HomeMy WebLinkAbout30139079 - Permit (2)city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA927o2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 3O139079
Pin #: 9O68E
Project Address: 228 N Harbor Blvd
Assessor'sParcel: 198-061-17 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Rangei 100-230
Historic: No
Suite Range:
Zoning: SP2
Phone:
Tenant Name: C V S Pharmacy
CVS Pharmacy
228 N Harbor Blvd
Santa Ana, CA 927033337
Septon Development Group
9414 E San Salvador Dr #'l5r
Scottsdale, DZ 85258
(480) 391-8383
Owner:
Address:
Contractor
Address:
Notes:
Amount
'13.69
12.23
18.80
21.25
52.98
Fee
$27.38
$24.46
$18.80
$21 .25
$52.98
Fee Typ€
Water Closet
Sink
Min Fee Adj
General Plan Update
lssuance
Qty
2.00
2.00
1.00
1.00
1.00
Phone
State Lic #: 903427
Lic Typer B
Bus. Lic #: 367818
Workers' Compensation lnsuranceCarrier: Exempt
Policy #;
Expires:
8otchir44232 - 6/11
off ice: CTYH Tnon
Accti:
Rcpti:0:291636 - 6
Tronsoct ion Iotal i At{
. t]t]
Planning Approval Date
Date
Date
Plan Checked
Permit lssued
0195679
0611112014
Accou nt#
$144.87
$0.00
$144.87
Occupancy:
Constr Type
Code:
M
V B, SPK
cPc 2016
Building Use:
Job Type:
Nature of Work
Commercial
Tenant lmprovement
T.t.
Misc Receipt:
Misc. Receipt.
Misc. Receipt:
Total
Amsden, Julie
Subject to Field:
Building Permit #:
Evory permit issued ahall become invalid unless t s work on the slle
authoized by such pemit is cammenced within 1 80 days atter its
issuance, ot il the work authoized on the site by such permit is suspended
ot abandgned for a period of 1 80 days aftet the time the v,/o* is
commenciEd.
lnspector MID#: 2018-141686
0'1 1'16002 51600
01 I 16002 51602
$21.25
9123.62
Fee Total:
Paid to Date:
Balance Due:
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 I 16002 51600
0'1 1 '16002 51602
gepton Develsp$ent,ir
T.l. - lnterior rernodel, accessibility upgrades to public
ar€as of the store.
Planning Conditions: lnterior T.l./No exterior alterations
PLUMBING-INSPECTOR RECORD
APPROVALS COMMENTS
UNDER GROUND
Waste & Vent
Water-Under floo
Gas-Underfloor
Buildin Sewer
Area,/Storm Drain
lnterc rl Clantier
TOP OUT
Waste & Vent
Water Piping @a)uA
Roof Drain
Tub/Shower Test
Rou h Water Heater
POOL/SPA
P-trap/Drain Line
l\rlain Drain/Pool Pi n
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn S rinkler
Back Flow Device
/4,
BSCSh Plumbing qa'/-1>lg )r.vh$
Final Gas Test \-/
Meter Release
FINAL 1 //4{n
Notes Remarks Etc
(,IVNI:R BUII-DER DT]I-(]ARAl'IoN
I hcrchy {flnnr uidcr Nnrlry r, Erjury rhd I d uxcmpr tiom rhc c(,trrd.fttra t-icrnsc Lrw a.r rhc foltowin! r vrn ts€ 7O3l l,Bu\inc\s md Proltsi( code): Any Ciry or counry shkh Eatuncs I {lcrn ro ..n{tucr_ rlrcr. improvc. d.nslirh or Npan any
sd.rut. lrior n, iN h{iR.c. rh. rcquires ihc ll,|licntu r.r skh ri.r,n lo filca si8trcd sofunrnr rhrr hcor shc n ticcn\cr, pu^uanr
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Pmtsrnnr\ Codc)orthlrh.orshc i\ crcn,fl rhcrcti.D0nd ihc h$n turrtr rllcs.dcrcnDri r Anyliotarion.tscclidrT0l.5byany
rprlicanr,oru pnnir luhjcckrhc rpplicu! ra n civil p.nall, .l mi nxrrcrhri tlvc hurtrcd doltus(g5ur).
-1.
a owm of $c Follny. or my crplo)es qnh *.8* .r rlEn sb .ohlEn$rhn, *ill do 0E sork ard rlr lrrur@ ir mt
inlend€d or ofls.d tor sk (Se.7044. Busimsi ,rd Prof6sioN Code Th. Conrractor's Liens t w doc. .n awl, lo d owB of
thc Fopcrty wlE t{i(j oi irlhB tlE6n. &rd sho des sxh wo,t hi@tf or lErstf or lhh.Bh hb or ha, own.mohyer.
Fovidcd rli.r Nch impoEmilr e ft, intc.t d MoIrcEd ttr $L. r. ho*E 0E hitdin8 d in{mwc, Lr $ld wirhir om Frof onpbrior rlE OsM Buit( wi! haE rh. ho,n n oa pevin8 du tE or rlE dil rct build or inp;r dc |'lrsty fm rlE nurF,E ot
_1. as owncr of rhe lmncru !h crclusivcl, .onradinS with li.cn{d .onrado6 to @nsldct th. Im}fl (S.c. 7044. Buyms
aM P,riixsbn Codc: Th. Conr&lois Liccnsc rrw d@r not q,ply ro d ow.o dfpmpcnl wtb buit& or imfforc3 rhcr.on.ond who .onr@ls lor ru.h piDj($ wnh r Conlndo(i) l[cncd poNanl to rh. Coni.rctdir Lic€is L.w).
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amcx.nrlr rndcr Sstio
woll(nlls' coMPFNsaT(tN
IEC!.AXATXON
I h.rcl,y affirn undc. Fmlry of pcrJrry om of rrE fotlo*ins delmlions:
-,
havc a.dwill mintlin r cc dirrare o f Conscnr ro s.ttt.s!rc ntr wortcr' conFnsdion, a\ noyi{icd ior hySeri.n t7o0 ofrhcbh" Codc, for lhc l).rromnc. of rhc wort for *hi.h rhc pcmir h issu.d.
_lh,vc..d willmhintlin wo*c conD.n\arion insur!rc., as eqxiEd by Sccr ion t?00 of dc tlbor Codc. fo, rhc pcrfonMncc of
thc work irr which thk lErnir is issuol. My *ortc6' $nFnsdion ins!tucc catricr ard Ftkt numb.r dc:
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c.dify ih in rhc lcrformns of ihc port for which rhh p(mi i3 isslcd, I shal nol cnploy a., pc^on in .ny tunrcrs N lo bc.om subier io lhc eltss smpcnsrion lass of Crli,omio. and agrcc h.r it I should hc{om subjd lo [E
workcB' .ompcnsdion phvisioB of Sc.lion 3700 of rh. tibor C.d€. I sh,lt. fonhlilh orply wirh rhos lovisiont..
WARNIN(;: Faihrc ro scm wort$J..'npcisarion olcr08c n un \h!ll subjcct m cmpk,lrr k, dihi'rl ncuiri.\ rnd
civil 6n.s up ro onc hunlrcd lfiouend doll& (Slm.ooo). iD addtr co\l olcotrllrcnslrn'n, d,::Q:io?/i:
lrl'( lI n lad flON
I h.r.h, trllrm undcr F* rlrr of ntrlury rhal I rm li$i*d utuler pmvndr of Chafrcr 9 (.onnruc in8 wirh Ssrixr T(xlo ) oi Dtr i\n,n .lol Ihc Ansinc\sand Pre,i*ions Codc. ond nrylicctrr i\ in l'utttir.c d.ff.cr
r>7o*,er(zk* c*,*,,,
C(TNSTRIIC-TION I fNDIN(: AGTNCY
! h.reb, rfirn undcr p.nelr, of pcrjrry rhar rhsc n n snsrturhn tcndin8 lgercy tor $c p..fo@trc .I rhc wo,k tor which rnis trrmn ir
i\sucn (S{. 1097. Civ C,)
APPI ICANl' DECt ARATIoN
I hor+t lnianundcr Fn,ht orFrjury onc olthc r('llosing dcclantiotrs:
I)cmlilion P$n!r\ Arhc\ro\ N.lific0rion Fdl.ral Rc8ul riflrs (Tirtc.r0, Pd6)
-Rquircd
tJ(.i or Ndiff,ltion
-l
.cnif, rhar thc tuml rc8oh(oB rcgsdinB sbcslos ,!mht e not lppttsbk lo tht pmirt.
_l ccnily rlN I harc fid rfih llplical {rre rhit rhc itrvc nrfontur
odinorcs ard Sratc Llws Elalirg rclrcsnlsriv.s oalhis Cn, ud Counrylo cnrs lpon ltr$.v. nrnttoncd proFny lor
ADDlicnn! or,l!cnt Si!nntu
nzllBl
ID/SIG.
/ lLl \
Gas Pipinq \_./
Sanitary Sewer/Cap
-A^ffil >b\rt AE,f) P.A^I wc J* {- A" dnl fu*!.1-
Policy Nu mbcr:-Evi6\: _
I agre rocomnly*ilh allCiiyrid Colnry
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I DATE