634 S VALLEY ST (3)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 EFFECTIVEDATE
wwwanaheim.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 202 C)o C),9 N Date: 61 1
Project address: C 3 9 S V aII e v C Pmrlwrritnnl C¢� 01:2 koU
Property Owner: L— Q u M F,\CL J 0- f o S c !"�, .
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
leeping area in the immediate vicinity of bedroom/s or in each hallway outside of the rooms.
S7oke Alarms: In each room used for sleeping purposes.
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
Signature:
require carbon monoxide detectors.I
Date: 2jor
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.neVbuilding B842
SMOKE/ CO ALARM REQUIRED LOCATIONS
Bedroom Bedroom
6 1 6 -
Bath Bedroom
08 in6
0
Kitchen
Living Room
gal
Figure 1
Family Room Bedroom
Dining
Living Room
Kitchen
Bedroom Bedroom
Figure 2
Attic
Bedroom Hall Bedroom
Living Room Hall Kitchen
Basement
Figure 3
REQUIRED SMOKE ALARM LOCATION
REQUIRED CARBON MONOXIDE ALARM LOCATION _
6
�I a• Ie
Ceilin
Acceptable a•
Here Never
Here r
Top of Detector
Acceptable Here
well
Figure 4
Garage
a
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00084
Issued: 01/10/2023
www.anaheim.net/building
(714)765-0626
Quarter Section: 41
Site Address: 634 S VALLEY ST, ANAHEIM, CA 92804
Mptlon:NTR 3346 BLK LOT 11
APN:
iDdi't
818307
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 -5153
Project Description: Reroof, To remove and install (28) squares of composition and shingles for the house and attached garage.
Living Area: Number of Stories: 1 Valuation: 14,900.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinklered:
Cool Roof: Total Fees paid for Permit: 340.94
People Associated with Project:
Permit Applicant Ulises Ahumada
Owner YAROSIK CARMELA TR 634 S VALLEY ST
Type Electrical Fixtures Qty Type Plumbing Fixtures Qty 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 P�Pt1EIM C9<
O� io
Building Division F y
U >
�D��►DED
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 ElectrodelUfer
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
si ne :
Building Final (714 765-5153) (AJ
Last Inspection-Final Only After Above omp eOd _ R
V
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
PARTIAL INSPECTIONS
Building Inspections
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 i
lot Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd ooF.Shear
Mechanical Inspections
E_�a�thing iaphragm/Frame)
ond 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)
Plumbing Inspections
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
(Do not backfill unless Maned ofn
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
x
Permit Number: BLD2023-00684
Issued: 01/10/2023
www.anahejm.net/building
(714)765-4626
Quarter Section: 41
Site Address: 634 S VALLEY ST, ANAHEIM, CA 92804
Legal Description: N TR 3346 BLK LOT 11
APN: 12818307
CITY OF ANAHEIM
BUILDING DMSION
200 S. ANAHEIM BLVD.
1714) 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 ATTORNEYS 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.
U 1 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 workers Compensation insurance carrier and policy are:
Cartier: STATE NATIONAL INSURANCE COMPANY INC Policy No.: CWC19491399 Expiration Date: 111/2024
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, if I should become subject to the workers compensation provisions of Section 3700 of the
bo de, I shall forthwith comply with those provisions.
t/ry/Z3
Ig ature of Applicant 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:
1 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 erend rtryiieea is in full force and effect.
Co tractor Signature
NUMBER EXPIRATION DATE LICENSE TYPE (S)
1042214 07/31/2024 C39
Date