HomeMy WebLinkAbout30141637 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714) 647-5853
Permit #: 3O141637
Pin #: 333{6
Proiect Address: 3618 S Van Ness Avea
Unit:
Block. NA
Bldg:
Tract: 6745
Address Range:
Historic: No
Suite Range:
Zoning: R1Assessor's Parcel. 410-141 -33 Lot: 32
Owner:
Address:
VARGAS, FAUSTINO
3618 S VAN NESS AVE
Santa Ana, CA 92707
(7141 e14-s8e2
01 1 16002 51602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type Amount
Wtr Htr (Res up to 50 g: 23.12
General Plan Update 22.9s
lssuance 57.20
Microfilm Records 3.91
Qty
1.00
1.00
1.00
1.00
Fee
$23.12
$22.9s
$57 20
$3.91
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Fast Water Heater Company
11715 North Creek Pkwy So
Bothell, WA 98011
14251 636-7084
State Lic #: 987398
Lic Type: C-36
Bus. Lic #: 319396
Workers' Compensation lnsurance:Carrier: lns Co of the West
Policy #: WLV50S206900
Expires: 1210112020
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Plumbing
Occupancy:
Constr Type:
Code:
R-3
VB
cPc 2016 Notes. Plumbing
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
web_user
Date:
Date:
Date:12t03t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
rssuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
N/A
N/A
No Balance
No Balance
Fee Total:
Paid to Date:
Balance Due:
$1 07.1 8
$107 18
$0.00
lnspector MID#: 201 9-156241
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BI'ILDER DELCARATION
I hcrcby allirm undcr pcnally of perjury lhal I m cxcnpt frcm lhc Contnclos' Liceorc lrw for thc following rc&sn (Ss.7031.5
Busincss 8nd Pmftssion Code): Any Cily o County which rcquircs 8 pcrmil to construct. sltei imprcvc, dcmlish or rcJnir any
struclurc, Jrk r to ils issuancc. ds rcquircs thc applkml for swh pcmit to filc 8 signcd sl8lcrcnt &sr he or CE is liccnsd puset
to thc prcvisioos of the C-nhctor's Lbensd tiw (Chaptcr 9. Commrcing with Sction 7fiD of Division 3 of thc Busircss ild
PrcfcssionsCode)sthdheorsheiscxetrptthmftomedthebqsisforthcallegcdexcqrtion. AnyviolathnofSelionT03l,5by8ny
rpplicant for a pcmit subj(ts thc spplicsnt to a civil pcmlty of not mre thm five hundrcd dollars ($500).
-1.
as owncr of thc pmf,erty. or my cmployecs with wages ss their sole comlrcnsalion. willdo thc work and thc stnrture ls nol
intcndcd or offercd for salc (Scr.7044. Busincss and Profcssions Code: Thc Contractor's License Law docs not apply to an owner of
the propcrty who builds or improves thercon. and who docs such work himsclf or herself or through his or her own cmployecs.
providcd that such improrrenrnts arc not inlendcd oroffered for salc. If. howcver. thc huilding or inqrroverEnt is soH within one )rcBr
of complction. the Owner Buildcr will have thc burden of poving that lrc or she did not buiH or imprnrrc ttrc fnopcrty for the purposc of
salc).
-1.
asowtrcrof the propcrly. amcxclusivelycontracting with liccnsctlconlractors to conslruct thc projcct (Scc. 7(X4. Business
and l'}rofcssion C]odc: Thc Contraclor's Liccnse Law docs not apply to an owncr of property who huilds or inrproves thercon.
and who conlrucls tbr such projc'cls with a Contractor(s) liccnscd pursuant t<l thc Contractor's Liccnsc Law).
-lamcxclnptundcr.Sccti<rn-.B.&P.C.tilrlhisrcason.
I)nle:0wner:_
WORKF.RW
DECLARAT]ON
I hcrcby alTirm undcr ;rcnalty of pcrjury onc of the following dcclarations:
-l
have and will rnaintain a Certificatc of Consent to Sclf-lnsure for workers' compensation. as povided for by Section 3700 of the
L-abor Codc. for the grcrfornunce of thc work for which thc permit is issued.
-l
havc and will maintain workcrs'compensation insurance. as requircd by Scction 3700 of the Labor Code. for the performancc of
the work for which this pcrmit is issued. My workers' compensation insurancc carricr and policy number arc:
Policv Numbcr: Exnircs:,
-l
ccrtily that in the prfbrnrancc of the work lbr which this pcrmit is issucd. I shall not c:rrploy any pcrson in any m&nner
so aslobccomcsubjccttothcworkers'contpcnsationlawsofCalifornia.andagreclhatiflshouldbcconrcsubjccttolhc
workcrs' comJrcnsation provisions of Scction 3700of thc L;rtnr Ccxle. I shall. forthwith comply with thosc provisions..
WARNING: Failure lo sccurc workers' compensation coveragc is unlawful. and shall subject an employer to criminal penalties and
civil tines up to onc hundrcd thousand dollars ($100.fint. in addition to thc cost of compcnsation. damagcs as provided for thc
Section 3076 of thc labor Code. intcrest and attorrrcy's fees.
Applicant:
LICENSED CON'I'RAC'I'(TR
DECLARATION
I hcrchy allirrn undcr pcnulty ol'pcrjury that I anr liccnscd undcr provision of Chaptcr 9lcorrrnrcncing with .Scclion 7Un) of Division .1
o[ the Business and Prol'cssions Codc. ancl nry liccnsc is in full frrrce und cft'ect.
License Class: License Number:
( 'ortl rlrt'lor
W
I hcrcby affirm under Fnalty of pcrjury thrt thre is a constructhn lcnding agcmy for thc perforw ofthc work for whhh this pcrmit k
issucd (Ss. 3097, Civ. C.).
Lcndcr's Nanrc:
lrndcr's Addrcss:
A PPLICANT IIECLARATION
I hcr$y allirnt undcr pcnalty of pcrjury onc of thc folkrwing declarat ions:
Dcntolition Pcrntits-Asbcslos Notification Fedcral Rcgulations (Titlc 40. Part(r)
-Rcquircd
l-ctlcr of Notification
-l
ccrlily lhill lhc l'cdcr{l rcgul.lkrns rcgudilg astrcstos rcmoval urc nol appliclblc to lhis pmFct.
-l
ccrtily thilt I hilvc rcild this npplhdlion und strlc lhilt lhc akrrc inlilrnutior is corccl. I agre to comply with trll City and County
ordinancc$ ond Statc liws rclaling to huilding constructiur. atrd hcrcby tulhoriTc ]cprcsntilti!c$ of Ihis City ond County lo cnlcr uF)n thc
ilJ$!t mllioncd propcny for irtspcclion purF)scs.
Applicant or Agent I ):rIt.
l)t'rrtrilee n:rnre ( ;lrilrl ) :
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf Ioor
Building Sewer
ArealStorm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back FIow
Pool Heaterlcas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCao
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release I I
FINAL I lutLil Dhrys 1
No[es,^flemarks, Etc.r-------l-
ll[,fl702 w R ccE ,.9 J Dtr*4 -l
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