HomeMy WebLinkAbout30141784 - Permit (2)tffi1 Cig of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA s2702 Ptumbing
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Permit #:3lJ141784
Pin #: 72969
Project Address: 1418 S Pacific Ave
Assessor's Parcel: 109-263-12 Lot: 62
Unit:
Block:NA
Bldg:
Tract: 1508
Address Range:
Historic: No
Suite Range:
Zoning: R1
Owner:
Address:
Phone
Victor Higareda
1418 S Pacific Ave
Santa Ana, CA 927043720
(714) 331-2166
01 1 16002 51602
01116002 51602
01 1 16002 51600
01 't 16002 51602
01116002 57770
Fee Type
Sink
Garbage Disp
General Plan Update
lssuance
Microfilm Records
Amount
13.20
11.08
22.95
57.20
3.91
Qty
1.00
1.00
1.00
1.00
1.00
Fee
$13.20
$11.08
$22.95
$57.20
$3.91
Tenant Name:
Contraclor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Botch*:53772 - l/7/282i
Office: CTYH Trnns*: 3Accti: Refi:
Rcpti:tt286(t395 - l/7/?lt2il
Tronssct ion Total
ID: N6ARC
3014I7S
11 :44 Al1
$304 . ?6
Victor Higaredn
l
Notes: Plumbing - Garbage disposal change out.
Owner-Builder form on file.
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
Chavez, Dave
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-3, U
VB
cPc 2019
01t0712020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total<-u
Every permit issued shall become invalid unless lhe 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 ls suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01't16002 51600
0't116002 51602
01116002 57770
$22.95
$81.48
$3.91
Fee Total:
Paid to Date:
Balance Due:
$108.34
$0.00
$108.34
lnspector MID#: 2020-156950
OWNER BUILDEN DELCARATION
I hcrcby atfrm undcr fEnalty of Frjury lhal I m erempt frcm lhc ContractoF' Liccnre hw for thc following rcssn (Scc.703l.5
Business and hofession Codc): Any Cily or Counly which rcquircs a permit lo construct. altq. improvc. demlish or rcpair sny
structuc. prior lo its issuance. also requires lhe applicant for such pemit lo file a sigrcd statemnt that he or shc is licensd pusanl
lo the pmvisions of lhe Contractor's Licensed hw (Chsplcr 9, Comercing with Sstion 7000 of Division 3 of thc Busiress mi
Prcfessions Code) or th6l he or she is exempt thsefrcm and the basis for the allegcd excmption. Any violation of Serk n 703 1.5 by any
,ffi:,
for a permit subjccls lhc upplicant lo ! civil pcnally of not morc than llvc hundrcd dollars ($500).
owner of lhc pDpcny. or my employccs with wagcs as their mlc compcnsation. will do thc work and tlrc stMw is mt
or offcrcd for slc (Sr.7044. Busincss ud Profcssions Codc: Thc C<rnlroclor's Licens kw docs not apply lo an owncr of
lhcproltrly whobuiklsoritrrl)rovcslhcrq)n.andwhodoc\suchtrorkhinlsclf(rrhcrsclIorthrrughhisorhcrowlctnployecs.
ol conrflcli(nr. lhc Owncr Buildcr will hsvc lhc hurdcn ol'prrving thrt hc or shc did not build or improvc thc !n)[Edy li)r lhc purfnsc of
salc ).
_1. Bs owncr of lhe propeny. am exclusively conlrscling with liccnscd conlBctoF to construct lhe pmjst (Se. 7044, Busincss
and Pmfssion Codc: Thc Conlrsclor's Licensc Law d@s not apply to an owncr of prepcny who builds or improvcs thcr@n.
and who contmcls for such prcjccts with I ) liccnsed pursuant to Contractor'r Licensc Law).
-l
anr cxcnlpl
a
&lor lhis
I'ECIdBAIII.IN
I hcreby uffinn undcr pcnally ofFrjury ooe ofthc following dcclarations:
-l
harc rrrd will nuintair a Ccnillcrlc of Conscnl Io Sclf'ln\urc for workcrs'coillpcnsrlifll. rs prrrvidcd lor hy Scctir)n 37(X) of thc
l,uhor Codc. lor thc pcrlbnnancc oflhc w(,rk for which lhc pcrnrit is issucd.
-l
havc and will mainlain workcrs' com;rcnsalion insurarcc, as rcquired by Sstion .1700 of the bbo, Code. for Ihe lrrfotmnce of
the work for which lhis pcmit is issuci. My workcrs' comlrcnsalion insurancc cmicr ard lnlicy numbcr uet
io as to bccom subjcct to thc workcrs' comfEnstion laws of California. and agrce that if I should becom subFct to thc
worktrs'mmlEnsalionprovisionsofStrtion3T0OofthctitnrCodc. lshall. lbnhwithcomplywilhthoBprevisions..
WARNING; Fuilure to scure workcrs'compensation covchgc is unlawful. and shall suhjet an cmployer to ciminal [Enshics and
civil fincs up lo one hundrcd lhousand dollars
J
damges as providcd for thc
Scction 3076 oflhe tnbor Codc. intercsl 8nd atlomy's
I)I.,CI,/\RA I'IoN
I hercby affrm under Jrcnalty of perjury that I am lienrcd undcr pmvision of Chspls 9 (@mncing with Section 7000)
of lhc Business and Pmfessions Code, md my licensc is in full forcc and elfcct.
Liccnsc Cluss:_l,iccnsc Nunlhcri
IN
Jt'"."
0l c0'ilnroli,,n.
Drte:_
CONSTRUCTTON LENDING AGENCY
I hcrcby all'irrrr un<lcr Jrcn{lly of pcrjlry lhat thcrc is a conslnrctkrn hnding agcncy lbr lhc pcrli)rnuncc ol the work for which this pcrntit il
issucd (Scc. .3097. Civ. C.).
lJndcr's Namci
kndcr's Address:
APPLICANT DECLARAl'ION
I hcrr$yailirmundcr pcnillly ofpcrjury onc oflhc following dcchrtrtiols:
Dcmolitbn Pcrmirs-Ashcslos Nolificatkil Fcdcral Rcguliilions (Tillc.10. Parl6)
_Requircd hllcr of Noliflctrthn
ccrlily that thc fcdcrill regulalbns rcgdding dsbcsk)s rcmoval arc n(il ilpplicahlc to this prejccl.
that I havc rc{d lhis and thrr rhc informdion is corccl. I agre lo comply with all Cityand County
and Slale Laws rchting irulhorizll rcprcscnlativc\ of lhi( City and/L-
,J n^,-. 2
Counly k, cntcr ufnn thc
.l"r/LaL'atx)ve srntioncd property for
ApplicoDt or Agrnl Signetu
Pemriaee nunre qf\n-
APPHOVALS DATE !D/SIG.COMMENTS
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildino 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-trapiDrain 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
Final Gas Test
Meter Release ,
FINAL Ul4l?P1 Vzr--e)^E>)
Notes, Remarks, Etc.AfIv
'-5)
PLUMBING.INSPECTOR RECORD
Dole:-
Policv Nuntbcr: F-xoircs:
$("n,rr,nr, in thc Frcrformncc of thc work for which this pcrmit is issucd. I shall not cmploy any pcrson in any manncr
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