1400 S DOUGLASS RD (11)Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00661
Issued: 03/20/2023
www.anaheim.neUbuilding
(714)7654626
Quarter Section: 126
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Site Address:. 1400 S DOUGLASS RD, Anaheim, CA 92806
Legal Description: P BK 304 PG 31 PAR 2 PM 304-31 PAR 2 & 3 AND POR 0
APN: 25352130
Project Description: Demolition: 60 sq ft guard booth.
Living Area: Number o1 Stories: 1 Valuation: 10,000.00
Garage Area: Construction Types: IIB
Carport Area: Occupancy Groups:
Balcony / Dock Area: Fire Sprinldered:
Cool Roof: Total Fees paid for Permit: 972.80
People Associated with Project:
Contractor HATHAWAY DINWIDDIE CONSTRUCTION COM 275 BATTERY STREET SUITE 300ABCDE11130093 SAN FRANCISCO, CA 90017
Permit Applicant Deniz Giliham
Owner ACC LLC 2101 E COAST HWY FL 3
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty
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City of Anaheim D� io
Building Division F y
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�D�NDED
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) 765-4280
Engineering Final (714) 765-5126
INSPECTION 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 ElectrodelUfer ,
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
Setback/Forms/Trenches (Footings)
COA/Migation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
Building Final (714 765-5153)
Last Inspectlon-Final Only After Above Completed 2 ?
L
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Building Inspections
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre -slab (Compaction/Membrane Reinf.)
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 s*aned--
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 COA/Mitagation Measures
Plumbing Inspections
Framing (Only after Plbg., Ele., Mec. & Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable items have been signed:
Drywall
Drywall Penetrations (Ele, Mec & Plbg)
Interior Lath
Exterior Lath
Electrical Inspections
Electrical Service Meter -(Meter will be set within 2-3
business days after approval) Excludes New
Construction
Exterior Plaster (Brown Coat)
T -Bar (Struct., Ele., or Mec.)
Grease Interceptor
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00661
Issued: 03/20/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 126
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 1400 S DOUGLASS RD, Anaheim, CA 92806
Legal Description: P BK 304 PG 31 PAR 2 PM 304-31 PAR 2 & 3 AND POR O
APN:25352130
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 ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self4nsure for worker's compensation, issued by the Director of Industrial Relations as provided for by
Section 3700 of the tabor Code, for the performance of the work for which this permit is Issued.
I 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 carrier and policy are:
Cartier. LIBERTY MUTUAL FIRE INSURANCE COMPANY Policy No.: WA266DO67046012 Expiration Date:101112023
Name of Agent: Phone No.:
I certify that in the performance of the work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the
worker's compensation laws of California, and agree that, if I should become subject to the worker's compensation provisions of Section 3700 of the
Labor Code, I sha 1 forthwith comply with those provisions.
Z171 /-'�
Signature of pli t
3/2x/23
Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is Issued
(Sec.3097.Civ.C):
Lender's Name:
Lender's Address:
LICENSED CONTRACTOR'S DECLARATION:
1 hereby affirm under the 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, and my license is in full force and effect.
22 12012'1
Contractor Signature Date
NUMBER EXPIRATION DATE LICENSE TYPE IS
729664 11/3012024 A, B