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175 S HEALTH TERCity of Anaheim 0 BUILDING DIVISION INSPECTION RECORD SWIMMING POOL ADDRESS: 175 S HEATH TER, ANAHEIM, CA 92807 OWNER: PERMIT#: SWI202D-00117 DATE ISSUED: 12/19/2022 DESCRIPTION: New Swimming Pool and Spa 474 sq.fl with equipment. POST THIS CARD WITH THE APPROVED PLANS IN A CONSPICUOUS PLACE ON THE JOB SITE Inspection Code I 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. BUD -Steel and Electric bonding (Rock Sbuctures,Slides Etc) 508 DO NOT GUNITE ROCK STRU�7 `TT (water feature, rock slide, fountain, waterfall, grotto etc)Vff /rl`pe�tlOry '' been signed. 6. Underground Electric 512 7. Gas Piping Test 514 NJ 8. P-Trap Receptor 516 9. Back9ow 518 10. Deck, Deck Drains, Equipotential & Accessory , Bondino 520 DO NOT POUR FLATWORK until all the above inspections have been signed. 11. Rough Electrical N 12. Fencing/Door Alarms 524 13, Plaster approval 526 DO NOT PLASTER unfit all the above inspections have been signed. 14. Final Electric 1 528 Sub -Contractors List MUST be approved and pool cover on s O PRIOR to Pool Final Inspection request FINAL INSPECTION CODE DATE INSPECTOR 15. Rough Demo 527 16. Final 599 MISC. INSPECTIONS Date Inspector 1. All plumbing to be completed and tlro system pressurized to 36 Me, with water or house pressure. 2. All metal within 5 feet of pod water, and all pool equipment, must be bonded W pod reinforcing steel with #e Wild copper wire. Niche light shell, deck inserts, etc. shall be bonded to pod radar. 3. Pool equipment ie not required to be set el this time. Insscaons 6-10: J. Underground electric Inspected prior to baM511ing. 2. Gas Ithe test at 10# for 15 minutes wan 15# gauge. 3. When polyethylene gas piping Is used, a cornices from a carolled Installer and tracer wire shall be provided per CPC 1210.1.7.2 APPENDIX I. Insoceons 11-13: 1. Rough elechk inspection when all wirng is completed and reedy prior to me plastering of poogapa. Fibre compound In place at plastic light niche. 2. Current Code requires that any pod. spa or water feature contacting water 18 unites or more in depth shall be enclosed by a bander adequate to prevent entry of small children. The barrier shall comply with section 3109 of current CI and CRC APPDENDIX V specifying the height of any fence provided as bamer W fine pod 3- shall be 60' above grade on me outside of me fence. 3. Doom from a garage shall meet the requirements for a gate. Glass windows within Vol pool water shall be tempered glees. 4. Prior to pre -plaster inspection, streets, curbs end city sidewalks will b r inspected for any damage due to construction of said or apse. 5. Grading complete with paudive drainage Is street or public way. All exposed plastic pipe shall W painted to protect from sunlight. Inspections 14.16: 1. Gas and Electrical completely removed and 2# hobs st bottom of Pool and/or isolated elements. 2. Pool baokNbd'. A.) with future Wild - sell -compacting sand 95% with recalPt B.1 No future Wild - any el. 3. Amer pod 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 Wilding inspection mine, please go to https:l/aca anaheim.net/Citc enActese Inspection can normally be reached between 7:30 - 8:00 A.M. (714)765-5153 + 0 To access your inspection timeframe: Please go www anaheim netlbullding after 7:30am on the day of your Inspection. Under Online services, dick on the link'Inspecfion Timeframes' or call (714) 765-5153 + 0 :ITY OF ANAHEIM / BUILDING DIVISION .rmk Number: SW12020-00117 200 S. ANAHEIM BLVD. Issued: 12/19/2022 (714) 765 - 5153 www.anaheim.netibuilding (714)765.4626 Quarter Section: 197 Site Address: 175 S HEATH TER, ANAHEIM, CA 92807 Legal Description: R BK 76 PG 28 PAR 3 APN: 35627102 Project Description: New Swimming Pool and Spa 474 sq.ft with equipment People Associated with Project: Permit Applicant SUSAN VODONICK OWNER - BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Law for the following reasonjs) indicated below by the checkmark(s) I have placed next to the applicable hernia) (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to construct, otter, 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). ❑ I, as owner of property, or my employees with wages as their sole compensation, will do (_) all or (_I portions of the work, and the structure is not intend) 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 gimps' or personal efforts, builds or improves the property, provided that the Improvements are not intended or offered for sale. If, however, the building or as the owner of the property, am exclusively contracting with licensed Contractors to construct the project (Sec. 7044 Business and Professions Code: he 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 pursuant to the Contractor's Stale 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: ❑ I have and will maintain a certificate of consent to seti-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. ❑ 1 have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code. for the performance of the work for which this permit is issued. My worker's Compensation insurance comer and policy are: Carrier: Policy No.: Expiration Date: This section need not be completed It the permit is for one hundred dollars ($100) or less. ❑ 1 oertity 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 worker's compensation laws of California, and agree that, ti I should become subject to the workers compensation provisions of Section 3700 of the Labor Code. I shall forthwith comDly with those provisions. Date Signature of Applicant 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 ATTORNEYS FEES. I CONSTRUCTION LENDING AGENCY II LICENSED CONTRACTORS DECLARATION I I hereby of nn under penalty of perjury that there is a construction lending agency for the performance Lender's 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 representhres of this city to enter upon the above mentioned property for inspection purposes. Late 1 5 atu of Applicant or Agen The premit shall expire by limitation en me 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 provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. Date: 12/19/2022 Contractor: Number: SW12020-00117 TYPE: Fees paid for Permit: Expiration Dale $877 75