871 S NORDICA STPermit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-01690
Issued: 04/11/2023
www.anaheim.net/building
(714)765-0626
Quarter Section: 114
Site Address: 871 S NORDICA ST, ANAHEIM, CA 92806
."go Description: N TR 6809 BLK LOT 20
Aki 253'12131
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765-5153
Project Description: Re -roof: tear -off old and install (32) sq of GAF composition shingles on entire house.
Living Area: Number of Stories: 1 Valuation: 10,000.00
Game Area: Construction Types: N/A
Carport Area: Occupancy Groups:
Balcony / Dock Area: Fire Spdnldered:
Cool Roof: Total Fees paid for Permit: 361.30
People Associated with Project:
Contractor TECUN ROOFING 10857 LEHIGH AVENUE PACOIMA, CA
Permit Applicant Elmer Escalante
Owner COVARRUBIAS FERNANDO R TR 871 S NORDICA ST
Type Electrical Fixtures City 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
Building Division
Do not occupy this building until the final inspections have been made.
INSPECTION I DATE INSPECTOR
Do not pour concrete until the following applicable items have been signed:
Plumbing (Ground/Underfloor Drain Waste)
Electrical Ground Electrode/Ufer
Setback/Forms/Trenches (Footings)
Do not install subfloor or pour floor slab until the follwing applicable items have been
s' e •
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 e•
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd
oof (Sheathing/ ' phragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation Measures
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 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
(Dn not backfill unless sinned off)
Sewer
Water Engineering Backflow (Testable Only)
Water Service
FINAL INSPECTIONS I DATE I 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
Fire Sprinkler (ONLY) (714) 765-5041
Fire Dept. Final (714) 765-5041
Water Engineering (714) 755-4591
Sub List/Bus. Lic. (714) 755-5194 (Allow 10 business days)
COA/Migation Measures
Building Final (714 755-5153)
Last Inspection -Final Only After Above Completed
PARTIAL INSPECTIONS
Buildinq Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-01690
Issued: 04/11/2023
www.anaheim.neUbuilding
(714)765-0626
Quarter Section: 114
Site Address: 871 S NORDICA ST, ANAHEIM, CA 92806
Legal Description: N TR 6809 BLK LOT 20
APN:25312131
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 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 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.
1 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 worker's Compensation insurance carrier and policy are:
Cartier. STATE COMPENSATION INSURANCE FUND Policy No.: 9303704 Expiration Date: 8/14/2023
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 taws of California, and agree that, if I should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
Aiit�ureof Dat
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 DECLARATION:
I hereby affirm under the penalty of Pedury 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 full force and effect.
Contractor Signature
NUMBER EXPIRATION DATE LICENSE TYPE (S)
1084003 11/30/2023 C39
Date T—