HomeMy WebLinkAbout30341929 - Permitcity of Santa Ana 20 civic center Plaza (M-19), Santa Ana, CA92702
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Plumbing Permit #:3O341929
Pin #: {7509\N
Proiect Address: 1055 W First St Unit: F
Block: 4/1
Bldg: Address Range: 1OS5-1069
Tract BALDWINS ADD/CRylistoric: No
Suite Range:
Zoning: ClAssessor'sParcel: 008-141-63 Lot: 1,2
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Sean Phillips
POBox
Tustin, CA 92781
(714) 614-8391
Coin Laundry
B & W Plumbing
6441 Alexandria Dr
Huntington Beach, CA 9264
(7141396-7711
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01116002 5777C
Fee Type Amount
Sink 13.20
Tankless Water Heater 68.14
Hose Bibb 16.08
GeneralPlan Update 22.95
lssuance 57.20
Microfilm Records 3.91
Qty
1.00
5.00
2.O0
1.00
1.00
1.00
Fee
$13.20
$340.70
$32.16
$22.95
$57.20
$3.91
state Lic #: 978613
Lic Type: C-36
" Bus. Lic #: 375100
Workers' Compensation lnsurance:Carrier: Norguard lns Co
Folicy #: DAWC083458
Expires: O3l0ll2020
Bot,ch*:54433 - 2/lS/2O29 ID: aororoleslE0ffice: CTYH Trons*: 32 1 of IAccti: Refi: 3tJ31L?29
Rcpt*:02896651 - 2/t8/2CI2(r 9:22 All
Tnonsoct ion Totsl ${70.12
B & td Plurbing
Replacement.
i22.91
$3.91
$443.26
t47g.t2Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial
Alteration
Plbg Tl
Occupanry:
Constr Type:
Code:
Date:
Date:
Date:
B
VB
cPc 2019
;::':,ii"'"'(02118t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes
Fee Total
Paid to Date:
Balance Due:
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within360 days afier its
,ssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced,
01 1 16002 5't 600
01116002 5't602
01116002 57770
$22.95
$443.26
$3.91
$470.12
$0.00
$470.12
lnspector MID#: 2020-157278
PLUMBING.INSPECTOR RECORD
ID/SIG.COMMENTSAPPROVALSDATE
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf loor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P{raplDrain Line
Main Drain/Pool Pipino
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 ,rl
FINAL - ) /zht , ,tw lrn
Notes Remarks
t/
I hereby affirm undcr penalty of perjury that I m excmpt frem thc Conbacton' Liccnsc kw for thc following reasn (Scc.7(B 1.5
Business and Profession Codc): Any Cily or Counly which rcquircs a Jmit to construct. alter improvc. demlish or rcp8ir my
structurc. lrior to ils issuarce. also requires the applic8nt for such [Emit to filc I sigrcd statemnl thsl he or she is licensd pmuant
to lhc lmvisions of thc Contractor'r Liensed llw (Chaptcr 9. Comrencing wilh Sslion 7m0 of Division 3 of the Busircss md
PmfcssionsCodc)orlhatheorshciscxcmptthcrefromsndthcbasisforthcsllcgcdcremption. AnyviolationofsstionTO3l.5byany
applicant for a pcrmit subjsts thc applicsnl lo a civil penslly of not mrc lhs fivc hundred dollils (3500).
_1. {s owncr ol'thc proFrly. or nry cnrpkryccs wilh rvilgcs ils thcir srrlc conll[nsrtion. will do thc work an(l lhc slruclurc is nol
lhelr)Fr1y uhohuiklsorirrprorc\lhorqnl.undwhodocssuchrvorkhinrscll-r)rhcrscll()rlhroughhisorhcro*ncnrpkrvccs.
slc).
nr(l who c(,nlrrcls li)r such pfi)iccl\ wilh r Cotilrrclor(s) li((n\c(l pilrsuilnl l() lhc (i)illrilcl(n's Li(ctrsc I-rw).
I ilm cxcnrot undcr B. & P.C. for lhis rcason.
l)ale:O*ner:_
woRKEns' cotuPENsATloN
DECL{RATION
I hcrcby af[irm undcr pcnalty of pcrjury onc of the follow hrg dcclarnl bns:
Lutx)r C(tdc. liir lhc pcrl-ornHncc r)l'lhc rvork li)r $tich lhc pcrnlit ir irsucrl.
thc
havcsndwillmaintainworke6'comlEnsationinsurancc.as rcquircdbySklion.lTU)ofthctiborCodc.forlhc[rcrformnceof
work for which this [Ermit is isscd. My workcs' comJrcnsation insurance canier and;nlicy number ue:
Policy _ 3- 7- 4o
-t
ccrrify that in thc pcrformrcc of the work for which lhis lErmit is issucd. I shrll not cmploy any J**n in
"ny
*nnf,.
s as to becom subjct to th€ worts' omJEnsation laws of Califomia. and a8m lhat if I shouH becom rubtrt to the '.
workm' @mpcnstion prcvisions of Setion 3700of thc tibor fue. I shall. fonhsilh comply with thos prcvhions.. ,
!
Scclion lO7(, (rl lhc l-ahrr (-rxlc. inlcrc\l iln(l rllorncv's Iccs.
D.le:_ApplioDt:-
ucnxseu coltx,lcroi
DIiCI.AEAIIQN
of lhc Ilusincss rnrl Proltssions ('rxlc. ud tny liccnsc i\ i[ Itll li)rcc rnd cllccl.
ILiccilsc
l)alel .{t-34z-tg-bzo
issucrl (Scc. 1097. ('iv. C.).
Lcndcr's Nlnrc:
lxndcr's Addrcss:
AfIIJCANI.DESABAI&N
l hcrtby allirnr undcr pcnalty of pcrjury otre (,f lhc ti)llowing (lcchrali([s:
Dcrnolitioil Pcflnits-Asbcstos Notificali('n l:cdcrrl Rcguhlions ( l'illc 40. Pafl6)
-Rcquirc(i
l-ctlcr of Notificsti(nl
_l ccnify rhar rhc fcderal rcgulations rcSuding ashcstos rcrreval arc not applicablc to this proFct.
ugr@ to comply with all Cily and County
ivcs ofthis Cily und County lo cnlcr lpon the
atovc Ncntioncd propcrty for
Appliconl or Agenl
Pemilee neme o
\lilc ahrvc is corect. I
Z
2
Cuinclor /