812 N LA REINA ST (3)Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00359
Issued: 01/24/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 18
Site Address: 812 N LA REINA ST, Anaheim, CA 92801
..-.ark.:.::. , :.
Legal Description: N TR 2332 BLK LOT 184
APN:'67028222
CITY OF ANAHEIM
BUILDING DMSION
200 S. ANAHEIM BLVD. '
(7141765-5153
Project Description: Remof: Remove existing to install (15) sq of composition shingles over entire house and (6) sq over detached
garage
Living Area: Number of Stories: 1 Valuation: 7.000.00
Garage Area: Construclion Types: NIA
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire Sprinklered:
Cool Roof: Total Fees paid for Permit339.91
People Associated with Project:
Permit Applicant Natalie Gultlerrez
Owner CDK HOLDINGS LLC 2100 W LINCOLN AVE
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.
P�Pt1E1119 �,q<
Cityof Anaheim a� �o
Building Division F z
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DED
Do not occupy 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 I 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 business days)
Setback/Forms/Trenches (Footings)
COA/Migation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
signed:
Building Final (714 765-5153)
Last Inspection -Final Only After A4eComple d
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)
Do not cover or conceal the work below until the following applicable items have
sinnedi
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2n
oof (Sheathi iaphragm/Frame) —
Mas my (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation Measures
Plumbinq 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 & Pibg)
Interior Lath
Exterior Lath
Electrical Inspections
Electrical Service Meter -(Meter will be set within 2-3
business days after approval) Excludes New
Construeflon
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
Permit Number: BLD202340359 r r
Issued: 01/24/2023
www.anaheim.net/buiiding
(714)765-4626
Quarter Section: 18
Site Address: 812 N LA REINA ST, Anaheim, CA 92801
Legal Description: N TR 2332 BLK LOT 184
APN:07028222
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 certBcate of consent to self4nsure 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. MIDWEST EMPLOYERS CASUALTY COMPANY Policy No.: BNUWC0157499 Expiration Date: 8/8/2023
Name of Agent:
Phone No.:
I certify Pat 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
worke" compensation laws of California, and agree that, if I should become subject to the worker's compensation provisions of Section 3700 of the
shall forthwith comply with those provisions.
Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penalty of pedury 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 CONT CTOR'S DECLARATION:
1 hereby affirm undo
nd r the penalty of Perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Profassi s Cod , and my Il ense Is in full force and effect.
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Cont/actor gignatuni Date
NUMBER EXPIRATION DATE LICENSE TYPE (S)
1057466 08/31/2023 B. C39
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