1135 N WEST ST (5)Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00613
Issued: 02/06/2023
www.anaheirnmet/building
(714)765-0626
Quarter Section: 60
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
1714) 76S - S1 S3
Site Address:.1135 N WEST ST, ANAHEIM, CA 92801
Legal Deiehiiition; S TWP 4 RGE 10 SEC 4:SEC 4 T 4 R 10 POR OF SEC
APNc 27.106120
Project Description: Reroof: Remove existing to install (27) sq of flat roof hot mop over entire building
Living Area: Number of Stories: 2 Valuation: 14,800.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinklered:
Cool Roof: Total Fees paid for Pem►It: 340.92
People Associated with Project:
Contractor DALES ROOFING INC 428 N BATAVIA ST ORANGE, CA 92843
Permit Applicant Javier Cuellar
Owner GREENFIELDSIDE LLC PO BOX 2012
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures aty
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�PptE1M Cq<
Cityof Anaheim D� io
Building Division X z
U a
�DVNDE0 ��y�
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 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 ElectrodelUfer
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
Setback/Forms/Trenches (Footings)
COA/Migation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
si ne 0!��ng:Fi�nal(714
Plumbing (Ground/Underfloor Water)
765-51 )
my After Above Completed — 2
Underfloor Rough Gas
Mechanical (Groundwork) I
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
les
PARTIAL INSPECTIONS
Buildinq Inspections
Floor (Joist/Girders)
Underfloor Insulation (Raised Foundation Only)
Floor Nailing (Raised Foundatibn Only)
2nd Floor (Floor Nailing)
Do not cover or conceal the work below until the following applicable items have
been si n d:
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2%.r
Mechanical Inspections
oof (Sheathing)Diaphragm/Frame)
ryReinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation 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 (Struct., Ele., or Mec.)
Grease Interceptor
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00613
Issued: 02/06/2023
www.Anaheim.net/building
(714)765-4626
Quarter Section: 60
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 1135 N WEST ST, ANAHEIM, CA 92801
Legal Description: S TWP 4 RGE 10 SEC_ 4 SEC 4 T 4 R 10 POR OF SEC
APN:27106120
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.
1 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
J C 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 worker's Compensation insurance carrier and policy are:
Cartier. STATE COMPENSATION INSURANCE FUND Policy No.: 9325167 Expiration Date: 10/1/2023
Name of Agent: Phone No.:
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 worker's compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
gnature of Applicant Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penally 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
Profess ns Code, and my license Is in full force and effect.
523
Cot ctor Signature Date
NUMBER EXPIRATION DATE LICENSE TYPE IS
1035435 01/3112024 C39