HomeMy WebLinkAbout30139800 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA127O2 Plumbing
Permit Counter: O14) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: f/14) 647-5853
Permit #: 3Ol398OO
Pin #: tO437
Project Address: 710 E Dver Rd
Assessor'sParcel: 411-141-03 Lot: NA
U nit:
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suile Range;
Zoning: M2
E
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
Dyer Oil lnc/Eli Khawam
710 E Dyer Road
Santa Ana, CA 92705
(714) 936-6400
Shell
Owner-Builder
01116002
011'16002
01116002
01116002
0'1116002
011'16002
51602
51602
51602
51602
51600
5'1602
Fee Typ6 Amount
Each Add'l 100'Sewer 22.25
Sewer Alter/Repair 44.51
Field Veritication 160.25
Min Fee Adj 6.62
General Plan Update 22.08
lssuance 55.04
Qty
'1.00
1.00
1.00
1.00
'1.00
1.00
Fee
$22.25
$44.51
$160.25
$6.62
$22.08
$55.04
Phone
State Lic #:
Lic Type:
Bus. Lic #;
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Sotch+:45151 - A/2/?gLg I0: 6ARCIAoffice: CTYH lrnnei3 +8 1 of 2Acct+: Ref+: 3l:lls9gutl
Rcpt+:023{67t7 - 8/2/2018 1:08 Ptl
Trcnsoct ion Totcl t32?.83
DeeP 0il Inc./Eli Khouorl
Commercial
Alteration
Repair Sewer Line
Occupancy;
Constr Type
Code:
N/A
N/A
cPc 20r6 Notes:
Generol Plon Updote Fee
(r1116002- 5160t000-
Plurb i ne
0111600?- 51602000-
V isc
CC+: *rI*rIlrr *r*761 I
lnspoctor may roqul16 plan check.
t22.tr8
t288.67
t3?9.93
Auth+:095740
Building Use:
Job Type.
Nature of Work
Planning Approval By
Plan Checked
Permit lssued
Subject to Fiel
Date:
Date:
Date:oato2l2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
ki, Teri
d:K. Kiker
Building Permit #:
Every pemit issued shall become invalid unless the wo* on the site
authoized by such permit is commenced within 1 80 days aflet its
issuanc;e, or il the work authoizod on the site by such pemit is suspended
ot abandoned fot a period of180 days aftet the time the wo* is
commehcecl.
$310.75
$0.00
$310.75
lnspector I\IlD#: 2018-'145101
$22.08
$288.67
Fee Total:
Paid to Date:
Balance Due:
Planning Conditions:
01116002 51600
01116002 51602
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
UNDEB GROUND
Waste & Vent ./i\
Water-Under floor 4..,441
Gas-Underfloor
Building Sewer
Area,/Storm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipino
Gas Piping
Roof Drain
Tub/Shower Test
Rough 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 1
Sanitary SeweriCX I ,V.q)Lt
Back Flow Devic6
Rough Plumbing
Final Gas Test
Meler Helease
FINAL I
Notes, Bemarks, Etc.
OWNFI AUILDER I}ELCARATION
I hcEby trftm un.ls lEnally of p.rjury thd I m crcnpl frlm ltf, a,ntra.lo6 LitN kw tot $c lollowin8 @en (Se ?01 1.5
Busiics aid Profcssion Codc): Any Cny or Co!d, which ,cqlircs , Fm0 ro .onstocr, dr6, imrrov.. dcmlish or Etan any
srudm. prtll ro ir. irsu&c. sho EluiEs $e lpplio! lor su.h Fmil lo fiL a si8ftd strlcmnl lhll lt 6, she is liccnsd putsua
to rhe pmvhiors of rhc Conrrdoas Limnert t 8 {Ch!pte. 9. Conmrcing wilh S(lion 7000 oa Diltion I of llE Businc$ and
Profcsions Codc) or rhor rr or sh. k cr.mpr rhcrcfrom and rhc blsis for rhc alL8cd dcqnion. AnytioluionofSe'ion?03l.rbyony
ll'Plicanr for al,cmn subj*r rhc apnlic.nt ro r.irilFnalryofnot mr fian 6rc hundrcd dolhrs (SJ00).
L rs osmr.trhc pmlrn). or nry.trdoyccs wilh vrscs us rhcn {r[ conrpcn\di(nr. *illdo rhc $ork otrd rhc {Mlm is ml
idunlcd oroflarcdntr\alc(S(TlEl.rlusincsnndPn,fcr\idNCrxlclhcConta.ttr'rl-iccnrtrNdocs.orqrplyro!no*icrof
rhcDmFdy $ h! lrrild\ or i'n|k)$s rhcR,n. ond who dB such woll hnnscll .r hc cll orrhr.ugnhis or ncr osn cmtlo)tcs.
,r'vidcd rhxi such i'nnn cftnrs m nor inicidcd or olT.ruJ lar {k lll hoqcvcr, thc huildii!.r i'nrcv.nrnr is vni $thi',d . }rr
ofconfldi, r,lt owncrBuiuc.sillhtrc rhc ti{i.lc tr ol ln,vn8 Ihal ltordrililnor huildor i'rptuv. rhc pn,Fdy ror ltr Nqrc ol
-l.
aso*mrofrhc Eopcny. !mexclusivclyonrroctins wirh lk.nsd conrdcro^ io otrntur
'rE
p,o.id (Scc. ?041. Businc$
r P,rftssim cod.: Thc Conlmcrols Lic.ns. Low docs mr opply lo an oNncr of rmFrr y who l,lildr or inprows dENn,
and *ho conrocrst{trslch tFjc.t wirhaC.rh.G'nr,.rois Li.cn\c liuJ
-lfln.xcmrl
lndcr 36l
I2Il.Lr\BlIMI
I hcrchy afiin undcr r,€nllry of pdjuty
-l
hrvc axlsillmrn rin!Ccdili.arcorCon\cnrroscllln\trcfttrNorkdiconrpcn$riotr.N p$ridcd for$ySccin,n:1?(x).rrrr
Lrh.tr Cdc, tu r lE rcrhruncc .l rhc sork for *hich thc pcrnil i\ h\ucd
_l h!v. and will minhin workcB comFosa'ion insxhncc. as (9!iEd hy ser ion l?00 of rlE t t.r Codc. itr lh. Frlomfte or
rhe work t r qhi.h rhk rfimh is h$cd. My workch corrcn$lion inlumn.c .ari.r sd policy numb.r E.:
I.cniiyrh.t in lhc p.rfoirmna of lhe work lbr which lnis pcrmit is Gsucd.l shall nor cntby rny Fnon in uny ftt.ncr
s ssto hc{.tu irbir'
'o
thc }od{dc6mFn$'ion lrvsofcllirornh. rnd.gB thd irl shuld h.rom ilbFl ro th.
s!tr*.6' confcnsarn,n tovhbn. of serion 17fi) of
'h.
Ijt r O)dc I sh.ll. fonh*ith comtly wnh thoe l,mrlrions..
WARNINC: tjlilurc to surc srkeN'
civil fincs !p lo onc hhdrcd lhousand
S&ri.n i{rri of rhc I atrr C.dc inrcrd
shlll subjer m ftplo)er to niminal [Eolis..d
d{ro8cs as pmvidcd au lhc
I turcbydfirmtrndcrFn t ol Frlury lhll
DECIdAATON
und.r Foviion of Cnlpr6 I (onmmine wnh Se.lbn ?000) of Divishn 3
ol rhe Busimss lnd Prof6rions Codc, snd my lic.nsc h
Liccne Nrnb.rl
C(TNSTRTICTIoN I FNDING AGI]NCY
I ltrby rfin'n undcr Fm]ryof |x jury lhlt lhcrc i\ n.ons'!diotr Lndina llctr.y rr rhc pcrrod&.c nl rhc work rhr qhich Ihn Pcnnir n
i$ud is.c lr)97. Ci! C )
8.8TI,I(JTTLIr[(:I,ABAJIU!
I h.1r{)y rnn r undc' t^-frlrt.l I*rJUry oi. ot rhc ii,lk,\ n8 delrfuri,trN.
I).ntrillri.tr l,cnnns A\h!{o\ Nori,l.rri,,n fc .rrl R.guhri(r\ ( airlc 10. Pi6)
Rcqun(J I.nrrotNorilicrrkrr
--J dc nor trptlt,hlc h this pmlccl
_l I agre k'e,rtlysirh rllC
l!ssclarin! ro huildi.e co;
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