HomeMy WebLinkAbout30141401 - 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 ft(
Permit #:3fJ'1414ll1
Pin #: 60338
Proiect Address: 3809 S Timber St
Assessor'sParcel: 410-062-19 Lot: 31
Unit:
Block: NA
Bldg:
Tract: 6433
Address Range:
Historic: No
Suite Range:
Zoning: R1
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
OAVIDV&JOMINTZER
3809 S TIMBER ST
Santa Ana, CA 927074950
(714)'812-8012
Green Home Development
6501 Sausalito Avenue
West Hills, CA 91307
(818) 941-0540
01 1 16002 51602
01 I 16002 51602
01116002 51602
01 1 16002 51600
01 1 16002 51602
Fee Type
Sink
Dishwasher
Garbage Disp
General Plan Update
lssuance
Amount
13.20
12.44
11.08
22.95
57.20
Qty
1.00
1.00
1.00
1.00
1.00
Fee
$13.20
$12.44
$11.08
$22.95
$57.20
State Lic #: 1031586
Lic Type: B
Bus. Lic#: 374025
Workers' Compensation lnsurance:Carrier: State Fund
Poficy #: 9238142
Expires: Ogl13l2O2O
Botchi:52332 - ltt/3/20t9 I0: ELIZABETH0ffice: CTYH Tronsf: 64 4 of 5Accti: Ref*: 30111{0f
Rcpti:02770344 - t0/3/2019 l2r02 ?n
Tronsoction Totol t715.16
Green Home Oevelopment
Building Use:
Job Type:
Nature of Work:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling OccuPancY:
Alteration Constr Type
SinUDishwasher/Garbags PCode:
R-3, U
VB
cPc 2016
$22.95
,?3.?2
$715.20
( $0. (r4 )
change out for kitchen remodel
Planning Conditions:
Verduzco,
Date:
Date:
Date:
Buirdins Permit #: 101101709
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within360 days after its
issuance, or if the work authorized on the site by such permit is suspended
or abandoned lor a period of360 days after the time the work is
commenced.
viorenl{10/03/2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
01 1 16002 51600
01 1 16002 51602
95
92
$22
$93
$116.87
$0.00
$116.87
lnspector MID#: 2019-154876
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hacby allim unda pcnalty of po'jury thal I m cxempt from thc ContractoG' Licsc Law for thc follou.ing r@n (Ss.7031.5
Busine and Prof*ion Codc): Any City or County which require a pmh to congruct. alt6. improvq dmolish oi repeir oy
structurc. [rior to its iswce, ako requirG thc applicilt for such tmit to file a signcd statmot rhat hc or shc b licoscd pwuet
to lhc prcvisioB of the Contmctor's Licmsed law (Chapts 9. Commencing with Scction 7000 of Division 3 of thc Busins md
ProfcsionsCodc)orthathcorsheisercmptthscfromedthebasisfortheallegedexmption. AnyviolationofscctionT0Sl.5byany
applicanl for a p€mit subjtrts lhe applicant to a civil penahy of not morc than fivc hundrcd dollus ($500).
-1,
c orvno of thc propcrty. or my €mploy$ with wag6 6 lheir sole compmsation, will do thc work md lhc strucluc is not
intoded or off6ed for ele (Se.7044, Bsins and Prcf6sions Code: Thc Conlractor's Licmsc Law do6 not apply to an ownq of
the prcpcny who builds or imprcve ths@n. md who do6 such uork himsclfor hesclfor threugh his or hd own cmployces.
providcd that such impro!'mmts ilc f,ot intmdcd or offtred for sle. If. hosd(. thc building or improvmmt is $ld within one y@
ofcomplction. th€ OMq Buildq will have thc hrda ofprcving thal hc or shc did not build or improvc the prepoty for the purlnsc of
sle).
-1.
romaoftheprop6ty. m crclNivelycontractiilg wilh licmsed conlractoclo construct lhc prej$t (S(. 7M4. Buins
md PmfsionCodc:TheContractor'sLicenseLawdocnotapplytomown6ofpropcflyrvhobuildsorimproveth6eon.
and who contmcts for such trojds with a Contmcto(s) licrucd pusuanr to lhe Contractor's l-icffc Law).
I arn erempl unds S(tion , U. & P.('. for lhis rcason.
l)ile:ONner:
WORKERS' COI\IPENSAT'IdN
DECLARA ]ON
I hacby affim undc p€mlty of pqjury onc of the following dalrations:
-l
havc and will mintain a Certificste of CoNsl to Self-lnsurc for work*' compwtion. r pmvidcd for by Sstion 3700 of the
tabor Codc. for thc pofommce of the work for which thc pqmh b issucd.
_l havc md will maint.in $ork6'Setion 3700 of the Labor Codq for thc pofnmmcc of
thc work for which this permit is ised.cmic and policy numbo ue:
Policy l;rpircsr
-l
ccfliry lhsl in thc psfomance of the work for which lhis pcmit is issued. I shall not mploy any pcmn in any monc
s s 1o bccomc aubjet to the Nork6' compsstion laws of Califomia. and agrc thd if I should bccomc aubjGt to thc
wortm' compwtion prcvisioro of Section 3700 of the t bor Cod€. I shsll. fonhwith comply with thos prcvisionr..
WARNING: Failurc to sure workm'compmation covmge is unlarvful. and shall subjrt m mployfi to qiminal pqnhie and
civil fincs up lo one hundred thowmd dollars ($100.000), in addition to thc cost of compqnsation. damagcs o providcd for the
S{lion inls6t md attomcy's fe6.
\
pE('l,An n()N
of lhc l]usirrcss and Profssions Code. md rnv license is in full lirrcc antl cll-cct
\ o \srcNunrhcr:
l)ate:o
CONS'I'RUCI'ION t,ENDING ACEN('Y
I hoeby allirtn under lmalty o f pejury lhal lhtre is a conslrucl ion lendirg agoc.v for I hc pofonnance of lhe srrrk for rvhich this fmit is
issucd (Sr. .1097. Civ. C.).
[rnd6 s Namc:
Lcods's Addrq:
APPLICAN DE('LARATION
I hoelry affirm undo penalty ofpojury one ofthe follos ing declarations:
Demolition Psmits-Asbeslos Notilicatiof, Fed6al Regulalions ('l ille 40. Pm6)
Raluircd Lettq of Notification
I cdiry lhat the fedral regulatioro reguding 6b6tos rmoval tre not applicablc to this prcjcct.
-l
cotiry that I havc rad this applicaliotr fid statc that the above infomation is corct. I agrc to comply wilh all City and County
ordinancs md Statc Larvs relating to building comtruclion. @d hseby aulhorize relrGotativs ofthis
above mentioned pmpety for impation
Applicrnt or Agent
Pernilee nnme
City ild Counly to
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
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
t/I ,11 .^R)
Rough Plumbing ,au%D7
Final Gas Test il
Meter Release I
FINAL
Notes Re Etc.
(-ailicr:
,,",., I arl
Tub/Shower Test
r//y ry
,
T)ffV Vr 6(*5/
l0
ll
I