HomeMy WebLinkAbout30140581 - PermitProject Address: 916 1/2 N Louise St
Assessor's Parcel: 405-262-09 Lot: NA
Unit:
Block: NA
Bldg: Address Range:
Tract LOURIES SUB. Historic: No
Suite Range:
Zoning: Rl
i.
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
Permit Counter: (714\ 647-5800 lnspection Requests: O14) 667-2738 lnspector Section: f/14) 647-5853
Permit #: 3014058{
Pin #: 95398
Owner:
Address:
Phone
Patricio & Carmen Lopez
916 Louise St
Santa Ana, CA 927032148
(7141 6314010
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 s1602
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
Fee Type
Water Closet
Shower/Bathtub
Sink
Clothes Washer
Add'l Sewer Connection
Gas Outlet, each Add'l
Wtr Htr (Res up to 50 ge
General Plan Update
lssuance '-,
Notes: Auth on file.
Fee Total
Paid to Date:
Balance Due:
Amount
14.22
22.25
12.70
13.97
22.25
7.06
22.25
22.08
55.04 t'li-tL'i
t iii ';' ti
:, ._,,,.':1.
l'. ti I "J
.,rl;',!i':r1t.ti,
Qty
1.00
1.00
1.00
1.00
2.00
1.00
1.00
1.00
1.00
Fee
$14.22
$22.2s
$12.70
$13.97
$44.50
$7.06
$22.25
$22.08
$ss.M
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work.
Planning Conditions:
Planning Approva! By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
New
New 2nd Dwelling Unit
Zuniga,o,,,rrr$7
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3, U
VB
cPc 2016
02t07t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Buildins Permit #: 1 0197 473
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 180 days after the time the wort< is
commenced.
lnspector MID#: 201 8-1441 81
01 1 16002 51600
01 1 16002 51602
$22.08
$191 .99
$214.07
$0.00
$21 4.07
PLU M BI NG.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hccby allirm undo pcmlty of pcrjury thd I .m cxcmpt liom th€ ContracloB' Liccns Law for thc following rcasn (Ss.7031.5
Busincss ard Pmfcsion Codc): Any City or County which rcquircs a ;mit to sn{rucl, alts, imprcvq dcmlish or rcDair 8ny
structurc, prhr to its isMrcc, als Eq[iffi lhc spplicant for such Imil to lilc a signc{ statcmnt lhrt hc or shc lr licosd pursmt
to thc pmviiiotri of thc ContrctG'! Lianscd taw (Chapta 9, Commcrcing with Scction 7000 of Division 3 of thc Businc$ 8nd
PmfcssionsCodc)orthathcordEirqcmptthcrcfiomandthcb&iirforthcallcgcdcxctrrption. AnyviolatiooofSelionT03l.5byany
applicantforapcmitsbjclsthc.pplicsnttoacivilpcEltyofmtmrclhrofivchundrcddollars($500).
_1, as own€r of the proFrerty, or my employees with wages as their sole compensation, will do the work and thc structure is not
intended or ofFered for sale (Sec.7044, Busircss and Professions Code: 'l'he Conlractor's License Law does not apply to an owner of
the property wtn buil& or Lnproves thereoq and wtn does such work himself or herself or thmugh his or her own employees,
provided that such impnovements are not intended or offered for mle. l(, tnwever. the htrilding or improvernent is sold within one )csr
of completion, the Owner Builder will tr,ave the burden of proving thal hc or she ditl rnt build or inqrmrrc the prop,erty for thc purynse of
sale).
_1, as owner of the property. am exclusively contracting with licensed contraftorsto construct the pr<rject (Sec. TM4,lJusiness
an owner of property who builds or improves thereon,ard Professkrn Code: 'l'he Contractor's does not lo
and u,ho contracts for such t<l the Contraclor's [-icense Law).
_l am exempt &fur this reason.
DECLARATION
I herehy affirm under penalty of perjury one of the following declarations:
-l
have and will maintain a Certificate of Consent to Self-lnsure for workers' contpensalion, as provided for by Section 3700 of the
l"abor Code, for the performance of the work for which the permit is issued.
_l have and will maintain workers' compensation insurance, as required hy Section 3700 of the Lahor Code, for the performance of
the work for which this permit is issred. My workers' compensation insurance carrier and Jnlicy number are:
Policy Number: Expires:
_l certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner
so as to become subject to the workers'compensation laws of California, and agree that if I should become subject to th€
workers' compensation provisions of Section 3700 of the Labor Code, I shall, forthwith conrply with ttnse provisions..
WARNING: l:ailure to secure workers'
civil fines up to one hundred thousand
coverage is unlawful, and shall subject an emfloyer to criminal penalties and
(sl lhe cost of as provided for the
LICENSED CON I RAC'I'OR
DECI ATI,I'I'ION
I hercby aflirm under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
License Class: License Numher:
Date: Contractor:
W
I hercby aflirnr under 1Emlty of perjury that thqe ii a onstruction lcnding agcncy for the pofomancc of thc work ,br which this Jrmit is
ismed (Sa. 3097, Civ. C.).
Lcndcr's Name
Lender's Address:
APPLICAN DTCI ARA'TION
I lrreby aflirm under penalty of perjury one of the lbllowing declarat ions:
Denrolition Permits-Asbestos Notification I;ederal Regulations ('l'itle 40, Part(r)
-Rertuired
Letter of Notification
-l
certify that the federal regulations regarding asbestos removal are not applicable to this project.
_l certify that I have read this application and state that the atnve information is corlgct. I agree to comply with all City and County
ordinances and State Laws rclating
atxlve mentiorrcd property for
Applicarrt or Agent
Permltee nanre
arxl of this City and County to enter u[x)n lhe
UNDER GROUND ltt=='l-^ ,ln /
Waste & Vent lr1/17L{ryx( )rwv Q(
Water-Under floor
Gas-Underfloor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ Clarifier
TOP OUT I
Waste & Vent I '-"''-
Water Piping luL-r',-K-t
Gas Piping 'i,n
Roof Drain
Tub/Shower Test
Rough Water Heater
POOUSPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fil! Line/Back FIow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back Flow Device
/
Rough Plumbins / /7 t ruDt "LI,DU:7
Final Gas Test I
tt It /r,
F!NAL lJ UYA guLuq {6t\
Noteg, ff,enpfks, Etq.1
I a
I ,(/t2//(/ t /V//L /r,,I I *L4rW- /6q
'l/ /t-s //q, tbit,4az_/dv
rlJ'il/1 Pl',h4 'a.rdIa
,t
a
DaV_/
A -a
Meter Release