HomeMy WebLinkAbout30139676 - Permit (2)AddressRange: 3800-392E
Historic: No
Suite Range:
Zoning: R4
EProiect Address: 3925 S Flower St
Assessor'sParcel: 410-291-02 Lot: NA
Un[: B
Block: NA
Btdg:
Tract: NA
city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permlt Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 3O139676
Pin #: E4IOE
Contractor
Address:
Prime & South Coast L P
50 California St 920
San Francisco, CA 941114606
(714) 556-7960
Western Plumbing Services
l8l0 N. Linwood Ave.
Santa Ana, CA 92705
(714) 492-s490
Feo Type
01116002 51602 Clothes Washer
01116002 51600 General Plan Update
0'l 'l 16002 51602 lssuance
Amount
13.97
22.O8
55.04
Fee
$13.97
$22.08
$55.04
Qty
1 .00
'1 .00
1.00Phone
Tenant Name:
Botcht:4{7{S - tltv20lB I0: CCUELLAft
office; CTYH Tnons+: 5{ 3 of 16Acctt: R6f+! 30139676
Rcpti:02Il29lll - TnYm$ 3202 ?n
Tronsqction Totol tlr355'52
llestern Plurb i nt Services
Phone
State Lic #: 1021101
Lic Type: C-36
Bus. Lic #: 364095
Workers' Compensation lnsurance:
Carrier: State Farm Fire and Casualty Company
Policy #: 90C6X6879
Expires: 0812412018
Generol PIon Updote Fee
01116002- 516ffn00-
Plurb ine
01u6002- 51602000-lhster CordSCl.rfirrrr*i*r3753
Notes: lnstall a washer & dryer in an existing closet.
,22 .98
369.01
tl r355.52
Auth::170104
R-2
VB
cPc 2016
Multi-Family (5 or more uni Occupancy:
Alteration Constr Type
Washer/dryer Code:
Planning Conditions:
Planning Approval By:Fregoso, Vince
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Every permit issued shall become invalid unless the wor* on the site
authoized by such permit is commenced within 180 days afret its
issuance, ot if the wo* authorized on the site by such pemit is suspended
ot abandoned lor a petiod of180 days after the time the wg* is
commenccd.
lnspector MID#: 20'18-144571
011 16002 51600
01116002 51602
$22.08
$69.01
Fee Total:
Paid to Date:
Balance Oue:
Amsden, Julie
o7 t11t2018
07111t2014
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
J $91 .09
$0.00
$91.09
Owner:
Address:
Building Use:
Job Type:
Nature of Work:
Date:
Date:
Date:
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OIINER BUILDER DTLCAR TION
I hcrchy .lilnn undcr ncnrlry ol pcriury rhar I un cxcnnr lom rhc Contrcttra Li(ctr* Ijw ln rhc ioll.wing rcr$r (Ss.70ll 5
t,u\incss lod Prcfc*ion Codc): A.t Cty .r counly *hi.h rcquncs r Fnnn lo con\lrucr. ulrcr. inrpu,vc, dcnFli(h o, rcPln uy
!d.rxrc, tii, k, irr i\su0,rc. rl$ rquncs thc dt'!li. trr rar such pcnnir lo filcn \i8 rJ {rrcmnr rhrr hco! shc h lic.n{d l)Ur\urr
h rhc nm*i,nn oa rtc Co rr.ttr s Li.cn\cd us (ChrUcr 9. Connrcncins *irh Sccrnrn 7m0 ol Dilisbn I ofrl. Buiinc\\ rtrd
Pn,n\sionsCodc).rrhlrtr or \hc hexcn|n lhcrcrio ond rhc h0sis torrlr nllcgcdcrcnrrrion. Atryvid iotrolsc.rirT0.ll Shyrry
opflicml lnra Nnnil subjcclrrhc lnplica t,acivilpcnllryolnol'B,.rhrnnvohrndrcddolhrs($500)
-1.
es ow*r of rlE !rcFny, o. ny enplo)r.s with w!8ci !s rh.t sh oslpcNlion. wil do llt edt ed ftc ninw is ml
iirclded o. ollcrcd fo, sk (5(.?044. BBimss cd Elacsions Cod.: Thc Conr&ld 3 Litns Llw &ca ml +ply lo u owM of
lfu pEpcny who tDilds or ir{mes tlte[ ed sho d@s sh e* him*lt o, h.r*lr or lhrcugh nir tr ncr o*n cflPlorNs.
rovided ltrr $ch iq!rctreill @ mt intc,i.d m ofici.d ftr eL. lL ho*.q.lhc hiuins n i@rnrcmfl Esldwnninonc yst
of @nptdon. d* Owr B!il&. vill h& !E b'!d.n ofpmvi.g lh{ h. o. dE dn d hild or inFow thc pbtary fo! tlt F[Ibs of
SOASDAIIS'IIPJIIAIION
DECI.AIAIIQ
I h.rcby aflim lndcr Fndry of pcjury oft of rhc follo*in! d€lrnraoBl
Ihr(cr lwillnDn uirr(trli,icnrcofc.nsorroS.li-lo\urcf(trworkc^ conei\di,nras ptuvidcd i(tr hyScdi('n]?00 orrhc
lrh,Oxlc, li)rrhclcrianMtuc olrhc work ld whichrl[ lEirni k n\ucd
I hn!. rnd will tuinr,in *ork rc comrcmlrion insurorcc. ar rciun d by SNrion l70o ofrhe tibor Cod., for lnc p.rfornucc o,
MyworkeF onrprnsalion insunncc ddi.r,M Flicy ounrl,cr m:
s'2118
-l
ccnify thrl in lhc l,crformne oflhc wo,t fo, shth rht F.nar is irsucd.l sh,ll nol employary Pcmt in 8ry mdnN,
$ N ro b.em $hixr 16 rt *0r*6' co,{x.stion hws ofcalifomi!. and astc rt r if| ih.lld h.cooE 3ubid to lh.
e*cB conrDcerio. p@visionsofselion 3?00orllr btor Codc.I slEll fonhwnho,qrlysilniho*pmvisions..
WARNINC: Failurc to Kurc qrkcs' .oolcnsai.n covcftg. is unlowtul. and shnll slhjst an cnDlort, ro nmintrl |f,Mnics md
.iqrl fincs un h oFc hund'cd rhouqnd dcllr^ rll(t),rl{D)in addirion ro thc cosr ofcodpeoiarioo. dumg.s as povidcd for rhc
S(lDn 1076 of rhc tiDor C.rlc, i.'ccs ond drlmy
-,.I]l \Ln,oo*,
DECIAMIIAN
I hcrcby Jlinn undcr pcnlltyol Frjury lhar I !n lftn{n undrr nmvi\t,n or Ch,Prcr 9(.onrmncin8 wirh Sslion 7fix)) orDivinon l
ol rh.lh\inc$ rd Pr.L!\n,n! Cod.. lnd nry liccn* i( in tul1loraandclf(l.
lo \('2\\o\
-"1 Dc\^ s--U
(:(INSTRTI(ITI(}N I ENDIN(; A(;ENCY
I hcrhy arfirh rndc. p.nrlryorp.rjDry'h!' rhcrc n acoNltu.tion lcndi.S rscncy ntr ih.lDn,rm.cc olrhc qork lor shicn rhis Fr.rir i\
issuld (sL\ 1091. Cn. C ).
a.ttu! llD[clAxallo!
I ttnby afllnr undci l)cnnlryofpcrjuryonc olthc followin8 dcchralio!\
l)cnDlirion Pcrnirs A\brdos Norin.arbn Fcdcrrl Rcgulriions (1irlc40, Pfi6)
Rcqrircd l.rrcr of Norifi ..rion
I.difyrh,t rhc fcd€rdlrcSul ions rusarding ashcsl.s rcnnv&l ur norlnplic,blc hrhislmitt.
-l
anilyrhlr I hlvc rudrhh aPliclrion ini {!rcrhar ihc atnvc inf.nmrion t coEccl losrNloco'nplywnhallCily,ndCounly
ofllinlRcsandSrarcl,wsrlarinBroblildinCconqodion.r.dhcEbyaurtorixrctEsnlsliv.soflhisCnylndCou.ryrocnrdupon.
ubov. d.riorcd pmFny for
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-underfloor
Buildino Sewer
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Tub/Shower Test
Rouoh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipino
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
/..1
Rouqh Plumbinq 7"t7-Jg ,.w41
Final Gas Test
Meter Release
FINAL vlr-tfu4 tt vryu^4rd -a)
a1Notes, Remarks, Etc.
Area,/Storm Drain
Roof Drain
_1, as ownc' of rhc nmpcny. !m exclu\i!.ly .ont r iIB wirh li(nsd . nkNk,^ tu .on(Nd lhc prcrc.l (Sa 7(H4, Bdlincs
aftl lhfssifi cod.: Th.Contrlcrois Li.ctr\c t,!u docs not lprlyk, atr osn.r oi prop.n, who buildsor imtrolcs rhctcon.
flnd who ..nrBd\ ror ruch l)mj€B sirh r Conri.!o(9 hrrMd puisum ro rne Conr.lcrols l.ic.ns tnw).
_l an cr.mfl rndcr S(r i(nr . B. & P C. for rhh rcnson.
lhrt (ltrNr
k,nl.a. Nr r
-
lxndcis Addrc.{
Appll.ant or ,lpcrl Slg@lure: