HomeMy WebLinkAbout30139107 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 h!Plumbing
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 3O{ 39{ O7
Pin #: 34923
Proiect Address: 2424 N Tustin Ave
Assessor'sParcel: 396-261-55 Lot: 8
Unit:
Block:A
Bldg: 24-K Address Range:
Tract:A.B. CHAPMAN Historic: No
Suite Range:1,3,4
Zoning: R4
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
The Bascom Group, LLC
26 Corporate Park Drive, Suite 200
lrvine, CA 92606
(s4s) 955-0888
AMA Repiping Plumbing, LL
401 Timberpoint Ct.
coLUMBlA, SC 29212
(866) 262-181s
Fee Type
01 1 16002 51602 ClothesWasher
01116002 51600 General Plan Update
01116002 51602 lssuance
Amount
13.45
21.25
52.98
Qty
3.00
1.00
't.00
Fee
$40.35
521.25
$52.98
r2t .25
t93.33
11t296.13
BoLchi:{2622 - 3/7/Z$tB I0: LROSALES6ffi6s: CTYH Tronsi: 37 3 of 23Accti: Ref *: 3t-rl39tl'r7
Rcpti:02193791 - 3/7!2[tl8 {:37 Pll
Tronsoct ion Totol t1t296.Ll
AltA Repipins Plunbine' LLC
State Lic #: 991 194
Lic Type: C-36, B, ASBS, C-16, C-10, C-20
Bus. Lic #: 368085
Workers' Compensation lnsurance:Carrier: Technology lnsurance Company, lnc.
Policy #: TWC3675469
Expires: 1212012018
Generol Plon Updote Fee
011t6002- 516000(rCI-
Plurb i ns
01 1 16[02- 516(r2(rtru-
ICL Check 00293S
Building Use:
Job Type:
Nature of Work:
Mutti-Family (5 or more uni Occupancy:
Alteration Constr Type:
WD Partition Wall (units 1,3,Code:
R-2
VB
cPc 2016
Planning Approval By: Date:
Plan Checked By: Date:
Permit lssued By: Chavez, Dave- Date: 0310712018
Subject to Field: >L'
Account#
Planning Conditions:
Buirdins Permit#: 10195702
Every permit issued shall become invalid unless the wofu on the site
authoized by such permit is commenced wilhin 180 days afrer its
lssuance, or if the work authoized on the site by such permit is suspended
or abandoned for a period of 180 days after the time the work is
commenced.
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Washers for units 1, 3, and 4.
Fee Total:
Paid to Date:
Balance Due:
01 1 I 6002 51 600 $21.25
$93.33
$114.58
$0.00
$114.58
lnspector MID#: 2018-141736
01116002 51602
DATE ID/SIG.COMMENTSAPPROVALS
UNDER GHOUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouoh Water Heater
POOL/SPA
P-trap/Drain Line
lVlain Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbing 9//t ,kq-w \tE;v {d
Final Gas Test
Meter Release .v S*4r)FINAL 4 '-02-17 s a-r.g I
Notes, Remarks, Etc
.J
l tl't,i'rj:i,1:',fil ffiIiT"'t:iijm':: ll ili:,:lr:TrJilr :J:il
xpt)licrnllirrilpcril)il\uhjccl\lhc xppli.rnlkixcirilpcnallv()ln()lilx)rclhrilli\chun(lrcddolltrs{55(X)).
sillc).
antl who e()trlract\ li)r such ptrriccls with il (i)rlrilclo(s) liccilscd pur\ur0l lo lhc Corxrirck)r's Liccnsc Lilw).
I rrr rxr:rnDt rrklur Sc.lx)o . Il. & l'.('. li,r lhis rur\on.
Dale:-Owner:_
WORKERS' COMPENSATION
DECI ARATION
I hcrcby allirm undcr tEnahy of pcrjury ooc of thc following dccltrations:
_l havcundwill MintuinrCcrtilicatcofConscnttoSelf-lnsurcti)rworkcrs'cotrrpcnsalion,as providcdl(,rbyScction3T0ooflhc
L{tx}r Gxlc. for thc pcrlbrnuncc oflhc work frrr which thc pcrntit is issucd.
_l have and will mnirtdin sorkcrs' conrrcnsation in{urancc. as rcquircd by scclion 37(D of thc lrhor G)dc. for lhc 1^-rlirrmncc ol
thc work for which this pcrmit is issucd. My workcrs' compcnsalion irsurancc canicr and lnlicy numhcr uc:
i
t oe
Policy
_l cenify that in the pcrformncc of thc work for which this permit is issued. I shall not employ any person in any manncr
s &s to tEom subj.rt to thc workcB' cor{Enslion laws of Colifomia. and agrc thal if I should bccom subject to thc
workers' compcnsation provisions of S€ction -1700 of the Latnr Codc. I shall. fonhwith comply with lho* prcvisions..
WARNING: Failurc lo surc workers'comfcnsalion covcEgc is unlawful. and shall subject an cmploycr to oimiml pmlties and
civil fincs up to one hundrcd thousand dollam ($1ffi.000). in
Seclion 3076 of lhe kbor Codc. inlercst ond atlomy's fecs.
addition to thc cost of providcd for thc
Applicunt:-X
I hcrcby affrm under pemlty of perjury thrr I m liansd under provision of Chaptq 9 (commrcing with Secrion 7000) of Division 3
of th€ Business ed Profcssions Code, ard my license is in full fore and cffect.
Nunrbcr:44ltt
UI u (
W
I hcrcby uflirm undcr Fnally of Frjury that lhcre is a construclkln lcnding 0gcncy lbr lhc pcrfoilmncc of thc work for which lhis fErmil is
issucd (Scc. 3097. Civ. C.).
[fndcr's Namc:
[*ndcr's Addrcss:
APIIJI;ANLDECI.AEAIIQN
I hcrcby aflim !ndcr pcnally of pcrjury onc of thc followinS dcchrations:
Dcrfi)lilir)n Pcrmits-Asbcslos Notificolion Fcdcral Rcgulalions ('I itlc 4t), Pan6)
Rcouircd [Iltcr ol Noliticalhn
_l ccnify that thc fcdcrsl rcgulnlions rcguding asbcstos rcn$vrlarc not applic0hlc lo lhis prrjccl.ol-- Ll ccf,ify that I havc ,cad rhis application ard stalc lhat thc ahovc information is corccl. I agre to comply with all City and County
ordinanccs and Slatc Lilws relaling lo building construction. and hcrcby authorize rcprcscntalives ofthis City and Counly to cntcr ufnn the
stnve mntiored pmpcny for
llrrtr ' !'lApplicunt or Agenl
PLUMBING.INSPECTOR RECORD
\rl)xtr: '
Pemllee name (printt: (.