1079 S MATTHEW WAYPOST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE ON THE JOB SITE
Inspection Code Date Inspector
City of Anaheim
2. Electric Bonding 506 IVY I
BUILDING DIVISION
4. Approval to Gunite 510
INSPECTION RECORD
5. BLD -Steel and Electric bonding
(Rock Structures,Slides Etc)
SWIMMING POOL
ADDRESS:
1079 S MATTHEW WAY, ANAHEIM, CA 92808
OWNER:
LUNDQUIST TYSON & TRACEY
PERMIT #:
SWI2022-00033
DATE ISSUED:
04/01/2022
DESCRIPTION:
New Pool/Spa: Pool 340 sq.ft , spa 48 sq.ft, with fire
516
pit and gas stub.
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 IVY I
3. Steel 508
4. Approval to Gunite 510
DO NOT GUNITE POOUSPA
until all the above inspections have been signed.
5. BLD -Steel and Electric bonding
(Rock Structures,Slides Etc)
508
DO NOT GUNITE ROCK STRUCTURE
(water feature, rock slide, fountain, waterfall, grotto etc.) urdil the above inspection has
been signed.
6. Underground Electric
512
2
7. Gas Piping Test
514
8. P -Trap Receptor
516
2
9. Backflow
518
10. Deck, Deck Drains,
Equipotential &Accessory
Bondino
520
�p f 16)
DO NOT POUR FLATWORK
until all the above inspections have been signed.
11. Rough Electrical 522 �V
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
EDATEINSPECTOR
15. Rough Demo 527
16. Final 599
MISC. INSPECTIONS Date Inspector
fbldjobcards
Insosctions 1S•
1. All plumbing to be completed and the system pressurized to 35 lbs. with water
or house pressure.
2. All metal within 5 feel of pool water, and all pool equipment, must be bonnded
to pool reinforcing steel with #8 solid copper wire. Niche light shell, deck Inserts,
etc. shall be bonded to pool reber.
3. Pool equipment is not required to be set at this time.
Inspedipns 6.10•
1. Underground electric Inspected prior to backfilling.
2. Gas line test at 100 for 15 minutes with 150 gauge.
3. When polyethylene gas piping Is used, a certificate from a certified installer
and tracer wire shall be provided per CPC 1210.1.7.2 APPENDIX I.
Inspections 1143:
1. Rough electric inspection when all wiring is completed and ready prior to the
plastering of poollspa. Potting compound in place at plastic light niche.
2. Current Code requires that any pool, spa or water feature
contacting water 18 Inches or more in depth shall be enclosed by a barrier
adequate to prevent entry of small children. The bonier shall comply with
Section 3109 of current CBC and CRC APPDENDIX V specifying the height of
any fence provided as bonier to the pool &- shall be 60- above grade on the
outside of the fence.
3. Doors from a garage shall meet the requirements for a gate. Glass
windows within 5' 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 pool 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 1416: 1
1. Gas and Electrical completely removed and 2x2 holes at bottom of pool
and/or Isolated elements.
2. Pool baddilled:
A.) with future build - self -compacting sand 95% with receipt.
B.) No future build - any 911.
3. After pool 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.neUCiUzenAccess
Inspection can normally be reached between
7:30 - 8:00 A.M.
(714)765.5153 + 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'Inspedion
Timeframes' or call (714) 765.5153 + 0
CITY OF ANAHEIM
Permit Number: SW12022-00033
Issued: 04/01/2022
www.anaheim.net/building
(714)765-0626
Quarter Section: 215
Site Address: 1079 S MATTHEW WAY, ANAHEIM, CA 92808
Legal Description: N TR 12686 BLK LOT 72
APN:35657325
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Project Description: New Pool/Spa: Pool 340 sq.ft , spa 48 sq.ft, with fire pit and gas stub.
People Associated with Project:
Contractor 0 C POOLSCAPES INC 3107 CITY LIGHTS DRIVE ALISO VIEJO, CA 92656
Permit Applicant Ingrid Andrade
Owner LUNDQUIST TYSON & TRACEY 1079 S MATTHEW WAY
OWNER - BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's 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 spy 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).
13 I, as owner of property, or my employees with wages as their sole compensation, will do"all or U 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
0 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 oursuant to the Contractor's State License Law).
I am exempt from licensure 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:
❑ 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.
PL 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 carder and policy are:
Cartier: WESCO INSURANCE COMPANY Policy No.: WWC3543211 Expiration Date: 6/30/20
This section need not be completed If the permit Is for one hundred dollars ($100) or less.
❑ 1 certify that in the performance of the work for which this pe t 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, if I sh b Ime subject to the workers compensation provisions of Section 3700 of the
Labor Code. I shall forthwith comDly with those orovisions.
Signature of
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION bOVERAGE 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 ATTORNEYS 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
Lender's 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 affirm under penalty of perjury that I am
licensed under provisions of ch h r 9 (commencing with
Section 7000) of Division 3of a iness and
Professions Code.
Date: 04/01/102:
Contractor:
Number: SWI2022-00033 Expiration Date 6/30/2022
TYPE: C53
Fees paid for Permit: $1,102.50