621 S HACIENDA STPermit Types
BLD ELE MEC PLM
X
Permit Number: OLD2023-01486
Issued: 03/29/2023
www.anaheim.net/building
(714)765-0626
Quarter Section: 48
Site Address: 621 S HACIENDA ST, Anaheim, CA 92804
Legal Description: N TR 2425 SLK LOT 94
APN: 12822416
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
1714) 765 -5153
Project Description: Re -roof, install (31) sq of asphalt shingles on entire house. Replace old roof underlayment if needed.
Living Area: Number of Stories: 1 Valuation: 13,000.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire Sprinldered:
Cool Roof: Total Fees paid for Permit: 362.69
People Associated with Project:
Contractor 5377 Heritage Oak Dr. Trabuco Canyon, CA 92679
Permit Applicant Maribel Lopez
Owner TRIEU KATRINA TR 621 S HACIENDA
Type Electrical Fixtures Qty 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 ofAnaheim
Building Division
Do not occupy this building until the final inspections have been made.
INSPECTION DATE I INSPECTOR
Do not pour concrete until the following applicable items have been signed:
Plumbing (Ground/Underfloor Drain Waste)
Electrical Ground Electrode/Ufer
Setback/Forms/Trenches (Footings)
Do not install subfloor or pour floor slab until the follwing applicable items have been
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre -slab (Compaction/Membrane Reinf.)
Floor (Joist/Girdem)
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 sianed:
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd Eloopqhear
(Sheathing/ iaphragmlFrame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation Measures
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 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 DATE I 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) 755-5125
Fire Sprinkler (ONLY) (714) 755-5041
Fire Dept. Final (714) 765-5041
Water Engineering (714) 755.4591
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
COA/Migation Measures
Building Final (714 755-5153)
Last Inspection -Final Only After Abo a Completed
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
BUILDING DIVISION
CITY OF ANAHEIM
BUILDING DEPARTMENT 2013 CALIFORNIA CODES
CODCYCLE
200 S. Anaheim Blvd., Suite 145
Anaheim, CA 92805 01/001/1/ 2001414
r_rrxcrivrnnrr_
714765-5153
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:
wk � " 2�e `° Date:
Project address: G)-1 S. S{-. 1 /-�t ah t,1.,,, 4 C A "1 2 9-0
Property Owner: Ki^ fain C., Tr le V1,
The undersigned does hereby certify that I am the property owner of the above referenced
property. I further certify that smoke alarms and carbon monoxide alarms are present and
functional in all the following locations. All boxes must be checked below
0 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.
G7/ 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 units with attached garages require carbon monoxide detectors.
Signature: '�Ir"� Date: OS 10.5 19,0 �-.3
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 SEPT 2015
www.anaheim.net/building 8842
Permit Types
BLD ELE MEC PLM
X
Permit Number. BLD2023-01486
Issued: 03/29/2023
www.anaheim.net/building
(714)765-0626
Quarter Section: 48
Site Address: 621 S HACIENDA ST, Anaheim, CA 92804
Legal Description: N TR 2425 BLK LOT 94
APN: 12822416
Chi't•1]&_AZLL'14W,I
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
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 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.
�. 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. Policy No.: Expiration Date:
Name of Agent: Phone No.:
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
worker's compensation laws of California, and agree that, t I should become subject to the worker's compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
Signature ofApplicant' 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:
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 end
Professions Code, and my license is in full force end effect.
Contractor Signature.
NUMBER EXPIRATION DATE LICENSE TYPE IS)
1085006
Date