5260 E NANTUCKET LN (2)City of Anaheim
BUILDING DIVISION
INSPECTION RECORD
SWIMMING POOL
ADDRESS: 5260 E NANTUCKET LN
OWNER: LARRY WOLFF
PERMIT #: SW12020-00136
DATE ISSUED: 12/14/2020
DESCRIPTION: Relocation pool equipment new gas line, subpanel and new
lighting to existing pool, fire pit.
POST THIS CARD WITH THE APPROVED PLANS IN A
CONSPICUOUS PLACE ON THE JOB SITE
Inspection Code Date Inspector
1. Main Outlet. a 504
2. Electric Bonding. 506
3. Steel. 508
4. Approval to Gunite. 510
DO NOT GUNITE POOL/SPA
until all the above inspections have been signed.
5. Steel and bonding. 508
DO NOT GUNITE ROCK STRUCTURE
(water feature, rock slide, fountain, waterfall, grotto
etc.) until all the above inspections have been signed.
6. Underground elect.
512
Slly z
Ap-
7. Gas piping test.
514
8. P -Trap Receptor.
516
C Jq/21
9. Backflow Device.
518
y
10. Deck, Deck
Drains, & accessory
bonding.
520
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fl 3
DO NOT POUR FLATWORK
until the above inspections have been signed.
11. Rough electric. 522
12. Fencing. 524
13. Plaster approval. 526 '
DO NOT PLASTER
until the above ins ections have=been-si ned:
14. Final Electric. 1 528 111/1qTJ
I I
Sub -Contractors list approved and
pool cover in place prior to final inspection.
15. FINAL
599
1/ &
A_
MISC. INSPECTIONS DATE INSPECTOR
Porneal - Sea -rt rolz1
Inspectors can normally be reached between
7:30 - 8:00 A.M. and 3:30 - 4:30 P.M.
(714) 765-5153 + 0
swimcard
Inspections 1 - 5:
1. All plumbing to be complete and the system
pressurized to 35 lbs. with water or house pressure.
2. All metal within 5 feet of pool water, and all pool
equipment, must be bonded to pool reinforcing steel
with #8 solid copper wire. Niche light shell, deck
inserts, etc., shall be bonded to pool rebar.
3. Pool equipment is not required to be set at this time.
Inspections 6 -10:
1. Underground electric inspected prior to backfilling.
2. Gas line test at 10# for 15 minutes, with 15# gauge.
3. When polyethylene gas piping is used, a certificate
from a certified installer and a metal tag at the meter
shall be provided per CPC 1211.3 APPENDIX I.
Inspections 11 -13:
1. Rough electric inspection when all wiring is
completed and ready to run prior to the plastering
of pool/spa.
2. City ordinance 6.56.010 requires that any pool, spa
or water feature containing water 18 inches or more
in depth shall be enclosed by a barrier adequate to
prevent entry of small children. The barrier shall
comply with Section 421 of the current CBC and City
of Anaheim ordinance 15.02.060.180 specifying the
height of any fence provided as barrier to the pool
shall be 60" above grade on the outside of the fence.
3. Doors from a garage shall meet the requirements
for a gate. Glass windows within T of pool water
shall be tempered glass.
4. Prior to pre -plaster inspection, streets, curbs and
city sidewalks will be inspected for any damage
due to construction of pool or spas.
5. Grading complete with positive drainage to street or
public way. All exposed plastic pipe painted to
protect from sunlight.
Inspections 14 -15:
1. After pool is operating and in working condition,
approved pool cover in place.
INSPECTION REQUESTS
Inspection requests made before 5:00 pm will be scheduled
on the following workday.
To schedule your building inspection online, please go to
http://www.anaheim.neVinspectionReciuest.
You may also request your inspection by calling (714) 76.5-46.26 and
continue with the following steps:
• Press 1 for inspection function.
• Press 1 to schedule inspection.
• Press 5 for Swimming Pool inspection.
• Enter your permit # 202000136.
•' Enter the Code number for the inspection requested
(indicated in blue).
• Press 1 for next business day, or enter date preferred.
• Select time preference (Request is subject to
inspector's schedule.)
To access.your inspection timeframe, please go to
www.anaheim.net/buildina after 7:30 am on the day of your
inspection. Under Online Services, click on the
"Inspection Timeframes" link or call (714) 765-5153 + 0.
BUILDING DIVISION
SWIMMING POOL PERMIT NO. SW12020-00136 Nii�
�p c4 200 S. ANAHEIM BLVD.
�r fr1�c:. (714) 765 - 5153
TYPE OF PERMIT
Repair or Alteration of Existing
DATE: 12/14/2020
JOB ADDRESS: 5260 E NANTUCKET LN
LEGAL DESCRIPTION: TR 9268 LOT 50 POR OF LOT
PERMIT APPLICANT: LARRY WOLFF
E I M INSPECTION REQUEST LINE:
(714) 765 - 4626
QUARTER SECTION: 175
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
LARRY WOLFF
5260 E NANTUCKET LN
ANAHEIM, CA 92807-4617
JOB DESCRIPTION: Relocation pool equipment new gas line, subpanel and new lighting to existing pool, fire pit
VALUATION:
PROCESSED BY: CMN
nereuy amrm unser penairy oT pequry that i am exempt tram the Contractor's License Law for the following reason (Sec. 7031.5 Business and Professions Code: any city or
county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed
Stemant
that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Profession
Cod or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil
khrough
of not more than five hundred dollars ($500).
as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044 Business
fessions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or
his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold with one year of
completion, the owner -builder will havelhe burden of proving that he did not build or improve for the purpose of sale).
❑ I, as the owner of the property, am a clusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions Code: The Contractor's
License Law does not apply to an ow o roperty who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's
License Law).
❑ I am exe pt u der Sec. B tL P.C. for this reason:
Date: % Own
COMPENSATION DECLARATION
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, as provided for
by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
pI have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code,
or the performance of the work for which this permit is issued. My worker's Compensation insurance carrier
and policy are:
Carrier: Policy Number:
This section need not be completed if t he permit Is for one hundred dollars ($100) or less.
❑ 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, I shall forthwith
comply with those provisions.
Date: 12/14/2020 Applicant:
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND
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 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I 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 Information:
I certify that I haRtabove
d this ap ication and state at the above information is correct. I agree to comply with
all city ordinancstate laws lacing to build construction, and hereby authorize representives of this
city to enter upo mentio d pmpArty inspection purposes.
Date: 12/14/2020
The permit shall expire Py limitatioond Mome null and void if the building or work has
not passed final inspec oin 365 days from the date of permit issunace. A new permit is
required to commence or continue work.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed
under provisions of chapter 9 (commencing with Section 7000)
of Divsion 3 of the Business and Professions Code.
Date: 12/14/2020 Contractor.
NUMBER: EXPIRATION DATE:
TYPE:
Census Code
n-- -
434
Fees paid for -Permit:
Total:
384.00
INSPECTION REQUEST LINE:
(714) 765 - 4626
Quarter Section: 175
Permit Number: SW12020-00136
Issued: 12/14/2020
s —
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
OWNER -BUILDER ACKNOWLEDGEMENT AND INFORMATION VERIFICATION FORM
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements
specified at 5260 E NANTUCKET LN .
We are providing you with an Owner -Builder Acknowledgement and Information Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder.
We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this
form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner,
obtain the prior approval of the permitting authority.
0 ctions: Read and initial each statement below to signify you understand or verify this information.
1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" building
permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an
Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully working as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to
workers on my property.
2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
myself from potential risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own.
4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
5. 1 understand if I employ or otherwise engage any persons, other than Caliifornia licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer"
under state and federal law.
6. 1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers's compensation disability insurance, and contribute to unemployment
compensation for each "employee". I also understand my failure to abide by these laws may subject me to serious financial
risk.
7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial
or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the
workmanship or materials.
9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service,
the United States Small Business Administration, the California Department of Benefit Payments, and the California Division
of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at
1-800-321-CSL13 (2752) or www.cslb.ca.gov for more information about licensed contractors.
fbld owner builder info verif
Permit Number: SW12020-00136
10. 1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
party legally and financially responsible for proposed construction activity at the following address: 5260 E NANTUCKET LN
11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner-Builders as well as employers.
12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
,someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial
loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is
also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while
working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire
Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of
their workers' compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the
agency responsible for issuing the permit.
Note: A co y of the prope owner's driver's license, form notarization, or other verification acceptable to the agency is required
to be pnZ ted when the p mit is issu to verify the property owner's signature.
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P fpl�
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s Signature Date:
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fbld owner builder info verif