1364 S MOONSTONE STPermit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-05373
Issued: 11/10/2022
www.anaheim.net/building
(714)765.4626
Quarter Section: 3
CITY OF ANAHEIM
Site Address: ;1364 S MOONSTONE ST, ANAHEIM, CA 92804
Legal, Descriptioe: N TR•3501 BLK LOT 239
APN: 13437.413
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Project Description: Residential Remodel: Replace (7) retrofit windows and (1) slider
LMng Area: Number of Stories: 1 Valuation: 6,500.00
Garage Area: Construction Types: N/A
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinldered: No
Cool Roof: Total Fees paid for Permit: 207.85
People Associated with Project:
Permit Applicant Kym Bixler
Owner BRIGHT ELMER JAMES TR 1364 S MOONSTONE ST
Type Electrical Fixtures Qty Type Plumbing Fixtures Qly Mechanical Fixtures Qty
The permit shall expire by limitation and become null and vold 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�PHEIM cq<
City of Anaheim o� io
Building Division F z
>
DED %ah^
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
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 (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:
Building Final (714 765-5153)
Last Inspection-Final Only After Above Completed
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
been smanede
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
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 & 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
(Do not hackfi
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
X
Permit Number. BLD2022-05373
Issued: 11/10/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 3
CITY OF ANAHEIM
Site Address: 1364 S MOONSTONE ST, ANAHEIM, CA 92804
Legal Description: N TR 3501 BLK LOT 2.39
APN:13437413
WORKER'S COMPENSATION DECLARATION:
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 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 worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which
k6 this permit is issued. My worker's Compensation insurance carder and policy are:
Cartier. OLD REPUBLIC INSU NCE COMPANY Policy No.: MWC314158 Expiration Date: 101112Q23
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
worker's compensation laws of California, and agree that, it I should become subject to the worker's compensation provisions of Section 3700 of the
Labor Cade, I shall forthwith comply with vis on .
-rn r;�
F Applicant �� /0L
�
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 DECLARATI
I hereby affirm under the penalty of Perjury tKIarn licensed unde sions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code, and my license is in•ful me and eff cR
ntrac o S�tu Date
NUMBER EXPIRATION DATE LICENSE TYPE ISI
990416 07/31/2023 B. C17