HomeMy WebLinkAbout30139608 - Permit (2)Proiect Address: 2414 N Tustin Ave
Assessor'sParcel: 396-261-55 Lot: 8
Unit:
Block: A
Bldg: l4-C Address Range:
Tract: A.B. CHAPMAN Historic: No
Suite Range: Unit C-9
Zoning: R4
q
citY of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA127O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: 1714) 647-5853
Owner:
Address
Contractor;
Address:
Tenant Name:
The Bascom Group
26 Corporate Park Drive, Suite 200
lrvine, CA 92606
(866) 695-5591
Katerra Renovations, LLC
3200 Earhart Orive
Carrollton, TX 75006
(972) 8r 8-'r065
011 16002 51602
01116002 5'1602
01 1 16002 51600
011 16002 s1602
Amount
12.23
't 1 .52
21.25
Fee
$48.92
$11.52
$21 .25
$52.98
Fse Type
Sink
Dishwasher
General Plan Update
lssuance
Qty
4.00
1.00
1 .00
1 .00
State Lic #: 1009989
Lic Typei .' , B
Bus. Lic #: 366547
Workers' Compensation lnsurance:Carrier: Midwest Employer's Casualty Company
Policy #: BNUWCo139070
Expires: 0110112019
Batchi:{4579 - 7/2/2(18
off i ce! CTYH Trons+i 69Acct9: Ref+
Rcpt?:02317558 - 7 /2/2tt1
Tronsoct ion Totol
Kotenro Renovot ion.-t [.[ i
Noles: Fixture change outs (unit 9)
Generol Plon lJedote FeE
01116002- 51600000-
Plunb i ns
0r 116002- 51602000-
ICL Check 003002
t2L.2S
t113.12
tlt 177 .?0
$
Itt; 1-PgSOatt2of32
3Dl3?608
t27 Pn
1t t7? .20
$134.67
$0.00
$134.57
Building Use:
Job Type:
Nature of Work
Planning Conditions;
Planning Approval By:
PIan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Multi-Family (5 or more uni Occupancy:
Miscellaneous Constr Type
Fixture change outs (unit 9) code:
R-2
VB
cPc 2016
Date
Date
Dale
[Iisc. Receipt:
l\4isc. Receipt:
l\4isc. Receipt:
Total
Chavez, Dave
Every permit issued shall become invalid unless the work on the site
authoized by such permit is commenced within 180 days after its
tssuance, ot if the wotk authoizod on the site by such pemit is suspended
ot abandoned for a period ot 1 80 days after the time the wo* is
commenced.
lnspector
o6t2512018
Account#
Fee Total:
Paid to Dale:
Balance Due:
$21.25
$1 13.42
Permit #: 3O139608
Pin #: 23O3E
Phone;
Phone:
01 1 16002 51600
01116002 51602
MID#: 2018-144248
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDI]R DIl-CARA'IloN
I hcrcby rlltn undcr ,)cntrlry oi rcdury rhar I cxcmnr nom rhc Conlriche l-icensc L.$ ior lhc follo*ins .cr\on 'Sec.?(,:11.5
BNnrs rnd ProLsrion Co.lc): Aiy Ciry .r Counly ahich lcqutcs r Fnnir io con(dcr. llrcr. inrn,k, d.fr,lirh or rqrn an!
ntu.rur. pior b ir\ i\surncc, al$ r.qunclrhc rpplicrri fu ch pcrnit t, filc r si!ftd {dcmm rhd h..r shc L\ li.ctr{d pur\ui,I
t, rhc ptr,vist,rs ollhc Conrr!.tn r l,ien\rd u\,(Chrprcr 9. Comnrncins *irh Srcri()n 7(xx) or l)i!ki,,n .l orrh. Burn*s and
Pmfcs\ion\ Codc) or lhsr l[.r shc k crcnu rhcr.lio atul rhI ln,\n for rhc dlk!*l crcnrBnnr. Any vioklnrn ofScclion?0.11.5 hy uy
llpliclnt lqa pcnnit n'bjcck rhc lpnlicnnl roa.i!ilpenoliyol not nmrclhnn lirc hundEd dolhF (S51t))
l. ss ownr 6f &e pf,rFny, or ny emrloy!.s wnh wag.s e\ lnct eh corwn$ri6n. will .lo 0F m* rnd lhc sturw is ml
iil€dcd or ofrcEd for slc (Se.?044. Blsim3s ed ProfessioN Cod.: Tn ConlEcltr s Li.cn$ L,* dB tul al'ply ro s oqfi of
lh. t'repdiy who hiktg or i'r?NB thasn .!d et docs tuh elt hidrclf or hcell Ooulh hi. o,lrr ow!.ophyc.s,
prcvn.n lllll such iqmwmnhe ml intci& orof.Erl ro. sle.ll ho**i lhc trildinS or iqmv.mnl is sld within on. Fe
ofcotrpLtbtr dE own.r Buit-16 will hlw dE buno ol pmving th{'r lr o, .h. dU mt hoin or inptDw dF proFry aor tlE purpos ol
-1,
!s owtur of tlE pmpcn, ad cxclusilcly conhdirs wilh lien*d conrtlcloh k, .onsulct rlr ptrj.ct (Se. 7044. B6uc$
lnd Eofshn Codr: Th. ConlEtols Lic.ns kw do.s mi apply ro m ownd oftrop.nt who builds.r inpmvcs ltcrcon.
lnd {ho .onncc for iuch pmr(k wirh u CoiEac$,li) liEnsd p!*u!n ro rnc Conr&br'r Liens llw),
I a .rrmtr uid.!S..r B. & PC. li)r rhi\ r.ne,n
Dri€: O*ner
WORI(ERS' COMPENSATION
IECI.AAAION
I h.obt aflir undcr Dcnohyof pcrjuryonc of rhc follooin8 dsLrations:
Ih.ecddsillnuinrdn!Ccnificrr..IConrnrt,Sclrlrulc,rsorkcB.o.llfnsrrir,..isfrDvidcdrrbySdio.lTUoofrhc
I trtxr Codc- i.r rhc rrformrce of rhc *ork f.tr shict lhc ,l.rmi h nul\|.
lhrluandeiUm!inr!i.s6ikcr'comFnsart,nin$rancc,osrcquirdhySori,nlTm.rrh.liborCod..forrncpcriormnccof
rhc w.rk for which rhis n6mir ir i.turl. M y worlcn conp.n\arion in$rane .arier arld policy .umb.r m:
MrdWVlf C4Sh lru
NUl.l 0 oap t.tl.lrt
+.2.16
IrcENSID.CONIAA.qIAB
IIECI,AAAIIQN
I ncreby aflirm undu pc,ahy ol !.rp.y rhd I an liensn un.lcr NvtionotChoprd 9 (c.mmtinB enh scclion 7m0) oiDivisn,n 3
ot lh. Busim$ {i PmfcssionF Codc. uld my liccns ir in tull forN id cfial
uiemccras, 6 Lkcn* Nuf,b.,I O01{&q
CANEIA]JCIIONIEIDIIGI.GE !I
I hcrcby amrnruder ncnolry orncrjurr rhlr
'hcrc
n ! consiflrcrion lcndinE lscncr au rhc pcnbrun.r orrhc sork ritr shi.h rhG lEmir i\
hsued (Scc. 3097. Civ. C.r
AIILICAIiIDICLIBAIIOIi
Llnby.nnn u.dcr pcndhy.lpc.jury otrc of'hc lolloqinS dc.Lrrriotrs:
D.'nolirion Pdrnrir\ Art*n.s Norifi.dnrn F.dcralRcguIrn,N (Tirl..ll,. Prd6)
R.quin txrr*olN.ritiori(r
-l(o,rtyrh.
rl-.ltdc Jlh.pulJri,+ rcc,rdirF r.t{in\rcnrnJJrc nnr,,!f flhll x' rhi. nni.
{r.nur,n,,, r,^.,-utna rrnl'. r 'a'kl{rrr rhr rhcrh)vc i'rron,urtn i\.oftrrr Ir!r{tu.onrdywrh0ll(rlynfld(h!trr!
ordtrrtu.s and Shrc Lr*\ rchrin! ro buildin! connrucrio!. r hc!.hy ldhorizc rcprt\cfidnd ufrhis Ciry $d Coutrry b cntcr ulntr dc
+.2.t9
UNDER GROUND
Waste & Vent
WaterUnder floor
Gas-Underfloor
Buildinq Sewer
lnterceptor/ Clarilier
TOP OUT
Waste & Vent
Water Piping
Gas Pipino
Rool Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipino
Fill Line/Back Flow
Pool Heater/Gas Line
Gas Service
Waler Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbinq
Final Gas Test
Meter Release
FINAL 'l>/ue 1\ {f6
Notes, Remarks, Etc.
Area/Storm Drain
Miscellaneous
I ccniry rhar in rhc pcrlb,tuncc oirhc trork for shkh rhn n rmir k i\\ocd.l \hrll nor cmploy trny p.r\on in.ny mrnNr
s rstobeonr subjrrltu rhc sollLyj conlrnsd ion lrws or Cnlinrnid. d 08rcc lhnl ilI rhouldh.oE ul,id ro rl'r
work$s' co,irt'ctr$r ion povnions of S(tion 3T00 or llr L2trtr cod.. l s,Bll. n,rhwirh co'rliy *ir h rhos tmvhions
WARNIN(;: lailure lo surc workcn' compcns0rion corro8e is ulnwtul. ind shlll \uhjecr an enplor. ro dninal Fn,lrts r.n
civil fincs ur h onc hundrcd lhou\and dollffi (Slr)o.tuo), in rddiliur ro rhc co\l ofcomri.nsrrioo. drmsc\ rs rbvidcd r.i $c
s(rn,n lt)76 olrhc lihor C.dc. inrerc( ud lnomy\ ttcs
,",", +.2'l& .-,."." F4tCtzl'4
Itr ., .
^ttJ'rr
abolc m.rt).cd proDcrr, for in ccrion puq,oes.
AobU.mt or A16r SI!nrtuR:
o".,,u* -*" rp.i"o, If a h t I AYt (\
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