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HomeMy WebLinkAbout30241901 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Plumbing Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 KY Permit #:3O2419O'l Pin #: 6,4751 Project Address: 923 S Minnie St Unit: Block:NA Bldg: Tracl:2437 Address Range: 923-927 Historic: No Suite Range: Zoning:R3Assessor'sParcel: 011-257-02 Lot: B Owner: Address: Michae! E Chez 3211 Circa De Tierra Encinitas, CA 920246908 (7601815-2248 Fee Type Amount Wtr Htr (Res/Comm ove 94.86 General Plan Update 22.95 lssuance 57.20 Microfilm Records 3.91 Qty 1.00 1.00 1.00 1.00 Fee $94.86 $22.95 $57.20 $3.91 *1't Q4 $112. r:16 93.91 $783.77 01 1 16002 51602 01 I I 6002 51 60C 01 1 1 6002 51 602 01116002 5777C Phone: Tenant Name: Contractor: Address: Owner-Builder Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #: Expires: Bstchir5424i' * 2/5/2029 I0t (:CUELLAR Office: CTYH Tngnsi: 39 I of 2Acctl: Refi: 3u2419tt RcpLi:02888344 - 2/5/292fi 1!3S Pll Trsnsoct ion Total i783,77 11 i,:lrsel E Che: Building Use: Job Type: Nature of Work: Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: W;;02t05t2020 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Multi-Family (5 or more uni Occupancy: Miscellaneous Constr Type: N/V-Water Heater Code: Date: R-2 VB cPc 2019 6etrernl Plon Updote Fee 01 I 16002- f,l6(r0(t00- Fluub i ns LrlIl6(rtr2- il602800- lli,:r'of ilt & DocuuenLs Lrl I l6(rtr2- 5777U1r00- ICL Check 1173 Notes: Legalize water heater replacement. Fee Total Paid to Date: Balance Due: Zuniga, Allissa Every permit issued shall become invalid unless the worl< on the site authorized by such permit is commenced within360 days afrar its lssuance, or if the wo* authorized on the site by such permit is suspended or abandoned br a period of 360 days after the time the wo* is commenced. 01 1 16002 51600 01116002 51602 01116002 57770 $22.95 $152.06 $3.91 $178.92 $0.00 $178.92 lnspector MID#: 2020-157587 PLUMBING-INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS ()WNER DUll,t)tlR Dtll,CARA'IION I hcrchy dllirrr uodcr pcnally of perjury lhul I am cxcnril lil)nr lhc C(!nlrrck)rs l,iccnsc l.aw li)r thc lolhwing rcr\oil (Sec.7oJl.5 IJusircss artd ['r()lcssi(xt Codc): Aoy Cily or C]ounly qhich rcquircs a pcrtrril lo c()nstrucl. ollcr. imfr)vc. dcilxrli\h or rcpair xny slnrclnrc. prior to itr issurncc. also rcquircr Ihc applicxnl lilr \uch frrnlil l() lilc o signcd \txlcrmlt thill lrc or shc is liccnscd purrutnl lo lhc proli\ions ol-llt CoDlracbr's Liccnscd Lrw (Chnplcr q. Connncnci[g rvilh ScclioD 7(XX) of Division ] ol'thc llusiiless a[d trpflicnilllorrpcrnrilstrhjcclslhc ilflicailllorcivilpcnallyol'nolnx)rclhflnl'ivchundrcd(k,llnrs($5(/J). -1. a( owncr of lhc prolEfly. or nly cnlpk,yccs wilh wagcs rs lhcir solc coilrl)cnqnli()n. willd() lhc work arxl thc slrolurc i\ not iilcilql orollircdlirrqlclScc.TOl.l.[]usincsrandProltssionsCodc:'IhcCollractor'sLiccnsclf,rwdocsnotapplyk]0oownerof lhc pn)Itf,y who huilds or iNprelcs lh((r)n, aild who docs such urtrk himsclf()r hcrsclfor through his or hcr o*n cnrployccs. provi(lc(l lhdl slch inrprotutills:m nol inlcndcd orollcre(l lirr sab. ll howclcr. thc btrilding or irnprolcnrcnl is sold withir onc )ear ofcotrflclion. lhe Owncr Iluildcr will hnvc lhc burdcn of proving thrl hc or shc did n(,1 buikl or improvc thc propny I(,r lht purlnse of salc ). 1k ". u*n", nt-th"f(rpcr!y. unr cxclusivcly conlraclir1t $ith liccn\cd contrnctrrr\ k) construct th. proFct (Scc. 7(H4. Busincss/antl lhrlirsionCo(tc:_lhcConlractor'sl-iccnscl-xwdoc\notappl)'loailorvncrofpropcrtywhohuildsorinrprovcsthcrcon. and sho contracls li)r such prcjccl( silh a C(nilracl(tr(s) liccn\cd pursuonl k) thc Coolrack)r's l,iccnsc liw). -l am cxempt undcr & P,C.this rcnsoil. Dil".pz-o g- z\ l hcrchy uflirrn undcr lcnally of I--rjury onc of lhc followi0g dcclilrnti(ilrs: -l havc and will nuinlrin n Ccnilicrtc of ConscDl lo Self-lnsurc li)r workcrs' conrpctrsatio[. as f,rovidcd lor by Scction .17(D of the Latxrr Code, l-or thc pcrlbrnrncc ofthc s(trk for rvhich Ihc pruit is issucd. -lhr(candwillilrainlain$orkcrs c()illpcn\nti()ninsurancc.as rcquircdhyScction-37(X)ofthctaborCodc.forthcpciloilmnccof thc rvork lbr which this pcrnlil is issucd. My workcrs cotrrpcnrrti()n insurancc carricr and policy nunrtrr arc: Policy _l ccrtil-\'lhat in thc pcrlirrnuncc ol thc work ti)r \\'hich this pcrmit is issucd. I shrll nol cnrpk)y r0y pcrson itr rty mrnncr so rs l() k+cotrrc subjccl t, lhc sorkcrr'c()nrl)cnsilion hws ol'Calil()rnin. iln(l agrcc thal if l sh([kl hcconrc subjcct k) thc WARNING: Failurc lo rccurc workcrs'@mJrcnslion olrm8c is unlawful. and shall snd civil fincs up to orc hundred thousand dollus ($l in addilion lo lhc cost of lhc Scction .1076 oflhe Labor Codc. inlcrcsl end 5 I hc(by aflirm undcr pcnally ofpcrjury lhrt I am liccnwl umlcr pn)vision ol Chilplcr 9 (comlEncing wilh Scclion 7fiX)) of Divisi<lr 3 of lhc Busincss and l'rofcssions Codc, snd my license is in lull tbrcc and cllcct. Liccnsc Class:-l-iccnsc Numhcr: l)ale CONSTRTIC'I'I(IN LENDINC ACI]NCY is\ucd (Scc..1097. Civ. C.). lrndq's N8m: lrndcr's Address: APPLICANT DECLARATI(IN I lwby allimr undcr pcilolt y of pcrjury onc of lhc fbllow ing dcclarnt ions I Dcnx)lition Pcrmils-Ashcshs Nolilication fcderal Rcgulntklns ('l itlc 40. Paa6t _Rcquircd Letlcr of Nolification -l ccnity lhot lhc fcdcralreguhtions rcguding ashcskrs rcm)val arc nol rpplicahlc k) this p()jcct. ?-, ccnily thtl I havc rcad this applicali()n iud slxlc lhal lhc !h)vc inlonnatt)n is cotrcct. I alre b comply with all City and County ordinanccs and State [{ws abovc mntioncd propcrly lo building construction. and hercby authoria rclresentatives ofthis City ud County lo cntcr upon thc Apl,li(ilil1 or Agetrl -E-ePcrtrrilce nnnte tt^r"i '/' ( '-- ) ( UNDER GROUND Waste & Vent Water-Under floor Gas-Underfloor Buildinq Sewer Area/Storm Drain lnterceptori Clarif ier TOP OUT Waste & Vent Water Pipinq Gas Pipino Roof Drain Tub/Shower Test Rough Water Heater POOL/SPA P-trap/Drain Line Main Drain/Pool Piping Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rouqh Plumbing Final Gas Test Meter Release \ FINAL as ')-v 4 /yw\tyl Notes, Remarks, Etc.I ( Dole:-b