1801 E KATELLA AVE (25)Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-05070
Issued: 10/25/2022
www.anaheim.neUbuilding
(714)765-0626
Quarter Section: 107
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765.5158
Site Address: 1801 E KATELLA AVE 2072, Anaheim, CA 92805
Legal Description: N TR 16618 BLK LOT 1 UN 2072 TRACT 16618, LOT 1 OF
APN: 93028856
Project Description: Plumbing to remove existing bathtub and install shower
Living Area: Number of Stories. 4 Valuation: ) 0.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony I Dedr Area: Fire Sprinldered:
Cool Roof: Total Fees paid for Permit: 167.00
People Associated with Project:
Permit Applicant Ben Medina
Owner DODGE JEFFREY 1801 E KATELLA AVE #2072
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty
Shower 1
The permit shall expire by limitation and become null and void If the building or work has not passed final Inspection 865 days from the
date of permit issuance. A new permit is required to commence or continue work.
P�pHEIM Cqf
City of Anaheim D� �o
Building Division F y
u >
�DUNDED �6h�
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 vleased
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (714) 7654280
Engineering Final (714) 765-5126
INSPECTION DATE 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
aned7
Building Final (714 765-5153)
Last Inspection-Final Only After Above Completed
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Building Inspections
A n
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Floor (Joist/Girdem)
1�
Underfloor Insulation (Raised Foundation Only)
I V0 I U61=1
Floor Nailing (Raised Foundation Only)
_
2nd Floor (Floor Nailing)
UAl
Do not cover or conceal the work below until the following applicable items have
been e
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
Plumbina 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
Sewer
t.
Water Engineering Backflow, (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
X
Perms"e Number. BLD2022-05070
Issued: 10/25/2022
www.anaheim.net/building
(714)765-0626
Quarter Section: 107
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 1801 E KATELLA AVE 2072, Anaheim, CA 92805
Legal Description: N TR 16618 BLK LOT 1 UN 2072 TRACT 16618, LOT 1 OF
APN:93028856
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 ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED
FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST, AND ATTORNEYS 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 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. BERKSHIRE HATHAWAY HOMESTATE INSURANCE COMPANY Policy No.: REWC227376 Expiration Date: 11/30/2022
Name of Agent: Phone No.:
I certify that in the performance of the work for which this permit is issued, l shall not employ any person in any manner so as to become subject to the
workers compasidion laws of California, and agree that, If I should become subject to the workers compensation provisions of Section 3700 of the
Labor, I Pit forthwith comply with those provisions. %
Signature- . _ -- - � - -- — - -- . .. _- --- - - - _- . -! �/���Z — _ • -- - - --
Apphca 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:
Lender's Address:
LICENSED CONTRACTOR'S DECLARATION:
1 hereby affirm under the penalty of Perjury that I am licensed under provisions of chapter 9 (commencino with Section 70001 of Division 3 of tha Rovinaan and
Professions Code my license is in full force and effect
�DIEEM F6igrti3fure
NUMBER
EXPIRATION DATE
LICENSE TYPE (S)
443682 08/31/2023 S. C-6
Date