HomeMy WebLinkAbout30142578 - PermitCity of Santa Ana 20CivicCenterPlaza(M-19), SantaAna, CA92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 tnspector Section: (714) 647-5853
Permit #: 30142578
Pin #: 90985
Project Address: 215 N Bush St
-
Assessor's Parcel: 937-833-52 Lot:
Unit:
Block: 8
Suite Range:
Zoning: DT
Owner:
Address.
Phone
Tenant Name:
Contractor:
Address:
Phone
Richard Rogers
215 N Bush
Santa Ana, CA 92701
(7141 319-9845
Liquid Plumbing
979 K Avenida Pic o #344
San Clemente, CA 92673
(949) 637-7117
01 1 16002 51602
01 1 1 6002 51 60C
01 1 1 6002 51 602
01 1 16002 5777C
Fee Type Amount
Wtr Htr (Res up to 50 gr 23.91
General Plan Update 23.19
lssuance 59.30
Microfilm Records 4.0S
Qty
1.00
1.00
1.00
1.00
Fee
$23.e7
$23.7e
$5e.30
$4.05
State Lic #: 322064
Lic Type: C-36, C-55
Bus. Lic #: 315757
Workers' Compensation lnsurance:Carrier: Traveler's Property Casualty Company of America
Policy #: UB4N013T2O
Expires: 09/01 12020
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
(F"rnandez,11t04t2020
Account#
Mixed-Use
Miscellaneous
Water Heater
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
U, R-l
V A, SPK
cPc 2019
Kathy
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: int location/auth on file
Fee Total
Paid to Date:
Balance Due:
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23.79
$83.27
$4 0s
$111.1'
$0.00
$11 1.11
6
b
A
lnspector MID#: 2020-162592
Bldg: Address Range:
Tract Town of Santa Ana Historic: No
PLUM BING.I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DETTARATION
I hm! alfrrn unda pqElty of psjury thd I m ampt from thc CoolretoE' Liccm Ls for thc following Iuon (Sc.7031.5
Bwias ard Profsion Codc); Any City or Coutrty which rcquirc a pamit to coNtruct, 8ltq, improvq daolish or ftDsir my
Etructurq Fior to fu isuucc, also rcquis thc epli@t for such pannh to filc a signcd stdmt thd hc or shc b lictr€d pwatt
to th€ FovisioN of thc Contrctor's Licoscd L:w (Chaptq 9. Comacing wirh Setion 7000 of Division 3 of thc Buim md
PrcfcsiomCodc)ortharhcorshebqmptthsctomandthcb6sisforthcalhgcdumption. AnyviolationofScrbnT03l.5byuy
applicaot for a psmit subjcts thc applicmt to 8 civil pcmlty of mt morc thm livc hundrcd dollm ($500).
_1. as owner of the property. or my employecs with wages as their sole compctrsation. willdo the work and the structure is not
intended or offered for sale (Sec.7044. Business and [tofessions Code: The Contractor's l-icense Law does not apply to an owner of
the property who builds or improves thermn. and who does such wort himself or herself or through his or her own employees.
provided that such improvanents are not intendod orofFered for sale. Ifl however. the building or improvement is sold within one y€ar
of cornplaion, the Or,vner Builder will have the burden of proving tha he or she did not build or improve the property for the purpose of
sale).
_1. as owner of the property. am exclusivcly contracting with licensed contraclors to construct thc project (Sec. 7M4, Busincss
and hofession Code: The Contractor's l-icense Law does not apply to an owner of propcrty who builds or improves thereon.
and u'ho contracts for such projects with a Contracto(s) licersed pursuant to the Contractor's [.icense law).
-l
am exempt under Section-. B. & P.C. for this reason.
WORKERS' COMPENSATION
DECLI\RATION
I hercby alTirm under penalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Conscnt to Self-lnsure for workers' compcnsation. as povided for by Section 3700 of the
Labor Code for the performance of the work for which the permit is issued.
-l
have and
the work for
will maintain workers' cornpensation insurance. as required by Section 3700 of the Labor Code. for the performance of
which this permit is issued. My workos' compensation insurance carrier and policy number are:
5e cuLr;+l" lV*l-iou I j"r, ". /^Carrier:)g /r/ .oztPolicy
_l certi& that in the performance of the rvork for which this permit is issued. I shall not cmploy any pcrson in any manner
so as to become subject to the wo*ers'compcnsation laws of California and agree thd if I shoutd bccome subject to the
work€rs' compensation provisions of Section 3700 of the tabor Code, I shall. forthwith comply with thosc provisions..
WARNING: Failure to secure workers'
civil fines up to one hundred thousand
Section 3076 of the Labor Code. intcrest
compcnsation coverage is unlarvful. and shall subject an to and
dollars ($100.000). in to the of thc
and
4 ?)z o
DECLARATION
I hereby affirm under panalty of perjury that I arn licensed under provision of Chapto 9 (cornmencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
License
o"r", lt[![zozo
CONSTNUCTION LENDTITG AGENCV
I hcrlby stfinn uda psuhy of pqjury thd tlt6 i! I onnruclbo ladilg sgtry for thc paforrrc of thc mrt br vhich thb pmt ir
isucd (Se. 3097. Civ. C.).
I .t'rrtlcr 's Nittttc.
Lender's Address:
APPLICANT DECLARATION
I hoeby affinn under penalty of perjury one of the following declarations:
Demolition Permils-Asbestos Notification Federal Regulations (Title 40. PaI16)
-Required
Letter of Notification
_l coti$ that the fderal regulations regarding asbcstos removal are not applicable to this project.
state that thc above information is correrl. I agree to comply with all City and County
authorize representatives of this City and County to enter upon the
above mentioned propcrty for inspection
Applicant or
4yt
o,r", lt f 't f zoe O
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ CIa rifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipins
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
FINAL ll,l6ar lLLtr r/6b s GZrT
Notes, Remarks, Etc.
I)ate:0wner:
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