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520 N RIO VISTA STCITY OF ANAHEIM BUILDING DEPARTMENT 2013 CALIFORNIA CODES 200 S. Anaheim Blvd., Suite 145 CODE Anaheim, CA 92805 01/01/2014 714 765-5153 EFFECTIVE DATE 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: WA ;oz - Date: 2- _ H ZU Project address: 5 G N, iib Vfo 5-r Ur iT .0 A - Property Owner: '� �--C V -e f�M .�G i-• l The undersigned does hereby 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 13 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. IZ Smoke Alarms: In each room used for sleeping purposes. R 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 dwelling units wit attached garages require carbon monoxide detectors. ��ASignature:4� Date: 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., Sulte 145 Anaheim, Califomia 92805 (714)765-5153 Phone (714)765.4607 Fax SEPT 2015 www.anaheim.netlbuilding B842 CITY OF ANAHEIM BUILDING DIVISION BUILDING DEPARTMENT 2013 CALIFORNIA CODES 200 S. Anaheim Blvd, Suite 145 CODE CYCLE Anaheim, CA 92805 01/01/2014 714 765-5153 EMCTNE DATE www.an2heim.net/building SMOKE DETECTORS AND CARBON MONOXIDE SELF CERTIFICATION * Final inspection approval will require this completed form to be on site along with the Jol card. Permit Number: 1310 aoaa -o55a-5 Date: 3 / 2,5 - Project 3Project address: 5.20 N. PPp Vl'SU Sfi (J11[t A Property Owner: �L/� J o The undersigned does hereby certify that 1 am the operty 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 P/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. a" smoke 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 dwelling units with Signature: garages require carbon monoxide J111 --7J California Residential Code (CRCKSection 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. 200S. Anaheim Blvd., Suite 145 Anaheim, California 92805 (714)765-5153 Phone (714)765-4607 Fax SEPT 2015 www.anaheim.netibuilding B842 CITY OF ANAHEIM BUILDING DEPARTMENT 2013 CALIFORNIA CODES YCLE 200 S. Anaheim Blvd. Suite 145 CODE Anaheim, CA 92805 01/01/2001414 EFFEC77VE DATE 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: .914 ao�), _ 0552-3 Date Project address: ?d D N -& V Y5 -N4 5t (� Property Owner: The undersigned does hereb 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 12 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. © Smoke 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 an a carbon monoxide detector installed on the upper level shall suffice for the adjacent lower le el provided that the lower level is less than one full story below•the upper level.) I dwelling units with attached g r ges require carbon monoxide detectors. gnature: Dater California Residential Code (R S t' n R314.6.2,CRC R315.2 States in part that existing dwellings be "retrofitted with smoke detecto d car on monoxide detectors when a building permit is issued for work on or in a building that is valued at $V,00 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.neVbuilding 8842 Permit Types BLD ELE MEC PLM X Permit Number: BLD2022-05523 Issued: 11/18/2022 www.anaheim.net/building (714)765-0626 Quarter Section: 133 CITY OF ANAHEIM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714)765-5153 YSIte Address:,520,N RIO. VISTA ST, ANAHEIM, CA 92806 T Legal.DescriWin: N TR 7218 BL'K LOT.UN HOLD APN-26817101 Project Description: Reroof: Tear off existing material to install (3,500) sq It of torched down over flat area for entire building (Units A, B, and C) Living Area: Number of Stories: 2 Valuation: 29,000.00 Garage Area: Construction Typea: NIA Carport Area: Occupancy Groups: Balcony I Deck Area: Fire Sprinklered: No Cool Roof: Total Fees paid for Permit: 364.77 People Associated w@h Project: Permit Applicant Luis Rios Owner HOLD PARCEL Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty, 0 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 CqC City of Anaheim o� io Building Division F i u a �o�NpEo �ay1 Do not occupy this building 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 DATE I 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) COAT Measures Do not install subfloor or pour floor slab until the follwing applicable items have been signed: Plumbing (Ground/Underfloor Water)11 Building Final 14 765-5153) • inal Only After Above Compl ted Underfloor Rough Gas Mechanical (Groundwork) Electrical (Underground Conduit) Pre-slab (Compaction/Membrane Reinf.) PARTIAL INSPECTIONS Buildinq Inspections 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 sionedi let Floor Shear Firesprinkler (Rough) (Fire Dept.) earheathingl Mechanical Inspections �MdF(Sor- 'aphragm/Frame) MElonry em . and Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Duct (Mechanical) Rough Mechanical Rough Electrical Rough COA/Mitagation Measures Framing (Only after Plbg., Ele., Mac. & Fire) Plumbinq Inspections 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 Sewer. Water Engineering Backflow (Testable Only) Water Service Permit Types BLD ELE MEWa- Permit X Number: BLD2022-05523 Issued: 11/18/2022 www.anaheim.net/building (714)765-4626 Quarter Section: 133 Site Address: 520 N RIO VISTA ST, ANAHEIM, CA 92806 Legal Description: N TR 7218 BLK LOT UN HOLD APN: 26817101 CITY OF ANAHEIM BUILDING DIVISION 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 ($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 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. LI 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: MIDWEST EMPLOYERS CASUALTY COMPANY Policy No.: ONUWC0155980 Expiration Date: 1/18/2023 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, if I should become subject to the workers compensation provisions of Section 3700 of the Labor Code, l shall forthwith comply with those provisions. Si nature of Applicant zx l8- 2 Z Date DECLARATION REGARDING CONSTRUCTION LENDING AGENCY: I 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 I 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 effect. C or ure Date NUMBER EXPIRATION DATE LICENSE TYPE ISI 1048449 01/31/2023 B. C39