HomeMy WebLinkAbout30142151 - Permit (3)City of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA927O2 Plumbing
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:3fl142151
Pin #: 9901{
Proiect Address: 2835 N Flower St
Assessor's Parcel: 002-291-20 Lot: POR 34 & POR 3!
Unit:
Block: NA
Bldg:
Tract 3374
Address Range:
Historic: No
Suite Range:
Zoning: R't
r/
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Sally Tate
2835 N Flower St
Santa Ana, CA 92706
(949) 520-0426
Ultimate Builders lnc Repipr
'19326 Ventura Blvd. #201
Tarzana, CA 91356
(866) 7374731
01 1 I 6002 51 602
01 1 16002 5160C
01 1 1 6002 51 602
o1't16002 5777C
Fee Type Amount
Repipe Res (Each 100' 46.25
GeneralPlan Update 22.95
lssuance 57.20
Microfilm Records 3.91
Qty
1.00
1.00
1.00
1.00
Fee
$46.25
$22.95
$s7.20
$3.91
State Lic #: 927892
Lic Type: C-36, B
Bus. Lic #: 338197
Workers' Compensation I nsurance:Carrier: Benchmark lnsurance Company
Policy #: CST5013781
Expires: 0911512020
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Plumbing
*"0-rr"r(
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cPc 2019
06/09/2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Plumbing
Fee Totat
Paid to Date:
Balance Due:
N/A - No
N/A - No
Balance
Balance
$130.31
$130.31
$0.00
Every permit issued shall become invalid unless the work on the slte
authorized by such permit is commenced within360 days after its
lssuance, 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.
lnspector MID#: 2020-159369
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/S!G.COMMENTS OWNER BUILDER DELCARATION
I hercby aflirm undcr penalty of lErjury thal I m cxempl f.om lhe Contraclos' Licene law for the following rcawn (Sc.7031.5
Business snd Profession Code): Any City or County which rcquires a 1rermil Io construct, altq, improve, demlish or rcpair any
structulc. prior to its issuance. ulso rcquires the applicut for such frcrmil to filc I signed statemnt that he or she is liccnscd pursuart
to thc prcvisions of thc Contractor's Liccnsd llw (Chapter 9. Commcncing with Setion 7000 of Division 3 of the Busincss md
Prcfcssions Code) or that he or she is cxcmpt thmfiom and thc basis for lhc sllcgcd exemplion. Any viol8tion of SBtion 703 I .5 by any
applicsnt for I pemit subjsts thc qpplicant lo s civil pcnalty of not mre than fivc hundred dolles (S500).
_1. as owncr of thc pmlErty, or my cmployees with wages as thcir sle compe nsation. will do the work ud lhc stnrtw ii nol
intcrdcd oroffercdforsle(Sa.T044.BusiressmdPrcfessionsCode:ThcContractor'sLicenscl:wdesnotapplytomowrcrof
thc ImtErty who boilds or irprcB themn. ard who dms $ch rcrk himself or hcrclf or lhmugh his or hcr own employccs.
provided that such imlrewmnts rc mt htcndcd oroffercd for slc. lf. howes. lhe buihing or itrprcremnt is $H wilhin onc )cU
ofcompletion. the Owncr Buihcr will haw thc burdcn ofproving lhat hc or shc did mt buiH or irprow the pmrErty for ttE purFDs of
sle).
_1. as owncr of thc lm]rcny. am cxclusively contracting eith lienscd contractoFlo mnsmcl thc treject (Str. 7044. Busincrs
and Profssion Codc: Thc Contractor's Licensc Law does nol apply to u owner of prolrfly who builds or improves lhcrcon.
and who contmcts for such prcjccls wilh a Contmclor(s) liccnsed pursuanl to lhc Contractor's License Lsw).
IamcxcmDlunderScction-.B.&P.c.forlhisrcason-
Dsle: o*ner:
IUI}8trEBLCIJIISENSAIIAN
D&CI"A8AII9N
I hcrchy al firrn undcr pcnalty of Jrcrjury 0c of thc lolkrwing dcclurat ions:
_l hrvcadwill nuinlilin{CcnitlcatcofConsc[tloSclLlnsurclirrworkcrs'conrpcnsation,x\ providcdlorhyScclion.lT(x)ofthc
Lak)r Codc. for thc pcrli)rnuncc ol lhc work for which Ihc frcrmit is issued.
_l havc and will Nninlrin porkcrs' c(,nrFEnsattrn insurancc. as rt'quircd hy Scctkn 37(X) oflhc libor Codc. for thc pcrforruncc of
thc work li)r which this pcrmil is issuLd. My workcrs' compcn\rli([ insurancc crricr ud [mlicy numbcr arc:
Policv Nunrhcr: Exoircs:
_l ccrtify lhat in thc FErformrce of lhc work for which this pcrmil is issucd. I shall nol cmploy any pcrson in any manrcr
so !s to bccore subjcct lo thc work6s'compcnsalion laws ofCalifornia. and agrcc lhflt ifl should becore subjcct to thc
workcrs' compcnsation provisions ofSNtion 37fl) ofthc ktnr Codc. I sh{ll. fonhwilh comply with thorc provisions..
WARNING: Failure to scuc worken'compctrsalion ovemgc is unlawful. and shall subjcct an employer to cimiml [EEltLs and
civil fincs up to onc hundrcd thousand dollus ($100.000), in addilion to thc cost of compcnsation, damgcs as provided for the
Scction 3076 ofthc Labor Codc, intcrest {nd allorrey's fces.
I ICENSI.]I) CON'TR,IC'TOR
DIICI,AIITIIION
o! thc llu\iDc\\ ilrtrl lt('lc\\i()trs ('(xlc. xn(l rtv licunsc is in ltrll {ircc uild cllccl.
Licensc L'lussr-Liccnsc Numhcr:
I )illr (inlril(l(,r
CONS'TRUC'TI(IN LIJNDING AGI.INCI'
i\\ucd (Scc. .1097. ( iv. ('.).
lrndcr's Nam:
Lcndcr's Addrcss:
AfILISANLDECI,AEAIII'N
I M,y amm under pcnahy of pcrjury onc of thc following dcclarations:
Dcmolition Pcrmits-Ashcstos Notificulion Fcdcral Rcgulations (Tillc 40. Pm6)
-Rcquircd
klter of Notilicalion
-l
ccrtify that the federal regulations rcgardinS asbestos rcmval m not applicablc to this pojet.
_l ccnily thut I hlvc rca(l lhis afplicirlk)n and slrlc lhnl lhc ah)vc itrlbrtralion is corrcct. I agrN k) comply wilh lll City and Counly
rlnr'c trrcDli()ncd prol--fly li)r inspcclr)n purposc\.
Applicatra or Agrot
Pemitee nnme (print): _
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildino Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Piping
Fill Line/Back Flow
Pool HeateriGas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbinq
Final Gas Test
Meter Release tt
FINAL 7fr40u rtu/a 'Sa ?K
Notes, Remarks, Etc
I)alr: ,\ppli(xnl: