5369 E WILLOWICK DR (2)City of Anaheim
BUILDING DIVISION
INSPECTION RECORD
19 SWIMMING POOL
ADDRESS:
5369 E WILLOWICK DR, ANAHEIM, CA 92807
OWNER:
DUONG VICTORIA VAN
PERMITM
SWI2022-00034
DATE ISSUED:
09112/2022
DESCRIPTION:
New Pool/Spa: 552 sq ft gunite pool and 74 sq It
DO NOT GUNITE ROCK STRUCTURE
(water feature, rock slide, fountain, waterfall, grotto etc.) until the above inspection has
been signed. _
gunite spa.
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 -Steell and Electrc 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
y
7. Gas Piping Test
514
2%[ /23
4
8. P -Trap Receptor
516
t 2
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9. Backflow
518
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_
10. Deck, Deck Drains,
Equipotential 8 Accessory
Bo dino
520
LTL
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DO NOT POUR FLATWORK
until all the above inspections have been signed.
11. Rough Electrical 522
1 en ' oor Ala 524
13. Plaster approval 526
DO NOT PLASTER
until all the above Inspections have been signed.
14. Final Electric 528 3 10 23
Sub -Contractors List MUST be approved and pool cover on site
PRIOR to Pool Final inspection request
FINAL INSPECTION CODE DATE INSPECTOR
15. Rough Demo 527
16. Final 599. /,, /u
MISC. INSPECTIONS' Date Inspector
fbldjobcards
Inspections 1.5•
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 pod equipment, must be bonded
to pool reinforcing steel with 98 solid copper wire. Niche light shell, deck Inserts,
etc. shag be bonded to pool rebar.
3. Pool equipment is not required to be set at this time.
Inspections 0.10:
1. Underground electric Inspected prior to baddilling.
2. Gas line test at 109 for 15 minutes with 159 gauge.
3. When polyethylene gas piping is used, a cerggcate from a certified Installer
and tracer wire shell be provided per CPC 1210.1.7.2 APPENDIX I.
Inspections 11.13:
1. Rough electric Inspection when all widng Is completed and ready prior to the
plastering of pod/spa. Potting compound in place at plastic light niche.
2. Current Code requires that any pod, spa or water feature
contacting water 18 Inches or more in depth shall be enclosed by a barrier
adequate to prevent entry of small children. The barrier shall comply with
Section 3109 of current CBC and CRC APPDENDIX V specifying the height of
any fence provided as border to the pool &- shall be Sr above grade on the
outside of the fence.
3. Doors from a garage shall most the requirements for a gate. Glass
windows within 5' of pool water shell be tempered glass.
4. Prior to paster 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 pod
andfor lactated elements.
2. Pool baddilled:
A.) With future build - self -compacting send 95% with recelpL
S.) 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
https9laca.anaheim.neUCitizenAccess
Inspection can normally be reached between
7:30 - 8:00 A.M.
(714)765.5153 + 0
To access your Inspection timeframe:
Please go to www.anaheim.nelibullding after 7:30am on the day of your
Inspection. Under Online Services, dick on the link -Inspection
Timeframes' or call (714) 765.5153 + 0
CITY OF ANAHEIM
Permit Number: SW12022-00034
Issued: 09/22/2022
www.anaheim.neUbuilding
(714)765-0626
Quarter Section: 181
Site Address: 5369 E WILLOWICK DR, ANAHEIM, CA 92807
Legal Description: N TR 7567 BLK LOT 27
APN:36315123
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 -5153
Project Description: New Pool/Spa: 552 sq ft gunite pool and 74 sq ft gunite spa.
People Associated with Project:
Permit Applicant Aaron Holder
Owner
DUONG VICTORIA VAN
5753 E SANTA ANA CANYON G545
OWNER - BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License State Law for the following reason(s) indicated below by the
checkmerk(s) I have placed next to the applicable Items) (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to
construct, alter, Improve, demolish or repair any structure, prior to Its Issuance, also requires the applicant for the permit to foe 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 1, as owner of property, or my employees with wages as their sole compensation, will do (__J 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 oursuant to the Contractors State License Lawl.
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 peri'ury one of the following declarations:
Fve and will maintain a certificate of consent to self Insure for workers compensation, Issued by the Director of Industrial Relations as provided for by
700 of the Labor Code, for the performance of the work for which this permit is issued.
ve 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 carder and policy are:
Cartier. EMPLOYERS PREFERRED INSURANCE COMPANY Policy No.: EIG282852703 Exp
This section need not be completed If the permit la for one hundred dollars ($100) or less.
❑ 1 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
compensation laws of California, and a0ee that, If I should be su �,�to the workers compensation provisions of Section 3700 of the
ideel shall forthwith comply with thos o visions. 77 7// /
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 CONSTRUCTION LENDING AGENCY II LICENSED CONTRACTORS DECLARATION I
1 hereby affirm under penalty of perjury that there is a construction lending agency for the performance
Lenders Information:
I hereby certify that I have read this application and state that the information above is correct. I agree
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 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.
I hereby affirm under penalty of perjury that I am
licensed under pro ' ions of chapter 9 (commencing with
Section 70 00) o Ion 3 of the usi and
Professions e.
Date: 09/22/2022
Contractor:
Number: SW12022-00034 Expiration Date 4/1/2023
TYPE: C53
Fees paid for Permit: $1,538.03