HomeMy WebLinkAbout30142541 - PermitProiect Address: 251 0 S Bristo! Sta
Assessor's Parcel: 412-191-05 Lot: NA
Unit:
Block: NA
Bldg:
Tract NA
Address Range: 2490-2530
Historic: No
Suite Range:
Zoning: C4
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 30142541
Pin #: 32604
Owner:
Address.
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Andrew Chu
9944 Garden Grove BIvd
Garden Grove, CA 92844
(7141 636-20e0
Lucky Massage
Cinda Construction lnc
14514 Fairgrove Avenue
La Puente, CA 91746
(626) 848-2736
State Lic #: 890143
Lic Type: B, A, C-20
Bus. Lic #: 376624
Workers' Compensation lnsurance:Carrier: State Fund
Policy #: 1919554
Expires: 05/01 12021
Notes:Plumbing for Tl
Building Use: Commercial
Job Type: Tenant lmprovement
Nature of Work: Tl
Planning Conditions: lnterior Tl only
Occupancy.
Constr Type:
Code:
Date:
Date:
Date:
B
VB
cPc 2019
Planning Approva! By:
Plan Checked By:
Permit lssued By:Verduzco
J
, Violet 10t26t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
TotalSubject to Field:
Buirdins Permit # 101 103877
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 permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2020-159047
01 1 1 6002 51 600
01 1 1 6002 51 602
01116002 57770
$23.79
$172.69
$4.0s
Fee Total
Paid to Date:
Balance Due:
$200.53
$0.00
$200.53
01 1 16002 51602
01 1 16002 51602
01 1 16002 5160C
01 1 1 6002 51 602
01116002 5777C
Fee Type Amount
Clothes Washer 15.05
Wtr Htr (Res/Comm ove 98.34
General Plan Update 23.79
lssuance 59.30
Microfilm Records 4.05
Qty
1.00
1.00
1 .00
100
100
Fee
$1s.05
$98.34
$23.7e
$5e.30
$4.05
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APPROVALS DATE !D/SIG.COMMENTS OWNER BUILDER DET CARATION
I hcby aflim undo pcnalty of pcrjury thrt t m cxcmpt &om thc CoitrutoB' Licre L:w for thc following @n (Sc.7031.5
Buincs and Prcfxion Co&): Any City or Couty which rcquire a pamit to onstruct, altc, imprcvc. &nolish or rcpoir my
struGluc, prior to its isumcc. abo rcquirB thc eplicilt for such pmnh to filc I signcd stdmat th0r lE or shc b licaEcd plsmt
to thc provisioN of thc Contractor's Licogcd trw (Chapt6 9, Commmcing with Scriotr 7000 of Division 3 of thc Buineond
PDfcsiom Code) or that hc or shc b qmpt thGcfrom ed thc bosis for thc allcacd cxoption. Any violation of Sctiotr 7031.5 by uy
applicutforap6mitsubjersthc spplicuttoocivilpaaltyofnotmorcthefivchundrcddollss($500).
_1. as owner of the property. or my employees with wages as their sole compensation. willdo the work and the structure is not
intcndcd or offerd for salc (Sec.7044. Business and hofessions Code: The Contractor's Lice'nse law does not apply to an owner of
the propoty who builds or improves thcrqrn. and who does such work himself or herself or through his or her own employees.
provided that such improvonents are not intended or offcrod for sale. l[, howet/cr, the building or improvement is sold within one ]ryr
of complaion. the Ov*ner Buildcr will have the hudcn of proving that he or she did not build or improve the propory for the purpose of
sale).
-1.
as o\+'ner of the propcrty. am exclusively contrac'ting with licensed contracton to construct the project (Sec. 7044. Business
and ttofession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon.
and rvho contracls for such p,rojccrs with a Contractor(s) licensed pusuant to the Contraclor's License Law).
-l
am exempt under Section-, B. & P.C. for this reason.
!)alc
WORKERS' COMPENSATTON
DECLARATION
I hereby affirm under pcnalty of pcrjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
Labor Code for the performance of the wort for which the pernrit b issued.
_l have and will maintain workers'as by Section 3700 of the Labor Code, for the performance of
and policy numbcr are:the rvork ";[ilW'tlissued
Policy
oz I
_l certifu that in the perforrnance of the work for which this permit is issued. I shall not employ any person any manner
so as to bccome subject to the workers'compcnsation laws of California and agree that if I should become subject to the
workers' compensation provisions of Sertion -3700 of the tabor Codq I sh8ll. forthwith comply with thosc provisions..
WARNING: Failure to sc.cure workers' compensation coverage is unlawful. and shall subject an employer to criminal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for the
Section 3076of $e t Fr 6d..interest and attorney's fees.
,,,,, lo le L I 'l,o \oApp,icanr:
I I LIcENSED coNrRACroR
DECI.ARATION
I hereby alTirm under penalty of perjury that I am licenscd under provision of Chapter 9 (comrnencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full fiorce and effect.
License Numbcr:
CONSTRUCTION LENDINC AGENCY
I h@by amrm unds pcnalty of ptrjury that thre is 8 construction loding agacy for thc psfomuce of thc work for which this pqmh b
issucd (SG. 3097. Civ. C.).
Lender's Name:
Lender's Address:
APPLICANT DECII\RATION
I hcr*y afrnn under penalty of ffiury one of the following declarations:
Dernolition Permits-Asbcstos Notification Federal Rcaulations (Title 40, Part6)
-Rcquired
l-cttcr of Notific*ion
._l certi& that the federal regulations regarding asbcstos rernoval are nol applicable to this project.
-l
certi& that I have read this application and state that the above correct. I agree to cornply with all City and
ordinances and State Laws relaing to building construction, and representatives of this City and
above mentioned property for
Applicent or Agent
Pernritee nRme
o (
enler
oi
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ Cla rifier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Poo! Piping
Fill Line/Back FIow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back FIow Device .-,
Roush Plumbins ///n< t %?o .{1 ffii)
Final Gas Test 't/
Meter Release I a ^ ,L.J
FINAL lLlX 'k)vtT{o I
Notes, Remarks, Etc.
PLUM BI NG.I NSPECTOR RECORD
d
Owner:
w