HomeMy WebLinkAbout30139592 - Permit (2)Permit #: 30{39592
Pin #: 7731(J
Project Address: 3117 S Douolas St
Assessor'sParcel: 412-231-07 Lot: 45
Unit:
Block: NA
Bldg:
Trad: 8280
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Y
Owner:
Address
Conlractor:
Address:
Tenant Name:
Josie Snow
3l l7 S Douglas St
Santa Ana, CA 92704
(714) 545-5043
Drain Right
18012 S Figueroa Street
Gardena, CA 90248
(310) 919.4681
Fee Type Amount
01116002 51602 Add'l Sewer Connection 21.42
01116002 51602 Sewer Alter/Repair 42.85
01116002 51600 General Plan Update 21.25
01 116002 51602 lssuance 52.98
Qty
1.00
1 .00
I .00
1 .00
Fee
$21.42
$42.85
$2',1.25
$52.98
Bolch+:44374 - 6/ !9/2OLg I0: NGARCIAoffice: CTYH Tronsi: 52 I ol 1Acct+! R€f+! 30139592
ncpt+t0229852{ - 6/19/2018 l2:39 p[
TFonsoct ion Totol llSS,50
0roin RishtState Lic #: 852708
Lac Type: C-36
Bus. Lic #: 346042
Workers' Compensation lnsurance:Carrier: Oak River lnsurance Company
Policy #: DRWC810543
Expires: 10lO4l2O1A
Genersl Plon llpdote Fee
0ll16002- 51600000-
PIurb ing
01116002- 51602000-
ICL Check 000000601{
t21 .25
tu7.25
tl3s.50
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject lo Field:
Building Permit #:
Single Family Owelling
Miscellaneous
Sewer repair
Chavez, DaveV,
Occupancy:
Constr Type
Code:
R-3
VB
cPc 2016
Misc. Receipt:
Misc. Receipt:
Misc. Receipl:
Total
Notes: Sewer repair. Letter ot contractor authorization on file
$138.s0
$0.00
$138.50
Every permit issued shall become invalid unless the work on the site
suthotized by such permit is commenced within 180 days aflet its
issuance, ot if the vlork authorized on the site by such permit is suspended
ot abendoned for a period of 180 days after the time the work is
commenced.
lnspector MID#: 2018-144139
01 1 16002 51600
01116002 s1602
$21.25
$117 .25
Fee Total:
Paid to Date:
Balance Oue:
city of Santa Ana 20 Civic Center Plaza (M-19), Santa An:r, CA\27O2 Plumbing
Permit Counter: i.714) 647-5800 lnspection Requests: (7'14) 667-2738 lnspector Section: (714).647-5853
Phone:
Phone:
06/19/2018
Account#
Date:
Date:
Date:
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS oWNl]R I}U!t,DEII OFJI,CARATION
I h.rcby rlftrn und.r |rnilry ('f Nrjury ihxr I !n .xrnlllr liom rhc L-o rados l,iccn\c tiw for rhc fdk)win8 rc0lnr (Sc.70:ll 5
Bu\trs 3nd Prolcssim C(rtc) Aiy Ciry.r Coxnry whi.h r.rluics 0 lctmir lo con(tucr. rhcr. inrrro\c. &nrlirh '{ EFn Jny
(rucrurc. prhr k' irs i*ui.c. sl\. rcqun$ rhc nppli.r fo! such pcrnrir ro nt ! \isNd drr.mnr rhd h. or shc is li.cnccd Nrsuor
k, rhc fovi\ions of rhc Conrrn.rors t,icctrscd li* (Ch{rcr L Comcn.ine sirh Sc.ri,r 70(xr ol Divnim I ofrhc Bnsinc$ nnd
Fdt\sions Codc) .r rhrr lr or shc n.kcnu rhcrcfnnn Md rhctsis lor rhcillc[cncrc'ntridr An! violrriooolS.{rion70.]15 byan,
,mli..trr rr,. p.irnil subj$lslhc lprlicnnr lo{.ivilp{ml'y.rno! ucrnm fivc hund.cd dollar (S5( )
-1.
&r owftr otrlE Fo|Eny. o. my.nployes *nh w!8.s as th.n sb onpeN.lion. wil.lo ll* *trt d llt.nv.te b mt
i.r.nrLd or oficr.d for ste (Sd.?044. Busift$ 6d PDtc$ioB Cod.r TIE Conlnciols Lims Law dca rel ePly to e o*m of
rh. ptopcnr eho hiLlr or inprDE r@Grnwhod.RtuhN hiGclf ot h@lf or inrcuEh his or hd o*!.nphyc(.
providcd lhd such iqmrmnk c mi intcnata orotftr.d rd sL. ll hoD.€. dE t{ildiiS o. in{eEmnl i3 $!d vilhir oN Fa
of@lpbib( ,r Owmr Builir will ltst lh. h(hn oftmvine thar h. or slE did ml hliB or irymE dE por6y for 0E FlrFrc of
L r oNtrcr.trhc flrpcriy. incvlu\itclycodr rirg rvirh liccnscdrodticrtrsro.on\tnrd lhc pojccl (sm 7(lrl. Bu\i'rcs
rnd hotbsJoclrlc:'l hc Con&&k,\ I-iccn{ l-rw dod n.( rtdy ro.n ownct olnrc|xn, who htrird\ or l,rfm(r rhcrcon.
rnd who coitn.G r.r ru.h lrcjccls $ilh trCo rfl.lo(oli..rxst pu*Lrni hrhcCotrtrrcln s l-iccns l:r*)
I in.rcnd uDdersenon .8 &PC fordicrcMn.
II}Bf,E8S:TAMTB$ITAN
DECI.AMtrO!
I h.reby ,fiirm undr p.nrlry of psjury orc of rhc followine dc.lanrnJnsl
Ihrk d sill ,tuinrro r (tn ifi.dc ol (ir{fl n, Scl,:1tr\u'c for (orkc^ c.n[.n\!tion.is,rDvid.dftnbrsccrtr'n]7()(lofrhc
trtxnCodc.forrh.!. nnMDc.otrhcMrk fnshi.[rhcli.rn,ir is n\u.d
-l
h!rc and vill mi.rah workcr' .onn n{lion insrhrc.. 0s rclui(d by Sdlion .l7m of ilE t$or Codc. for lh. perfomEN of
rh. *ort tor whict rhir lemn ii ilsEd. My w.rk6 @q,c6otion iBtuc 6hr 3,!d Plty nunbct m:
/1lk P,,'tek f n;<trzqnca-
R 1 /o a
-l
ccnilythul in rhc r..for@nc. ofth. eork aor which lhh l)c.Dit is issu.d. I 3h0U @r cmploy.ny pcmn in lny m.nNr
$ asro b.mm slbjccl lo lhc *ortcB coq)cnsraon lo$ of Cnlilom,a, and !8Ec ln l if I should bc.6m sub.iccr lo rlE
woftcr.on,..salionrmvisions.tSslionl?0OofrhcLiborCode.lshall.fonn*ithoddywirhrh,cpmvision,..
WARNING: Faillurc ro scurc $ortcn' conFosrrion covc.agc is unhwful. and shall iubjccr m cnploysr ro cnminrl |lctuhb4 rnd
on. huniL'd rholsnd dollas (SllD,0m). i6 ddilhn lo ttr.osr ofcomPcnsuri.n. darogcs as prolided for lhc
hc l,tn Crxlc. inrocsr and atormy\ t cs.
/rq l*e7-
IIEIIdEAI](,)N
I hcEbylmrm und.r FnrhyoflErjur! rhor I u lien$n undcr t)oli\ion orCbalrcr 9 (onmncins wnh Sc.rt,n 7000) ofDivision 3
of rhc Busimss lnd Pofc$ionr Cod., ,ri my lt.nr h in full foe and cllL{r
*<x1 o8
ao/rq /tr ( SeevteSr 'l
lf,r'dcr'' Ad.[(s
-
dItuc NfDEllAad.lM!
I hrlhy!fiinnundcr l. hyol rojury oic ol rhc i(nbqnr! dcclnrali,ins:
Dcflxnirion l'cflnirlA\tr{o! Nori,i.rri( Fcdcr.l RcgularidN (Tillc,l0- Prn6)
-Rcqutcd
kllcr of Norifi .rhn
I ccn iry rh,r th. rcd.r rcaulolion{ rsedirs dtf,(.srcnhvrl dc nor,pdicabL k,lhn I,r.t:cr
2<l ccf,ily rhd I hlvc ,crd rhr rrrplr rrtr,n drl {,rc I hr rhc .bovc itrromErion t com.r I r*B ro comPly r irh lrr (: y rnd c.unry
-ftairumc. ,na Srrrc t,r. . L,rinr ro hu
'U 'nx
r. srrucuun. anti hctcby aurhtriz. Etn*nr,rivcs of rhh Cjty 3nd Counry tu .trtrt uFn rrE
ahov. mnliomd ooFfly for i.spccion llurrsr.
Ap!lienl or Ag.nr SigMIuE:
V- .t)z,t t,att
/q t7
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer tL G[zt t tt 16.fif ,
Area/Storm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipino
Roof Drain
Tub/Shower Test
Rough 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
Rouqh Plumbinq
Final Gas Test
Meter Release A
FINAL -7 I
I YM,lL
Notes, Remarks, Etc.
CONiIBICTQNIENDIN(iJqINCI
I hcruhyrtfirdundd l.ialry.l rcrjury thir lhsc ir0(r{rudion kndirarlcmy lor rhc pctlilrruncc olrhusork tur *hichrhn t.nn n
issucd (Scc. .lor?. Ci! C ).
txnJr. NJnrc
-
f------T------
f------T------
I
I
=