729 N CLEMENTINE ST (3)CITY OF ANAHEIM
BUILDING DIVISION
. d Number: SW12023-00037
200 S. ANa EIM BLVD.
p1a)7s •5,j1�
www.anahei .net/ ing
www.anaheim.net/building
(714)765-4626
Quarter Section: 71
Site Address: 729 N CLEMENTINE ST, ANAHEIM, CA 92805
Legal Description: N TR 336 BILK LOT 9
APN: 03425309
Project Description: New Pool/Spa: 532 sq it pool with 65 sq ft spa
People Associated with Project:
Contractor ROCK N POOL INC DBA SWIMMING POOL
1233 WEST PRIMROSE DRIVE202103151422467580 ORANGE, CA 92868
Permit Applicant Luis APerez
1233 W Primrose Or Orange, CA 92868
Owner CONNELLY MICHAEL
7040 AVENIDA ENCINAS #104-5
OWNER - BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Law for the following reasons) Indicated below by the
checkmark(s) I have placed next to the applicable hamlet (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 mom than five hundred dollars (f500).
❑ I, as owner of property, or my employees with wages as their sole compensation, will do (_) 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
❑ 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 Dursuant to the Contractor's State License Law).
I am exempt from licensors 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:
❑ I have and will maintain a certificate of consent to sell -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 the work for which this Permit is issued.
171 1 hew 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 carrier and policy are:
Carrier: STATE COMPENSATION INSURANCE FUND Policy No.: 9331320 Expiration Date:
This section no" not be completed ff the permit Is for one hundred dollars ($100) or leas.
❑ I 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. ff Iphc cold become subject to the worker's compensation provisions of Section 3700 of the
m Labor Code. 1 shall forthwith coply, with those urovisions.
WARNING: FAILURE TO SECURE WORKERS' COMROSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10O,DDO). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES
AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST. AND ATTORNEYS FEES.
I CONSTRUCTION LENDING AGENCY II LICENSED CONTRACTORS DECLARATION I
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance
Lenders Information:
I hereby certify that 1 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 premil shall expire by limitation and become null and void ff the building or work has not passed
final inspection 365 days from the date of permit issuance. A new permit is required to commerce or
continue work.
I hereby affirm under penally of perjury that I am
licensed under provisions of chapter 9 (commencing with
Section 7000) of Division 3 of th usiness and
Professions Code
Date: 0b708/2 3
Contractor: SWIM G POOL
Number: SW12023-00037 Expiration Date
TYPE: C63
Fees paid for Permit:
City of Anaheim
0
BUILDING DIVISION
INSPECTION RECORD
SWIMMING POOL
ADDRESS:
729 N CLEMENTINE ST, ANAHEIM, CA 92WS
OWNER:
CONNELLY MICHAEL
PERMIT#:
SWI2023-00037
DATE ISSUED:
05/08/2023
DESCRIPTION:
New Pool/Spa: 532 so It pool with 65 sq it spa
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE ON THE JOB SITE
Inspection
Code
Date
— nspector
1. Main Drain
504
2. Electric Bonding
506
3. Steel
508
4. Approval to Gunite
510
DO NOT GUNITE POOLISPA
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 Wide, fountain, waterfall, grotto etc.) unW the above nspection ams
been signed.
6. Underground Electric
512
7. Gas Piping Test
514
8. P-Trap Receptor
516
9. Backflow
518
10. Deck, Deck Drains,
Equipotential 8 Accessory
Bondina�—
520
DO NOT POUR FLATINORK
unfit all the above inspections have been signed.
11. Rough Electrical
522 (
_�
12. Fencing/Door Alarms
524
13. Plaster approval
526
�w
DO NOT PLASTER
until all the above inspections have n signet.
14. Final Electric 528
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
MISC. INSPECTIONS
Date
Inspector
inspections 14,
1, All Plumbing to be completed and the system pressurized for 36 Its. with water
or house preswre.
2. NI metal within 6 feet of Pool water, ern NI pool equipment must be bonrded
to pod reinforcing steal with #8 solid copper wire. Niche light shell, deck Imperial
etcshall be bonded to Pool rebar.
3. Pool equipment is not required to be set at this time.
Inspections 6.10,
1. Undergroud elects, Inspected pill u badtll8hq.
2. Gas line lest at 1W for 15 minutes with 150 gauge.
3. Winn polyethylene ge , piping is used, a cartridge from a certified installer
and tracer wire shell be povdad per CPC 1210.112 APPENDIX I.
Insaacfion3 11.13,
1. Rough electric Inspection when all wiring a completed and ready prior to the
plastering of poollspa. Putting compound In piece at plastic light niche.
2. Current Code requires that any pool, spa or water feature
contacting water 18 inches or more In depth shell be enclosed by a bemer
adequate to prevent entry of ..If children. The banner shall comply with
section 3109 of current CSC and CRC APPDENDIX V specifying the height of
any fence provided as barrier to the pool 6- shall be 60' above grace 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, tempered glass.
4. Prier to pre -Plaster mAmdbon, streets, curbs and cry sidewalks will m
inspected for any damage due to construction of pool or Was.
5. Grading compute with Wr bve drainage to great m public way. All
exposed plastic pipe shall be painted to protect tom sunlight.
Inspection, 14-16,
1. Gas and Elecdcel completely removed and 24! holes at bottom of pool
and/or isolated elements.
2 Pool backblled:
A.) With mime build - sed.nipsom, all 95% with receipt.
B.I No future Wild - 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 Wilding inspection onfine, phase go to
dtps:lfaca.anaheim. net/CitizenAccess
Inspection can normally be reached between
7:30 - 8:00 A.M.
(7141765-5153 + 0
To access your inspection timeframe:
Please go to rvv, , anal,._m, i,1 a„iddiny after 7:30am on the day of your
inspection. Under Online Services, dick on the link 'Inspection
Ti neframee' or cell (714) 765-5153+0
•bcerds