HomeMy WebLinkAbout30138862 - Permit (2)Proiect Address: 1901 E First Sta
-
Assessor'sParcel: 400-081-08 Lot: POR 15
unit: 136
Block:NA
Bldg:
Tract:MAYBURY
Address Range: 1901-1903
Historic: No
Suite Range:
Zoning:C5
E
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: 3O{ 38862
Pin #: 71252
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
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
Fee Type
011 16002 51602 Revision
01 1 I 6002 51600 General Plan Update
Amount
2't3.86
21.25
Qty
1.00
0.00
Fee
$213.86
$0.00
Phone:
State Lic #: 831334
Lic Type: B
Bus. Lic #: 352269
Workers' Compensation lnsurance:Carrier: 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:
Subject to Field:
Mixed-Use
Tenant lmprovement
T.l. Revision
West, Glen
Link, Patricia
01t02t2018
02t20t2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
B, R-2
ilA
cPc 2016 Notes: NOTE: A gravity grease interceptor is not req'd per
PWApplicant to install a Hydro-Mechanical Grease
lnterceptor.
BuitdinsPermit#: 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 o suspended
or abandoned for a period of 180 days after the time the work is
commenced.
Permitee MID#: 2017-137579
01116002 51602 $213.86 Fee Total:
Paid to Date:
Balance Due:
$213.86
$0.00
$21s.86
PLUMBING.INSPECTOR RECORD
APPBOVALS DATE ID/S!G.COMMENTS olvNER BUII-DI.]R I)I'L('ARA'TIoN
l]usinc\s atxl l,()li's\hn Codc): Any City (,r County u'hich rcquirc\ a lr-rmil lo conslnrcl. ilhcr. iilrprc\'c. dcnnlirh or rcprir arv
rpplicrnllbrrpcrnril\uhjcrl\lhc applicailtk)aci!ilpcrilllyof[(,lnx)rcthinl'irchundrcddollrrs(55(X)).
_1. as owncr of I hc pr 'lrf,y. r)r rny crnpl()vccs wil h s ngc\ r\ lhcir \olc cotrrpen\rl hn. will do lhc $1)rk nnd lhc stnrturc is tr(,t
thcpr)J--f,y whohuiklsoritrrprolcsllErqnl.nn(lshodocssuchsorkhinrsclf()rhcrsclt'orlh()u8hhisorhcrowncntpkrvces.
providrll thal \uch itrrpro\cnEnts ir fi iric[lcd orolTcr*l lrrr salc. ll. ho$crcr. llt huildinS or inrpro\cmil is wld *ithin onc \trr
srlc l.
x[(l uho conlrilctsli,r\uchfr()jcclswilhxC(nilrrcktr(s)liccnscrllursurnlkrlhc(bntrilclor'sl,iccnscl.aw).
lamcxcmDIundcrsccli(,n-.B.&P.C,forlhisrcason'
()snrr
WORKERS' COMPENSATION
DECIdEAIIQN
I hcreby a[f]m undcr fEnally oflErjury onc ofthc following delatalionsl
_lhaveandwill nuintain{CcnificfllcofC(nrsnlloSclf-lnsuref(rrworkcrs'compcilsation.as;rotidcdforhySeli([.17{[)ollhc
Iitx)r Codc. Ior thc pcrli)riltncc ofthc work for which lhc Jrcrmit i\ issucd.
thc rvork lhr which thi\ pcrtrrit is i\suc(|. My w(trkcrs' cotrlpcnsrlk)tr itrsrnncc c{[icr tn(l F]licy nunthcr nrc:
Polic!, Numbcr: Expircs:
_l ccrrify that in the ff,rformme of lhc work for whkh this permit is issucd. I shall nol cmploy any Frcmn in any manner
s as to bcmm subjert to lhc workers'com[rcnsalion laws ofCalifomia. and Egrcc th.t ifl slDuld hc{om suhjct to thc
workers'compensalionprovisionsofScction3T0OofthcLaborCodc.lshall.fonhwilhomplywilhlhospmvisions..
IVARNIN(I: l;ailurc to rcurc $orkcrs'conrpcn$tion covcrrgc is unhwtitl. and shrll suhjcct str cnrphyer t) rintintl lEnxlli'\ a0(l
civil llncs up to one hundrcd thousand rlollars ($l(X).(XX)). in nd(lilioil lo thc cosl ofcornl)cnsalion. darnges as provklc(l lirr lhc
Scction .1076 of thc tjtxrr (irdc. irilcrcsl rn(l rnorrcy's fccs-
Applicant:
LICEII,IEJLCANTaAIrcE
DECLARATION
I herchy rlllnn un(ler pcnalty of pcrjury thnt I anr liccn*tl untlcr pro!ision of Chrplcr 9 (commncinE wilh Scclion 7(XX)) ol l)ivi\i(,n :l
of thc Busincss aild ltofcrsions Codc. arxl my liccn(c is in lill lirrcc ard c{ltcl.
l-iccnsc Nxnlhcr:
( r)illrn(lr)r
CONS'I'RUC'I'ION LIJNDIN(; ACENCY
I hcrcby ilfllrill undcr Fnrhy of Frjury thrt thcrc is a con\t nrct ion lcnding r8cocy lirr I hc pcrfornutrcc of lhc pork lirr shich this Frmil i\
issucrl (Scc. -1097. Civ. C.).
lrn(lcr's Nrtrrc:
kndcr's Addrcss:
APPLICANT DECLARATION
I hcr$,y aflim undcr pcnalty of pcrjury onc of lhc following dcclarations:
Dcfi)lition Pcrmit\-Asbcsl(,s Nolification Fedcral RcSulflliflls (l illc 40. I'ilrt6)
-Rcquircd
[,cllcr of Nolificaliul
-l
cmify that thc fcdcrul regulalions rcgarding Bsbeslos removal arc nol applicubh b this proje.l.
ilhovc ilNnlionc{l pr()l)crly tor inspccli()n purlx)scs
Applicsnl or Agenl I )illc
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
lr/ain 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 t
FINAL -/zaltd a4qry4 I
Notes, Remarks, Etc.-./-v
Pemritee name (prinl):