HomeMy WebLinkAbout30139673 - Permit (2)Project Address: 3918 S Flower St
Assessor'sParcel: 410-291-02 Lot: NA
Unit: G
Block: NA
Bldg:
Tract: NA
AddressRange: 3800-3928
Historic: No
Suite Range:
Zoning: R4
q
Permit #: 3O139673
Pin #: AAO72
Owner:
Address:
Contractor
Address:
Prime & South coast L P
50 California St 920
San Francisco, CA 941114606
(714) 5s5-7960
Western Plumbing Services
18'10 N. Linwood Ave.
Santa Ana, CA 92705
(714) 492-5490
Fee Type
01116002 51602 Clothes Washer
01116002 51600 General Plan Update
011'16002 51602 lssuance
Amount
13.97
22.O8
55.04
Feo
$13.97
$22.08
$5s.04
Qty
1.00
1.00
1.00Phone
Tenant Name:
Phone
State Lic #: 1021101
Lic Type: C-36
Bus. Lic #: 364095
Workers' Compensalion lnsurance;Carrier: State Farm Fire and Casualty Company
Policy #: 90C6X6879
Expires: OBI?U2O1A
Generol Plon ljpdote Fee01tl6m2- 516flrcO0-
Plt,lb i ns
01r 16002- 51602m0-
Itost€P Cord
CCi !trrrrrr*r*rr3753
- t22.08
t69.ll1
tl rJ55.52
Auth+: l70lt14
Bdtchi:{{7{s - 7llll20l8 ID: CCUEI.LARoffice: CTYI Trons+: 54 ltt oI 16Accti: Raf+: 30139673
Rcpt+!02322m8 - Tlll/2018 3.02 Ptl
Tronsoct ion Totol 111355,52
llestern Plurb i ne SePviceg
$91.09
$0.00
$91.09
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By: Fregoso, Vince
Multi-Family (5 or more uni Occupancy:
Alteration Constr Type
Washer/dryer Code:
R-2
VB
cPc 20't6 Notes: lnstall a washer & dryer in an existing closet.
?
Date:
Date:
Date:
07 t1112018 Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Amsden, Julie
Every permit issued shall become invalid unless the work on the site
authotizgd by such permit is commenc,ed within 1 80 deys after its
issuance, or it the v,lotk authoized on lhe site by such permit is suspended
or abendoned fot a peiod ol 1 80 days aftet the time the work is
commenced.
lnspector MID#: 2018-144562
0711112018
Account#
011 16002 51600
011 16002 51602
Fee Total:
Paid to Date:
Balance Due:
$22.08
$69.01
city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #;
PLUMBING-INSPECTOR HECORD
APPROVALS DATE ID/SIG.COMMENTS OITNI'R BI]ILDEI' DEI-CARATION
I hcrcby tr!finn undd rcnilry .ri t8iury lhnl I rm crcnur lrom lhc ConrrJcro^ t-i.cn\c Lnw n, rh. nr[,]ins rcl$n (S.c?011.5
Dn\ircr\ rnd Pnnt$i,,n Cqt) Any Ciry or G,Lnry which mqrnc\ n rnnn n, .otr{rud. .lrcr- nnnr.\c. lcnnri\h '{ rcnrn ,,ny
(tudur.. priortu irs i\\uan.c. rl{ icqurc\ rhc {rDli.nnr r(tr !u.h Fann b lilc r \ilncd {lrctrrnr rhir hcor \hc is li.cn{rl Pusurtrr
kr lhc |novisios ol rhc Conrr!.ktr \ l-iccnscd liw ((hrpi.r L C.n ncncnrg wirh sc.rion ?(xD of Division 3 of rnc Btrsid.ss and
.ttli.n ntr rlf,nlnr subjc.Grhc opplimnr r' ncivilpcnslryoin.r nFrcihrn i_Lvc hu ndRl doUr\ ($5(D)
l.$owtrcrollhcpmFny,ortrryemtn,yccswilhwrscsu\rhcir$lccompcn\aii{rr.*illdorh.s{ andrlE(R1ucisRn
inrmlsl oroitrcdl'ors0lc(sa7Or-1.Bu\in.\\mdPmlc\\nrn\Codc:lhcconhaclolsLi.cnschwdoesnorflmlyro!noen.ror
rhcnnr|ity sho huius or nnnrx$ rh.N)n, !'xl who dRs \u.h $* hinrcllor hcrsdllor rhsuEh his or hct own cnDbyccs.
Drcvnhd rhdr \u.[ nnlmrenr.r\ @ mr idcndcd or ofiscd t'or \ah ll: ho*cr.i rhc Soildin8 or irpnntmnr is $H wirhir onc ,s
or.ontphri,n. rh. o*ncr Buiu$ sill ltr\c r bunL. of pr.vin8 rhd lE or shc did d h'ild or i,.4r,t rhc rr,Fit tor rhc Nqss of
l. ar 6wn.r oa ilB l'nth,, an.x.lusiv.ly ronlr.ctif,B wnh lanrcd conlrKxE lo oonod rlE !oj.!t (Se 7G14, Buiiftrs
and Eoftasion Codc: Thc ConrMror\ Lk.nrc tiw dfts nor qDly r. d owncr of lrop.ny who builds or ihpovcr rhe.co..
rnd who .o 6cr fm sch pmj$rs wirh ! Connftlo(9 liccnEn pu*u'n ro thc Coniracror's LBrs tjw).
I lmcrcmD' undcr SNriotr . B & PC for lhn rN\.n
l)ll.: O*ner:
loaf,E&:t!]!4rENsAtr0N
DEIIdSAII(A
I lErcby lrtrn undcr Pcnlh, of rdjuy om of ln. followinB delaBri6Bi
-l
hrvc uftl sill trEinrli! ! (cnificlrc of G,n{ r ro sclt hsurc rff $ukci. con\tuns i(,n,$ F,vidcdlnrhyScrrio.l7U)orIhc
L,h, (r)dc. rr rhc lttrllnnnrNc olthc so rhr lhicn lhc rcmil is nsucd
I hlvc and eall @inrain wortc* corycnsarion insummc. os Equircd l,y Ssrnrn 1700 of rhe L.h., Cdl.. for lllc rsftrtrre of
h rhis pcmil n ns&d My *ortcN compcnsalion insuroN @icr 6ild rblky numh.r m:
4OCC,-11 7'lL1 \tr
-l
ccnit, thar in lhc Frfor.run c ofrhc work lu *hkh lhb Fnrn is issucd, I shall nol employlny p€en in any manroi
s rsro tE .m.uhiyr ro lh. worlEl o,rqFnr.rion laws ofcaliforni!. dd agm rh{ ilI srbuld h..om $tiNl lo rhe
workdc ompcn$tion lmlisionsofScrton 1700 ofrnc tjtnr Cidc.l rhrll. fonhqirh comply wilhrhos pmvlsio.s,.
WARNINGT F"ilurc lo scun polkcs comp.nsalion covcEsc is lnlaefll. dd rh8ll strbhcl m.mplotlr lo aiminal I'cMlrk. dd
.ivil fi.cs up ro om hundrcd rnousand doll{s (SI00.()O0). in rddirioi ro rhc corr of coiiFnsiliof,. dam8cs os providcd for lhc
Scrion 1076 of ttrc tibor Codc. inteten ud lrromy s
,",", -l-11.\t
IXCIAMIITN
I hcahyain unncr pcmlry ol Frjury rhd I li.ci*l undrr F,ri\i(,n ofchrrlcr 9(.omrmmin! vith Sari,n ?off)) ofDivision:l
of rhc Busin.* rnd Piofcsri{,ns (ndc- md myliccns n h tull lorcc unl crltcr
L3 t-\0-L\ta\
CONSTRTJCTION I FNNINC AGENCY
I hcrcby affirm undcr IEMlry of p.rjury rhd rhm k ! mftrtu lion hndinS agcncy for lic psfotmre of lhc work fo. which lhG lcmil i(
issucd (se.109?, civ. c.).
AEELICANI.DES.AAAIIAN
, h.n:6y altim undcr rcoalr y ol pcrjury oft ol rhc rollowins d6b,ario.\:
Dcrmliion PcrmnsArbe(os Notificariotr Fcdc,al Rc8ul ions (rirt,l0. Pan6)
-RcquiEd
Lcrtcr of Notifi curion
-l
.cnify rhlr 0E fcrkdl Egpb oos E8{iling a.b.slos rcmvr! m ml .p,licabk ro lhn poj6l
I ccnitirhar I hnvc rcad rhis otpltarion and sr.rc thot tnc lbr intormrioo k.ond. I r8e loenply pilh ![ Cnylnd Colnr,
ordintrtrfti rd s{arc tr*s Elalina ldiis co.ntucrio nd tueby autb u c Eprcenrariws or lhk Cily and Counry lo c.l6 uFn tlt
ibdv. mnrioncd toFdy ror ins 1\\ lY
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq 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
Sanitary Sewer/Cap
Back Flow Device L
Rough Plumbing 7"17-tY h "V/jlil,
Final Gas Test V
Meter Release
FINAL ,.r1_tq ttlauzr<6")
INotes, Remarks, Etc.l
$/-\-f
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