515 N HARBOR BLVD (4)Permit Number: SW12023-00002
Issued: 01/11/2023
www.anaheim.neUbuilding
(714)765-0626
Quarter Section: 72
Site Address: 515 N HARBOR BLVD, ANAHEIM, CA 92805
Legal Description: N -TR 2,237 BLK LOT 3
APN:03420321
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Project Description: Demolition: 450 sq. ft. gunite pool with shell to remain and (3) 34 holes.
People Associated with Project:
Permit Applicant Huyen ThiPham
Owner BUI TERRY 515 N HARBOR BLVD
OWNER - BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contrectof s License State Law for the following reason(s) Indicated below by the
checkmark(s) I have placed next to the applicable Items) (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' 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
a�p(lop for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
16m -r �' a owner of property, or my employees with wages as their sole compensation, will do U all or U 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
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' 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 oursuant to the Contractor's State 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:
❑ 1 have and will maintain a certificate of consent to self -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 carder and policy are:
Cartier. Policy No.: Expiration Date:
This section need not be completed K the permit Is for one hundred dollars ($100) or leas.
❑ 1 certify that in the performance of the work for which Ihis permit 1%jet6ed, I shall -ors t employ any person In any manner so as to become subject to the
worker's compensation laws of California, and agree
Labor Code. LshalD(orthwith comoly with those crovi
to the worker's compensation provisions of Section 3700 of the
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 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 afire under penalty of pedury that I am
Lender's Information: licensed under provisions of chapter 9 (commencing with
Section 7000) of Division 3 of the Business and
I hereby certify that I have read this application and state that the information above is correct. I agree Professions Code.
to comply with all city ordinances and state laws relating building construction, and hereby authorize
representives of this city to enter upon the above mentione 7operty for inspectio rposes. Date: 01/11/2023
„, Contractor:
Signature of
The premit shell expire by limitation and become null and v�gidlfthe 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.
Number: SW12023-00002
TYPE:
Fees paid for Permit:
Expiration Date
$170.00
City of Anaheim
• BUILDING DIVISION
• . INSPECTION RECORD
SWIMMING POOL
ADDRESS:
515 N HARBOR BLVD, ANAHEIM, CA 92805
OWNER:
BUI TERRY
PERMITM
SWI2023-00002
DATE ISSUED:
01/11/2023
DESCRIPTION:
Demolition: 450 sq. ft. gunite pool with shell to remain
DO NOT GUNITE ROCK STRUCTURE
(water feature, rock slide, fountain, waterfall, grotto etc.) until the above Inspection has
been signed.
and (3) 3x3 holes.
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE ON THE JOB SITE
nspection Code Date Inspector
504
ding 506
508
PBLD-Steel
Gunite 510
DO NOT GUNITE POOUSPA
until all the above inspections have been signed.
nd Electric bonding
(Rock Structures,Slides Etc)
508
DO NOT GUNITE ROCK STRUCTURE
(water feature, rock slide, fountain, waterfall, grotto etc.) until the above Inspection has
been signed.
6. Underground Electric
512
7. Gas Piping Test
514
8. P -Trap Receptor
516
9. BacMlow
518
10. Deck, Deck Drains,
Equipotential & Accessory
Bondina
520
DO NOT POUR FLATWORK
until all the above Inspections have been signed.
11. Rough Electrical 522
12. Fencing/Door Alarms S24
13. Plaster approval 526
DO NOT PLASTER
until all the above inspections have been signed.
14. Final Electric 1 528
Sub -Contractors List MUST be approved and pool cover on site
PRIOR to Pool Final Inspection request
FIN CTION CON DATE INSPECTOR
. ough Demo 27
1 . Fin 599
RIM INSPECTIONS Date I specto
fbldjobcerds
Insoections 14:
1. All plumbing to be completed and the system pressurized to 35 lbs. with water
or house pressure.
2. All metal within 5 feet of pool water, and all pool equipment, must be bonded
to pool reinforcing steel with 08 sold copper wke. Niche light shell, deck inserts,
etc. shall be bonded to pool rebar.
3. Pool equipment is not required to be set at this time.
Insosctlons 6.10:
1. Underground electric Inspected prior to backfilling.
2. Gas line test at 100 for 15 minutes with 1 S# gouge.
3. When polyethylene gas piping is used, a certOicate from a certified Installer
and tracer wire shall be provided per CPC 1210.1.7.2 APPENDIX I.
Inssections 11.13:
1. Rough electric inspection when all wiring is completed and ready prior to the
plastering of pooUspe. Potting compound in place at plastic light niche.
2. Current Code requires that any pool, spa or water feature
contacting water 18 indrcs or more in depth shall be enclosed by a bonier
adequate to prevent entry of small children. The barrier shall comply with
Section 3109 of current CBC and CRC APPDENDIX V specifying the height of
any fence provided as barrier to the pool 3- shall be 60- above grade on the
outside of the fence.
3. Doors from a garage shag meet the requirements for a gate. Glass
windows within Val pool water shag be tempered glass.
4. Prior to pre -plaster Inspection, streets, curbs and idly sidewalks 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 shag be painted to protect from sunlight.
Insosellons 14.18:
1. Gas and Electrical completely removed and 2x2 holes at bottom of pool
and/or Isolated elements.
2. Pool backfilled:
A.) With future build - seO-compacting sand 95% with receipt.
B.) No future build - any fill.
3. After pool Is operating and in working condition with approved pool cover on
SRO.
INSPECTION REQUESTS
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
https://aca.anaheim.neUCitizenAccess
Inspection can normally be reached between
7:30.8:00 A.M.
(714)7655153 + 0
To access your inspection timeframe:
Please go to www.anaheim.netlbullding after 7:30am on the day of your
Inspection. Under Online Services, dick on the link -Inspection
Timeframes' or call (714) 765.5153 + 0