HomeMy WebLinkAbout30139893 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, cAg27o2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Sectionr (714) 647-5853
Permit #: 30{ 39E93
Pin #: 23038
Proiect Address: 2424 N Tustin Ave Unit:
Block: A
Bldg: 24-F Address Range:
Tract: A.B. CHAPMAN Historic: No
Suite Range: Unit F-'l 1
Zoning: R4
w
Assessor'sParcel: 396-261-55 Lot.8
The Bascom Group, lnc
26 Corporate Park Drive, Suite 200
lrvine, CA 92606
(949) 95s-0888
01116002 51602
01 I 16002 51602
01116002 51600
0't116002 51602
Fee Type
Sink
Dishwasher
General Plan Update
lssuance
Qty
4.00
1.00
1.00
1.00
Fee
$s0.80
$11.97
$22.08
$s5.04Tenant Name:
Contractor
Address:
Katerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-1065
State Lic #: 1009989
Lic Type: B
Bus. Lic #: 366547
Workers' Compensalion lnsurance:Carrier; Midwest Employer's Casualty Company
Policy #: BNUWCo139070
Expires: 0'l/01/2019
P
g
'*
,\
Building Use:
Job Type:
Nature of Work
Multi-Family (5 or more uni Occupancy:
Alteration Constr TYPe
Fixture change outs (unit I I Code:
R-2
VB
cPc 2016
Notes: Fixture change outs (unit ll)
Planning Approval By
Plan Checked By:
Permit Issued By:
Subject to Field:
Building Permit #:
Chavez, Dave
Date
Date
Date 09/0412018
Account#
Every pomit issued shall become invalid unlessthe wo* on the site
authotized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such pemit is suspended
ot abandoned fot a peiod of 180 days after the time the work is
comnencecl.
MID#: 2018-145649
01 1 16002 51600
01 1 16002 51602
$22.08
$117.81
$139.89
$0.00
$139.89
Owner:
Address:
Phone:
Planning Conditions:
Amount
12.70
11.97
22.08
55.04
Phone:
lvlisc. Receipt:
L4isc. Receipt:
l,4isc. Receipt:
Total
lnspector
Fee Total:
Paid to Date:
Balance Due:
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I h...by.lIro utdr p.mhy ofFoury th,l I D.x.mpi tDm llE co riclon Lic.M Llw for $c loltosing dsn (s€.?011.5
8uiin6. a.d PmfdsioD Co&): Any Cny or Cohly tr'iicn Rqlnd ! p.nn ro @ 5rucr, ah6. itrrpElr d.mlith .r FI{n 0.y
itNct'tr., prhr ro ils iiiw@. ats r.qui6 1hc apllts| for sch ,.mn lo fl. . tiSEd !lal.m.t th.l tE or 3h. ir li.car.d oll@nr
ro rh. povi.ios of i. Codncrd! Lien*d Llw (Chlrlr 9, Conlmring Fnh S.crion 7000 of Divirion I of lh. Buiin.B lrd
Prcf.sioN Cod.) o.thar tEor E i! q.mrt ft.cfibnsid 0. bsis fo! thc !lL8.d q.mplion Anyviolalionofsc.rb. T0ll.5 by.ny
arplica for a p.mit objes ih. .prlicrnl ro r civil t mliy of ml mE lhs fiv. hlndr.d &llM (1500).
-1,
ar olm. of lh. Im!.n, or my rmploye ,ilh wass as llEn $1. sqi.Mrio.. wil .b lh. vor* drd tl* drud@ n mr
inrarH or o,Icrcd for sL (S(.704d Bu.irss dd Pmf.sio6 C.d.: 1'h. (tnlEclor'r Lic.trk L., &rd Nl qi!!y ro dn owrr of
th. ptu '.ny sh. h <r! .r inp,lE tlEmtr rid wlD d.6 sch wd( hims.lf 6r h.elf6r thmugh hh or h.r own .nploy.6,
[ovid.d rhar soch iDpmrd.lts e ml nnc.d.d or o,nr.d fi)r sk tf, lrw*r, dE huildinS or ir{mEmnl k $ld wnhin oE Fe
of6q,Lliotl, rh€ Ow*r Buildd will haw th. tu&. ofrmvfu $al tE o. ih. did d hoild or in'pmE lh. ,,mpdy for llE I,uqB* of
l. as owr ofrhc pmn.ny. !h .xcturiv.ly.o.hcr ing wnh licosd conlEcloB to sn{rud rh. lojer (Se. 7044, Buims
and PEtrnn C6d.: Ih. Conl6cloa s Lic.nF t.w do€s mt .nDly ro rn own.r o lnnp.ny wh. huildr or imDmvcs lhetsn.
and whn onr@rs fo, $ch plbirrr wiih . co.rEcr.(r) |i..tr$d puls.r ro lh. Conl.lcloi! Lico,. be)
-l
m .x.mrt u.dcr Secr 11 &PC for rhE roq,n
WOTTKE&SI COM Pf, NSATION
DECIdEAIIA!
I h.Fby 6ltm und.r p.dhy olrdjury o& ofrh. followilg d6horio6:
I h0rc ond w nl minr.in . C(nr nclre or Cons.nr t' scl,ln rc l.r \ o, ksl 6n,pcnsrnrn, as plrvd.d firhysdhn l7r)0 otthe
L.hr c(de. nr rh. n$lomnc. of th. work nr which rhc nanrn h Fsur{l
-l
h!!c 6nd will hlinrain work.E omp..iati.n immm.. 6i rcquiEd hy Set ion 3700 .f rhc t to. co&, for lh. pnftmamc 6l
rh. wo,k lor which fih p.mil i! is.d. My worl(m comp.nsrnJn insmmc ediftr'd t$hcy nunb.r a.:
-l
c.nify (h.l in rh. !.laormru. oflhc work for Ehichliis p.rmn ir Lrs.d.l slhll Dl .mploy.ry p..sn i. any manM
m s to l,.com $hjd to thc m,t 6 @npaeloh la*! o a c,liaomi., tnd 0sr thar if I rh.uld $..om flbFl to llE
wo*6.omr.nsriontmli.ioBofserion1700oath.btorC.d..IitEll,fonh*ilh@q)lywnhrlrstmvisions
WA(Nlllc: ldiluE lo *te qdl6 @mpdution 66.!E ir ulawtuL di sl$ll ebjdt m dnrlo)r. ro dioiMlFehie lid
civil lin . up to oB hundr.d rtEusdnd dollan (1100.000). in.ddnion ro tlE coc ot@ry.Mlioq dmle.i $ pmvid.d for rlE
S.clion 10?6 ofrlE lrb.r Codc irr.En 5r'd alronEy! fd.
ApDuotrr'-
uclalD)-coNraAcroa
DICIASAIIAI
IherehynllrnrunderFnrhyolp.rjuryth,rIamI'c.f,s.{undrpn'hio.ofchnplerq(conrmencnBwrhs.crnn7l)001oiDirk'on.l
ol rhc Buen6, Md Po,ssions Code. !ry1 nry ncen{ R in tu|l ri,t. i cfiecr
coauxlEr&uIluDlNc-ecfNcr
I hcEhy nmrm undcr Frolry olr,.rlu'-a thll llEE s a con(Edbn lcndins ls.tuy hr rh. ,.rhmrrct ol lh. sork Inr *h,th rhic ,.mn ir
issucd(Scc ll)97,C1v C.)
AftllcArLltEclAsauQ!
I h,y.fiimunder D.ntrhyoIp.rjor-worcof rlE lbllowinr d.cl.dions:
Dcmlili.n Peinrs-a.lEsto. Norific ion l:.dcEl R.3ul.lions ('l'irl.40, Prd6)
RetuiEd L.tr.r olMtiliqrio.
-l
c.ni8 lh.t th. fcddll rsulandN Egardin8 olh{rG r.mwl .rc fl arpliobL rc rhiq t mjer
-l
ccniry thd I lsv. dd rnis lrrticorion ..d ,arc rhlr rh. ob6rc i.lo@lkrn is corut. I .sre (o mmlly wnh o[ Cily tnd Cooly
ordi@n6 !d Stn. L,ws Ehtiis lo ttuildins codtuclioi. &rd h.rcbyNlt riz. r.rrcnldiB oflhh Cny..d Counlylo.nl.r qDn lh.
dborc ffirion.d php.ny f6r iBFdion DUrp(Er.
,\ppllcorl or &eol slgnituft:
UNDER GROUND
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P{rap/Drain Line
Main Drain/Pool Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release
FINAL lUtpl,t qt\Kt
Notes, Remarks, Etc.
Polic, Nldb.r:-ExlJiB:
-
L.odeis N!m.
-
Waste & Vent
Gas Service