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Home My WebLink About10200877 - PermitPLUMBING PERMIT \ PROJECT ADDREES:611 N. BRISTOL ST 302@@877 PERMIT NO.ez,l sunE: * |FFte{SUTTE RANGE:DESCRIPTION FEES ADORESS RANGE: 611-563 BUILDING NUMBER: ou\rNER: SHADOWWOOD HOME OWNERS ASSOC. ADDRE$: Gll- N BRrsroL sr, *1 I hcoby efina unda p.mlty ol pcrjury th.l I .m mmpt ftm th. conf.cbrs' liccns lil ior th. iolbwing ffi: _ Scfion 70.144, l, as mcr of lha propcrty, o{ my cmplo}ea with mg6 a3 thcir sla compcmation, will do thc yyork, and thc structura is not inbndcd or ofLlld ior l.la. S*tion 70448, l, as mcr ot with SANTA ANA, CA PHONE: CONTRACTOR: Dtr STA t + tn srr.rlA eti- I L- v ! BUSINESS LICENSETT PERMIT SPECIFICATIONS: JOBTYPE: MULTI /AL NAN'RE OF WORK:PIPING I hcr.by.ffim und.r pGnatty ol pcrjury on. of thc frolliling O.clantions: I hm rnd will m.int in r C.ft'fiâ‚¬tr Ol Conrcnt to SclrJnsurc l,or Workc6' Fmpcnetim, .s pBid.d br by Scction 37m of thc Labor Cod., for thc pcttonnsno ot th. rc* b, which this P.rmit is iasucd. _l hm .nd will mint in WorkcB Comp.nsation lnsunn6, aE rcquiGd byffim 3700 ol thc Labq tu., io, th. poriomano of thc mri ior which this' pcrmit i. i$u.d. My WortcF Comp.nEtion lnsunn@ â‚¬ricr .nd policy numbcr .nl: Policy Numb.r_(thi.;e{on nccA or lcrt). in thc pGlfomancc of th6 rcrk for which this pcrmit is issucd, I any pamn in any manncr I as tro becomc sub.iccl to thc Workcc' of I should to thc of thc WARNING: Failurc to sccurc Work6E'cengc is unlawful, and tho9 shall rubi6{ an cmploy.r to thous.nd dolla6 (S1@,O00), pmidcd ior in Scction 3706 VN TYPE OF CONSTRUCTION:R-tOCCUPANCY GROUP: BUILOING PERMIT f:x-oFLOOD ZONE: APPROVALS: PLANNING APPROVAL:OATE: I hcmby alfm undGr pGnalv of pcrjury that I am lic.ns.d undcr provirionr of Chaptcr I (commcrcing with Setion 7@) ol DMsion 3 ol thc B$inN .nd Profr3sions Cod., .nd my liccns i3 in full br@ and cncct Ucala Cla$:_ Licans. tlo.:_ D.t!: Conbector PLAN CHECK BY:DATE: BDNPERMIT ISSUED BY:08/L7 /99OATE: .-_-MAILING ADDRESS- CITY OF SAI'TAANA BUILDING SAFETY DTV. M.I9 P.O. BOX l9t8 SANTA ANA CA- 92?01 _--PUBLICCOUNTER--- 206W.4rh STREET 2nd FL(rcR PHONENUMBER ol4) 64?-sEm EEE TYPE AITIOUNT QTY FEE 1 1 1 3 18 2L TOTALPAID TO DATE AMOUNT DUE 43 @ CAP FTXTURUIN FEE AD ISSUANCE .25.75 .o@ 3 18 2L 25 75 Drrnolitioa P.rmiE-A3Mr tlotific.don Fcdcral R.gul.tions (rd. lo, Pen E) _Rcquitrd L.tbr of llotifietion. _l ortly th.t th. Hcnl rcgul.tions r.garding .sbGsto6 romml .rc not .ppliebl. b lhis prcia;t {pdient 6"-itt " to and to L thal I haa that thc aboo inlormation is and Slatc laY6 of this City ot agcnt 3iO. n.m (prino: OWNER-BUILDER DECLARATION WORI(ERS COMPENSATION DECLARATION LICENSED CONTRACTORS DECLARATION APPLICANT'S DECLARATION This permit shall expire by limilation and become null and void if lhe work aulhorized by lhis permit is nol commenced wilhin 180 days from lhe date of lhis permil, or if lhe vyork aulhorized by lhis pâ‚¬rmil is suspended or abandoned for 180 days, at any lime aner vrork was commenced, ln such case a nevv permil shall lirsl be oblained before such r^,o,k can be recommencsd.t?/w +rs9Plt Hnf,EL t+:1.00 INSPECTOR COPY. ACCOUNT NO. 011.01.5912 ... PERMIT VALIDATION u"L cs-611 I IIa I _l itorn Site Work Remarks Date Signature I.D Sanitary Sewer Area / Storm Drain Water Piping / Service Gas Service Gas Pipinq Pool P-Trap & Backwash I, ao, circ. Pipinq Pool Fill Line t Backflow Pool Heater - Vent Lawn Sprinller / Backflow Other - Backllow Waste lnterceptor / Clarilier Address Unit/Suite: PLI.JMBING .-. INSPECTION RECORD Notes, Remarks, etc.: OWNERAUILDER DECLARAT]ON I hereby aflirm under penalty of perjury lhal I am exempl from lhe Conlrac,lors' License Lanr for the following reason (Sec. 7031.5 Business and Professions Code): Any City or County wftich requires a po,mit lo conslruc.t, aller, improve, demolish, or repair any Glructuro, prior to ita iasuanco,.lso requira lhe applicanl for such permil lo lile e signed stalement that he or she is licensed purauant lo lhe prolrisions of the Conlraclors' Licensa Law (Chepler 9. commencing with Seclion 7fiD of Division 3 of the Business and Professions Code) or thal he or she is oxempl lherefrom and tho basis for the alloged exemplion. Any violation of Sec.lion 7Gt1.5 by any applicant for a permil subjec'ls lhe applicanl lo a civil penalty of nol more than five hundred dollars (35d)). _1, as ovtrner of lho property, or my employrea wilh u,ege3 eB their sole compensation, will do the v\rork, and the struclure is not intended or ofiered for tale (Sec. 7(X4, Busincs and Professions Code: The Contrac-tors' Licengo Law doet nol apply lo an ovlrner of lhe properly wtro builds or impaovc lhereon, and wtro does such y\rork himsolf ot herself or through his or her orrn employeee. providod lhat such improvemenls are nol inlendod or ofiered for aalc. lf, honqwr, lhe building or improvemenl ie sold within one yrar of completion, lhe Omer-Builder will have lhe burden of ptoving that he or she did nol build or improve for the purpce of sale). _1, as owncr of the propody. am exclusively contrac.ling with licensed contreclom to construc-t the projec.t (Sec. 7(X4, Bueinecs and Prcfessionc Cod6: Ths Conlractors' Licen:a Law doec not apply to en olvner of property who builds or improm thereon, and wtro contrec-ts for such projeclr with a Conlraclor(B) liconsed purauanl to tho Contrecdorr' Licenr Law.). _l am exempt under Remarks Date Signature I.D.Building Under Floor / Slab - W. A V. - Water - Gas - Other Waste & Vent Top Test Roof Drain - Oownsgout Tub / Shower+an Water Tesl Water Heater - Vent Gas /Water Re+ipe ROUGH PLUMBING **ar/-. t FINAL GAS+RESSURE TEST /,:7_Y:-,/ I FINAL PLUMBING -T O ea,vl Omer: B. E P.C. for lhis reeson. I + I + + t -/ ,"/ 7.r I 1t