852 N JANSS STPermit Types
BLD ELE MEC PLM
X
Permit Number: OLD2022.05295
Issued: 11/08/2022
www.anaheim.net/building
(714)7654626
Quarter Section: 61
Site Address: 852 N JANSS ST, ANAHEIM, CA 92805
Legal Description: N TR 1019 BLK LOT 2
APN: 03419302
CITY OF ANAHEIM
_ BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Project Description: Main Electric Service Size: 200 Amps
Living Area: Number of Stories: Valuation: 0.00
Garage Area: C and D: Option 2 Construction Types.
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire Sprinidered:
Cool Roar: Total Fns paid for Permit: 167.00
People Associated with Project:
Permit Applicant Nicholas KATSENIS 3108 GLENDALE BLVD #138 LOS ANGLES, CA 90339
Type Electrical Fixtures City Type Plumbing Fixtures Qty Mechanical Fixtures Qty
Meter/Disc Sw - Under 600 V, up to 200 1
amps
t
The permit shall expire by limitation and become null and void K 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.
P�pHEIM Cq<
City of Anaheim D� io
Building Division F z
u >
�DUNDED �8�1
Do not occuov this buildinq 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 Electrode/Ufer
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 Inspection -Final Only After Above Completed
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Buildinq 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)
II L.
Do not cover or conceal the work below until the following applicable items have
been siane&
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
111a not hackfill unia%s sinned off)
Sewer
Water Engineering Backflow, (Testable Only)
Water Service
' Permit Types
BLD ELE MEC PLM
X
Permit Number. BLD2022-05295
Issued: 11/08/2022
www.tknaheim.net/building
(714)765-0626
Quarter Section: 61
Site Address: 852 N JANSS ST, ANAHEIM, CA 92805
Legal Description: N TR 1019 BLK LOT 2
APN:03419302
CITY OF ANAHEIM
BUILDING OMSION
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.
1 hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to setfdnsure for worker's compensation, issued by the Director of Industrial Relations as provided for by
NK Section 3700 of the tabor Code, for the performance of the work far 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. STATE COMPENSATION INSURANCE FUND Policy No.: 9327408 Expiration Date: 11/5=3
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
workers compensation laws of California, and agree'that, if I should became subject to the worker's compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
_ Nicholas KATSENIS 11/8/2022
Signature of Applicant 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):
Lenders Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATION:
1 hereby affirm under the penalty of Perjury that 1 am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
•Protesslons Code, and my license Is in full force and effect
GREEN INTEGRATIONS AND MANAGEMENT INC
Contractor Signature
NUMBER EXPIRATION DATE LICENSE TYPE ISl
1031392 09/30/2023 C39, CIU
Date
11/8/2022