HomeMy WebLinkAbout30139563 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Sanla Ana, CA127O2 Plumbing
Permit Counter: C/14) 647-5800 lnspection Requests: (7141667-2738 lnspector Section: (714) 647-5853
Permit #: 30{39553
Pin #: 54171
Project Address: 2902 W Borchard Ave Unit:
Block: NA
Bldg:
Tract 3627
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessofsParcel: 407-041-24 Lot: 2
Phone
Tenant Name;
Thuc Nguyen
2902 W Eorchard Ave
Santa Ana, CA 927043005
(714) 675-8606
Owner-Builder
Owner:
Address:
Contractor
Address:
0't 'l 16002
01116002
01116002
01't 16002
01116002
0 t 1 16002
s',t602
51602
51602
51602
51600
51602
Amount
13.69
2't.42
12.23
42.85
21.25
52.98
Fee
$13.69
$21.42
$12.23
$42.85
$21.25
$52.98
Fee Type
Water Closet
Shower/Bathtub
Sink
Sewer Alter/Repair
General Plan Update
lssuance
Qty
00
00
00
00
00
00
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Bot,:hi!{4251 - 6/1?./
0ff i ce: CTYH Trgns
Rcpt+:0?293lSl - 6
Trsnsoct ion Totol
Ihuc l{gusen
Building Use:
Job Type:
Nature of Work
Generol Plon Upd(lt
0l 11 6002- 5l 611r.110r-1
f'lufib ine
rrl 1 16002- :1 6n?r'lr:I.i
V iso
CC+: rxrr**rrr*rrI
Single Family Dwelling
Addition
Addition
R.3, U
VB
cPc 2016
11r
Notes:
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Buildins Permit #: 101 95340
Every pemit issued shall becgme invalid unless the work on the site
authoized by such pemit is commenced within 1 80 days efrat its
issuance, ot il the wor* authoized on the site by such pemit is suspended
ot abandoned for a period ot 1 80 days efret the time the wotk is
commehced.
$$ n"r"no"r, *"tny
Misc. Receipt:
Misc. Receipt:
Misc. Recelpt:
Total
0611212018
Account#
$164.42
$0.00
$164.42
$21.25
$ 143.17
Fee Total:
Paid to Date:
Balance Due:
Phone:
Occupancy:
Constr Type:
Code:
Oate:
Oate:
Date:
011'16002 51600
01116002 51602
lnspector MID#: 2017-138714
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
UNOER GROUND
Waste & Vent ft)c\tu\tV AV 1LI er)* f-,,a
Water-Under floor
Gas-Underfloor
Building Sewer
Area/Storm Drain
lnterceptori Clarif ier
TOP OUT
Waste & Vent '7lt4l,a -rN?9
Water Pi ptng 1ln'tfi.rilD
Gas Piping
Roof Drain
Tubi Shower Test 1l.alfl 1rtu )
Ro ugh Water Heater
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Water Servrce
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release
FINAL VJ;it /rtr -,,? )
Notes, Remarks Etc.
OWNER EUILDER DELCARATION
I h.r.b, rfirm und.r Fnally of pcrj'ry l,t!l I m crcdlpl fdn rh. Co ktoB Liccn* k{ lor lnc follo*ine @sn (S€.?031.J
Busincss lnd Pmfcssion Cod.): Any City or Counly vnkn rqlunB r Fni, lo snrtucl, altn, inpr6v., dcmlish o llIir my
,tocluc, t ior ro nt ietue.. alro rguias rhc amuca' for such lEmit ro fik s sisnd sr.rce rhrr lE or slE is liensd pulsut ,
ro rh. tDvisiris of d. Conlmctuls Liftnsd L3* (Chlpt r 9. Con@rine wilh S.clion ?000 ol Division 3 of llE Blsims .rd
Pmfcssio.s Cod.) or thal lE or sh. ir.renq lnercfem dd lh. b6ie for rhc elhscd cicn$ion, Any viol.rbn of Setio.70l1.5 by any
.lplicail for a psmit subFls ll'€ applicanl lo ! civil p.uhy of ml mrc rhlr 6vc hlndEd d.llar ($m).
-1,
&r ovmr of lh. ptup.ny. or my cmplors3 sirh w,gcs &c Ocir $L oiqEnsarior. wiU do ttE r@t ,!d ,E nn.rE ii Dr
inrei&d or oocn! for $L (Se.7Ol4. Blsircss 8nd Ptsf.sbm Cod.: TIE Conrfttols Lic.s Llw dos mt rpply ro e owmr of
lhc poFny wio boilll d iq,mrcs llEmn. dd wtb dc Mh s& nimrclf or h.slf or rh6tr8rr hL d h.r 6*n .npl,or.s.
p.ovllcd rhrr sch iqftvm.h @ mr hrdd.d orotu fm sL. lf, hokE rlE tDiUi,S or itrprowmnr ie $ld *nhin om )Ed
olonphtiotr llE OwB Buil&r sin hrt iir hldd otltrotiig rlEr li or slf, dil ml hlild o. iqerc Oc po ny fo. $c purpo$ ot
-1,.sowncrofln
pmpcny, smcxclusirly.onlreli.S wath li.d$d.oor.&to^t oriulcr rhc Ireifl (Sr,7Ol4. aunms
,nd PDf$sim Code: Thc Conrt.|or's Liccnsc ljw docs ml.mly to an owncr ofprcpcnyvho builds or impmvcs thsmr.
and *ho .onlE ts for sucn pmjds wirh r Coihlo(O ltcnsd p!6unr ro rhc ConrEcroir Lk .s La*).
-l
uncxcnU undcrscdio. .B.
,",", 06^ft2-llg
I hcrcby offtrm und.r p.mlty of pdrury orc of lnc lollowing ddl@ri.!s:
-l
hlvc eld f,ill minldn ! Ccnifadc of Con*.t lo Scll-lnrurc ror *orlns .on{Ens.rion. ri FDvidcd lor by Seclion 3700 of lh.
L,&tr Cod.. for th. F.folr@e of lh. w6rk ror thhh lhc }ortit h hswd.
_l hlw and will fr.inhin eorkcB comle.sllion insur!rc.. 3s Fquircd by Seiior l70O of lhc t b.r Cod., for $. Frformmc of
rh. 8.* lo, shich lhh !.m is hn&d My krksl ompcnelion insuEm€ cmi.r $d plty numbcr m:
PolicvNumb.r:JtDiEs
-l
enify ltll in rlE r.rformrc oflh. worl for which rhis pcrmn ir Lisu.J, I sh,ll no' .ry,loy any F(on i. any mnn.r
s s !o h..Dm subier ro thc worl6 on4eneri6n laei of Califonia. and artc rhar if I should t coft slbirI ro tlr
wo cs' (nFnsarion lmviioB of sdion l70o ol lhc L$or Codc, I rlEll. fonhwirh @opry wnh lh.c p&risioG..
WARNINC: FliluE lo surc workc( comp.ns,iion oKne. i3 unbwtul. Nd sh0ll subj$l ofl cmoloFr lo aininal Fmllics &d
.ivil lincsulrlooml ndred lhols.d dollss ($10o.00o). in addhhn b llE cosl olcom!..$lion, dadgcs as povidcd fo. th.
Sdion 1076 ofrhe Ld,r cldc. itrtcrc( ond ltlormy s
Dtlrllltllr)N
of rlr Ilrrirc\\ ni Pn'lc\\i(trr C.dc, rid n,yli..tr\. i\ ir lillinrru irrlcll..r
Corhdoi_
CONSTRUCTIoN LFNI)II!(; A(;DNCV
I h.tb! anir r utrdcr ri lr!orp.rjurrrhrrIhc.cisaconsrru.riotrbrdinsa[cncyr.rrtcpcliolnuNcoirhc\orkaor$hichrhnpcoiri\
i\sucd ISL{ l0r)7 Civ Cl
A.EEIIIANLDECLAf,AIIO!
I ttrb, !fin! utulcr p.nrh, of p..jur, orc oarhc rirllowin8 dcclanliflrs:
nctrnirbn PcrnrirsAsbc osNorificaln,n ledcrul RcEul,rions('Iirh,r0. lM6)
-Rcqutcd
lxrlcr of Norifi clrion
l.cniIrhni rhcf.d$dlrcUuhrt)ns rclarding a\lrnol rcnrivrl 3rc norr!f]icfilc (' rlrisr'otcrr
-l
ccnify rhd I h8v. rcd rhn 8,'Dlkalion dd slir rhor rh. uthlc infonurion h .6m.r I lclc io comply wirh all Ciry 0nd Cou.ry
onliMnas,fld Stl. hws EhlinS lo buildins.oD(rucrion, ard h..cb, althbrizc rcpEs.fl,riv.! ofrhis Cny 6nd C.uorylo omd nroo rtf,
atxrc mtrricncd phr.ny for
Alpllc"nl or A8ent Sirn"lu oqzl lr
ffil
POOL/SPA
Gas Service
",,, oe l?-ltg
*."u'*--",0n", -tl4lA/