HomeMy WebLinkAbout30138634 - PermitCity 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 #: 3O{ 38634
Pin #: 95695
Project Address: 1901 E First St
Assessor'sParcel: 400-081-08 Lot: POR 15
unit: 138
Block: NA
Bldg:
Tract:MAYBURY
Address Range: 1901-1903
Historic: No
Suite Range:
Zoning:C5
E
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Lyon Realty Advisors lnc
4901 Birch St.
Newport Beach, CA 92660
(949) 838-1239
Huskins Coffee Co
MITCHELL GENERAL CONT
52 TESLA
lrvine, CA 92618
1949l 387-4477
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 16002
01 1 1 6002
01 1 16002
01 1 1 6002
01 1 1 6002
01 1 16002
01 1 1 6002
01 1 16002
01 1 1 6002
01 1 16002
01 1 16002
01 1 16002
51602
51602
51602
51602
51602
51602
51602
51602
51602
51602
51602
51602
51602
53602
51 600
51602
Qty
1.00
1.00
5.00
1.00
1.00
2.00
2.00
1.00
1.00
1.00
2.00
1.00
1.00
353.88
1.00
1.00
Fee
$13.69
$10.47
$61 .1 5
$11.52
$10.26
$31.06
$31.06
$62.18
$42.85
$21.42
$42.84
$21.42
$36.1 5
$230.02
$21.25
$52.98
Fee Type Amount
Water Closet 13.69
Urinal 10.47
Sink 12.23
Dishwasher 11.52
Garbage Disp 10.26
Floor Drain 15.53
Floor Sink 15.53
New Sewer (First 100') 62.18
Gas System 14 42.85
Wtr Htr (Comm up to 50 21.42
lnstallWtr Htr Comm 21.42
Backflow < 2" 21 .42
GreaseMastelntercept 36.15
PIC - 650/o 0.65
General Plan Update 21 .25
lssuance 52.98
State Lic #: 831334
Lic Type: B
Bus. Lic #: 352269
Workers' Compensation I nsurance:Carrier: EVEREST NATIONAL INSURANCE COMPANY
Policy #: 7590000014
Expires: 03/08/2018
Building Use:
Job Type:
Nature of Work:
Mixed-Use OccuPancY:
Tenant lmprovement Constr TYPe:
Tl/Card Reader/Roof Mtd EqrCode:
B, R-2
iltA
cPc 2016 Notes: NOTE: A gravity grease interceptor is not req'd per
PWApplicant to install a Hydro-Mechanical Grease
lnterceptor.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Buildins Permit #: 10194533
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 permit ls suspended
or abandoned for a period of 180 days after the time the work is
commenced.
West, Glen
Link, Patricia
Date:
Date:
Date:
12t07t2017
02t20t2018
Account#
Misc. Receipt: 70184
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 51602
$21.25
$449.05
Fee Total:
Paid to Date:
Balance Due:
$700.32
$230.02
$470.30
Permitee MtD#. 2017-139450
Phone:
PLUMBING.INSPECTOR RECORD
APPROVALS DATE IDiS!G.COMMENTS 0WNI.:R BTIII,I)I]R I)I'T,CARA'TtoN
I hcrchy allirnr uil(lcr lrlnlty of pcrjury lhnl I arn cxcnrpl liom lhc Coillracl(x's' Liccnsc [:w lbr lhc lblk)wirg rcrson (Scc.7(lJl.5
Busincss and Prollsstrn Corlc): Any City or County which rcquirc\ tr Frilril lo c()nslnrcl. altcr. inlprovc. dcrrrlish or rcpair any
to thc provi\ions ol'thc C('ntrictor'( l-iccnscrl ks' (Chaplcr 9. Connrcncing uilh Sccli(il 7(X)0 of Dilision -1 o[ lhc Bnsinc(\ nn(l
ilpplicanl lor a pctrnil \uhjccls lhc npplicrnl lo fl civil pcnally ol'nol nt)rc lhan {ivc hun(lrcd dollnrs ($5(X)).
_1. xs owncr ol-lhc propcfly. or nry cmf k)yccs wilh sxgcs ns lhcir solc c()rrlpcnsxli()n. willdo thc rvork and the slruclurc is il,1
iticlxlcd orollcrc(llirr$lc(Scc.7()l.l.Businc\sand['i)lcssi(nl\Co(lc:'lhcContrrclor'\l.iccnscl;rwdocsnolapplytounowncrol'
thc pfirfrfly sho build\ or irnprovcs llrrcrn. ilnd who (l(rs such srrrk hintscll or hcrscll or through hi{ or hcr own cmpl()ycc\.
sillc I
ilil(l $ltrr coillrncl\ for \uch l)rojcels with a (i)rxrrcl(nIs] licctrsc(l pursuilnl lo lhc (inilrxcloas l-iccnsc l-rw).
-l
amcxcmpt under sstion-. B. & P.c. for lhis reason.
WORI(ERS' COilIPT:NSATTON
DECLARA'I'ION
I hcrchy affirm undcr lrnally of pcrjlry oilc of lhc following dcclaralhns:
Lrtxrr(ixlc.liirlhcpcrlirnilrnccolthc\Irkli)r$hichlltncrnili\i\\nc(!.
tlr s(trk li)r u'hich lhir pcrnrit is issucrl. My *orkcrs coillpcn\xli()n ir\urrncc.nflicr an(l Filicy nunrhcr ilrc:
Policy Nunrhcr: Expircs:
_l cenify that in thc Jrrformrcc of thc work for which lhis frrmil is issucd. I shall noi cmploy any person in any mnrer
s as lo becorrc suhjcct lo thc wo.kers' conrpcnsalion laws of California. flnd agrcc lhat if I should hccom subjcct to lhe
workcrs' compensation previsions of Scction 3700 of thc titnr Code. I shall. forthwith comply with lhorc provisions..
ciril llncs up to {)nc hundrcd thousand dollars (Sl(X}.{XX)). in trddilion lo lhc cost of conrpcnsatirrn. danragcs as provitlctl for lht:
Scclion 1076 oflhc l.atxr Crxlc. irilcrc\l and xlk)rrcy \ lccs.
l)alci
LICENSFN C(IN'IR CT(TR
DECLARA'IION
I hcrchy allirnr undcr pcnalty of pcriury thnl I am licc0scd Indcr provi\ion of Chaptcr 9 (conrtrrncilg wilh Scclirn ?(XX)) of l)ivision .1
ol' lhc Busincss iin(l Prolts\i(lns Codc. rnd mv liccnrc is in full forcc rnd cflcct.
l-iccnsc Numbcr:
I)sle:
CONSTRUCTION LENDING A.GENCY
I hercby affirm undcr Jrcnalty of lErjury that thcrc is a conslruclion lending agercy for thc [rrfomrce of the work for which this pcmil ir
issucd (Scc, 3097. Civ. C.).
[lndcr's Nanrc:
Lrndcr's A<ldrcss:
APPLICANT TIECLARATIOIN
I lrrt*ry allirm untlcr pcflahy r)l pcrjury onc r)f thc li)lk)wiilg dc(lxrrti{}n(:
[)cilr)litioil Pcrmits-Ashcsto\ Notillcati()n l;cdcrrl RcEUlrlion\ ( l illc.]{). I'da6)
-Rcquircd
[-cllcr of Nolilicali{)n
_l ccrlily lhat lhc ltdcrill rcgulalions fegdrding nshcslos rcilrrval arc nrl applicahlc Io lhis proiccl.
atxrvc illctrlioncd p()l^-ny f(rr inspccli{)n nurfxr\cs.
Applicnnl ',r Agcnl l)illr:
Pcmit@ mme (print):_.-
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf loor
Buildinq Sewer
Area/Storm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
N/lain Drain/Pool Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbinq
Final Gas Test
Meter Release ,
F!NAL 7 / ztlrt -&,lt
Notes, Remarks, Etc.-vv