HomeMy WebLinkAbout30138633 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
PermitCounter: (714) 647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: 3O138633
Pin #: 35524
Proiect Address: 1901 E First St
Assessor'sParcel: 400-081-08 Lot:POR 15
unft: 136
Block:NA
Btdg:
Tract:MAYBURY
Address Range: 1901-1903
Historic: No
Suite Range:
Zoning:C5
E
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Lyon Realty Advisors lnc
4901 Birch St.
Newport Beach, CA 92660
(949) 838-1239
Por-Ovita Juice
MITCHELL GENERAL CONT
52 TESLA
lrvine, CA 92618
194913874477
01 1 I 6002
01 I 1 6002
01 I 1 6002
011'16002
01 1 16002
01 1 16002
01 1 16002
01 1 16002
01 1 16002
01 1 16002
01 1 I 6002
01't16002
s1602
51602
51602
51602
51602
51602
51602
51602
51602
53602
51 600
51602
Fee Type Amount
Water Closet 13.69
Sink 12.23
Dishwasher '11.52
Floor Drain 15.53
Floor Sink 15.53
Wtr Htr (Comm up to 50 21.42
lnstallWtr Htr Comm 21.42
Backflow < 2" 21.42
GreaseMastelntercept 36.15
PIC - 650/o 0.65
GeneralPlan Update 21.25
lssuance 52.98
Qty
1.00
5.00
1.00
2.O0
2.00
1.00
1.00
1.00
1.00
228.12
1.00
1.00
Fee
$13.69
$61 .1 s
$11.s2
$31.06
$31.06
$21.42
$21.42
$21.42
$36.1 5
$148.28
$21.25
$52.98
State Lic #: 831334
Lic Type: B
Bus. Lic #: 352269
Workers' Compensation lnsurance:CaTTieT: EVEREST NATIONAL INSURANCE COMPANY
Policy #: 2690000014
Expires: 03/08/2018
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Mixed-Use occupancy:
Tenant lmprovement Constr TYPe:
Tl/Card Reader/Roof Mtd EqrCode:
B, R.2
iltA
cPc 2016 Notes: NOTE: A gravity grease interceptor is not req'd per
PWApplicant to install a Hydro-Mechanical Grease
lnterceptor.
West, Glen
Link, Patricia
Date:
Date:
Date:
1210712017
02t20t2018
Account#
Misc. Receipt 70184
Misc. Receipt:
Misc. Receipt:
TotalSubject to Field:
BuildinsPermit#: 10194534
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permit rs suspended
or abandoned for a period of 180 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51602
$21.25
$301.87
Fee Total:
Paid to Date:
Balance Due:
$471.40
$148.28
$323.12
Permitee MID#: 2017-139449
PLUMBING.!NSPECTOR RECORD
APPROVALS DATE !D/SIG COMMENTS OWNER AUILDER DELCARATION
I hcrchy affirm undcr [Enalty of Frjury that I m erempl fmm the Conlraclors' Licens kw for the following rcason (Sr.70.31.5
Business and hofcssion Code): Any Cily or County which rcquircs a Imit Io @nslruct, alter. imprcve. dcmlish or rcpair any
structurc, prirr to its issusnce. also rcquires lhe applicanl for such Frermit lo filc I sigred statemnt that hc or she is licenrcd pursuanl
lo the prcvisions of thc Contnctor's Licersd txw (Chapter 9. Commencing wilh Section 7000 of Division 3 of thc Eusincss and
PrcfcssionsCodc)orthathcorsheiscxemptlhercfromsndthcbasisforlhcallegcderemplion. AnyviolationofsrctionTO3l.5hyany
applicant for a pcmit subjects thc applicsnl k) a civil pen.lty of not mrc lhan fivc hundred dollss ($50O).
_1. as owrer of the prcperly. or my employees with wages as lheir slc conlEnsdion. will do the wot 8rd the stMtw is mt
interded or offercd for sle (Ss.?044. Business and Professions Codc: The Contmctor's Licens lxw d(Es not apply to an ownct of
the polErry who builds or irn{mve 0mn, and who des ruch wort himself or her*lf or lhmugh his or her own employees.
provided rhat such impmrcmnts m ret intended or offered for sb. lf, howcw. the boiHins or imptftmnt is sH withir ore )Ee
of corphtion, the Owrcr Buikhr will harc tlE burden of pmving that h€ or shc did mt buiH or impmrc the prcFmy for the puqrs of
sh).
_1. ts owncr ol'thc prcpcny. am cxclusively conlr&clilg wilh licenscd conlraclors lo con\lrucl lhc proFcl (Scc. 7()14. Busirrcrs
tlxl PNfcssinr C(xlc: 'l-he Contrnctor's l-iccnsc Law (krcs not apply b nn osner ofpropcrly who builds or inrprovcs fhcrcon.
and who conlracls li)r such projccts wilh fl Colilrack)r(s) liccnscd pursuxnl lo lhc Conlract)r's l.iccnsc hw).
liln|cxcD|DtUndcrsc.li(nl-.B.&P,C.li)rthisrclson,
ITQE6EBLI]QMfIN&IIIAN
DECIdBAIIAN
I hcrcby affirm undcr pcnalty of Jrrjury orc of lhc following declarations:
_l harcanrlwill maintninoCcnillcntcofConscnlk)Scl['llsurcli)r$1nkcr\'conllEn\ilion.as fovi(lcdli)rbySccti(tn.l7(X)oflhc
Lak)r (i)dc. f(tr thc pcrli)riluncc ol lhc work li)r which lhc pcilnil i\ is\uc(|.
_lhavcandwillmaintainworkcrs'compensalioninsurrncc.as requircdbySclion-17fi)ofthctiborCodc.forlhcperfomurccof
tlE work for which this permit ir issued. My workers' compcnsulion insurance carier &rd plicy numbcr m:
Policy
_l ccnily lhat in lhe pcrforronce of lhc work for which this lErmit is issued. I shall nol employ any FErson in any munner
$ as to bccom subjcct lo the workcrs' compensation laws ofCalifomis. and agre lhal if I stnuld tHom subjctl lo lhc
worktrs'comlEnsalionprcvisionsofScclion3T0OoftheLrborCodc.lshall.fonhwithcomplywiththosprcvisions..
WARNIN(i: I;tilurc to *curc workcrs'compcn\dtion covcrrgc is unlawtirl. aml shall suh.icct an cnrploycr lo critninal Jtnnltics and
civil lincs ul to onc hundrc(l thorsund dollrrs ($l{X).(xX)). in addilion lo thc cost ofcompcnsalion. darnagcs as frovi(lcd lbr thc
Scclioil 3{)7(, of thc l-xh)r Codc. inlerc\l ond atkrrncy's fccs
I ICENSED CONTRAC'TOR
UECLABAIIAN
I hcrchy nflirm undcr pcnxlly of Frjury lhat I anr licenrd undcr provision of Chaplcr 9 (cotrnncncinS wilh Sccliotr 7(XX)) of Divisiil -i
of thc Busincss and Proltrsions (iilc. aml my Iicensc is in full lbrcc ud clfccl.
Liccnsc Chss:-Liccnsc Nunlhcr:
Contrsclor:__
CONSTRUCTION LENI)ING ACENCY
I hcrcby rlllrnr undcr Frcil0lty of pcrjury that Ihcrc is d constructk)n lcnding {gcn(y li)r thc Jrrfonnancc of the work for s'hich lhis frcrmit is
issucd (Scc. .1097. Civ. C.).
Lxn(lcr's Namc:
-
lrndcr's Addrcss:
AfIIICANIIECI.AM.IION
I hscby affmundcr penally of perjury onc of the folhwing dGleetions:
Dcmlition Pcrmits-Asbestos Notification Fcdcral Rcgulations (Title 40. Part6)
-Rcquircd
kltcr of Notifrcatkrn
-l
cenify thal thc fcdcralrcgulalions rcBarding asbcslos rcnrvalarc not spplicablc lo lhis proFcl.
_l ccrtili thut I huvc rc[tl this application an(l slrtc thrt lhc ahrvc inlbrntrlion is coffccl. I aSrcc h conuly wilh all ('ily and Counly
()rdinnnccs nild Stalc Irws rcltling to building constrctbn. ind hcrchy rulhorizc rcprcscnlrlir'cs ol this City and Counly lo cntcr ufon lhc
atx)vc nr0ti()[cd propcny for inspccli()n purp(,scs.
ApplicHnl or Agent Signslure:
Pemiae nrme
l)nlc
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildino Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbinq
Final Gas Test
Meter Release I
FINAL 7 /,2-T/llf 49.t t
Notes, Remarks, Etc /v
l)slr: ApplitnDl: