200 W MIDWAY DR (5)City of Anaheim
BUILDING DIVISION
INSPECTION RECORD
0 SWIMMING POOL
ADDRESS:
200 W MIDWAY DR, Anaheim, CA 9211
OWNER:
ENCORE ANAHEIM LLC
PERMIT a:
SWI2022-00144
DATE ISSUED:
12/062022
DESCRIPTION:
Demolition: 400 sq. ft. gunite pool with complete shell
removal.
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 POOLISPA
unfit all the above inspections have been signed
5. BLD-Steel and Electric bonding
(Rock Structures,Slides Etc)
508
_'
hi
DO NOT GUNITE ROCK STRUCTURE �� �,,��`C
(water feature, rock slide, fountain, waterfall. grotto etc.) until the above tgfpPFmL"E TE
been signed.
6. Underground Electric
512
7. Gas Piping Test
51*�
` . --
8. P-Trap Receptor
516
— -
9. Backlow
518
10. Deck, Deck Drains,
Equipotential 8 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 signs.
14. Final Electric 1 528
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
Z3
I eudd,tiun. 1.5:
i. All plumbing to be completed add Me system pressurized to 35 Me, with water
or house pressure.
2. All metal within 5 feet of pool water, and all pool equipment, must be bonded
to pool relnlorcing steel with ea wild copper were. Niche light sell, deck Mewls.
elcshall be bonded to pool debar.
3. Pool equipment is not required to be set at this time.
Inspection. 6.10,
1. Underground electric Impeded pd., to backfihing.
2. Gas line test at 1114 for 15 minutes with 15e gauge.
3. When polyethylene gas piping Is used, a cerg5ces sum a cartfiatl Installer
and tracer wire shall be provided per CPC 1210.1.7.2 APPENDIX I.
ataoeetloM 11-13,
1. Rough electric Inspection when all wimp is completed and ready poor to Me
plastering a1 pooyspe. Poling compound in piece at plastic light niche.
2. Current Code requires Met any pool, spa or water feature
connecting water 18 Inches or more In depth shell be enclosed by a border
adequate te prevent entry of small children. The barrier shell comply with
Section 3IN of current CBC and CRC APPDENDIX V specifying Me height of
any fence provided as harder to the pool 3- shall be 67 above grade on the
ouside of the fence.
3. Does from a garage shall meet the requirements for a gate. Glass
windows within 5' of pool water shall be tampered glass.
4. Prior t0 pre -plaster Inspection. streets, curbs and city sldawalks 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 mil Electrical compli tey removed! and 2x2 ides at bottom of pool
and/or isolated elements.
2. Pool beckfilled:
A.) With future build - self -compacting send 95%with receipt.
B.) No future build - any fill.
3. After pool Is operating and In working condition with approved pool cover on
she.
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
Naps:l/aca ersheim.net/CitizenAccess
Inspection can normally be reached between
7:30 - 8:00 A.M.
(714)765-5153 • 0
To access your inspection tinnefrande:
Please go to wow amenim netbwmuw after 7:30am on the day of your
Inspection. Under Online services, dick on Me link -Inspection
Thnefromed or call (714) 706-6163. 0
fbldjobcards
Permit Number: SW12022-001"
Issued: 12/05/2022
www.anaheim.neUbuilding
(714)765-4626
Quarter Section: 86
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 200 W MIDWAY DR, Anaheim, CA 92805
Legal Description: N TR 419 BLK 2 LOT 4 TRACT 419 BLK 2 LOTS 4,5,6,21
APN: 08218558
Project Description: Demolition: 400 sq. ft. gunite pool with complete shell removal.
People Associated with Project:
Permit Applicant Jorge Estrada 770 Temalpais Dr Suite 401E Corte Madera, CA 94925
Owner ENCORE ANAHEIM LLC 770 TAMALPAIS DR 401 B
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($) 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, 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' Stale 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 licansure 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 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
t-b 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' Stale 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 pursuant to the Contractors State License Lawl.
I am exempt frgm licansure under the Contractors, StpJgLke9aaJLaw for the followinq reason:
mnnonzep Agem
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.
❑ 1 have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Corte, for the pedormanei of the work for which this
permit is issued. My workers Compensation insurance carrier and policy are:
Carder: Policy No.: Expiration Date:
This section need not be completed lt the permit Is for ens hundred dollar ($100) or lose.
❑ 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 should become subject to the workers compensation provisions of Section 3700 of the
Labor CAde, I ghall forthwith cemDly with those gro4pkos. /„
WARNING: FAILURE TO SECURE WORM§RS' 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 ATTORNEYS 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 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.
The permit shall expire by limitation and become null and veld It 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 Division 3 of the Business and
Professions Code.
Date: 12/05/2022
Contractor:
Number: SW12022-00144 Expiration Date
TYPE:
Fees paid for Permit.
$171 00