209 S LEANDRO STPermit Types
BLD I ELE I MEC PLM
X I x I x I x
Permit Number. BLD2023-01691
Issued: 04/12/2023
www.anaheim.neUbuilding
(714)765-4626
Quarter Section: 191
Site Address: 209 S LEANDRO ST, ANAHEIM, CA 92807
Legal Description: N TR 7003 BLK LOT 53
APN: 36313305
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Project Description: Residential Remodel: replace (1) shower with file and upgrade mechanical and electrical for (1) bathroom
Living Area: Number of Stories: 1 Valuation: 15,000.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony / Dock Area: Fire Sprinidered: No
Cool Roof. Total Fees paid for permit: 270.95
People Associated with Project:
Contractor RVM CONSTRUCTION INC 1200 NORTH JEFFERSON ST UNIT J200112071212310380 ANAHEIM, CA 92807
Permit Applicant RON VANDER MOOREN
Owner STRYKER JEFFREY DAVID TR 209 S LEANDRO ST
Type Electrical Fixtures City Type Plumbing Fixtures Qty Mechanical Fixtures Qty
Receptacle, switches, lights 7 Shower 1 Ventilation Fan - <= 300 cfm on single duct 1
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 of Anaheim
Building Division
Do not occupy this building until the final inspections have been made.
INSPECTION
DATE INSPECTOR
Do not pour concrete until the following applicable items have been signed:
Plumbing (Ground/Underfloor Drain Waste)
Electrical Ground Electrode/Ufer
MS lso vw
Setback/Forms/Trenches (Footings)
612w-_3
Do not install subfloor or pour floor slab until the follwing applicable items have been
smoneds
Plumbing (Ground/Underfloor Water)
Cross Connection Control (714) 765-4280
Underfloor Rough Gas
Engineering Final (714) 765-5126
Mechanical (Groundwork)
Fire Sprinkler (ONLY) (714) 765-5041
Electrical (Underground Conduit)
Fire Dept. Final (714) 765-5041
Pre -slab (Compaction/Membrane Reinf.)
Water Engineering (714) 765-4591
Floor (JOISUGirders)
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
Underfloor Insulation (Raised Foundation Only)
Floor Nailing (Raised Foundation Only)
Building Final (714 765-5153)
Last Inspection -Final Only After Above Completed
2nd Floor (Floor Nailing)
Do not cover or conceal the work below until the following applicable items have
been e•
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
t
Rough Plumbing (Top Out)
Z3 I$a -
Rough Duct (Mechanical)
Rough Mechanical
S%L3 G
Rough Electrical
Rough COA/Mitagation Measures
Framing (Only after Plbg.. Ele., Mec. & Fire)
Zc3 oyti. c -
Insulation (Sound/Energy)
$ ?b it'd( -
Do not tape or plaster until the following applicable items have been signed:
DrywallZ-
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
MS lso vw
Plumbing Final
612w-_3
Mechanical Final
Cross Connection Control (714) 765-4280
Engineering Final (714) 765-5126
Fire Sprinkler (ONLY) (714) 765-5041
Fire Dept. Final (714) 765-5041
Water Engineering (714) 765-4591
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
COAIMigation Measures
Building Final (714 765-5153)
Last Inspection -Final Only After Above Completed
PARTIAL INSPECTIONS
Mechanical Inspections
Plumbinq Inspections
Electrical Inspections
Permit Types
BLD ELE MEC PLM
X I X I X X
Permit Number: BLD2023-01691
Issued: 04/12/2023
www.anaheim.net/building
(714)765-0626
Quarter Section: 191
Site Address: 209 S LEANDRO ST, ANAHEIM, CA 92807
Legal Description: N TR 7003 BLK LOT 53
APN: 36313305
WORKER'S COMPENSATION DECLARATION:
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
17141 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 self4nsum for workers compensation, issued by the Director of Industrial Relations as provided for by
action 3700 of the Labor Code, for the performance of the work for which this permit Is issued.
V41",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:
Carrier. FALLS LAKE FIRE AND CASUALTY COMPANY Policy No.: FLA01332103 Expiration Date: 1/1/2024
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, K I should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
Signature of A,pll nt
1-f (
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:
I hereby affirm under the penalty of Perjury that I am licensed under provisions of chapter 9 (commencing with Section 70001 of Division 3 of tho ausinnan and
Professions Code, and license is In full force and effect.
Contractor
NUMBER EXPIRATION DATE LICENSE TYPE ISI
586334 01/31/2024 B. C36
Date