3365 W GLEN HOLLY DRPermit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-04915
Issued: 10/17/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 6
CITY OF ANAHEIM
Site Address: 3365 W GLEN HOLLY DR, ANAHEIM, CA 92804
.Legal Description; N•TR 2839.BLk LOT 201
APN: 07945224
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
z
1 y
Project Description: Re -roof: Remove existing material, Install (25) squares of composition shingles over entire house and attached
garage
Living Area: Number of Stories: 1 Valuation: 10,000.00
Garage Area: Construction Types: WA
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire SprinNered:
Cool Roof: Total Fees paid for Permit: 340.30
People Associated with Project:
Permit Applicant Yarden Israel
Owner WARE DAVID E & RYAN 3365 W HOLLY GLEN OR
Type Electrical Fixtures Oly Type Plumbing Fixtures Qty Mechanical Fixtures Qty
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.
City of Anaheim
Building Division
Do not occupy this building until the final inspections have been made.
FINAL INSPECTIONS I DATE I INSPECTOR
All applicable items below must be signed before utilities are released
ial Gas Test
ictrical Final
imbing Final
ichanical Final
ass Connection Control (714) 7654280
gineering Final (714) 765-5126
re Sprinkler (ONLY) (714) 765-5041
re Dept. Final (714) 765-5041
r Engineering (714) 765-4591
b List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
OA/Migation Measures
Bu
Final (714 765-5153)
it Inspection -Final Only After Above Completed
INSPECTION DATE INSPECTOR Fi
Do not pour concrete until the following applicable items have been signed: Fi
Plumbing (Ground/Underfloor Drain Waste) Wate
PARTIAL INSPECTIONS
Nina Inspections
�chanical Inspections
Imbina Inspections
,ctrical Inspections
Electrical Ground Electrode/Ufer
Su
Setback/Forms/Trenches (Footings)
C
Do not install subfloor or pour floor slab until the follwing applicable items have been
B
Plumbing (Ground/Underfloor Water)
La
Underfloor Rough Gas
Mechanical (Groundwork)
Electrical (Underground Conduit)
BIL
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*aned7
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
ME
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
PII
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
Eli
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
FINAL INSPECTIONS I DATE I INSPECTOR
All applicable items below must be signed before utilities are released
ial Gas Test
ictrical Final
imbing Final
ichanical Final
ass Connection Control (714) 7654280
gineering Final (714) 765-5126
re Sprinkler (ONLY) (714) 765-5041
re Dept. Final (714) 765-5041
r Engineering (714) 765-4591
b List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
OA/Migation Measures
Bu
Final (714 765-5153)
it Inspection -Final Only After Above Completed
INSPECTION DATE INSPECTOR Fi
Do not pour concrete until the following applicable items have been signed: Fi
Plumbing (Ground/Underfloor Drain Waste) Wate
PARTIAL INSPECTIONS
Nina Inspections
�chanical Inspections
Imbina Inspections
,ctrical Inspections
0)
RJu IU ikl
CITY OF ANAHEIM
BUILDING DIVISION
BUILDING DEPARTMENT 2016 CALIFORNIA CODES
CODE
200 S. Anaheim Blvd., Suite 145 CYCLE
Anaheim, CA 92805 01/001/201/20177
714 765-5153 EFFECT/VEDATE
www.anaheim.net/building
SMOKE DETECTORS AND CARBON MONOXIDE SELF CERTIFICATION
* Final inspection approval will require this completed form to be on site along with the job card.
Permit Number: �l� 2 l� 7 $ Date:
Project address: 3 ��/� �—lvoo-h �"� 1''/
Property Owner: CA l—�-
The undersigned does hereby certify that I am the property owner of the
property. I further certify that smoke alarms and carbon monoxide alarms
functional in all the following locations. All boxes must be checked below
above referenced
are present and
Smoke Alarms and Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
sleeping area in the immediate vicinity of bedroom/s or in each hallway outside of the rooms.
Smoke Alarms: In each room used for sleeping purposes.
Of/Smoke Alarm and Carbon Monoxide Alarm: In each story, including any habitable basement;
(Note: in dwellings or dwelling units with split levels and without an intervening door between
the adjacent levels, a smoke alarm and a carbon monoxide detector installed on the upper level
shall suffice for the adjacent lower level provided that the lower level is less than one full story
below the upper level.)
All dwelling urttswith attached garages require carbon monoxide detectors.
Signature:
California Residential Code (CRC) Section R314.6.2,CRC R315.2 states in part that existing dwellings be
"retrofitted with smoke detectors and carbon monoxide detectors when a building permit is issued for work on or
in a building that is valued at $1,000 or more." CRC Section R314.3, CRC R315.2 defines required locations as
indicted above.
NOTE: This certification is only used when normal access to the interior of the dwelling by the City of Anaheim
Inspector is not achieved during the course of project construction. It is normally used for exterior projects such
as re -roofing, re -siding, patio covers, solar photovoltaic installations, and similar exterior construction work.
200 S. Anaheim Blvd., Suite 145 Anaheim, California 92805 (714)765-5153 Phone (714)765-4607 Fax FEB 2018
www.anaheim.net/building B842
SMOKE/ CO ALARM REQUIRED LOCATIONS
Bedroom Bedroom
6
Bath
Bedroom
Kitchen
Living Room
Figure 1
Family Room Bedroom
q,D
Dining
Living Room
Kitchen
Bedroom Bedroom
Figure
/ Attic \
Bedroom Hall Bedroom
&a
Living Room Halt Kitchen
7L Basement
Figure 3
REQUIRED SMOKE ALARM LOCATION
REQUIRED CARBON MONOXIDE ALARM LOCATION
I
�I V
Acceptable J 4�
Here Never
Here Tir
Top of Detector I
Acceptable Here
Garage
wall
Figure 4
Permit Types .
BLD ELE MEC PLM
X
Permit Number. BLD2022-04915
Issued: 10/17/2022
www.anaheim.net/building
(714)765.4626
Quarter Section: 6
CITY OF ANAHEIM
Site Address: 3365 W GLEN HOLLY DR, ANAHEIM, CA 92804
Legal Description: N TR 2839 BLK LOT 201
APN: 07945224
WORKER'S COMPENSATION DECLARATION:
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
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.
1 hereby affirm under penalty of perjury one of the folia" declarations:
I have and will maintain a certificate of consent to selfeinsure 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 workers Compensation insurance carrier and policy are:
Cartier: STATE COMPENSATION INSURANCE FUND Policy No.: 9291512 Expiration Date: 1/27/2023
Name of Agent: Phone No.:
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 1 should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, I sh with comply with those provisions.
Signature of Applican 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 Ws permit Is Issued
(Sec.3097.Civ.C):
Lender's Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATION:
I 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.
Contractor Si u
NUMBER EXPIRATION DATE LICENSE TYPE (Sl
1073368 02/28/2023 C39
10 1r I2Aza
Date