607 W PROVENTIAL DR 1-12Permit Types
BLDELE MEC PLM
X
Permit Number: BLD2023-01621
Issued: 04/06/2023
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
www.anaheim.net/building
(714)765.4626
Quarter Section: 74
Sits Address: 607 W PROVENTIAL DR 1-12, ANAHEIM, CA 92805
Legal Description: P BK 133 PG 40 PAR 1 P M 133-40 PAR 1 AND PAR 2
APN: 03618344
Project Description: Re -roof: tear -off existing and Install (79) sq of class A composition shingles ( Units 10:1-12).
Living Area: Number of Stories: 2 Valuation: 47,360.00
Garape Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire SpdnMered:
Cool Roof: Total Fees paid for Permit: 462.26
People Associated with project:
Contractor MIDWEST ROOFING CO INC 1305 WEST 132ND STREET GARDENA, CA 90247
Permit Applicant Kevin H.
Owner MITCHELL KATHRYN C TR 2912 DAIMLER ST
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 penult Is required to commence or continue work.
City of Anaheim
Building Division
Do not occupy this building until the final inspections have been made.
INSPECTION I 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
Mane&
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 seaneds
lot Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd Floor Shear
Roo( Sheathing iaphragmlFrame)
Masonry (Reinf./Bond Beam/Pre-Grout) for
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
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
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BUILDING DIVISION
Com• OF ANAHEW
BURMUM DEPARTS 2016 CALVORMA CODES
200&AnahrimMY&5rrfte 145 r=trtZ
Anaadm, CA 92805 01/01/201.7
714765-:1S3 rrF�ctrrrL►ssc
vrwWA0MhVl=t/6uiEtilns
SMIOKE DETECTORS AMD CARBON MONOXIDE SELF cmnmCATIOM
• Fired hMP:dh rl EV rckd grill MQUI o Oft PRmptetcd form to ba aite.glana virtu ft job cut.
Permit Number. 5 LD2Q2.3 rel um Bate: M UT 2��_
Project address: LQO f w . YrOV e Al 11riye
Property Owner M AVCk% t\ 9NYI Z- A, UQ A-V\�
The undersigned does hereby ceriity that I am the property owner of the above referenced
property. 1 further certify that smoke alarms and carbon monoxide alarms are present and
functional In all the following locations. All boxes must be checked below
a''Smoke Alarms and Carbon Monoxide Alarm: On the telling or wain outside of each separate
steeping area in -the immediate vicinity of bedrooms or in each hallway outside of the moms..
CQ-trnoke Alarms: In each room used forsleeping purposes.
tr"SMake Alarm and Carbon Monoxide Alarm: In each story, induding any habitable basement;
(Note: in dwellings or dwelling units with split levels and without an intervening door between
the adjacent levels, a smoke alarm and a carbon monoxide detector installed on the upper level
shall suffice for the adjacent lower levet provided that the lower level is less than one full story
below the upper level.)
All dwelling un" r>� aftached
Signature:
monariide detectors.
California Residential Code (CRC) Section R314.6.24RC 83152 states in part that e&ang dwellings be
'retrofitted with smoke detectors and c.9rbon monoxide detectors when a building permit is issued far work on or
In a building that is valued at S1,000 or more' CRC Section 8314.3, CRC 8315.2 defines required locations as
Indicted above.
NOT& This Ceriigtion is ordy used when norma) access to the Interior of the dwelling by the City of Anaheim
Inspector isnot achieved during the course of project consMvoon. it is normally used for exterior projects such
as re foofing, re -siding, patio covers, solar photovoltaic installations, and sirrillar exterior construction work.
20 5. Atter► 8W.,.Wb 145 AMft", C stb 826E (714)!65-6153 Phone (714) " $07 Ft& M-4018
'.t.� 18842
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-01621
Issued: 04/06/2023
www.anaheim.net/building
(714)765.4626
Quarter Section: 74
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 607 W PROVENTIAL DR 1-12, ANAHEIM, CA 92805
Legal Description: P BK 133 PG 40 PAR 1 P M 133-40 PAR 1 AND PAR 2
APN: 03618344
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 seHinsure 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 workers Compensation insurance carrier and policy are:
Cartier. AMERICAN ZURICH INSURANCE COMPANY Policy No.: WC169089101 Expiration Date: 12/31/2023
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
workers compensation laws of California, and agree that, N I should become subject to the workers compensation provisions of Section 3700 of the
C i�LabO all forthwith comply with those provisions.
Signature of Applicant 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):
Lender's Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATION:
I hereby affirm under the penalty of Perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Divlslon 3 of the Business and
Professions Code, and my Il se Is in full force and effect
Con rector Signature
NUMBER EXPIRATION DATE
769615 10/31/2023
4y
Z.3
Date
LICENSE TYPE IS)
C39, C39, C39, C39, C39, C39, C39, C39, C39, C39, C39, C39,024, D24, D24, D24, D24, D24, D24, D24, D24, D24, D24, D24