HomeMy WebLinkAbout30139513 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cAg27o2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 30{395{3
Pin #: 27299
EProject Address: 2414 N Tustin Ave
Assessor'sParcel. 396-26'l-55 Lot: 8
Unit:
Block: A
Bldg: l4-A Address Range:
Tract: A.B. CHAPMAN Historic: No
Suite Range: Unit A4
Zonlng: R4
Owner:
Address:
Contractor
Address:
P hone
Tenant Name:
Katerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-r065
01 1 16002 51602
01 1 16002 51602
01 1 16002 51600
011'16002 51602
Amount
12.23
11 .52
21.25
52.98
Fee Type
Sink
Dishwasher
General Plan Update
lssuance
Fee
$36.69
$1 1.52
$21.25
$s2.98
Phone
State Lic #: 1009989
Lic Typq: B ,.
Bus. Lic #: 366547
Workers' Compensation lnsurance:Carrier: Midwest Employe/s Casualty Company
Policy #: BNUWCo'!39070
Expires: 0110112019
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Multi-Family (5 or more uni Occupancy:
Alteration Constr Type
Fixture change outs (unit 4) code:
Datel
Date:
Date;
R-2
VB
cPc 2016
Chavez, Dave
Every pemit issued shallbecorne invalid unlessthe wo* on the site
authonzed by such permit is commanced within 180 days aftet its
issuance, ot if tho itlork authoized on tll4- site by such permil is suspended
or abandoned for a peiod of 180 days aftot the tifie the wgtu is
commenced.
06/1't /2018
Account#
MID#: 20'18-143647
01116002 51600
01116002 51602
$21.25
$101.19
Fee Total:
Paid to Date;
Balance Due:
The Bascom Group
26 Corporate Park Drive Ste. 200
lrvine, CA 92606
(949) 9s5-0888
Qty
3.00
't.00
'1.00
'1.00
Misc. Receipt:
Mjsc. Receipt;
Misc. Receipt:
Total
Notes: Fixture change outs (unit 4).
$122.44
$o.oo
$122.44
lnspector
PLUMBING-INSPECTOR RECOHD
APPROVALS DATE ID/SIG.COMMENTS oWNl]R NUILI,,ER DIiLCARATION
I h.rcby nafinn uDdcr pcntrlry.l Frjury rhlr I m.rr6pr lmnr rhc Conrrlor'Liccn* L(w n rhc r.tn,trins rcavnr lst.70l5
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lh. pF,r.ny w,[ hildr or iEFo6 tlE@tr and who .lo.s sh mrt hirelf or lEetf or rh(udr hir or h.r o*n chptoln!
l,hridcd thol su.h inllbEftnN@ ml intcricd oroltu ao$h.lf, hosq. Ur huildin8 or iqrowEnr i. $U wirhin ore FqoamIphlbtr tlE Owmr Blildcr w h.w tlE h,n n olFtroving [d tr or dE dn d 6ild or inp6* dE po!6ry fDr rlt porr(rc of
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DECI.Af,AtrON
I hceb, rmfln undcr p.mhy of trjury onc of rhc toUowins dRldalions:
lhrvcrldsrllnrdrirtrC'cni,i.ddolC.n\cnrr)Selllisurcnnwork.rrcompcn\(nrn.J\t(rvid.dtirrhySccriotr.lT00ollhc
Lrhn CGlc. n)rrhc FrromrD..nlrhc *or[ lo, Fhich rhc n n ir n n\ucd
I havc lnd *ill mainrain work rJ c.hpenslrion insuruncc, as Rqun.d hy serion l7m 6f rh. Libor Codc. for rhc rrto1mre of
lhis D.mn t isad. My worlst coqrcnsrion inslmncc dEh. a Fli.y nunl,q e
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ccniry rhar in lic pdtormsflcc ot rh. work lor which rhn pcnnir n issu€d., shlll not cq)loy any pcMo io any @nci$ !sro lEom subiet to th. m&c6 onlEnsation laws of Cuirumi4 nnd rgft rhsr ial snould hecom subF.l lo rh.
worlcF' compcnsln,n povhion. of S(lion :l?00 of thc bnor Conc, I shlrl. ionhwirh ..nloly wirh thoe p&tnions..
WARNING: Faahrc ro scurc e*cs' conq*nsarion .rwtus€ ir ,nlswtul. lnd shall subi{l e cmployr ro simln l F@[i6 Md
cilil 6ncs ut ro onc hundrcd thousand dollos (t100.000). in lddiln,n h rtc cost of.omp.&nag$ as lpvidcd fo. rhc
Sdn n -1076 ofrhc lrtnr Codc. inlcrc( Md,Jf 1t 2018
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of lhc llu\incss md Pr)fc{siorN Co{lc. uxl nry li.cnsc i\ in fulltur.{ d.tticr
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C(TNSTRUCA'ION I FNDIN(; ACFNCY
I hcnby aflir'n undcr lenalry of pcqury lh rhs. h a .oNtucrion h.dinB oscrcy for lh. pcrfo.mtrc ol rhc work ror which rhh tnmir i!
iss!.d (Scc. 109?, Ci! C.).
APPLIC NT DFCI,ARAT(IN
I rtnh, rlim undcr pcnnlly of Frjury onc of rh. firbwnrs d(lnrdnN
Dcnx,liri,)n Pe nitsAslrnDs Norifi.dion Fcdcral RclullIions lTiit 4). Prn6)
Rcquncd l. cr.lMnilicdion
l.cnili rhal lhc t dcnrlEeullInnN rcEftline r\h.{,x rcnroval0rc nolq,nlictrhlc lo thh ,)lor.r
Ll ccni,y Ihd I Mvc Ead thh aptilicliinn lnd sIlrc rhnr rlt ahrvc infonrEri'D is cotrcct I asc l0 condy with rlt cir, Md cbunry
ordinnmes and Sr.rc liws Rlnring io hxildin8 consirucri.n. dd h&cb! rdhrnd rcpE\cnrrrilcs otrhn Cirymd Gunlylo cntcr upon rhc
uh,!c rrcnl i(trrd ptupdy r.r in\p{crion
,\lpli(ul nr /\lunl Six. ltr *,JL,N X. 1,. 2018
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
Area/Storm Drain
TOP OUT
Waste & Vent
Roof Drain
Tub/Shower Test
Rou h Water Heater
POOL/SPA
P{rap/Drain Line
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sani tary Sewer/Cap
BS!!Sh Plumbing r\q\tt tl&i(Tq
Final Gas Test
Meter Release
FINAL t/LUc 5Dltb
Notes Remarks
lnterceptor/ Clarif ier
Water Pipino
Gas Pipinq
Main Drain/Pool Pioino
Back Flow Devrce
Etc.
P"*ire nane tprino, &rr^