HomeMy WebLinkAbout30118722 - Permit (2)City of Santa Ana
Pernrit Counter: (714) 647-5800
Project Address: 1108 N Olive St
Assessor's Parcel: 005-093-20 Lot: 37
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Pa
lnspection Requests: (7 14) 667 -2738
Plumbing Permit #: 3O{ 18722
lnspector's Section: (7 1 4) 647 -5853
Suite Range:
Zoning: Rl
Suite:
Block: NA
Bldg:
Tract:354
Address Range:
Historic: No
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Phone
Christin Wilson
1108 N Olive St
Santa Ana, CA 92703
(7141337-2903
Nock Plumbing, lnc
11612 Knott Av#17
Garden Grove, CA 92841
(714) 89s-1246
FeeType Amount
Wtr Htr (Gas) Res/Com 8.15lssuance 32.50
Notes: Direct change out.
Fee Total:
Paid to Date:
Balance Due:
(:itc of Sonto Anq
PDZ12/28/zt:II:t5ID:STTARTINELOC: CTYH _ OLIl(:I.JST: IHV:3Cr11S722
fil:lll7 til102 r:rlr:rl4t:r53 L2/28/?frtt1 1:3gt'H
TRANSA{:TIOH TOTAL: TS1.3D
Bu i ld i ns f4U.65(:K ig1 .3Lr(:HAl,lGE ttr.ull
Qty
1.00
1.00
Fee
$8.15
$32.50
$40.65
$0.00
$40.65
State Lic #: 707775
Lic Type: C-36, C-36, HlC, HIC
Bus. Lic #: 0151428
Workers' Compensation lnsurance:Carrier: Clarendon National lns Co
Policy #: 02KR0028858
Expires: 09/01/2006
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By
Permit lssued
Single Family Dwelling
Alteration
Water Heater
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
v-N
cPc 2001
12t2812005
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:Teri
Subject to Field:
Building Permit
This permit shall expire by limitation and become null and void if the wotu authoized by this permit
is not commenced within 180 days from the date of this permit, or if the work authoized by this
permitis suspended or abandoned at any time after the wofu is commenced for a peiod of 180 days.
Before such work can be recommenced, a new permit shall be first obtained to do so.
Account #: 011-01-5912 lnspector MID#: 2005-66710
lolto PLUMBING{NSPECTOR REGORD
APPROVALS DATE !D/SIG.COMMENTS
UNDER GROUND
Waste & Vent
Water-Underfloor
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipeing
Roof Drain
Tub/Shower Test
Rough Water Heater
POOUSPA
P-trap/Drain Line
Main Drain/Pool Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Misc
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release
FINAL 7 u-/? /-4-r./L 4'L(
Notes, Remarks, Etc.
owncr-Buildcr Dcclsation
* ,t*t mI hacby aftim undr psn8lty of pcrjury dl8t I m ampt fm thc Cotrcto6' Limsc Lav :^r thc following rcson (r
ud Prcfsion Codc): Any City o Couty which rcquirc 8 pcmit to mstruct, alt6, improvc, dmolish s rcpair qy snmrc pdr ro is
isswcc, also rcquic thc a;plicmt fo such pcmit to filc a signcd statmmt that hc or shc is liccnscd puEuut to the Foviiios oTrhc
Contrrctq's Licmscd Law (Chaptd 9, Comacing with Sction 7000 of Division 3 of thc Bwinss ud Profssions Codc) or th* hc or
shc is cxmp thacfrom md thc bsis fq thc sllcgcd qmption .Any violstion of Scction 7031.5 by ay applicet fo 8 pqmit subjccts thc
spplicot to a civil p@6lty ofrot morc ihd fivc hundrcd dollm ($500),
-I,
o omr of thc Fopslty, or my mployB with wags a tlcir solc compcnsation, will do thc work ed thc structwc is trot intmdrd
or offccd fc salc ( 5@.7044, Buir6 ed Profosions Codc: Thc Contrrcor's Licmsc Lsw dG not apply to u omr of thc propcrty
who builds q improvd thmn, md who dm such wsk hiroclf or hmclf c 0rough his or hr om mployu, povidcd thu such
imprcvcmotr 8c not intandcd or offqcd for salc. I( hovcvs, thc building or improvmot is sold within onc yco of complction, thc
Ownq-Builds will havc thc bwdm ofproving that hc or shc not build or improvc for thc purpoc of salc).
_[, u ownr of thc propcrty, m excluivcly @ntsrcting with lic€nscd contsrctos to construct thc projcct ( Scc. 7044, B6inss ud
Profcsio Codc: Thc Cmtretor's Li@sc Law dm not apply to u owlr of propcrty who buil& o impove thocon , ud who
cmrea ftr such projcca with 8 Cots&to(s) licmcd pmumt !o thc Contactq's Licffr Law. ).
_I m cxmpt uda S6tim
-B.
& P.C. for thb r6otr
Datcl Ownq:
WORKERS COMPENSATION DECLARATION
I hacby allim udr p€nalty of pcrjury onc of thc following debadons:
_IhavcodwillmintainaCcrtifietcofCmscnttoSqlf-InrwforworkG'comp@satim,c providcdfabySccrion3T00ofthc
Labor Codc, for thc psfmucc of thc wuk for which thc pamit is issucd.
_l havc od will maintain workcE' compmsation inswucc, o rcquircd by Sccrion 3700 of thc Labor Code, for thc pcrfomucc of thc
work for which this pamit is isucd. My work6' rcmFnsation insurucc wic ud policy numbcr ae:
Policy Nmbr Expire:
(This srction nccd no, u" .orpt"*d ir ttffi 0o) o t6s)
_t ccrtiry ftat in thc pqfommcc of thc work for which this pcrmit ir issucd I shall not cmploy uy pmon in 4y mun6 so 4 to
bccmc aubj*t to thc workm ' compcmatio lawe of Califmia, od sgrcc thd if I should bc{omc subj@t to thc workm'
of 3700 ofthc I shall, fothwith with thec provisim..
WARNING: Failuc to sccurc workm'
fina up to onc hu&cd tlrowud dollm
compcnsati on
($100,000),in
is unlawful, od shall subjcct u mploya to oiminal poaltie md civil
addition to thc cost ofcompcnsation, damagcs a providcd fo the Scction 3076 of
thc Labor Codc, intmt ud Ettomsy's f6.
LICENSED CONTNACTORS DECLARATION
I hscby affim undq pcnalty of pcrjury thal I m licmscd ud6 provision of Chaptq 9 (@mmcing wit]r Scction 7000) of Dvbion 3 of
thc Buines ad Prcfasions Codc, ud my licasc is in full fqcc md cffcct.
Licosc Clcs:_ Licosc Nmbq
Datc:
I hscby aflim undq pcnslty ofpcrjury tiat
issucd (Scc. 3097, Civ. C.).
L@dq's Nmc:
a lading rgocy for thc pcrfomacc of $c work for which this pcrmit is
Lcndcr's Addr6s:
APPLICA.TYT'S DECLARATION
Dcmolition Pmits-Asb6tos Notificatioo Fcdaal Rcgulations (Titlc 40, Pan 6)
_ Rcquircd LctEr ofNotificcrion
_l cmify that thc fc&ral rcgulations rcguding sbctos rcmoval ac not applicablc to tlis projcct.
rhat I rcad this applicatim ud statc that thc abovc infomsdon is @rot. I agrcc ro comply with tll City md County
ordin0cs rclaing to building consmctim, ad hcby authorirc rsprecnrativq of this City md Counry to ql! upon thc
abovc
Applicut or
Pmtic5q(
for inspcction
OS