636 S KENMORE ST (3)Permit Types
BLD ELE MEC PLM
X X
Permit Number: BLD2022-04861
Issued: 10/12/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 21
Site Address: 636 S KENMORE ST, ANAHEIM, CA 92804
Legal'Dssc'iption: N TR .4750 BLK LOT 1
APN: 12619406
CITY OF ANAHEIM
Project Description: Patio Cover: 544 sq It patio with electrical.
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Living Area: Number of Stories: 0 Valuation: 15,000.00
Garage Area: Consbuclion Types: VB
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire Sprinldered:
Cool Root Total Fees paid for permit: 849.43
People Associated with Project:
Owner HILO RYAN STAWRI & REMA E 636 S KENMORE ST
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty
Receptacle, switches, lights 8
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.
P�Pr1E1M CSC
Cityof Anaheim o� io
Building Division F mZ
u aEre--ctical
�DGNDED ��y�
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
F1 nal Gas Test
Fina
1.— `
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) 7654591
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
i
2
14 765-5153) t
aLaFecRionFinalOnly After Above Com le
44
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 sioned7
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
RqQb COA/Mitagation Measures 11
Plumbing Inspections
ming my after Plbg., Ele., Mec. & Fire
ion (Sound/Energy) W
Do not tape or plaster until the following app icable 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 X
Permit Number: BLD2022-04861
Issued: 10/12/2022
www.anaheim.neUbuilding
(714)765-4626
Quarter Section: 21
Site Address: 636 S KENMORE ST, ANAHEIM, CA 92804
Legal Description: N TR 4750 BLK LOT 1
APN: 12619406
WORKER'S COMPENSATION DECLARATION:
CITY OF ANAHEIM
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 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 selfminsure 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 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: NORGUARD INSURANCE COMPANY Policy No.: DAWC358843 Expiration Date: 811=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, it I should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, I shall forthwith Comply with those provisions.
Wl" a Jct -1-2-
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):
Lender's Name:
Lender's 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 Signature
NUMBER EXPIRATION DATE LICENSE TYPE (S)
615917 03/31/2023 024, D28, D03, D41
l
Date