2394 S WILLOWBROOK LN 17Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-01115
Issued: 03/07/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 89
CITY OF ANAHEIM
BUILDING DIVISION
(714) 765 -5153
Site Address: 2394 S WILLOWBROOK LN 17, ANAHEIM, CA 92802
Legal Description: N TR 10476 BLK LOT 2 UN 17 TR 10476 LOT 2 UNIT 17
APN:93758017
Project Description: Residential Remodel: Replace (9) retrofit windows and (1) sliding door
Living Area: Number of Stories: 1 Valuation: 13,411.35
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony I Deck Area: Fire Sprinklered: No
Cool Roof: Total Fees paid for Permit: 242.74
People Associated with Project:
Contractor HOME DEPOT U S A INC DBA THE HOME DEPO P O BOX 105451 ATTN LICENSE MANAGEMENT 200408130950507570 ATLANTA, GA 9260
Permit Applicant Jeffrey Pao
Owner TESTA KAMERIN 7924 CUMBERLAND PARK DR 5101
Type Electrical Fixtures City 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�PYtElm Cq<
Cityof Anaheim D� io
Building Division y
u a
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 LisUBus. Lic. (714) 765-5194 (Allow 10 business days)
Setback/Forms/Trenches (Footings)
COAIMigation Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
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 Mane&
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
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-01115
Issued: 03/07/2023
www.anaheirnmet/building
(714)765.4626
Quarter Section: 89
CITY OF ANAHEIM
BU!LPING DIVISION
• ,'
200 5k;,r: ANAHEIM BLVD.
17141765 -5153
Site Address: 2394 S WILLOWBROOK LN 17, ANAHEIM, CA 92802
Legal Description: N TR 10476 BLK LOT 2 UN 17 TR 10476 LOT 2 UNIT 17
APN:93758017
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 selfinsure 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 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:
Carrier: ACE AMERICAN INSURANCE COMPANY Policy No.: WLRCSOO68150 Expiration Date: 3/1/2024
Name of Agent: Phone No.:
Ice ' at 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
orkees compensation laws of California, and agree that, if I should become subject to Ore worker's compensation provisions of section 3700 of the
lab r Code, l s th comply with those provisions.
Signature of Applicant Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penalty of pedury 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 5ONTRACTOWS DECLARATION:
I hereby afryfi under the penalty of Pe ury that 1 am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Protesslo Cod and my lice Is in II force and effect. jj rr
ss
Contractor Signature Date
NUMBER EXPIRATION DATE LICENSE TYPE (SI
602331 09/30/2024 C10, B, D12, G2, C39, C-6, C17, C36, D34, D41, D24