8260 E LADYFERN LN (3)Permit Number: BLD2022-06013 •'
Issued: 12/20/2022
www.anaheim.netibuilding
(714)765-4626
Quarter Section: 220
Site Address: 8260 E LADYFERN LN, ANAHEIM, CA 92808
Legal DescNptlon: N TR 12992 BLK LOT 50
APN:35438221
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765.5153
Project Description: Reroof: Relay (32) sq of light weight tile (5.5 psi, ESR -1900) over entire house and attached garage
Living Area: Number of Stories: 0 Valuation: 11,200.00
Garage Area: Construction Types: N/A
Carport Area: Occupancy Groups:
Balcony / Deck Area: ' " Fire Sprinklered:
Cool Root Total Fees paid for Permit: 362A6
People Associated with Project:
Permit Applicant Rotem Perez
Owner WHITT DAVID S & KAREN BONNER 8260 E LADYFERN LN
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.
City of Anaheim A
I\il.�li.... Irlivi�\iAr\ 9
FINAL INSPECTIONS I DATE
All applicable Items below must be signed before utilities are
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Electrical Final
Plumbing Final
�OGNDED %aMechanical Final
Cross Connection Control (714) 765.4280
Do not occupy this building until the final inspections have been made. Engineering Final (714) 765-5126
INSPECTION I 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
sinned:
wilding Final 14765-5153) 4/, Q�j en
Last Inspection -Final Only After Above Completed
PARTIAL INSPECTIONS
Building Inspections
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
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 sinned:
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
Mechanical Inspections
2nd FI r Shear
Sheathin hragm/Frame) 7
asonry (Reinf.IBond 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., Mac. & 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 (Strutt., Ele., or Mec.)
Grease Interceptor
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE ME4m-
Permit
X Number: BLD2022-06013
Issued: 12/20/2022
www.anaheim.net/building
(714)765-0626
Quarter Section: 220
Site Address: 8260 E LADYFERN LN, ANAHEIM, CA 92808
Legal Description: N TR 12992 BLK LOT 50
APN:35438221
CITY OF ANAHEIM
BUILDING DMSION
260 S. ANAHEIM BLVD.
1714) 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.
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.
LI A 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
W+i this permit is issued. My worker's Compensation insurance caner and policy are:
Carrier. STATE COMPENSATION INSURANCE FUND Policy No.: 9315111 Expiration Date: 3/26/2023
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
worker's compensation laws of California, and agree that, If I should become subject to the worker's compensation provisions of Section 3700 of the
Labor Code, l shall forthwith comply with those provisions.
Signatu f 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:
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 7000) of Division 3 of the Business and
Professions Code, and my license is In hull force and effect.
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Contractor Signature
NUMBER EXPIRATION DATE LICENSE TYPE (S)
1089382 04/30/2024 C39
Date