1906 W WOODWORTH RDCity of Anaheim
BUILDING DIVISION
INSPECTION RECORD
Go SWIMMING POOL
ADDRESS:
1906 W WOODWORTH RD, Anaheim, CA 92804
OWNER:
LEE ANDY K
PERMIT#:
SWI2022-00121
DATE ISSUED:
10/19/2022
DESCRIPTION:
Demolition: 380 sq ft pool to be demolished with shell
DO NOT GUNITE ROCK STRUCTURE
(water feature, rock slide, fountain, waterfall, grotto etc.) until the above inspection has
been signed.
to remain with (3) 3X3 holes
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE ON THE JOB SITE
Inspection Code Date Inspector
1. Main Drain 504
2. Electric Bonding 506
3. Steel 508
4. Approval to Gunite 510
DO NOT GUNITE POOUSPA
until all the above inspections have been signed.
5. BLD -Steel and Electric bonding.
(Rock Structures,Slides Etc)
508
DO NOT GUNITE ROCK STRUCTURE
(water feature, rock slide, fountain, waterfall, grotto etc.) until the above inspection has
been signed.
6. Underground Electric-` " ' - -
512-
12--7.
7.Gas Piping Test
514
8. P -Trap Receptor
516
9. Backflow
518
10. Deck, Deck Drains,
Equipotential & Accessory
Bonding
520
DO NOT POUR FLATWORK
until all the above inspections have been signed.
11. Rough Electrical 522
12. Fencing/Door Alarms 524
13. Plaster approval 526
DO NOT PLASTER
until all the above Inspections have been signed.
14. Final Electric 528
Sub -Contractors List MUST be approved and pool cover on site
PRIOR to Pool Final Inspection request
FINAL INSPECTION CODEDATE INSPECTOR
15. Rough Demo 527
16. Final 599 .. �j
MISC. INSPECTIONS Date Inspector
fbldjobcords
Inspections 14:
1. All plumbing to be completed and the system pressurized to 35 lbs. with water
or house pressure.
2. All metal within 5 feet of pool water, and all pool equipment, must be bounded
to pool reinforcing steel with #8 solid copper wire. Niche light shell, deck Inserts,
etc. shall be bonded to pool rebar.
3. Pool equipment Is not required to be set at this time.
Inspections 6.10:
1. Underground electric Inspected prior to backfilling.
2. Gas line test at 100 for 15 minutes with 150 gauge.
3. When polyethylene gas piping Is used, a cergOcate from a certified installer
and tracer wire shall be provided per CPC 1210.1.7.2 APPENDIX 1.
Inspections 11.13:
1. Rough electric inspection when all wiring is completed and ready prior to the
plastering of poollspa. Potting compound In place at plastic light niche.
2. Current Code requires that any pool, spa or water feature
contacting water 18 inches or more In depth shall be enclosed by a bonier
adequate to prevent entry of small children. The border shall comply with
Section 3109 of current CBC and CRC APPDENDIX V specifying the height of
any fence provided as bander to the pool 8,- shall be 60' above grade on the
outside of the fence.
3. Doors from a garage shall meet the requirements for a gate. Glass
windows within V of pool water shall be tempered glass.
4. Prior to prelloster inspection, streets, curbs and city sidewalks will be
Inspected for any damage due to construction of pool or spas.
5. Grading complete with positive drainage to street or public way. All
exposed plastic pipe shall be painted to protect from sunlight
Inspections 14.16:
1. Gas and Electrical completely removed and 2x2 holes at bottom of pool
and/or Isolated elements.
2. Pool back Bled:
A.) with future build - seg -compacting sand 95% with reeelpt
B.) No future build - any fill.
3. After pool Is operating and In working condition with approved pool cover on
site.
INSPECTION REQUESTS
Inspection requests made prior to 5:00 pm Monday - Friday
will be scheduled on the following workday.
To schedule your building Inspection online, please go to
httpsJ/aca.anaheim.net/CilizenAccess
Inspection can normally be reached between
7:30 - 8:00 A.M.
(714)7655153 + 0
To access your inspection timeframe:
Please go to www.anaheim.net/building after 7.30am on the day of your
Inspection. Under Online Services, dick an the link "Inspection
Timeframes' or call (714) 7655153 + 0
CITY OF ANAHEIM
Permit Number: SW12022.00121
Issued: 10/19/2022
www.anaheim.net/building
(714)765-1626
Quarter Section: 42
Site Address: 1906 W WOODWORTH RD, Anaheim, CA 92804
Legal Description: N TR 3882 BLK LOT 20
APN: 12861315
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 -5153
Project Description: Demolition: 380 sq It pool to be demolished with shell to remain with (3) 3X3 holes
People Associated with Project:
Permit Applicant Benjamin Abbott 10182 Dakota Ave Anaheim, CA 92805
Owner
LEE ANDY K
1906 W WOODWORTH RD
OWNER - BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Law for the following reason(s) Indicated below by the
checkmark(s) I have placed next to the applicable Item(s) (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to
construct, after, Improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for the permit to file a signed statement that he
or she is licensed pursuant to the provisions of the Contractors' State License Law Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
13 I, as owner of property, or my employees with wages as their sole compensation, will do U all or"portions of the work, and the structure is not
intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractors' State License law does not apply to an owner of property who, through
employees' or personal efforts, builds or improves the property, provided that the Improvements are not Intended or offered for sale. If, however, the building or
0 I, as the owner of the property, am exclusively contracting with licensed Contractors to construct the project (Sec. 7044 Business and Professions Code:
The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for the projects with a licensed
Contractor oursuent to the Contractor's State License Law).
I am exempt from licensure under the Contractors, State License Law for the following reason:
Date Signature of Property Owner or Authorized Agent
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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.
ATI 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
hermit is issued. My workers Compensation Insurance carrier and policy are:
Carrier. STATE COMPENSATION INSURANCE FUND Policy No.: 9292872 Expiration Date:
This section need not be completed 9 the permit Is for one hundred dollars ($100) or less.
❑ I certify that in the performance of coo r 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 agrethat, If I should become subject to the worker's compensation provisions of Section 3700 of the
forthwith comoji with
WARNING: FAILURE TO SECgRE�(69K—ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE NONDRED 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.
CONSTRUCTION LENDING AGENCY LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing with
Lenders Information:
Section 7000) of Division 3 of the Business and
I hereby certify that 1 have read this application and state that the Information above is correct. I agree Professions Code.
to comply with all city ordinances and state laws relating building construction, and hereby authorize
representives of this city to enter upon the above mentioned property for inspection purposes. Date: 19@022
Contractor.
Number: SWI2022-00121 Expiration Date 2/18/2023
Date Signature of Applicant or Agen
The premit 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.
TYPE: A. B
Fees paid for Permit: $170.00