954 S LA SALLE CIR (3)City of Anaheim
BUILDING DIVISION
INSPECTION RECORD
0 SWIMMING POOL
ADDRESS:
954 S LA SALLE CIR, ANAHEIM, CA 92807
OWNER:
VERMEEREN, KEITH ANDREW TR JEAN DUDLEV VERMEER
PERMIT N:
SW12023-00039
DATE ISSUED:
06/15/2023
DESCRIPTION:
New Swimming PWVSpa: 237 sq. ft. gunite pool and
42 sq. ft. 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
610
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
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.
it. Rough Electrical
522
12. Fencing/Door Alarms
524
13. Plaster approval
526
DO NOT PLASTER
until all the above inspections have n signed.
14. Final Electric 528
Sub -Contractors List MUST be approved and pool cover on site
PRIOR to Pool Final inspection request
FINAL INSPECTION
CODE
15. Rough Demo
527
tDAZTEINSPECTOR
16. Final599
MISC. INSPECTIONS
Date
Inspector
Inaaictiona 1.5:
1. All plumbing to be completed and the system pressurized to 35 as. war , las
or house pressure.
2. All metal wine 5 feel of pool water, grid all pool equipmem, must be bbonded
to pool roinforeing steel with #8 solid copper wire. Niche light shell, deck inserts,
etc. shall be bonded to pool nabs,.
3. Pool equipment is rat required W be set at this time.
Insoacuons 6.%
1. Underground electric Inspected Poor to backfilling.
2. Gas line test at W# for 15 minutes with 15# gauge.
3. When polyethylene as piping Ia used, a ceNfiesda burn a certated ImtaXar
and tracer wire shall be provided per CPC 12101 APPENDIX I.
Insoacdark 11.13:
1. Rough second Inspection when all wiring Is completed and ready prior to the
plastering of Peeks". Porting compouM in place at plastic light areas.
2. current Cade requires that any pool, spa or water feature
contacting water 18 inches or more in depth shall be enclosed by a banner
adequate to prevent entry of smell Mtidren, The barrier shall comply with
Section 3IN of current CSC and CRC APPDENDIX V specifying me heght of
any fence provided as barrier a the pool 6- Shall be 6m above grade on the
outside of the fence.
3. Doors from a garage shall meet the requirements for a gate. Glass
windows within 5' of Pool water shall be timpanist glass.
4. Poor to pre -plaster Inspection, streets, cups 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.
Impactions 14.10,
1. Gas and Electoral completetyremoved she 21c2 holes at bottom of pool
endfor Isolated elements.
2. Poe backfilled:
A.) With knees bull - selpeompacomg sand 95 k with receipt.
B.) No future buXd - any fill.
3. After pool Is operating end in working comfiften 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
Inspection can normally be reached between
7:30 - 8:00 A.M.
(7141765-5153 + 0
To access Your inspection timeframe:
Please go to vww anahuim neubuler, after 7'.30am on the stay of your
Inspection. Under Omlm services, dick on the link'Inspection
TMsframas' or call (714) 765-5163 +0
fbld)obcards
Permit Number: SW12023-00039
Issued: 06115/2023
www.anaheim. net1build i ng
(714)765-4626
Quarter Section: 217
Site Address: 954 S LA SALLE CIR, ANAHEIM, CA 92807
Legal Description: N TR 8075 BLK LOT 71
APN: 36515212
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141 765 - 5153
Project Description: New Swimming Pool/Spa: 237 sq. ft. gunite pool and 42 sq, ft. spa.
People Associated with Project:
Contractor COASTLINE POOLS 2306 HALF MOON LN COSTA MESA, CA 92627
Owner VERMEEREN, KEITH ANDREW TR JEAN DUDL 954 S LA SALLE CIR
OWNER • BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License State Law for the following mason(s) indicated below by the
checkmark(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 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 Ilcensure 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).
❑ I, as owner of Property, or my employees with wages as their sole compensation, will do (_) all or (_) portions o1 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
❑ 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 Lew does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed
Contractor Duruant to the Contractors State License Lawl.
I am exempt from licensors under the Contractors, State License Law for the followinq reason:
Data Signature of Property Owner or Authorized Agent
WORKER'S COMPENSATION DECLARATION
I hereby aRrn under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to set -insure for worker's compensation, issued by the Director of Industrial Relations as provided for by
Ilion 3700 of the Labor Code, for the performance of the work for which this perrnil is issued.
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
ermit is issued. My workers Compensation insurance carrier and policy are:
Carder: STATE COMPENSATION INSURANCE FUND Policy No.: 9$11076 Expiration Date:
This section need not be completed If the permit Is 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
workers compensation laws of California, and agree that, if I should become subject to the workers compensation provisions of Section 3700 of the
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.
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
Lenders Information:
I hereby certify that I have read this application and stale that the information above is correct. I agree
to comply with all city ordinances and state laws relating building construction, and hereby authorize
repirsentives of this city to enter upon the above mentioned property for inspection purposes.
Date Signature of Applicant or Agen
The premt 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.
licensed under provisions of chapter 9 (commencing with
Section 7000) of D' i ion f the Business and
Professions Co1.
Date: b611512623
Contractor:
Number: SW12023-00039 Expiration Date 1012024
TYPE'. C53
Fees paid for Permit:
$1,091.25