319 S PEREGRINE ST (9)�- Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-05145
Issued: 04/05/2023
www.anaheim.net/building
(714)765.4626
Quarter Section: 113
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
1714)765-5153
Site Address: 319 S PEREGRINE ST, ANAHEIM, CA 92806
Legal Description: S TWP 4 RGE.10 SEC 12 T 4 R 10 SEC 12 POR SW1/4 -
APN: 6$305114
Project Description: Antenna Cell Site: Modification to existing monopine cell site for "Verizon".
Lhdng Area: Number of Stories: 0 Valuation:
Garage Area:
Carport Area:
Balcony / Dedc Area:
Cool Roof:
Construction Types:
Occupancy Groups:
Fire Sprinldered:
Total Fees paid for Permit:
People Associated with Project:
Contractor TECHSICO INC 910 S HUDSON AVE201909161447511080 TULSA, OK 92880
Permit Applicant Emily Pruitt
Owner NMC ANAHEIM LLC 5850 CANOGA AVE 650
25,000.00
N/A
764.00
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�PHEIM CqC
City of Anaheim D� �O
Building Division F i
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DEO'
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
z�
let
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
PARTIAL INSPECTIONS
Building 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 s*aneds
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
Plumbing 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
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
A BLD ELE MEC fPLM
X
Permit Number: BLD2022-05145
Issued- 04/05/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 113
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 319 S PEREGRINE ST, ANAHEIM, CA 92806
Legal Description: S TWP 4 RGE 10 SEC 12 T 4 R 10 SEC 12 POR SWI/4 -
APN: 08305114
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.
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. VALLEY FORGE INSURANCE COMPANY Policy No.: 7018614915 Expiration Date: 41110M
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, 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.
r
f I -
Signat6ecIff Applicant
Ck OcJ/ZbZ3
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 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.
FJ4� 0 4 Lo 4 2(ya
Contrac Signature Date
NUMBER EXPIRATION DATE LICENSE TYPE IS)
1052016 04/30/2023 B. C10, A