HomeMy WebLinkAbout30139593 - Permit (2)city of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714r 667-2738 lnspector Section: (714\ 647-5853
Permit #: 30{39593
Pin #: lB6171
Project Address: 2038 1/2 S Main St Bldg AddressRange: 2034-2038
Historic: No
q
AssessofsParcel: 015-074-17 Lol: 5, 6, 7 Block: I Tract: 517
Owner:
Address:
Veronica M Jimenez
53 Setan Road
lrvine, CA 92612
(949) 981-6290
01116002 51602
01116002 51602
01't 16002 51602
01116002 51600
01'116002 51602
Amount
13.69
12.23
32.49
21.25
52.98
Qty
1.00
2.00
1 .00
1 .00
1.00
Fee
$13.69
$24.46
$32.49
$21.25
$52.98
Phone:
Tenant Name:
Phone
Bot(hi:{{384 - 6/19/7Btg I0! o0oofficel CTYH Trons+: 67 2 tAccti: Refa: 3l:r139lj
Rcpti:tf2298720 - 6/l?/2tJl8 t2!2 i,'
Tnonsoct ion Tolol t289,74Slate Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
veron icB ll J irenez
,;en€rol Plnn updote Fee
r11116002- 516U0008-Ilu b ins
!'r I I 16t102- 516020U0-
tloster Cord
CCi: *rxI*rlri***8504 Auth+ 1r_rl
Building Use:
Job Type:
Nature of Work
Commercial
Miscellaneous
Plumbing fixtures
Occupancy:
Constr Type
Code:Notes: Change out existing
Planning Conditions
Planning Approval By Date:
Date:
Date:
Misc. Receipl:
Misc. Receipt:
Misc. Receipt:
Total
Plan Checked By
Permil lssued By , Julie 06/19/20't8
Account#Subject to Field:
Building Permit #$21.25
$123.62
$144.A7
$0.00
$144.87
Every permil issued shall become invalid unlass the wo* on the site
authoized by such permil is commenced wilhin 1 80 days after its
issuance, ot it the wotu authoized on the site by such peftnit is suspended
ot abandoned tot a pedod ol 1 80 days after the time the wo* is
comnenced
lnspector MID#: 2018-144151
01 1 16002 51600
01 1 16002 51602
Fee Total:
Paid to Date:
Balance Due:
Unit:Suite Range;
Zoning; CSM
Fee Type
Water Closet
Sink
Min Fee Adj
General Plan Update
lssuance
Contraclor:
Address:
Owner-Builder
B
VB
cPc 2016
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNI,R BUILDTiR DEt,CARA'TION
I hcrchy.fllrn u cr Fnrlry {,f pcljury lhnr I am crenDr liom rhc G ra.ttrJ Lkcnsc Lrw li,r rhc folhqing r.i\ (SN.7l:115
lJusinc$ rnd Profcsnr C(xtc) Atry Ciry or O)utrry shith r.ttuirc{ r ,oni t, .oi{tu.r, rlr.r. inwort. 4cnmli\h o. rcpat 3ny
{ru.rurc, priu h its N{rncc. aho Lnutc\rhc rpplicrtrr nr \d(h n rnrir ro filcn silncd (nErmnl rhar ltor shc N li..n\cd Pusurni
h rhc pr.vili{nN or th. Contmrols l-icctrscd lns lchl0cr 9. Commcncir! {irh sr.rt,n rfiD ol Divhion I of rhc Bu\i[c\s dnd
Pr.ri\\n,n\ Codcr.'rhsr hcorshc i\cxcmrrrhcrclronrmd rh.hrsn n,lhcallcgrdcxctrr nnr. AnyvioltrtionofSftihnr03l5hyrtry
rnfl'\,J{{ l'{ Jnsm .uhtc!tsrhc iml'.rrth,r.1\'l|cnJl)nIa, nn rrhJtrlrchutrJ(tlJ,,rlrr.'!<rvr'
I.r\ owkrorrhcpnrr^-.nr.ornry.mpl{'yccswir[w!sc\rslhcir{,ld.o.r trs0rmn. willno rhc voii ddcdmrmia{
inrc.atorofic'.dhrslc(S(7(}l-{.Bu(inc$nndFYoLssioniCodc:lh.Conrrc(,\Li...\ctisdo.snor0pplyr.rnosk'of
rhc nn{rny $ho hrikls o! irrrDrcs rh.rN.. rxl *ho docs \xch Nod hnn\(lfor hcr$lf.r rhrcugir ti\ or hcr own cnrll.yccs,
pn,vnhd rhlr \rch n$olcmnisrE nori cndLrd orolilrln n, {lc ll tx'wc\..rh.huiklnEorin{rottr.r N wkl wirhiion. )cr
ol'conl|lkri('n. lhc O$ncr BliUcr sillhr\t rlt bunlcn of F'virE llaf hc or shc did mr huiH or iq,nrc thc !^]Fny fot 11* IurJr,s ol
-1.
&s otrncr of rnc prol)clry. af,.rclusivcl,cont,clingwnh liccn*d co mcloF lo connrucr llE Fojccl (S(. ?044. Blsin6s
,rt Brfsio( Codc: Thc Conr.dols Liccnsc Ij* dEi flol aPrrly ro & oen r of prcp.ny who builds or iaprov.s rhercon.
and who conlEcrs for sch ptDi$t eirh . co.|d.lo(3) !...sd pumanl Io tlt conln roa. Lixnr r,w)
a & PC nrrhi\ rcnvnr
DEII.ATAIION
I lrcEb, .lfirn und.r pcn.lry of Fjury o.. of lhc followinS dehrulions:
-lhrvcan(lwiUnuinrli.aQifi.dcotconsctrrt,sclilNurcr(trworkcsconi|*n\arion,{providcJlhrhySccrn,nlTmolrhclahtr (r)dc. Ior rhc n nbrro!.c ol rhc sork f{r rhich rh. Frrnir ii i\nrci
-l
halc anrl will roi.tain wort6 conpensatiotr ins!6ncc. as rcqlncd by Sccrion 3?00 of ih. tjbor Codc. lot th. Frfo]rure of
rh. {o& lor whth lhis prmil is issEd. My sortcc conqsrslior iosuec cdtr 8In Polky numhd u.:
PoltyNu!$.r: Fxp
ll&6tifyrh in rhc pdformmc of rnc wort for which rnis lermir is hsued. I shall nor cq,loy lny pcison in .ny Mno
$ $ ro b€lm .uii(l ro lh. sort R'om!.nslrion laws of Glifomi.. .rd alrE lh.r il I slnuld hccom subitl ro llx
vorkda.oqEn$ti.nDmvkionsofs.rtiorlT00oflhcktorCodc.lshall.fonhwilhmnplywilhtho*!'roiiiions.
WARNINC: Fnilurc to $curc *or*qs ..4tnsrnrn svcmgc is unh*tu|. and shall \ubj.cr d cnPloycr ro rinrinal lEnahics 3.d
civil in s ut ro.nc hundrcd lhousatul dolle$ (Sloo,ux)), in {ddnion lo rtu.on olconFnsrio.. drmSls as rmidcd for rhc
q ydn tco
DA:Ir'AAIION
I hcrciy nnrn{lcrpcnalryornlurylhitI!mliccncdundcrprcvisb.orchnprcr9(c.mmncin8wiltSsri,n?uI))olDirisionI
of rlr Busirc$ otrd Prcri$ions Adq md my li.dn{ i{ h full nncc and cficci
co!flf,ucuaN!ENllluclclNlt
I hcrchy afiid !nd.r Fraxt ol pcrjury rn r thcrc h a .onslrucrion lc.din8 ie.n , ror rhc [{rfornErc ot rrE sork for whi.h rht ncmn is
ksucd lsc. 3097. cir. c.)
PPLICANT DECI ARA'I'I{TN
I hcdy rnim urdcr pcnalry or !.ijfiy onc.frhc ftllowin8 dcclarnrions:
Dcnolilnrn Pctrnirs Ashcsro\ Norifi.ntk,n Fcdcnl R.Sulilio.s (rirh 40, Pan6)
-Rcqrirci
lr(.r of Ndill.:ni.n
I ccn ily rh0l rhc ltdcrrl rc-subl ions rclrdins asb.N.\ rcmuvrl m n r atdicahk lo rhn pn,Nr.
I ccnify that I nolc rcrd rhir apnli.arion dt strlc rhnr rhc atnr intonurt,. is corm'. LS'N lo cory)ly wilh all Cnyand (t,rnry
ordmrNcs und Srnre lrws shrins ro hxildnr! con{rucLon, ed hcrcby rul hoiizc rcprcscnr,riv.s.frhis Ciry.nd G,hryro c.r.r uF n rh.
ovc mbtiomd tml,cfly for in
AtDlionl or Allenl Si8mlure
PemiIF mmelprlnt)
q a
UNDER GROUND
Water-Under lloor
Gas-Underfloor
Buildino Sewer
Area,/Storm Drain
lnterceptor/ Clarilier
Waste & Vent
Water Pipino
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
lr/ain 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
Final Gas Test
Meter Release
FINAL ,b/drA -aErl(jrrrld',
Notes, Remarks, Etc vu
Waste & Vent
TOP OUT
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