HomeMy WebLinkAbout30139845 - Permit (2)Assessor'sParcel: 403-082-02 Lot: NA
Unit:
Block: NA
Bldg:
Tract NA
Address Range: 1560-1590
Historic: No
Suite Range:
Zoning: Ml
20 Civic Center Plaza (M-19), Santa Ana, CA927O2
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
gr?1 PlumbingCity of Santa Ana
Permit Counter: (714]. 647-5800
Owner:
Address:
Contractor:
Addressi
Phone:
Tenanl Name: Gold Coast Baking
Leed Warner Llc
PO Box 17777
Beverly Hills, CA 902093777
Todd Construction Services
172 W Monterey Ave
Pomona, CA 91768
(909) 469-6242
01 1 16002 5160'
01 1 16002 51602
01 't 16002 5160C
01 1 16002 51602
Foo Type Amount
Gas Line alter/extend/a( 65.57
Min Fee Adj 7.81
General Plan Update 22.08
lssuance 55.04
Qty
1.00
1.00
1.00
1.00
Fee
$65.57
$7.81
$22.08
$55.04
Phone
State Lic #: 463296
Lic Type: B, C4
Bus. Lic #: 37O27O
Workers' Compensation lnsurance:Carrier: State Compensatiion lnsurance Fund
Policy #: 9050776
Expires: O4lO1l2O'lS
Batch+:{5360 - 8/t+/ZtJtg I0r LR0SA|0ffice: CTYH TrnnBir ti 4 otAcct+! RBti: St:rl3?8,ffiRcpti:02354384 - 8,/t1/?ttl1 tt:19 AnTransact ion Totol t9.1i.?4
Todd Construct ion Ser,/ices Ini
Genarsl Plon Updote Fee
01r1600?- 51600cr00-
Pluob ins
011160(t?- 51602000-
llssten Ccnd
CCi: rrr******r*r3497
- t 22. !18
- tt2g.41
1935.7{
Auth +: 92913Building Use:
Job Type:
Nature of Work
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Sub.iecl to Field:
Building Permit #:
Commercial
Miscellaneous
Enclosure & Pad
[t"..n"n
Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
lvlisc. Receipt:
Total
Occupancy:
Constr Type:
Code:
F-1
III B, SPK
cPc 2016
Notes
dez, Kathy
10195488
Every pennit issued shd bocane invalid unless the worl< on the site
authodzed by such pemit is commenced within 180 days afler its
issuance, ot if the wod< authotized on the site by such permit is suspended
ot abandoned for e peiod of 1 80 days after the time tho wotk is
commenced.
lnspector MID#: 2017-139831
08t14t2018
Account#
01116002 51600
01116002 51602
Fee Total
Paid to Oate:
Balance Oue:
$22.08
$128.42
$150.50
$0.00
$150.50
Permit #: 30{39845
Pin #: 34141
Project Address: 1590 E St Gertrude Pl
PLUMBING-INSPECTOB RECORD
APPROVALS DATE COMMENTS OWNER BTIILDI:II DEI,CAI' TION
I h.rchy anirr un(lcr Fnrlr, {)a lf,rjury rh, I In crc'.pr lhd rhc (innn'.rnJ Li..nsc tjw for rhc following rcr$n (5(.?011.5
Busitu$ md PioLsnrn C.ih) Any Cily or Counry whi.h ..quncs r lErnir ro con(rud. llrcr. idpn,vc. &fr,lirh ot Epln atry r-
{rudurc. lrnn ro ils issutrtrcc, nho rcquncslhc o,,plic:nl fo! ch Fr.rirb nh tr siEn d lrd.mfl rhrt neor stu is licenBd Pusuanr',
x, rh. pn,viionr otrhe Cookr.rr \ Licciscd Li{ (Chdtr$ 9. Cinn En.nrp Nith Sc.lion 7O(() ol'Di!hi,,n.3 olrnc Burnrss ard
Piirfd\\n,orCodoorrharh..rsh.i\crc.rrrth.rctiomu thrhalisf.r rhcul[Bcdcxcm ion.Anyviohlionofsc.liD?0]l5bydtry
!t!pli.r( ror r pcmrir suhjLrk rhc applicanr bn.ivilpc.!kyornor nFrc$an rirc hundrcd dolln^ (S51x))
-1.
&s oser of lh. pol'nr, or my coplo}!€s {nh Mgcs &r rhcn $b conp.n..rion. will & llE wst srrd lhc tn$@ h mr
inro.Ld orof.Ed for elc (Se.1044. Ausircs ed ProfcssionsCorlq Thc Co radoas Liclns Lra da rcl rplly lo s owrcr of
rhc prclany eho boiUs or iqmB dEpn. 8xt who dcr sh s* hiNclf oi lEall or thmugh hir or hd o*n cr{,loyt6.
provilcd thll s!.h inpmwils N ml inlcrk d odcrBl for slc.lt bo*m.lh. tDilding or itr{,ftftin t eld qhni. onc rE(
.f orpLriol! dE ol,m Built . wix lEr tlE hrd.n ol Fotire hrh slr did rcl hlild or inprorc thc polsly forlL tEIEEof
-1.
os ouncr .f Ih. I,mr.ny, !m cxclusiely onrEctins wnh liccnscd onrrror $ sn*ud lh. IJmro.t (Scc. ?044. Bosimre
lrd h.l6rbn Code: Thc Conreior\ Li.cnsc L{w d6cs nor amly lo e own.r ofprcp.ny qho builds or improvB rhomr,
and who onrEls aor sBh nmj.{rseirh i Conlmto(s) Iiccnscn rusoair 16 rh. G,nt@rol3 Ljen* tiw).
I mdcmd undcr SNli,n ,A &PC forrhn,lMn.
UOBf,ETS:(OMIE!'AIIQN
DECL4NAA-rON
I hcret , s,firm undcr pcnalty ot pcrjury orc ofihc loU.wing d6l@tions:
-I
hrvc rrd eitl minlain . C4nifrdc olconsnt ro S.lt-lnse for qortcs oq,misrion, s poviled for by S*lioi 3700 01lh.
kbor C.d.. for rlr pcrfolmN of rh. *orL for ehich thc ldnn i! hrEd,
-l
havc and qill mifllin qorlc,s compcnralion imu.Ec. s EnuiEn by Scl k'n 1700 of thc tjbo. Codc. fo, lhe ldollMc of
rne qort lor whkn rni! I.mn ii h.rcd. My workos' oqrN,tion iBtrmN cei6 dn polcy tunbcr @l
-l.cnify
lhot in lhc performmc orlhc qork for vhich lhis tcrni ii nrkd.l $rll ml.nrloymy P.rsn in any truncr
s ar ro tt..m suhixr r. rhc work ^ con{EN{ion hws orcalirorni!. md !8rc $at ifl slhuld lEtonE sub}ld ro rh.
*orkcB ompcnsrion pmvhions of Sclion 3?0o of lhc bbor Cod.. I shrll. fonn*nh smply eith lhoc PDvi.ions .
WARNINGT rrilurc k, surc workcn' coqcnsarnn oycrdsc n unhstul, dnd shall suhict an lnployct to riminal [arulrt\ md
civil finc\ up h onc hlMrcd iho!\aftl dollrr lslm,(Xn), ii ro rhc .os of cohFns.rion. d.tu8cs os p,orilcd lor llE
Sccttun 3076 olthc kbr Codc inrcosta.d
l!]j(!tltlllaN
I her.6y .fli.n undd F.aliy of p.rrury lh.l I @ li..nsd uids Fovirion of Cnlpld 9 (onmrcing wifi Sdtio. 7000) ol Division 3
of $. Brsift* ,nd P'of.$io$ Codc. !r'd ny liccEc i. ii tull toE. Md .lIal.
cd'ndor 1 )t\=(
CONIiIBI]CIAN.L! DIIG.ACINII
I lrEhy llfirnr un,lcr Fmllyoll{irtryrhd lhcrc n ! cotr\rrucli(in kndin8,8.n.y ror rhc t'.normmc oflhc $ort lor *hich lhis Frmi' n
hlucd (sN :109?. cir c ).
APII,ICAII.DECI.ABAIION
I hs6y aiim uflds Fnalry of pcriury of ot tlE follo*ing dc.hnrio.r:
D.,Flition Pcrnih-Asbcsros Norificlrion F.n.d Rq:rlalions (Tirle {0. Pai6)
-Rcquircd
Lcllcr of l'lotinculion
Iccniryrh l h.vc r.nd rhis apDlic.rion 0 shre rhal rhe ltovc informrion h cor<t. l rgre ro con ly qirh sll Cily ard Counly
ordinrnc.s ond sr.re tiws rcLrin8 ro brild rcprc*nlariv.i ofrhh ciryand cou y ro enrs upon tlE
nh,v..rnri.n d pol)cdt n)r
Applicml or A$nl Si*ndluF:
p"*n-** rpa,o' G4rr'.'-E J L
,*,",ey'u/N
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
lnterceplor/ Clarilier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Rool Drain
TubiShower 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 Plumbinq
Final Gas Test rNZrug re)
Meter Release Uh
FINAL qh a'nm.+t<4s)1r ,u,1Notes, Remarks, Etc.
ID/SIG.
5lrllul(
Policy Noob.i =rpics:
-l
..nify thar rlr tcd.Bl Eguhlions Bgsrding !sb.s$ Enn%l rc ml q,plicablc lo lht lmlf,r,
tl