HomeMy WebLinkAbout30140787 - Permit (2)City of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA927O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:3fJ140787
pin #: 1oe211{
Proiect Address: 1918 W West Winda
-
Unit:
Block: NA
Bldg:
Iracl:.7711
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 412-224-22
Owner:
Address:
Tenant Name:
Contraclor:
Address:
Phone:
William Marlowe
1918 W West Wind
Santa Ana, CA 927047144
(714) s56.4104
Greenstar Home Services In
1951 N Main Street
Orange, CA 92865
(949) 885-0102
Fee Type Amount
01116002 51602 Wtr Htr (Res up to 50 gr 22.25
01116002 5160C GeneralPlan Update 22.08
01 1 'l 6002 51602 lssuance 55.04
Qty
1.00
1.00
1.00
Fee
$22.25
$22.08
$s5.04
State Lic #: 795556
Lic Type: C-36, C-20
Bus. Lic #: 344246
Workers' Compensation lnsurance:Carrier: Liberty lnsurance Corp
Policy #: WA763D508631018
Expires: 1OlO1l2O19
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
Water Heater
Kelaher, Selena
Notes:
Fee Total
Paid to Date:
Balance Due:
04108t2019
04/08/2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
{/n",.nrno"r,Kathy
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3, U
VB
cPc 2016
01116002 51600
01 1 16002 51602
08
29
$22
$77
$99.37
$0.00
$99.37
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 1 80 days after the time the work is
commenced.
lnspector MID#: 2019-150596
Lot: 35
Phone:
PLUMBING.!NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER AUILI'ER Df,LCARATION
I hereby affirm undcr penalty ofpcrjury that I m cxempt frem lhe Conlractors' License Law for thc following rcamn (Sec.7031.5
Business ord Pmfcssion Code): Any City or County which rcqufes s lmil to @trstruct, alt6, improvq d€molhh or E?air any
structurc, prior to its irssnce, al$ requires the applicanl for wch Jrmit to filc a signcd slalercnt that h€ or ihe is licenscd puNnnl
to the pmvisions of thc Contractor's Licensed Law (Chaptcr 9, Comeming wilh Section 7000 of Division 3 of lhc Bucincss and
Pmfcasions Codc) or that he or she is cxempt therefrom and the basis for thc alleged exemption. Any violalion ofs(tion 701 1.5 by Bny
applicantfor6pemilsubjectsthe applicanltoacivilpcmltyofnotmorclhanfivehundrcddollars($500).
_1, aB owncr of thc pmpe(y. or my employees with wagcs as thcir sle compcnsation, will do thc work and thc stnEtrc is mt
intcrdcd or offered for mlc (Sc.?044, Busircss and Pmfeseionq Codc: -l'h. Contr.clor's Licmsc kw dos ret apply lo an owrcr of
rhe pmlErty wtn buildr or in{rrcv* thmq aod wln &m sch wo* himsclf or hcrclf or thmugh his or hcr own cmployees,
providcd that such impmrcmnts m ml intcrded or oflered for mle. l[, lnwwr. thc building or irprovcmnt is sld within onc yw
of completioq thc Osrcr Builder will have thc hurdcn of pmving tha hc or shc dil mt buiH or inrpmrc thc pmpaty for thc pupr of
mlc).
_1, as owner of the pmperty, am exclusivcly contmcting wilh licensed contmclon lo onflrucl th€ pmj$t (Sec. 7044, Busires
and PmfrssionCode: lheContractor'sLiccnscLawdoesnolapplytoanownerofpropcrtywhobuildsorimpmvesthercon.
and who ontmcts for such pDjets with a Codmcto(s) lic.Ncd puNuant to lhc Codractor's Licenk Las).
-l
om cxempt undcr S(tion-. B. & P.C. for thi3 reosn.
l)ate:
IVORr(f, RS' COIUPENSAl'tON
DECLARATTON
I herehy affirm under penalty ofperjury orc ofthe following delamlioosl
_l havc and will maintain a Certificate of Consent to Selflrrure for workers' conrpenlation, as prcvidcd for hy Strtion 3700 of the
hbor Code, for thc perfomrcc of thc work for which lhe pcmit ir isilcd.
_l have and will mainlain workerg' compcnsalion insurance, as required by Scctiun 3?00 oflhc Lahor Code, for thc pcrfomance of
the work for which this pemil is issed. My workss' @mpcnstion insurarce carier ard Jrlicy numher uc:
WA 9a^9 G II'o I iet
_l cenify that in the performncc of the work for which this p.rmit is issued. I shall not employ any Jrcrson in any manner
m as to trom subjel lo thc Bortm'compcnqtion laws of Califomia. 6nd agrcc that if I slnuld becomc sbjet lo thc
wort6' smpcnsation pmvisions of Setion 3700 of the Latnr Codc. I shall, forthwilh $mply wilh thos pmvisions..
WARNING: roilure to sue workeB'compenslion @veruge is unlawful. and shall suhjst an mplo,€r to siminal lEmhi.s and
civil fines up to one hundrcd thousond dollars ($l lhe cost ofcompensalion, damges as provided for lhc
Sation 3076 of Code, iilcrd and snorney's
4 q
I hcrchy aflirm uoder pcmlty of pcrjury that I m lienscd undcr povision of Choptq 9 (@mmming with Section 7000) of Division 3
of thc Busincss and Pmfcssions Codc, and my liccnse is in full force and effet.
License
Date:cl
I hercby affirm undcr ;rmlty of pcrjury that thcre b s @rctruclion
isscd (S(. 3097, Civ. C.).
lbr thc psfonn nce of the u,ork for which lhis rrmil is
Lender's Name:
l.ender's Address:
APPLICANl' DI'CLARAI'I0N
I lm'hy allinn under pcnalty ofperjury onc ol the frrlkx ing declarrl irns'
Dcnr)lilion Pcrnrits-Asheslos Nolilicrtion Ijederal RcEulatft)ns ( l ille 40. Prd(r)
_licquirc(l l.ettcr of Notilication
-l
ceniry thal rhc fedeml .elulations rcBarding asbestos rcmval are nol applicable lo lhis prej.ct.
_l certiry thal I havc read lhis applical
ordimnces and Statc Laws GlatinS to bui
above mcnlioncd pmperty for inspection
thc ntnve inlbrtrr.lion is corect. I .8ree to comply with 0ll Cily {nd Counly
ard herehy autlnrize represnlatives ofthis Cily and County to enlE upon lhc
,\pplicntrl or,\grtrt
Pernritec nanre (prinl)
,,,"-{g[L
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
lnterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain 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
Rough Plumbing
Fina! Gas Test
Meter Release I
FINAL dtaltu)Dftn/?,n #Yt
Notes, Remarks, Etc.I vl
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