225 N RANCHITO STBUILDING DIVISION
CITY OF ANAHEIM
BUILDING DEPARTMENT 2016 CALIFORNIA CODES
CODE CYCLE
200 S. Anaheim Blvd., Suite 145 01/01/2017
Anaheim, CA 92805 EFFECT/VEDATE
714 765-5153
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:- Z r Date:
Project address:��
Property OWher:
The undersigned does her&y certify that I am the property owner of the above referenced
property. I further certify that smoke alarms and carbon monoxide alarms are present and
functional in all the following locations. All boxes must be checked below
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.
FSmoke Alarms: In each room used for sleeping purposes.
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 between
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 dwellinglic he garages require carbon monoxide detectors.
Signature: _ Date: 7-22-- Z1.3
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 FEB 2018
www.anaheim.net/building B842
SMOKE/ CO ALARM REQUIRED LOCATIONS
Family Room Bedroom
Dining
Living Room
Kitchen
Bedroo1;8edmom
Figure 1 Figure 2
'
Attic \
Bedroom Hall Bedroom
Living Room Hell Kitchen
64n
Basement
�I 4•
Ceilin la
Acceptable 4•
Here Never
Here ?��•
Top of Detector
Acceptable Here
Wall
Figure 4
Figure 3
REQUIRED SMOKE ALARM LOCATION
~J REQUIRED CARBON MONOXIDE ALARM LOCATION
Garage
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00822
Issued: 02/21/2023
www.anaheim.neUbuilding
(714)765.4626
Quarter Section: 32
Site Address: 225 N RANCHITO ST, ANAHEIM, CA 92801
�. A i fI .
1.6gal.;Deseription: N TR ;1569 BLK LOT 25
AP . 67118206 '
CITY OF ANAHEIM
BUILDING DIVISION
'240 S: ANAL BLVD.
(714) 765.5153
Project Description: Reroof. Overlay (1,6) sq of composition shingles over entire house and attached garage
Living Area: Number of Stories: 1 Valuation: 61500.00
Garage Area: Construction Types. NIA
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire Spdnldered:
Cool Roca Total Fear) paid for permit: 339.85
People Associated with Project:
Contractor ROCKET ROOFING 39991 FALCON WAY20211OD41245515418 MURRIETA, CA 92562
Permit Applicant Patrick Gault
Owner TIMCHALK JOHN 12697 JALEPENO AVE
Type Electrical Fbdures 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.
P�PNEIM �q<
City of Anaheim o� io
Building Division F z
u >
�DGNDED day^
Do not occupy this buildinq 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
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/Mjqgtiaq Measures A.
Do not install subfloor or pour floor slab until the follwing applicable items have been
s' e •
wilding Fina (714 765-5153)(%
Last Inspe n -Final Only Ager Above Completed —16
,gs
Plumbing (GroundlUnderfloor 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
ens' e•
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd
cof (Sheathin iaphragm/Frame)
WMMrn-ry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
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
(Do nnt backfill unless Maned off)
Sewer
Water Engineering Backflow, (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
X
Permit NuWe�: BLB2023-00822
Issued: 02/21/2023
www.anaheim.net/building
(714)7654626
Quarter Section: 32
Site Address: 225 N RANCHITO ST, ANAHEIM, CA 92801
Legal Description: N TR 1569 BLK LOT 25
APN:07118206
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
.firms..
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 self -Insure for workers 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 workers 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:
Carrier. STATE NATIONAL INSURANCE COMPANY INC Policy No.: CWC719491378 Expiration Date: 11112023
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 compen on laws of California, and agree that, if I should become subject to the workers compensation provisions of Section 3700 of the
r , I sh 1 th se rovisions.
ure 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):
Lenders Name:
Lender's Address:
LICENSED CONTRACTOR'S DECLARATION:
I hereby affirm under the Ity of Perjury that isemsedvnderprovisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Prole Co nd m li se Is in force and effect.
ZZI 2�
Contractor Signature Date
NUMBER EXPIRATION DATE LICENSE TYPE (Sl
1068508 09/30/2022 C39