HomeMy WebLinkAbout30142604 - PermitProject Address: 3118 S Rita Way
Assessor's Parcel: 412-022-04 Lot: 16
Unit:
Block: NA
Bldg:
Tract: 6564
Address Range:
Historic: No
Suite Range:
Zoning: Rl
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 301426o,4
Pin #: 28568
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
MIKE PESAK
3118 S RITA WAY
Santa Ana, CA 927046737
(7141 557-901s
Safe Step Walk-in Tub Coml
15262 Pipeline Lane
Huntington Beach, CA 9264
(7141 373-8545
ol 1 1 6002 sl 602 5ffi,llri^d
01 116002 51600 General Plan Update
01 1 16002 51602 lssuance
01 1 16002 57770 Microfilm Records
Amount
23.97
23.79
59.30
4.05
Qty
1 .00
1 .00
100
1.00
Fee
$23.97
$23.79
$se.30
$4.05
Botch *z?:7244 F LI/ tg/2tJ20
Off i ce: CTYH Trans*: 6Acct*: Refi
Rcpt+:03113175 - fl/Ig/2
Trgnsoct i on Totn IState Lic #: 983603
Lic Type: B
Bus. Lic #: 365881
Workers' Compensation I nsurance:Carrier: State Compensation lnsurance Fund
Policy #: 9002477
Expires: 0110112021
Snfe Step tlnlll-in Tub
Genernl PIan Updote Fee
ttl 1 160$2- 5l 6trttlltlfl-
Pluub i ns
trl t 160112- 516tr2ttfi[t-
11 icrof i lm & Oocurents
r:r 1 1 161102- 1777f)0(rfi-
ICL Check t1[tt-tflu[t362Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Alteration
Walk in Tub
Verduzco, Vio,n$
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-3, U
VB
cPc 2019
11t18t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: to include acrylic surround
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 the sife by such permit rs suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Inspector MID#: 2020-162810
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
79
27
05
$23
$83
$+
$1 11.11
$0.00
$1 1 1.11
PLUM BI NG.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DETTARATION
I hccby aIlim unda paalty of pcrjury that I m cxcmpt ftom thc ContractoE' LiccE [rw for thc following rcen (Se?03{.5
Busincs and Profsion Codc): Any city or County which rcquirc a pcmit to consiruct, altq, improvq dqnolish or rqir sy
structurq Fior to its issurec, also rcquirc thc ,pplicmt for such pcmit to filc 8 sig,ncd stdcmt thal hc or slrc b licascd puuam
to thc provisioN of thc Contrrctor's Licoscd law (Ch.pt6 9. Commocing wirh Sction 7000 of Division 3 of thc Buine md
PrcfNions Codc) or that hc or shc is cxmpt th@ftom ed the b8is for thc allclcd crmption. Any violaiion of Sctbn 7031.5 by my
sp,plicant for 8 pmit subjEts thc applient to a civil penslty of not morc the livc hundltd dolles ($500).
_1. as owner ofthe property. or my employees with wages as their sole comperualion, willdo thc work and the stnrctrne b not
intcndod or offcred for sale (Se.7044, Brsiness and hofcssions Code: The Contractor's Liccnsc l-aw does not apply to an owner of
the propcrty who hrilds or improve ttrcrcor\ and who does such work himself or hcrsclf or through his or her own employecs.
provided that such improvanrents are not intendod or offqcd for sale. lf, howerrer, the building or improvfiEnt is sold within one )€ar
of complaion, the Omer Buildo will have the hrntcn of proving tha he or she did not build or improve the propaty for thc purpose of
sale).
_1. is owner of the Fopcrty. arn cxclusively contracting with licerrsed contraclos to consitruct the project (Sec. 7044. Brsiness
and Prrofession Code: Thc Contractor's License Law does not apply to an own€r of propcrty who builds or improves thereon,
and who contracts for such projccts with a Contracto(s) licensed pursuant to the Contraclor's Licctrse taw).
-l
am exempt under B. & P.C. for this reason.
WORKERS' COMPENSATION
DECLAR/tTION
I hereby allirm under pcnalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Conscnt to Self-lnsurc for workers' compcnsation. as p,rovided for by Section 3700 of the
Labor Code. for the perfonnance of the work for which the permit is issued.
_l have and will rnaintain workers' compensation insurance. as required by Section -1700 of the Labor Code. for the performance of
the work for which this permit is issued. My workers' compensation insurance carrier and policy number are:
Policy 77 t /t/rl
_l certi& that in the pcrformance of the work for which this pcrmit is issued. I shall not employ any person in any manner
so as to become subjcct to the workers'compensation laws of California" and agree that if I should becomc subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall. forthwith comply with those provisions..
WARNING: Failure to secure workers' compcnsation coverage is unlawful, and shall subject an anployer to qiminal panalties and
civil fines up to one hundred thousand dollars ($100.000), in addition to the cost of compensation. damages as provided for the
Section 3076 of the tabor Code interest and attorney's fecs.
d
I hereby affrrm undcr penaltyof pcrjury that I am liccnscd Chaptcr 9 (commencing with Section 7000) of Division -i
of the Business and Professions Code. and my liccnsc is in full force and effect.
Licensc
floto.
I hereby affrnn under penalty of perjury that there
issued (Sec. 3097. Civ. C.).
agexcy the performance of the work for which this pcrmil b
lrnder's Name:
Lcnder's Address:
APPLICAI\T DECLARATION
I herety aflirm under pcnalty of perjury onc of the following declarations:
Dernolition Permits-Asbcstos Notification Federal Regulations (Title 40. Part6)
-Required
letter of Notification
-t
cdiry thd thc fcdcal rcgulstioB rcgrding abetos mvsl ffi trot epliclblc to fiis pmjEr.
-l
cqriry thar I haw rad thb application ad st8tc that thc abovc infomdion is con6t. I agre to @mply with .ll City ed Couty
ordinmce md Statc Lrw rclairg to building onstuuciion, md h@by 8uthoria rqEwntrtivc of thb City and Coutrty to mts upon thc
above mentioned property for
Applicent or Agent
Perrnilee nRme
W ^,,,f l'K'fu
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
ArealStorm Drain
I nterceptor/ Cla rifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCao
Back Flow Device
Rouqh Plumbinq
Final Gas Test
Meter Release ,,4
FINAL //.)f,a Z 1!r ,l llog "ru
Notes, Remarks, Etc.
tu
0