816 S WILDFLOWER LN (4)Permit Types
BLD 1LE MEC FILM
Permit Number: BLD2020-00797
Issued: 02/19/2020
INSPECTION REQUEST LINE:
(714) 765 - 4626
Quarter Section: 220
Site Address: 816 S WILDFLOWER LN
Legal Description: N TR 12993 LOT 49
Project Description: Residential EV charger Level 2 inside the garage
People Associated with Project
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Valuation:
Construcion Types:
Fire Sprinkleredl
Cool Roof
Total Fees paid for Permit:
$0.00
NIA, ,
No
No
0.00
Permit Applicant MITRA KAMRAN
Owner MITRA KAMRAN 816 S WILDFLOWER LN ANAHEIM CA 92808-2300
Type Electrical Fixtures Qty, Type Plumbing Fixtures Qty Type Mechanical Fixtures Qty
EV Charger 1
The permit 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. fold_permilcombo
i
City of Anaheim �f,F1EDW c�
Ot O
Building Division F i
�OVNDEC) te`'^
Do not occupy this building until the final inspections have been made.
FINAL INSPECTIONS
DATE
INSPECTOR
All applicable items below must be signed before utilities are released
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (714) 765-4260
Engineering Final (714) 765-5126
INSPECTION I
DATE
I INSPECTOR
Fire Sprinkler (ONLY) (714) 765-5041
Do not pour concrete until the following applicable items have been signed.
Fire Dept. Final (714) 765-5041
Plumbing (Ground/Underfloor Drain Waste)
Water Engineering (714) 765-4591
Electrical Ground Electrode/Ufer
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
Setback/Formsrrrenches (Footings)
COA/Migation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
sioned
Building Final (714 765.5153)
Last Inspection -Final Only After Above Completed
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Building Inspections
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre -slab (Compaction/Membrane Relnf.)
Floor (Joist/Girders)
Underfloor Insulation (Raised Foundation Only)
Floor Nailing (Raised Foundation Only)
2nd Floor (Floor Nailing)
Do not cover or conceal the work below until the following applicable items have
been sioned
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COAIMitagation Measures
Plumbing Inspections
Framing (Only after ping.. Ele.. Mee. & Fire)
Insulation (Sound/Energy)
Dr, not tape or plaster until the following applicable items have been signed
Drywall
Drywall Penetrations (Ele, Mee & Plbg)
Interior Lath
Exterior Lath
Electrical Inspections
PERMIT E X P I R E r_
7C N I l
Electrical Service Meter -(Meter will be set within 2-3
business days after approval) Excludes New
Exterior Plaster (Brown Coat)
T-Bar (Struct., Ele., or Mee.)
INSPECTION
Grease Interceptor
N 0 T
CO
M
P
I
E T
E
D
Sewer
Water Engineering Backflow (Testable Only)
Water Service
a Permit 4pes
BLD
ELE
MEC
PLM
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Permit Number: BLD2020-00797
Issued: 2/1912020
INSPECTION REQUEST LINE:
(714) 765 - 4626
Quarter Section: 220
Site Address: 816 S WILDFLOWER LN
Legal Description: N TR 12993 LOT 49
OWNER - BUILDER DECLARATION:
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 766 - 5163
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Law for the following reason(s) indicated
below by the checkmarke) I have placed next to the applicable items) (Sec. 7031.6 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 licensure and the
basis for the alleged exemption. Any violation of Section 7031.E by any applicant for a permit subjects the applicant to a civil penalty of not
more W-A91YWjA8f88@k1A4T4WIoyees 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 improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
X improved for the purpose of sale).
2LI, 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 pursuant to the Contractor's State License Law).
I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the
improvements covered by this pemli , I cannot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by
licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when
this armiration is submi0ed or at the following Web saehhrr/Iwww leninfn a nnv/ralaw html
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have mad this applicafion and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction
I authorize representatives of this city or county to enter the above -identified property for Inspection purposes.
WTRA KAMRAN 2/19/2020
Electronic Signature of Property Owner or Authorized Agent Date
WORKER'S COMPENSATION DECLARATION:
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 hereby affirm under penalty of perjury one of the following declarations:
I 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.
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 permit is issued. My worker's Compensation insurance carrier and policy are:
Carrier Policy No:
Name of Agent: Phone No
Expiration Date:
X 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, lt I should become subject to the workers compensation provisions of Section 3700 of
the Labor Code, I shall forthwith comply with those provisions.
MITRA KAMRAN 2/19/2020
Electronic Signature of Applicant
Date