2130 W CRESCENT AVE (46)BUILDING DIVISION
CITY OF ANAHEIM
BUILDING DEPARTMENT 2013 CALIFORNIA CODES
200 S. Anaheim Blvd., Suite 145 CODECrCLE
Anaheim, CA 92805 01/01/2014
714 765-5153 EFTEC"VEnATE
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: BLD2023-00201
Project address: 2130 W. Crescent Ave. Anaheim, CA 92801
Date:
2086-2091
Property Owner: Tara Hill Owner LLC.
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
0 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.
0 . Smoke Alarms: In each room used for sleeping purposes.
V 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:
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 SEPT 2015
www.anaheim.neUbuilding B842
Permit Types
BLD ELE MEC
X
Permit Number: BLD2023-00201
Issued: 01/17/2023
www.anahelm.net/building
(714)765-4626
Quarter Section: 39
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141 765 - 5153
Site Address: 2130 W CRESCENT AVE 2086-2091, ANAHEIM, CA 92801
Legal Description: P BK 32 PG 24 PAR 1
.0,
'APN:07207109
Project Description: Reroof: Relay (71) sq ft of existing file over entire building units #2086-2091
k
Living Area: Number of Stories: 2 Valuation: 60,000.00
Garage Area: Construction Types: NIA
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Sprinklered:
Cool Roof: Total Fees paid for Permit: • 467.80
People Associated with Project:
Permit Applicant Breanna Yankin
Owner TARA HILL OWNER LLC 2130 W CRESCENT AVE
Type Electrical Fixtures Qty 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�PHEIM Cq<
City of Anaheim c� io
Building Division F i
u a
�DUNDED �8y^
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 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 ListlBus. Lic. (714) 765-5194 (Allow 10 business days)
Setback/Forms/Trenches (Footings)
COAT 'ion Measures
Do not install subfloor or pour floor slab until the follwing applicable items have been
s'
rdinginal 14 765-5153)
Ltio inal Only After Aboveto�mpleted
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 Wly)
2nd Floor (Floor Nailing)
Do not cover or conceal the work below until the following applicable items have
been sionedi
1st Floor Shear
Firesprinkler (Rough) (Fire Dept)
Mechanical Inspections
2n She
oof (Sheathin Dip rag /Frame)
(Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Rough COA/Mitagation Measures
Plumbinci 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 (Struct., Ele., or Mec.)
Grease Interceptor
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Types
BLD ELE MEC PLM
X
Permit Number: BLD2023-00201
Issued: 01/17/2023
www.anaheim.net/building
(714)765-4626
Quarter Section: 39
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141 765 -5153
Site Address: 2130 W CRESCENT AVE 2086-2087, ANAHEIM, CA 92801
Legal Description: P BK 32 PG 24 PAR 1
APN: 07207109
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 pedury one of the following declarations:
I have and will maintain a certificate of consent to seif4nsure 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. AMERICAN ZURICH INSURANCE COMPANY Policy No.: WC169089101 Expiration Date: 112MIL2023
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 worker's compensation provisions of Section 3700 of the
Labor Code, l shall forthwith comply with those provisions.
Sig ure of Ap nt Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
1 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 Code, and my license is in full force and effect.
Contractor ignature
NUMBER EXPIRATION DATE LICENSE TYPE (S)
769615 10/31/2023 C39, C39, D24, D24
Date