HomeMy WebLinkAbout30137137 - Permit (2)city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 n Ptumbing Permit #: 3O{ 37137
Pin #: 91242PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Proiect Address: 1561 W Walnut St
Assessor'sParcel: O07-203-25 Lot:9-13
Unit: 52
Block: 8
Bldg: Address Range:
Tract: PACIFIC ELECTRICtfl istoric: No
Suite Range:
Zoning
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Olson Company
120 S Pacific Ave Unit# 34
Seal Beach, CA 92703
(562) 5s64770
Olson Urban Housing L P
3020 Old Ranch Pkwy #400
Seal Beach, CA 90740
(562) 5964770
01116002 51602
01 I 16002 51602
01 1 16002 51602
01 1 16002 51602
01 I 16002 51602
01 1 1 6002 51 602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
011 16002 51602
01 1 16002 53602
01 1 16002 51600
01 1 16002 51602
Fee Type Amount
Water Closet 13.24
Shower/Bathtub 20.73
Sink 11.83
ClothesWashelt3.01
Dishwasher 11.16
Garbage Disp 9.92
New Sewer (First 100') 60.16
Gas System 14 41.46
Tankless Water Heater 61.07
Water Service (Each 10 41.46
Hose Bibb 14.41
PIC - 650/o 0.65
GeneralPlan Update 20.56
lssuance 51 .26
Qty
3.00
2.00
5.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
2.00
407.39
1.00
1.00
Fee
$39.72
$41.46
$59.15
$13.01
$11.16
$9.92
$60.16
$41.46
$61.07
$41.46
$28.82
$264.80
$20.56
$51.26
State Lic #: 939166
Lic Type: B
Bus. Lic #: 363131
Workers' Compensation lnsurance:Carrier: Cypress lnsurance Company
Policy #: lNWC7ot7Zl
Expires: 0110112018
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Condominium
New
New Condo w/garage
West, Glen
Hernandez, Kathy
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-2, S-2
V B, SPK
cPc 2013 Notes: Plan ZAlfees pd on M-69686
03103t2017
06t15t2017
Account#
Misc. Receipt: 68297
Misc. Receipt:
Misc. Receipt:
Total
PAID
JUN 1 5 2017
City of Santa Ana
Subject to Field:
Building Permit #: 10190476
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
,ssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 1 80 days after the time the work is
commenced.
Fee Total:
Paid to Date:
Balance Due:
$744.01
$744.O1
$0.00
lnspector MID#: 2016-131124
N/A - No Balance
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hocby aftrm und6 pcnalty of psjury that I m crmp fiom thc Cootracto6' Licre l-aw for thc following r@n (Sc.7031.5
B$in6s 8nd Profxion Codc): Any City or County which rcquirG 8 pqrdt to construct, 8ltq, improvg &rnolish or repah my
structuc. prior to its isuecc. also rcquir6 thc eplicet for such pcrrnil to filc a signcd statmmt thsr hc or shc b licccd puBut
to thc FovisioB of thc Contmtor's Licmscd kw (Chsptq 9, Cormmcing with Sstion 7000 of Division 3 of thc Buins and
Prcfc$ionsCodc)orthathcorshciscxcmptlhacfromudthcbosisforthcallcgcdcxmptioo. AnyviolationofScctionT03l.5byany
applicmt for s pcdnit subj(ts thc applicut to I civil pcnalty ofoot morc the fivc hun&ed dollas ($500).
-1.
o omq of thc propcriy, or my cmployc with wage r thcir rclc compwtion. will do the work and thc stnrtrc is not
intadcd or offscd for elc (Se.7044, Busine ud Profsions Code Thc Conraclor's Licffi Law do6 not @ply to m oms of
thc property who tuilds or improvG thron, md who doe such wrk himsclf or heclf or thrcugh his or ho om mployec.
providcd that such imprcvaMts rc not htqded or offqcd for slc. I f, howryq. thc building or imprcvmmt is rcld within one yw
ofcomplaion, thc orrn6 Buildq will havc thc hrdm ofproving tha he or she did not build or improvc 0re prcpcty for the purpos of
ulc).
_1. c omo of thc prcpgty. an cxclusively contracting with licrued contracloN to construct thc project (Se. 7044, Buine
ad PrpfusionCodc:ThcContractor'sLiccnscLawdo6notapplytomownoofpropcrtywhobuildsorimprovcsthseon.
md who contncts for such projets whh a Cortraclo(s) licsed purs@t to the Contractor's Lic@e tsw),
-l
m exempt unds Swtkrn--. B. & P.C. for this re6on.
YABrc$5Q!!8ENIAIIAN
DECLAITATION
t hccby affm undo poraltyof pojuryonc of the following delsatiom:
-l
havc srd will roint8in a Cqrificatc of Comt to SclfJmuc for workm' composaion, c povidcd for by Sction 3700 of thc
I-abor Code for thc pqfommcc of thc work for which thc pqrnit b issucd.
-l
havc and will maintain works' compc$ation iNurancc, 6 rcquircd by Sation 3700 of thc Labor Codc. for thc pqfommcc of
thc work for which this pcrmit is issucd- My work6' compostion iuurmcc miq ud policy numbo ac:
Policy l-\-tv
_l certiry that in thc pctfomcc of the work for which this prmit is isucd. I shall not oploy uy pason in ey mmn6
rc s to bqorc subjet to thc wrt6' compqEalion lam of Califomia, od agc that if I should b6omc subjct to thc
work6' @mpqstion pmvisiore of Scrion 3700 of thc Lsbq Codc. I shall. fonhwith comply with thos prcvisiou..
WARNING: Failure to suc worlm'compqualion covmgc is unlawful, md shall subjet o mpbyc to qiminal pqultie ed
civil fine up to onc hundrcd thosnd dollm ($100.000). in addition to thc cosl of compcwtion. darugo re provided for the
Setion 3076 of thc labor Codc. intaGt md dtomey's fc.
D",", G)-L1-fl C
I hrcby affrm undo poalty of pojury that I m licoscd 9 (comachg with Scrion 7000) of Division 3
of thc Bwinq md PrcfBioN Codc. ed my licre is in full forcc ud cffst.
r-i"*"ct"*' B t-t*tb t-
o'r'' (4-1i\-('\
CONSTRUCTION LENDTNG AGENCY
I hwby affm undo pcnalty of pojury thd thqc is a congruaion hnding ag6cy for thc pqfomcc of thc work for which thb pgrnit b
isucd (Sc. 3097. Civ. C.).
l4ndq's Nmc:
I crrttr s \,iiIeis
ASSJCANLDECI.AEABqN
I harty atrrru unda pcnalty of pcjury onc ofthc followirg dclaraions:
Dctrolitioo PmiteAsb6tos Notification Fcdqal RegulstioB (Titlc 40, Ptrt6)
-Rcquircd
lrtt6 of Notificdion
_l cctiry that thc fuoal rcgulatioru rcleding ubctos rmoval rc nol spplicablc to this projet.
-t
cdiry thst I havc ud this applicarion ed statcthal thc abovc infomtion is corect. I agrG to comply with atl City ild Couty
ordinmca md Slatc hws rclating to building connrudioq ud hdcby suthoriz rcpr6@tativ6 of this City ud County to mtq upon thc
abovc motioncd propcrty for insp€ction
Permlte nlme (print):
o",", (o-11-..r
UNDER GROUND
Waste & Vent '//9t I l/,,,
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT I i
Waste & Vent t+\
Water Pipinq
Gas Piping v /V
Roof Drain
Tub/Shower Test
Rouqh 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
/I I
Rouqh Plumbinq rut I
Final Gas Test *
Meter Release rl .tl I rl
F!NAL t_iltllA,+:flf-.-Ir INotes, Remarks, Etc
/,H
>frfl,vl
Appllcrnt or ASent Slgnalure:{
lt l'l /N\
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