2129 S VERN STPermit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-02165
Issued: 05/04/2023
www.anaheim.net/building
(714)765.4626
Quarter Section: 99
Site Address: 2129 S VERN ST, Anaheim, CA 92802
Legal Description: N TR 3916 BLK LOT 4
APN:13735108
CITY OF ANAHEIM
BUILDING DMSION
200 S. ANAHEIM BLVD.
(7141765-5153
Project Description: Retool: Remove existing to install (30) sq of composition shingles over the entire house and attached garage
Living Area: Number of Stories: 1 Valuation: 15,000.00
Garage Area: Construction Types: N!A
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinklered:
Cool Roof: Total Fees paid for Permit: 340.95
People Associated with Project:
Contractor HEXAGON ROOFING INC 21515 HAWTHORN BLVD #200 TORRANCE, CA
Permit Applicant Cesar Cebailos
Owner PRAM, KHANH CONG TR THE K 12002 MORRIE LN
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
FINAL INSPECTIONS
items below must be
DATE IINSPECTOR
before utilities are released
�UIIUIf19 UIVIUI0I1 Z
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Do not occupy this building until the final inspections have been made.
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/M' ation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
sioned7
Plumbing (Ground/Underfloor Water)
u ding Fin 1(714 765-5153)
n -Final Only Atter AbovCompleted
Underfloor Rough Gas
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre -slab (Compaction/Membrane Reinf.)
PARTIAL INSPECTIONS
Building 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 sianed:
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd Floor S
Mechanical Inspections
Sheathin aphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COAIMitagation Measures
Framing (Only after Plbg., Ele., Mec. & Fire)
Plumbing 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 (Strutt., Ele., or Mec.)
Grease Interceptor
fill unlPsr, Monad nffi
Sewer
Water Engineering Backflow (Testable Only)
Water Service
CITY OF ANAHEIM
BUILDING DEPARTMENT 2013 CALIFORNIA CODES
200 S. Anaheim Blvd., Suite 145 CODE Cyt IL ,
Anaheim, CA 92805 01/01/2014
714 765-5153 HFFE1 711'Aarr:
www.anaheini.net/building
SMOKE DETECTORS AND CARBON MONOXIDE SELF CERTIFICATION
k Final inspection approval will require this completed form to be on site along with the job card.
Permit Number: BLD2023-02165
2129 s Vern
Project address: Anaheim. CA 92802
Property Owner:
Khanh Pham
Date: 06/07/2023
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
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.
Cid 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
Signature:
attached garages require carbon monoxide detectors.
06/07/2023
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
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-02165
Issued: 05/04/2023
www.anaheim.nef/building
(714)765.4626
Quarter Section: 99
CITY OF ANAHEIM
BUILDING DMSION
200 S. ANAHEIM BLVD.
(7141 765 - 5153
Site Address: 2129 S VERN ST, Anaheim, CA 92802
Legal Description: N TR 3916 BLK LOT 4 Y;
APN:13735108 9.
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 Our 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
G - Cr this permit Is issued. My workers Compensation insurance carrier and policy are:
Carrier: STATE COMPENSATION INSURANCE FUND Policy No.: 9309158 Expiration Date: 1112412023
Name of Agent: ) c i x' - O Phone No.:
y
I certify that in the performance of the work for which this permit is Issued, l 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, I shall forthwith comply with those provisions.
5 N 2
Sign lure o Applica t Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penalty of peh jury 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:
Lender's 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.
Cont c(or Si n
NUMBER EXPIRATION DATE LICENSE TYPE ISl
1085614 01/31/2024 C39
S /(-// Z 23
Date