HomeMy WebLinkAbout30142241 - PermitCity Of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: O14) 647-5800 lnspection Requests: (714) 667-2738 lnspec{or Section: (714) 647-5853
Permit #: 30'142241
Pin #: 88076
Project Address: 1227 S Orange Ave
Assessor's Parcel: 014-01 3-08 Lot: 7
Unit:
Block: G
Bldg:
Tract: 266
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Benjamin Vallejo
1227 Orange ave
Santa Ana, CA 92707
(7141 227-2615
01 1 16002 s1602
01 1 16002 51602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type Amount
Sink 13.68
Gas Line alter/extend/ar 70.64
General Plan Update 23.79
lssuance 59.30
Microfilm Records 4.05
Qty
1.00
1.00
1.00
1.00
1.00
Fee
$13.68
$70.64
$23.7s
$5e.30
$4.05
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Building 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
Miscellaneous
Plumbing
web_user 07109t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Notes: Plumbing
Fee Total:
Paid to Date.
Balance Due:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cPc 2019
Total
N/A - No Balance
N/A - No Balance
$171 .46
$171 .46
$0.00
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe site by such permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2020-160047
PLUM BING.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNEN,BUILDERDELCARATION 'I hErcby sflirm undcr pcnslty of perjury rhrt I m cxcmpt &om thc ContrdctoG' Lbens hw for thc following rc&sn (Ss.7031.5
Busincss rnd hofcssion Codc): Any City or County which rcquircs I lrrmil lo @nstruct, altcr. improrc, dcmlish or rcpah my
structurc. prior to its issurre, olso rcquircs thc rpplbmt for sch lrcmil to lih s signcd statemnl that hc or slE is licenred ptmuant
to thc trcvisions of thc Conrettr's Licrned [:w (Chrpter 9, Comrercing with Setion 7000 of Divisbn 3 of thc Busircss md
Prcfe$sions Codc) or thst hc q she is cxcnpl thcrefrcm and the bssis for the sllcgcd cxcmprion. Any violation of Sec-rion 7031.5 by tny
rpplicsnt for I pgtnit subtrts the applicant to I civil pemlty of nol mE lhm livc hundrcd dollm ($500).
_1. as owner of the proF,erty. or my cmployecs with wages as thcir solc compensation. will do the work and the structurc is not
intendcd or offcrcd for salc (Scr.7044, Busincss and Professions Code: The Contractor's License hw does not apply to an owncr of
the propcrty wlro builds or inprovcs thereon, and who does such work himsclf or hcrself or lhrough his or her own employees.
provided that such improrrnrnts are not intcndcd or offcrd for sah. lf. however. thc bruilding or improvetrEnt is sold wilhin one )rcar
of comptction. the Owner Buildcr will harrc thc burden of proving lhat hc or shc did not truild or improve thc proJrcrty for thc purF)sc of
sah).
_1. as owncr of the propcrly. ant cxclusivcly contracting with liccnsccl conlraclrlrs lo construct lhc projccl (.Sec. 70.{4. Iltrsincss
and t,nrll.ssion Codc: 'l'hc Contractor's l-iccrrsc l-aw docs nol af,ply lo an owncr of'propcrty who huiltls or inrprovcs lhc'rcon.
and who contrilcts for such pr<rjccts with a Conlractor(s) liccnscd pursuanl lo lhc C'ontractor's l-iccnsc [-aw).
-lalncxcmr,tunderScctitln-.B'&P.C.frrrthisrcastln.( )rvnrr:
WORKERS' COII| PFNSA'I'ION
DECI ARATION
I hercby alfirm undcr pnalty of pcrjury onc of thc l'ollowing dcclarations:
_l havc und will nraintain a Ccrtilicatc of Conscnt to Sclf'-lnsure lbr workcrs'cornpensation. as providcd for by Scction 37fi) of thc
labor Codc. for thc pcrforrnance of the work for which thc pcrrnit is issucd.
_l havc and will maintain workers'comJrcnsation insurancc. Bs rcquircd by Scction 37fi) of thc labor Code. for thc 1rcrf<lrmance o[
the work for which this pcrmit is issucd. My workcrs' comlrcnsation insurancc carricr and plicy numbcr arc:
Policy Nuntbcr: ['ixPircs:
_l ccrtify that in thc pcrformance of thc work for which this pcrrnit is issucd. I shall not cmploy any Frcrson in any milnner
so as to hcconrc subjccl to thc workcrs'compcnsation laws of California. and agrcc thal if I should bcconrc subjcct to thc
workcrs' conrpcnsation provisions of Scction 3700 of the Lahrr C--odc. I shall. forthwith comply with thorrc provisions..
WARNING: Failure to sccure workers' conrpensation coverage is unlawful. and shall subject an cmploycr to criminal pcnalties and
civil fincs up to orrc hundrcd thousand doltars ($100.m0). in addition to tlrc cost of comlrcnsation. damages as provided for the
Section 3076 of the L:bor Codc. interest and attonrcy's fees.
Date: Applicnnt:
LICENSED CONTRACI'OR
DF'CLARATTON
I hcrcby allrrm undcr pcnatty of pcrjury that I am ticcnscd undcr provisiort of Chaptcr 9 (comnrcncing with Scction 7UX)) of Division 3
of the Busincss and Profcssions Codc. arxl nry license is in full tbrce ard cl'fcc'|.
Liccrtsc Nurnbcr:
l)alt' ('olllritclor.
C(TNSTRUCTION I T'NDIN(; AGFNCY
I hc.rcby aflirm undcr lrcnalty of fErjury that tlrcrc is a construction lcndinS qcncy for lhc lrcrforlurct ofthc $ork for shich this F]mil is
issucd (Scc. 1097, Civ. C.).
kndcr's Namc:
APPLIC {NT DF'CLARATI(IN
I hcrcby allinn undcr pcnalt y of pcrjury onc of t hc tbllowing dcclaral ions:
Dcnxrlit ion Pcrnrits-Asbcslos Notificat ion Fcdcral Regulat ions ('l'it lc 40. Parl6)
-Rcquircd
lrtter of Notilicalion
-l
ccnify that thc fcdcral rcgulations rcgruding asbcslos rcmovsl ure nol applicublc to lhis pmjccl.
_l ccnify lhat I h.vc rcsd lhis 0pplication and st8tc lhnt thc alnvc inforroIioD is corcl. I agxe Io comply wilh all City end County
ordinarccs and SIatc Laws rclaling to huitding construction. and hcrchy authorizc rcprcsnlalivcs of lhis Cily and Counly to cnts ulnn lhc
atnvc nrntiomd pm1rfly for insFction purF)ss.
Appllcant or Agent Signature:
Pemlle mmc (prina):-
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf loor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipino
Gas Pipins
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pioino
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCao
Back FIow Device
Rouqh Plumbinq
Final Gas Test
Meter Release ll t A
FINAL w I '//2 vtw(
Notes, Remarks, Etc
,l
Date:_