HomeMy WebLinkAbout30142005 - Permitcity 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 ftf
Permit #: 3O{ 42OO5
Pin #: 53388
Proiect Address: 2002 W Alton Avea
Unit:
Block:NA
Bldg:
Tract 88
AddressRange: 2000-2012
Historic: No
Suite Range:
ZoningAssessor's Parcel: 412-541-07 Lot:
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Christ Our Savior Catholic Parish
13280 Chapman Ave
Orange, CA 92868
(7141282-3012
Christ Our Savior Church
Bayley Construction L P
800s sE 28th st
Mercer lsland, WA 98040
(714) 540-8863
Fee Type
01 1 1 6002 51602 O/T lnspection
01 1 1 6002 5160C General Plan Update
011'16002 5777C Microfilm Records
Amount
166.53
22.95
3.91
Qty
4.00
0.00
0.00
Fee
$666.1 2
$0.00
$0.00
s666. I
State Lic #: 1027512
Lic Type: B
Bus. Lic #: 374089
Workers' Compensation lnsurance:Carrier: First Liberty lns Corp
Policy #: WCG291444206049
Expires: 1213112020
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Plurb r ns
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1656. rl
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
O,,,..M
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
Commercial
New
O/T lnspection
Zuniga,
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
N/A
N/A
cPc 2019 Ok to issue O/T lnspection for tl/G plumbing on Friday,
31612020. lnspector: John Pham @ 7 14-240-3585
Contact: Ethan Barnett 7 1 4-929-077 0
$666.1 2
$0.00
$666.12
03t05t2020
Account#
Every permit issued shall become invalid unless tf,e work on the site
authorized by such permit is ammenced within360 days after its
issuance, 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.
lnspector MID#: 2018-148026
0't 1 't6002 51602 $666.1 2
PLUMBING-!NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I h6cby affm unda pmalty of pcrjury that I m exmpt frcm thc ContractoE' Licre kw for lhc following r@n (Ss.7031.5
Buin6s ed Profsion Cod.)r Any Cily or County rvhich requirB a pqmit to construct. altq, im!trovq dmolish or rcpair any
slructuc, prior to its isumcc. also rcquirc the Eplicmt for such pemit to 6le a signcd statmmt that hc or shc b lic@rcd pwumt
io thc Frovisiom of lhc Contmclor's Liccn*d Larv (Chapl6 9. Commocing rvith Sstion 7000 of Division 3 of thc Buine ud
ProfcssionsCodc)orthatheorshciscxcmptthqcliomedthcbsisfortheallegedcxcmpion. AnyviolationofscctionT0-1l.5byany
applicant for a pmit subj(ts thc applicsnl to a civil poalty of not morc the five hundrcd dollus ($500).
-1,
I oMq of thc fopcdy, or my mployc with wag6 I thcir solc compcroation, will do thc work ed thc struclw is trot
intqdod or oFcrcd for ele (56.7044, Bwins ud hofsions Codc: Thc Contraclor's Licoc law doc not apply to u omr of
the propsty who builds or improve tluarr Ed who do6 such rcrt hiroelf or hwlf or thrcugh his or ho ow mploye.
providcdthstsuch improlqrcl$erctintodcdorolfqcdforslc. lf.howdc,thctuiHingorirnprcvcrcntisrcHwithinonc]qr
ofcompk iotr thc Orra Buikb will havc tlrc hudo ofFoving thd hc or shc did not build or imprcvc thc prcpcty for thc prrpos of
sh).
l. as o$rro ofthe propoty. au crclusively conlracling $'ith liccils.ai conlracloE k) consrnrct the proisl (Se. 7044. Busirres
and I'nrfsion('ode:-[heConlraclor'sl-icensel-awdocsnolapplyloano\rnerofproperly\!'hobuildsorimprovesthercon.
and \vho contracls for such proie(ls lvilh a Contracto(s) licensed pulsuant lo the Contract(rr's License l-arv).
I am cxen)pl undq Selion . Ii. & P.('. for this rcason.
()N ner:
WORKERS' COIIPENSATION
DECI.ABAIIAN
I hacby rffm undc poultyof pojury onc of the following dcluatiorc:
I halc ancl s'ill ntaintain a ('cnilicale ofConsenl to Self-lilsurc fol srrrktrs conrpensation. as proriricd for by SGtion 1700 ofthc
l,atxrr('odc.forlhepo'fornranceofthc\rorkfor$]lichlhepornilisissucd.
I hnve and will maintain workers'Strtion 3700 of lhc kbor Codc. for thc pcfomocc of
the rvork for which this pmit is cmiq md policy numbs [e:t Car -^\rClr
Policy
. wrt/Ao
-
I cenify (hal in lhe psfomancc of the work for which this pomit is issued. I shall not mploy any poson in any mmn(
I 6 to bccomc subject to thc work6' compensation laws of Califomia. and agre that if I should bacome subjcct lo thc
workss'compansalionprovisionsofScction3T00ofthelrborCodqlshall.forthwithcomplywiththospmvisioN..
WARNING: Failure to scurc workm'compmsation coverage is tularvful. and shall subjet an mployo to oirninal psultie md
civil hnes up to one hundred thouund dollare ($100,000), in addition to the cost of compcnsation. dmags 6 provided for the
Sqtion -1076 of thc t bor Codc. irt66t and attoB's fG.
x/AD
DECT.,1RA ION
I hctcby alfirrn under pmally of ptrjury lhat I am licensc<l untler prr)\ ision ofChaptft 9 (commencing s'ith Sction 7000) of Dit'ision l
of thc llusincss md Prclssions Code. md rny licose is in full forcc md effect.
4 \ot'15\&Liccnsc
Drte:
Number:
-l/5/Po"ro
CONS'I'RU('I'ION I,ENDINC ACEN('I'
I hcteby aflirrn under penall! o f per iur)' lhat thse is a conslructi()n lcncling agmcy- for the pcfonnancc of lhe rsork for s hich this pcrnit is
issucd (Sec. 3097. Civ. C.).
lrnds s Namel
l,ender's Address: __ _
APPLICANT D3:CLARA'I'ION
I hottyaflim undo pmalty ofper.jury one ofthe follos'ing delarations:
t)ern<rlition Pqmits-Asbestos Notification Fedsal Regulations (-l irle 40. Pan6)
Requied Lel(s of Nolifi cation
with all City and County
ild County to mls u[nn the
above molioned propdy for
Appllcrnt or Agetrt
Permlle name
*,..91 t//t>N
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing
Fina! Gas Test
Meter Release
FINAL
Notes Remarks Etc.
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Cmis
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