2840 W ROWLAND CIR (2)Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2022-05071
Issued: 10/2512022
www.anaheim.netibuilding
(714)765-0626
Quarter Section: 13
Site Address: 2840 W ROWLAND CIR, Anaheim, CA 92804
Legal. Description: N TR 2400 UK` LOT 150
6
OW'.12608209
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Project Description: Mechanical to change out air conditioner, (1) furnace and (1) coil.
Living Area: Number of Stories: 1 Valuation: 0.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups.
Balcony I Deck Area: Fire Sprinldered:
Cool Roof: Total Fees paid for Permit: 217.00
People Associated with Project:
Permit Applicant Ben Medina
Owner PHINEY GARY R 2840 W ROWLAND CIR
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Mechanical Fixtures Qty
Compressor/Boller - up to 15 hp 1
Heating Appliances, including vent 1
HeatinglCooling Coil 1
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�PNEIM Cqt FINAL INSPECTIONS DATE INSPECTOR
Cityof Anaheim D� io All applicable items below must be signed before utilities are released
Building Division F i Final Gas Test
u D Electrical Final
Plumbing Final
�DGNDED �a�� a apical Final C 2'L
Cross Connection Control 14) 76!W280
Do not occupy this buildinq until the final inspections have been made. Engineering Final (714) 765-5126
INSPECTION I DATE 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 si ed:
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 COAIMitagation 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 (Strutt., Ele., or Mec.)
Grease Interceptor
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
X
PerrSit Number: OLD2022-05071
Issued: 10/25/2022
www.anaheim.net/building
(714)765-0626
Quarter Section: 13
Site Address: 2840 W ROWLAND CIR, Anaheim, CA 92804
Legal Description: N TR 2400 BLK LOT 150
APN:12608209
WORKER'S COMPENSATION DECLARATION:
CITY OF ANAHEIM
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
this permit is issued. My worker's Compensation insurance carrier and policy are:
Cartier: A I U INSURANCE COMPANY Policy No.: 053419323 Expiration Date: 7/1/2023
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
workers compensation laws of California, and agree that, It I should become subject to the worker's compensation provisions of Section 3700 of the
Labor Code allforthwlt mply with those provisions.
Signature of Appli 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):
Lenders Name:
Lenders Address:
LICENSED CONTRACTOR'S DECLARATION:
I hereby affirm under the penalty of Per)ury that 1 am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code, and m saxal e Is in foil force and effect.
fo
Contract °Signator Date
NUMBER EXPIRATION DATE LICENSE TYPE Ia
974908 07/31/2024 C-2, C20
sc
7w"540
CITY OF ANAHEIM PLOT PLAN
PLANNING SERVICES DIVISION
APPROVED
DATEIv �' �" ZONE
OT t r )
DEV FEE S
WATER FFICIENCY
192 Exempt New >500ft' Alter >2,500 ft
'Plans comp wdh Me 18 of the A.M.C. (Zoning).
Thif'does constitute approval of building �C
penrit or a violation of any ' y Codes.
RECIVSD
;b �' T 2022
BUILDI _DIVISION - -
�OW 6,4� A .
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