HomeMy WebLinkAbout30141581 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 *Plumbing Permit #: 3O{4{58{
Pin #: 75585PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Project Address: 3224 S Main St Unit:
Block: NA
Bldg:
Tract 7408
AddressRange: 3100-3260
Historic; No
Suite Range.
Zoning: CRAssessor's Parcel: 410-231-02 Lot: 83
Owner:
Address
Decron
3124 S Main St
Santa Ana, CA 92707
17141546-5220
01 1 16002 51602
01 1 16002 5160C
01 I 16002 51602
01116002 5777C
Fee Type Amount
Tankless Water Heater 68.14
General Plan Update 22.95
lssuance 57.20
Microfilm Records 3.91
Qty
1.00
1.00
1.00
0.00
Fee
$68.1 4
$22.95
$57.20
$0.00
Phone
Tenant Name:
Contractor:
Address:
Phone:
American Power Solutions I
14355lndustry Cir
La Mirada, CA 90638
(714) 926-0300
Botchi:53133 - 11,
Otf ice: CTYH Trt
Acct*:
Rcpti:t12S11856 -
Trsnsoct ion Totol
State Lic #: 804648
Lic Type: C-36, C-10, C-20, C-38
Bus. Lic #: 373173
Workers' Compensation lnsurance:Carrier: Benchmark lns Co
Policy #: CST5015362
Expires: O3lO1l2O20
lmenicnn Pouer Solut
Generol Plon UPdote Fet
trl I 16002- 5l600cr0tr-
Plurb i ns
rrrl16002- 5160200tr-
icu c.trectr 025818
Building Use: Multi-Family (5 or more uni Occupancy:
Job Type: Miscellaneous Constr Type:
Nature of Work: Water Heater Code:
R-2
VB
cPc 2016 Notes: Change out within existing enclosure.
Planning Conditions: Ok per Planning
Planning Approval By:
Plan Checked By:
Permit lssued By.
Subject to Field:
Building Permit #:
Zuniga, Allissa
Date:
Date:'t1t2212019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 't 1 6002 51 602
$22.95
$125.34
Fee Total
Paid to Date:
Balance Due:
$148.29
$0.00
$148.29
lnspector MtD#. 2019-156037
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hereby aflirm undcr pcnalty of fErjury that I m excmpl ffom the Con(racloN' Licens [:w for lhe following rcasn (Ss.70.11.5
Busincss and hofcssion Code): Any City or County which rcquires a ;rcrmit to @nstrucl. alts. improve, demlish or rcJrir uy
struclurc. prior to ils issuarcc, also rcquircs lhe applic.nl for such frcrmil lo file a sigrcd stalemnl that hc or shc is liccnsd pusuont
lo thc pmvisions of lhc Conlractor's Licen*d hw (Chaptcr 9. Comcming with Section 7000 of Division 3 of the Busincss ud
Ppfcssions Codc) or that hc or shc is cxcmpl lhcrcfrom and the b6sis for thc alleged cremption. Any violation of S(tion 703 I .5 by any
applicant for a pe.mil subjects the applicant to B civil penalty of not mre lhan five hundred dollus ($500).
-1.
os owner of lhe prcJErly, or my emploFcs with wogcs as thcir solc compcnsation. will do thc wok and thc structw is mt
intcrded oroffcrcdforslc(S€,T044,BusincssandPmfessionsCodc:ThcContrsclor'sLicensehwdresnotspplytoarowrcrof
lhe pmFny who builds or inpmrcs themn, and who dcs mh work himself or hcrElf or thrcugh his or her own employcer.
provided lhat such imFovemnls rc rct inlcndcd or offercd for sb. If, howcv6. thc building or ir{,mrerent is sH wirhin orc F{
of or{,htion. the Owrer Buikler will harc the burdcn of pmving thd he or shc did ml huild or imprcrc the prctEty for tlE purlDs of
sle).
-1.
as owner of the pmpefly. amexclusivcly conlracling with licensed contraclos to mnstrucl thc proFct (S4. 7044. Busiress
and ProfesshnCodclThcContraclor'sLiccnseLawd@snotapplytomowncrofprcff,rtywhobuildsorimpmvesthermn.
and who conlmcts for such ImjcTts wilh a Contmcto(s) liccnred pursuail to lhc Conlraclor's Lhcns hw).
I amercmDt undcr Sstion . B. & P.C. forthis reason.
Dale:_
!VORKER.S' C()I\IPENSATION
DECI.ARA'I'ION
I hcreby affirm undcr pcnalty of lujury orc of thc following dccluations:
-l
hrvcaildNill niriilrhlrCcnitlcilcol-Conscilk)Sclllnsurclirrworkcrs cornpcnsrtion.ns provi(lcdforbySccti(rn37(nofthc
Lahor (ixlc. lirr thc pcrlbnnnncc of lhe work lor s'hich thc pcrmit is issuc(I.
-l
havc and will minlain workcrs'compcnsation insurarcc. ss rcquircd by Scction 3700 of thc tihor Code. for thc pedormrce of
lhc s'ork rhi\is issucd. My workcrs'insurancc cari6 erd lFlicy number ue:
t\
1Yt r>oPolicy,3
-l
ccnify lhat in lhc pcrformrcc of lhe work for which this [rcrmil is issucd. I shall not cmploy any pcrson in any manncr
s as to bccom subjat to lhc workcrs'comlEnsation laws ofCslifornio. and agrcc that ifl should hccorc subjcct to thc
workcrs'compensalionprovisiousofScclion3Tfi)ofthchb()rCodc.lshall.forlhwithcomplywilhthoscpmvisions.,
WARNING: Failure to $cure workcrs'compensalion coveagc is unlawful. and shall subjcct an employer to siminal tmaltics md
civil fines up to onc hundrcd thousond dollars ($100.000). in addilion to the cost of daroges an pmvidcd for the
Scclion .3076 of thc inlercst and fccs.Lll q
I hcrehy rlfirrl undcr pcnalty of pcrjury lhal I am liccnscd pmvision of Chaptd 9 (commrcing with Section 70OO) of Division 3
of the Business and Profcssions Codc. and my license is in full fore and effcct.
Liccnsc 'f36
q
I hcrchy affirnr undcr frcn.hy of pcrjury that therc is d conslrucli(rn hnding agcncy for lhc pcrfomance of thc work for which this Jrrmit is
issued (Scc. .1097. Civ. C.).
hndcr's Namc:
Lcndcr's Addrcss:
APPLICANT DECLARATION
I lErhy allinn undcr pcnillty of pcrjury onc ol thc follo$ ing dccluralionsl
l)cnr)lilion Pcrilrits-Ashcslos Nolificnlior Fcdcrll Rcgulalio0\ {-Iitlc 4{). Purt6)
_Requircd lrtlcr ol N(ilificrthn
_l ccnity lhal lhc fcdcrulrcgulations rcgarding asbeslos rernovalarc not applicablc lo this pmjNt.
-l
ccrlify thal I hsvc read this applictrtion ard statc lhal lhc abovc informtion with oll City and County
ordinarces and Stale ljws rclatirg to hcrcbv aulhorizc
i\ corrccl I rgrcc lo contply
' rcprc{cntrtives of rhi\ Cily enlcr ulmn lhc
ak)vc nrcnlioncd propcrly for
Applicant or AgeDt
---/h.z
and
t4
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
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
Fina! Gas Test
Meter Release I
FINAL lltq '7/)ra* nn r Lbffi
Notes, Remarks, Etc.lr
,
t?-t((q-r (L -Dt*Y)6L*f?
t I I t'
Dsle:
Pemile trame (prinl):