COMPENSATION INSURANCE FUND Policy No.: 1949902 Expiration Date: 12/1/2022
Name of Agent: Phone No.:
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 became subject to the worker's compensation provisions of Section 3700 of the
Labor Code, l shall forthwith comply with those provisions.
Sig;r of Applicant
lei,f
Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
1 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):
Lenders Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATION:
I hereby affirm under the penalty of Perjury that 1 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 eftecL
�w ae��
71tradtor Signature
NUMBER EXPIRATION DATE LICENSE TYPE ISl
956843 01/31/2023 C39
Date