723-729 W BELLEVUE DRCITY OF ANAHEIM
Permit Number: SW12022-00057
Issued: 05/18/2022
www.anaheim.net/building
(714)7654626
Quarter Section: 74
Site Addrfsss: 723-729 W BELLEVUE DR, ANAHEIM, CA 92805
L®gal Description: N TR 1886 BLK LOT 14
APN: 251.12102
BUILDING DIVISION
200 S. ANAHEIM BLVD.
1714) 765- 5153
Project Description: Demolition: 320 sq ft pool with (1) 34 hole with shell to remain
People Associated with Project:
Permit Applicant James Hansen
Owner HANSEN JAMES D TR 3906 E GREEN CLOVER CIR
Owner HANSEN JAMES D TR 3906 E GREEN CLOVER CIR
OWNER - BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Law for the following resson(s) Indicated below by the
checkmark(s) I have placed next to the applicable Item(s) (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to
construct, alter, Improve, demolish or repair any structure, prior to Its Issuance, also requires the applicant for the permit to file a signed statement that he
or she is licensed pursuant to the provisions of the Contractors' State License Law Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any
app/ nt for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
LW I, as owner of property, or my employees with wages as their sole compensation, will do (_) all or u portions of the work, and the structure is not
Intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractors' State License Law does not apply to an owner of property, who, through
employees' or personal efforts, builds or improves the property, provided that the Improvements are not intended or offered for sale. If, however, the building or
13 I, as the owner of the property, am exclusively contracting with licensed Contractors to construct the project (Sec. 7044 Business and Professions Code:
The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed
Contractor oursuant to the Contractor's State License Law).
I am exempt from licensure under the Con a ,State License Lawrie follow1
S— l6'- 2-2—
Date
2
Date eKhature of Property Owner or Authorized Agent
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of pedury one of the following declarations:
❑ 1 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.
❑ 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. Policy No.: Expiration Date:
This section need not be completed N the permit Is for one hundred dollars ($100) or less.
❑ 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 comDly with those provisions. -
Date Signature of Applicant —
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.
CONSTRUCTION LENDING AGENCY LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of pedury that there is a construction lending agency for the performance
Lender's Information:
I hereby certify that i have read this application and state that the information above is correct. I agree
to comply with all city ordinances and state laws relating building construction, and hereby authorize
representives of this city to enter upon the above mentioned property, for inspection purposes.
1 hereby affirm under 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.
Date: 05/18/2022
Contractor:
Number: SWI2022-00057 Expiration Date
Date Signature of Applicant or Agen TYPE:
The premit 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.
Fees paid for Permit:
$217.00
City of Anaheim
BUILDING DIVISION
INSPECTION RECORD
4) SWIMMING POOL
ADDRESS:
723-729 W BELLEVUE DR, ANAHEIM, CA 92805
OWNER:
HANSEN JAMES D TR
PERMITM
SW12022-00057
DATE ISSUED:
05/18/2022
DESCRIPTION:
Demolition: 320 sq It pool with (1) 3x3 hole with shell
DO NOT GUNITE ROCK STRUCTURE
ter feature, rock slide, fountain, waterfall, grotto etc.) unfit the above inspection has
been signed.
to remain
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE ON THE JOB SITE
Inspection Code Date Inspector
1. Main Drain 504
2. Electric Bonding 506
3. Steel 508
4. Approval to Gunite 510
DO NOT GUNITE POOLISPA
until all the above inspections have been signed.
5. BLD -Steel and Electric bonding
(Rock Structures,Slides Etc)
508
DO NOT GUNITE ROCK STRUCTURE
ter feature, rock slide, fountain, waterfall, grotto etc.) unfit the above inspection has
been signed.
round Electric
512
ping Test
FBondina
514
Receptor
516
w,
518
Deck Drains,
tiai & Accessory
520
DO NOT POUR FLATWORK
until all the above Inspections have been signed.
11. Rough Electrical 522
12. Fencing/Door Alarms 524
13. Plaster approval 526
DO NOT PLASTER
until all the above inspections have been signed.
14. Final Electric 528
Sub -Contractors List MUST be approved and pool cover on site
PRIOR to Pool Final inspection request
FINAL INSPECTION CODE FD-#Tg INSPECTOR
15. Rough Demo 527
16. Final 599 fbc
MISC. INSPECTIONS Dat4 inspector
fbldjobcards
Inspections 1.5•
1. All plumbing to be completed and the system pressurized to 35 lbs. with water
or house pressure.
2. All metal within 5 feet of pool water, and all pool equipment, must be bonded
to pod reinforcing steel with 08 solid copper wire. Niche light shell, deck inserts,
etc. shall be bonded to pod rebar.
3. Pool equipment is not required to be set at this Ilme.
Inspections 640:
1. Underground electric Inspected prior to boddilling.
2. Gas line lest at 10# for 15 minutes with 15# gouge.
3. When polyethylene gas piping Is used, a certificate from a certified installer
and tracer wire shall be provided per CPC 1210.1.7.2 APPENDIX I.
Inspections 11-13,
1. Rough electric Inspection when all wiring is completed and ready prior to the
Plastering of pool/spa. Potting compound in place at plastic light niche.
2. Current Code requires that any pod, spa or water feature
contacting water 18 inches or more in depth shall be enclosed by a barrier
adequate to prevent entry of small children. The barrier shall comply with
Section 3109 of current CBC and CRC APPDENDIX V specifying the height of
any fence provided as barrier to the pod 3- shall be 60' above grade on the
outside of the fence.
3. Doors from a garage shall meet the requirements for a gate. Glass
windows within 5' of pod water shall be tempered glass.
4. Prior to pre -plaster Inspection, streets, curbs and city sidewalks will be
inspected for any damage due to construction of pool or spas.
5. Grading complete with positive drainage to street or public way. All
exposed plastic pipe shall be painted to prated from sunlight.
Inspections 14.16:
1. Gas and ElecWcal completely removed and 2x2 holes at bottom of pod
and/or isolated elements.
2. Pool backfilled:
A.) With future build - seteompecting sand 95% with receipt
B.) No future build - any fill.
3. After pod Is operating and in working condition with approved pool cover on
site.
INSPECTION REQUESTS
Inspection requests made prior to 5:00 pm Monday - Friday
will be scheduled on the following workday.
Ai I To schedule your building inspection online, please go to
LhttpsJ/aca.anaheim.net/CitizenAccess
pection can normally be reached between
7:30 - 8:00 A.M.
(714)765-5153 + 0
To access yourTo access inspection timeframe timeframe:
Please go to www.anaheim.net/buiiding after 7:30am an the day of your
Inspection. Under Online Services, dick on the link "Inspection
Timeframes' or call (714) 765.5153 + 0
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Address: 723-729 W BELLEVUE DR
Zone: RM -4
Required I Proposed
Front
Setback
Side
Setback
Rear
Setback
Max. Lot
Max.
Bldg
Residential Site Plan
Planning Services Division
PPROVED
BY:
(DA it
Z.Z
Descriptio otes: Ok for pool demo.
Common recreational area to comply with
AMC Section 18.06.100.020.0203
Plans comply with Title 18 of the A.M.C. (Zoning)
Plan Review Fee Required $
Building Division
APPROVED
BY:
DATE:
Case No.
Notes:
The issuance of this permit does not approve violation
of any of the Building Codes of the City. The Holder of
this permit proceeds at his own risk.
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