HomeMy WebLinkAbout30139871 - Permit (2)CitY of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (7'14) 647-5853
Permit #: 30{3987{
Pin #: sr22l.l
Project Address: 3101 S Joane Way Unit:
Block: NA
Btdg:
Tract: 8200
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor'sParcel: 412-274-03 Lot: 35
Owner:
Address
Fee Type
01'116002 51602 Cap Fixtures
011 16002 51600 General Plan Update
01116002 51602 lssuance
Amount
6.95
22.O8
55.04
Qty
1.00
1.00
1.00
Fee
$6.95
$22.08
$s5.04Phone
Tenant Name:
Contractor:
Address:
Caspers Demolition
2243 E South Redwood
Anaheim, CA 92806
(7r4) 863.s474
State Lic #: 1015067
Lic Type: C-21
Bus. Lic #: 370351
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9222370
Expires: 1210612018
Building Use:
Job Type:
Nature of Work
Single Family Dwelling
Demolition
Pool Oemo
Occupancy:
Constr Type
Code:
R-3, U
VB
cPc 2016 Notes: lnfill pool/spa
Planning conditions
Zuniga, Allissa
10197452
Date
Date
Date o8t22t2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc Receipt:
Total
Every pemil issued shall become invalid unless lhe work o, the site
authoized by such pemit is commenced within180 days aftar its
issuance, or if the wo* authorized on the site by such permit is suspended
ot abandoned for a peiod of 1 80 days aftet the tme lhe work is
commenced.
$22.08
$61.99
$84.07
$0.00
s84.07
lnspector MID#: 20'18-145573
01116002 51600
011 16002 51602
Fee Total:
Paid to Dale:
Balance Due:
Bao
3101 S Joane Way
Santa Ana, CA 927046125
(714) 261-'1566
Phone:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
PLUMBING-INSPECTOB BECORD
APPBOVALS DATE ID/SIG.COMMENTS OWNER AI]II-DER DI'LCARATI0N
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inrcnd.d oroficRd for sk (Sc.7041. Busimss ed PrDfdsbnstuq Tle C.nleror's Lic.N t *drcsmlarptytouowol
rlE pmFny who builds or i,rpmts tlisll. .nd wlb dca sch rcd( hinsclf or n ,*ltor rhbu8h hh or hd own crrlpk rfts.
Dbvil.d rhlt suct iE|mwEnc I ml hld&d do6.itd fD, eL. tl ho*.E 0E hilding or inpiffin il $ld $ilhh om Jqr
ofotrpkri,r {E olrrcr Builts qill haw ,E hlthr ofFlving tlEl lE or slE dii ml boild or iq,Dk dtc Flpcty tur dE PuqDc of
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,nd Fbftssion Codci ThcContretols Licenlc Llw dfts.or amlt to o. owncr of Pmtcrly *lE builds or imPorcs lhcrcon.
lnd who ontdcrs for slch pmiels wilh r Conlaclo(s) ltcnscd plBuur ro rh. Conlraclor's Ltc.sc L!q)
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ancredfl undd S6rion- B. & P.C. for rhis etson.
!!8TD&i:COM@IAIIQN
DECLAMITON
I h.Eby affirnuder peiolryofpBjuryoe olrn followinS dclaalioni:
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trilln nrlifrC.nifKtrrcofcotr*nrtosclf.ltr{trcld*orks^ onrPcrtnridr.as I'r)rincdntrhts ridr:l?(x).lihc
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-lh0vcond*illmrinrainso.isco,rn€Nlrioninsuramc.asrcquir.dbySerbnl7mofth.bbortuc,forIh.0.rfolr:wcoflhc woi( for which rhi\ pctnl is i,su.d. My wortm onDcnsslion insudc. .mLr ad ,olicy numbo e:
P{ric, Nrmbo:-EiP
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!o sro h(otr {brcr ro thc worl6' sdncn$l,nn l,$r ol CililnmE snd lErcc lhsl ill fould bc.om obF' !o rhc
wuAcN mmFnsaion pm!isions otscdion 1TOOofrhc tibm Codc.l \hau.lonl *th cdlhly *rh ltrc pFvrhn'.
WARNINC: l:{ilurc ro $curc workcn o'npctrs iotr covcflgc is unln*iul, rnd shill rui'lc.r dr cnrtlorr lo lrn ndl Nnrlras lnd
.ivil ftrs np h otrc hlndrcd rhors,tril dolla^ {Sluo,000), in rkldiri{nr lo rtu.on or.o r]rn\0rnnr. d!trusc\ as ptuvtrcd rhr lhc
sccrnr 1076 olthc Lrhtr Cdlc, 'nrcrci and anoaryt lics
IICENS[Dj0N:I3 crA,U
II,CIdBAIIQN
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CANII8II:IIaISIINDINGIGENII
I hcEbt affrm undd pcMlry ot p.rjury lhd thcrc is a ointudhn tc.dirg agcey for tt PcrfolrMe of $c gtrt for whi.h llis pemil is
isura rsN 3{|)7,civ. c )
AITLLCANLDICIAB.trUq!
I lihity illnn u.dcr petrrlly.ipcrjury orc orrhc n,lbwinE dc.lmrnrns:
DcnFlirion Pfnirs Aih.no\ Nolilicalion FcdcralRcEullri(,.\ lfirlc 41). P,n6)
Rrquircd trn.r of Nor ifi!$ion
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ccnify thd llc tcdcdl EgrLrion. rcei,{ii8 asbcslos rcmvol @ nor q'nlhabh lo this pmict
I ccnili rlur I hxvcrclld rhi\ rypll.rri,rrnd q!icrhJr rh.rh)!c iikmrrior i\corsr lrsrsi'.. rrly$nhtrllCirynndG)!trry
onlinrn.r\ r d shrc liss nhrins ro hull{llns coo(tucrion- nl hcrhyrurtrrizc qnc{lllrlivcs oirhi\ Ciryrnd Counly ro cnl.r uF)n rlt
inc lrnrirncd nop.nt lbr n,\Fdnnt Nrnoscs.
ApplicsnlorAae Si(nrlure
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
lnterceptor/ Clarilier
TOP OUT
Waste & Vent
Water Piping
Gas Pipino
Rool Drain
Tub/Shower Test
Rouoh Water Heater
POOL/SPA
P{raplDrain 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 :zrt)
Notes Remarks Etc.
Area/Storm Drain
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