1410 S PEMBROOKE LN (2)` Permit Types
BLD ELE MEC PLM
X
Permit Number: OLD202245263
Issued: 11/07/2022
www.anaheim.net/building
(714)765.4626
Quarter Section: 42
CITY OF ANAHEIM
SIN Add4"ss::1410:S PEMBROOKE LN, ANAHEIM, CA 92804
,L gaF1.De�ption::N -flu& 8 BLK L6T;35
APN:12862205
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Project Description: Reroot Remove existing material, and install (36) squares of composition shingles for the house and attached
garage
Living Area: Number of Stories: 2 Valuation: 9.400.00
Garage Area: Construction Types: WA
Carport Area: Occupancy Groups:
Balcony I Dedc Area: Fire Sprinidered:
Cool Roof: Total Fns paid for Permit: 340.22
People Associated with Project:
Owner OTENG ELIZABETH TR 1410 S PEMBROOKE LN
Type Electrical Fixtures Qty Type Plumbing Fbdures 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 worts.
P�PHEIM CSC
City of Anaheim c� io
Building Division F i
u >
DED X11kochanical
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
Plu Fm
Final Q�-
Cross Connection Control (714) 79V480
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
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 sionedp
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 (Strutt., Ele., or Mec.)
Grease Interceptor
Sewer
Water Engineering Backflow (Testable Only)
Water Service
pp=ppp"
Permit Types
BLD ELE, MEC PLM
X
Permit Number: BLD2022-05263
Issued: 11/07/2022
www.anaheim.net/building
(714)765.4626
Quarter Section: 42
CITY OF ANAHEIM
Site Addrbss:1410 S PEMBROOKE LN, ANAHEIM, CA 92804
Legal Description: N. 6089.BLK LOT 35
APN:12862205
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
Project Description: Reroof: Remove existing material, and install (36) squares of composition shingles for the house and attached
garage
Living Area: Number of Stories: 2 Valuation: 9,400.00
Garage Area: Constriction Types: NIA
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Spdrddered:
Cool Roof. Total Fen paid for Permit: 340.22
People Associated with Project:
Owner OTENG ELIZABETH TR 1410 S PEMBROOKE LN
Type Electrical Fixtures Qty Type Plumbing Fixtures. Oty Mechanical Fixtures Oty
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
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
st Floor Shear
(Fire
Shear
111Ilhasonry'( em�d Beam/Pre-Grout) WL ll I f+ j
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 Penetrations (Ele, Mec &
Interior Lath
Exterior Lath
I Service Meter -(Meter will be set within 2-3
days after approval) Excludes New
Exterior Plaster (Brown Coat)
T -Bar (Struct., Ele., or Mec.)
Grease Interceptor
Engineering Backflow (Testable Only)
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) 766-4691
Sub List/Bus. Lic. (714) 765-5194 (Allow 10 business days)
COA/Migation Measures
ilding Final 714 765-5153)
Last Inspecti
in
Only After Above Completed Z
PARTIAL INSPECTIONS
Buildinq Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
a
BUILDING DIVISION
CITY OF ANAHEIM
BUILDING DEPARTMENT 2016 CALIFORNIA CODES
200 S. Anaheim Blvd., Suite 145 CODE CYCLE
Anaheim, CA 92805 01/01/2017
714 765-5153 EFFECTIVE DATE
www.anaheim.net/building
SMOKE DETECTORS AND CARBON MONOXIDE SELF CERTIFICATION
* Final inspection approval will require this completed form to be on site along with the job card.
Permit Number: d L b a. 0 2',- O r V j6 3 —Date:–It 1 13 2-0 22
Project address: 1 4 (0 C. P E m 13120OlcE L #-J ArJ.44 ) vy (-A- qa?ay
Property Owner: C L i z A t3 G- i i f O T E)J q
The undersigned does hereby certify that I am the property owner of the above referenced
property._, I_further_certify_that. smoke -alarms and carbon- monoxide-, alarms -are -present and.:.. _
functional in all the following locations. All boxes must be checked below
Smoke Alarms and Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
sleeping area in the immediate vicinity of bedroom/s or in each hallway outside of the rooms.
FSmoke Alarms: In each room used for sleeping purposes.
1A Smoke Alarm and Carbon Monoxide Alarm: In each story, including any habitable basement;
(Note: in dwellings or dwelling units with split levels and without an intervening door between
the adjacent levels, a smoke alarm and a carbon monoxide detector installed on the upper level
shall suffice for the adjacent lower level provided that the lower level is less than one full story
below the upper level.)
All dwelling units with attached garages require carbon monoxide detectors.
Signature: Date: 11 13 9 �Z
California Residential Code (CRC) Section R314.6.2,CRC R315.2 states in part that existing dwellings be
.retrofitted with smoke detectors and carbon monoxide detectors when a building permit is issued for work on or
in a building that is valued at $1,000 or more." CRC Section R314.3, CRC R315.2 defines required locations as
indicted above.
NOTE: This certification is only used when normal access to the interior of the dwelling by the City of Anaheim
Inspector is not achieved during the course of project construction. It is normally used for exterior projects such
as re -roofing, re -siding, patio covers, solar photovoltaic installations, and similar exterior construction work.
200 S. Anaheim Blvd., Suite 145 Anaheim, California 92805 (714)765-5153 Phone (714)765-4607 Fax FEB 2018
www.anaheim.nettbuilding 6842
SMOKE/ CO ALARM REQUIRED LOCATIONS
Bedroom Bedroom
O
Bath L1 Bedroom
0
Kitchen
Living Room
o$ e
Family Room Bedroom
Dining
Living Room
Kitchen
BedroomZ
Bedroom
Figure 1 Figure 2 V
CeTn�
Acceptable Never �4-
Here Hen: ��r
Attic Top of Detector
Acceptable Here
6 Wall
Bedroom Hall Bedroom Figure 4
Living Room Hall Kitchen
Basement Garage
Figure 3
REQUIRED SMOKE ALARM LOCATION
REQUIRED CARBON MONOXIDE ALARM LOCATION
Permit Types _
BLD ELE MEC PLM
X
Permit Number. BLD2022-05263
Issued: 11/07/2022
Www.anaheim.net/buiiding
(714)7654626
Quarter Section: 42
CITY OF ANAHEIM
Site Address: 1410 S PEMBROOKE LN, ANAHEIM, CA 92804
Legal Description: N TR 6089 BLK LOT 35
APN: 12862205
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 Blowing declarations:
I have and will maintain a certificate of consent to selfansure 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 tabor Code, for the performance of the work for which
this permit Is issued. My workers Compensation insurance carrier and policy are:
Carrier. STATE COMPENSATION INSURANCE FUND Policy No.: 9160074 E oration Date: OMA023
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 workers compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
4--�gnature of Applicant
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
--- — - -- - -
Date
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 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 full force and effect.
.oOM-ritracttor Signature
NUMBER EXPIRATION DATE LICENSE TYPE (S1
1014058 05/31/2024 B, C39, C33
4l-%- zozz
Date