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Home My WebLink About30142408 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing PermitCounter: (7'14)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714) 647-5853 Permit #: 3O1424OE Pin #: 4740{i^ Proiect Address: 400 N Tustin Avea Assessor's Parcel: 400-043-09 Lot: POR 6 Unit: 401 Block: NA Bldg: Tract: 678 Address Range: Historic: No Suite Range: Zoning: P Owner: Address: Phone: Tenant Name: Contractor: Address: Phone: PARK CENTER 4OO LLC 400 N Tustin Avenue, #260 Santa Ana, CA 92705 (7141 667-0602 Fitzgerald Campbell Service First Contractors Ne 2510 N Grand, #1 10 Santa Ana, CA 92705 (7141 573-2200 01 1 16002 51602 01 1 16002 51602 01 1 16002 51602 01 1 16002 51600 01 1 16002 51602 01 1 16002 57770 Fee Type Sink Garbage Disp Min Fee Adj General Plan Update lssuance Microfilm Records Amount 13.68 11 .49 24.67 23.79 59.30 4.05 Qty 2.00 2.00 1 .00 1.00 100 1 .00 Fee $27.36 $22.e8 $24.67 $23.79 $5e.30 $4.05 state Lic #: 556812 Lic Type: C-36, B, ASBS, C-61, C-2, C-10, C-21 , C-53, C-20, C-33, D-35 Bus. Lic #: '|.41280 Workers' Compensation lnsurance:Carrier: State National Ins Co Policy #: AMX082002100i Expires: 0211212021 Building Use: Job Type: Nature of Work: Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Commercial Tenant lmprovement TI Julie Misc. Receipt: Misc. Receipt: Misc. Receipt. Total Notes: Plumbing for Tl Fee Total. Paid to Date: Balance Due: 09/09/2020 Account# Occupancy. Constr Type: Code: Date: Date. Date: B II A, SPK cPc 2019 01 103356 Every permit issued 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 permit rs 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 $1 34 31 $4.0s $1 62.1 5 $0.00 $162.15 lnspector MID#: 2020-158442 @ PLUM BING.INSPECTOR RECORD APPROVALS DATE ID/S!G.COMMENTS OWNEREUILDEIDELCARATIoN i I hercby afftrm under Fnslty of Frjury thst I m cxerft ftom thc Coilmcl6' License law for thc following rc&sn (5&.70]1.5 Busincss and Prcfession Code): Any City or County which r3quircs a lErmil to @nstruct. 8ltq. imprcvc. dcmlish or rcpair rny structurc, friffi to its issuance. ds requircs the applicsnt for such Frmil lo filc I signcd stotercnl that hc or dlc is liccnsed purssnt to the prcvisions of thc Contrscttr's Licenrcd L:s (Chaptq 9. Comrcncing with Sction 7000 of Division 3 of the Busircss 8nd PrcfcssionsCodc)orthsthcorshciscrcmptthcrcfrcmandthâ‚¬bssisfortherlhge{exemption. Anyviolationofssli,nT03l.5byany applicsnt for I pemit subj$ts thc spplicail to s civil fEmlty of not mrc lhrn fivc hundrcd dolles ($500). _l.as owncroflhcpropcrty.ormyernployccswilhrvagcsasthcirsolccorntlcnsation.s'illdolhcs'orkandlhcslnr:lurcisnol inlcrrdcrl or ()ll'crcd frrr salc ( Scc.7044. Busincss antl l)rofl'ssions C}xtc': 'l'hc (irnlractor's Liccnsc [.aw docs not apply lo nn orvncr ol' thc prrpny who huilds or irnprovcs lhcrcon. and who <locs such work hinrsclt'or hcrscll'or lhrough his or hcr own cnrployccs. of conrphtion. thc Owncr tsuiklcr will havc thc bunlcn o[ proving thal l** or slrc did not huild or irrtprovc thc proprty ftrr thc purynrc of sah). _1. as()wncrof thc propcrly. anrcxclusivclyconlr:rcting rvith liccnsctl conlractorsto conslnrct thc pr<lject (Scc. 7()44. Busincss and [hrll'ssionCodc: "l'hc('ontrnclor'sLiccnscl.awdocsnottpplyloanowncrofpropcrlywhobuildsorirttprovcslhcreon. and who contracls frrr such ;lrojccts with a Contraclor(s) liccnscd pursuanl to thc Contractor's l-iccnsc Law). -lalttcxcltlptundcr.Scclit,tl-.B'&P.C.lbrlhisrcason. I )al t. ( )rr ltcr WORKT'RS' COMPENSATION DECLARATION I hercby affirm under penalty of pcrjury one of the following declarations: -l have and will maintain a Ccrtifrcatc of Consenl to Self-lnsure for workers' compensalion, as providcd for by Scction 3700 of thc l-abor Codc. for lhe performancc of the work for which thc pc'rmit is issucd. -l have and will maintain workers'compensation insurancc. as requircd by Section 37U) of thc l-abor Codc. for thc Jrcrformance of thc work ttrr this is issucd. My workcrs'insurancc carricr und;xllicy numbcr arc: Policy Ll zt _l ccrtify that in the pcrfornrancc of the work for which this permil is issucd. I shall not crnploy any pcrson in any manner so as to hccomc subject to thc workcrs'conl;lensation laws of California. and agree that if I should bccomc subjcct to thc workcrs' cornpcnsation provisions of Section 37fi) of thc Labor Codc. I shall. forthwith conrply with those provisions.. t WARNING: Failure to sccurc workcrs' cornpcnsation coveragc is unlawful. and shall subicl an cnploycr lo criminal pcnaltics and civil fincs up to onc hundrcd thousand dollars (S!U).UX)). in addition lo thc cost of co]npcnsalion. damagcs as provided for thc Scction 3076 of thc Latnr Codc. interest and attorncy's l'ees. ,)ir,,.:Sff12a2o LICT'NSED CONTRACTOR DECLARATION r liccnscd under provision of Chaptcr liccnse is in full forcc and cffcct. I hcrcby afhrm undcr pcnalty of pcrjury that I am of the Business and Profcssions Code. and my I 9 (commcncing with Section 7ffiru) of Division 3 INurnbcr: CONSTRUCTION LENTTTNG AGENCY I hercby allirm undcr pnalty of pcrjury thal lhcre is ! construclion lcnding aScncy for thc tf,rformnce of lhc work fo, which this lumil is issucd (Scc. .1097. Civ. C.). Lcndcr's Numc: Lender's Address: APPLICANT DECLARATION I hcrchy aflirrn urrdcr pcnalty of pcrjury onc of thc lirllowing dcclarations: Dcrnolit iorr Pcrnrils-Asbestos Notificat ion Fcdcral Rcgulal ions (Title 40. Parl6) -Rcquircd l-ctlcr of Notification -l ccrtify that thc federal rcgulations rcgarding asbcstos rcmovalarc nol applicable to this projcct. _l ccnify that I have rcad this applicstion ud slotc lhat thc ilnve informdion is corcct. I a[re to comply wilh all Cilyand Counly ordinanccs ond Strtc ljws rclating to building construclio[. rnd hcrcby autlx)rirc rcprcsnlativcs ofthis City and County to cntq u]nn lhc atxlvc nrcntioncd propcrty frlr Applicant or Agent Pernrilee nanre ,,u,"SzipFq2^5 UNDER GROUND Waste & Vent Water-Under floor Gas-Underf loor Building Sewer ArealStorm Drain I nterceptor/ Clarif ier TOP OUT Waste & Vent Water Piping Gas Pipinq Roof Drain Tub/Shower Test Rouqh Water Heater POOL/SPA P-traplDrain Line Main Drain/Pool Pipinq Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary SewerlCao Back FIow Device Rough Plumbinq Final Gas Test Meter Release --_ FINAL tl-21 ,4ln t )rI rht ,19 Notes, Remarks, Etc. Carricr:_ Exoircs: Liccnsc ctu*, b ,,,", Sc{t1l