HomeMy WebLinkAbout30134238 - Permitcity of santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Plumbing Permit #: 3O{ 3,423A
Pin #: 2{ 096nt
Project Address: 3640 S Bear St
Assessor's Parcel: 412433-04 Lot: 1-8, A, B, C
Unit: L
Block: NA
Bldg:
Tract:11859
Address Range: 3600-3770
Historic: No
Suite Range:
Zoning: R4
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Brett
3640 S Bear
Santa Ana, CA 927032543
(s62) 773-9978
Orange !nstallers
905 E Chalynn Ave
Orange, CA 92866
(714) 348-9040
FeeType Amount
01116002 51602 Wtr Htr (Res up to 50 g: 19.62
01116002 51600 General Plan Update 19.46
01116002 51602 lssuance 48.52
Qty
1.00
1.00
1.00
Fee
$19.62
$19.46
$48.52
Phone:
State Lic #: 511971
Lic Type: C-36
Bus. Lic #: 322104
Workers' Compensation lnsurance:Carrier: Security National lnsurance Company
Policy #: SWC1018292
Expires: 0110712015
I ronl
Jrqne
iener.llllr
'Iurb
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Wr"rn"roez, Kathy
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: interiorlocation
Fee Total:
Paid to Date:
Balance Due:
Condominium
Miscellaneous
Water Heater
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-2
VB
cPc 2013
12t01t2014
Account#
01 1 't 6002 51 600
01 1 16002 51602
$19.46
$68.14
$87.60
$0.00
$87.60
Every permitissued sha/l become invalid unless the wofu
on the site authoized by such permit is commenced within
180 days after itsissuance, or if the wo* authoized on the
site by such permit is suspended or abandoned for a peiod
d 1 80 days after the time the wo* is commenced.
lnspector MID#: 2014-118078
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
UNDER GROUND
Waste & Vent
Water-Underfloor
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
Ptrap/Drain Line
Main Drain/Pool Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Misc
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release
(I It -2-FINAL 5 Itn "l O DW)) a:7r6 /
Notes, Remarks, Etc.ut,- t
Orrncr-Euildcr Dccluation
I hgcby aflim unda pcmlty of pcrjury thst I am .xcmil form the Contrsctors' Liccn* kw for tlrc following r@tr (sE 7031.5lEin6s
ud Prcf6sioo Codc): Any City or County which rcquiru r pcmh lo o6tBcl. ahfi. improvc. dmolish or rcpah ey structua. dh.' to fu
issuncc, rlso rcquirc thc spplicsot for such pcmh to filc a rigncd 3tEtmcot thrt hc or shc b liccEd puBusd to thc prcvisior o-rthc
Conmcmr's Lienscd Law (Chaptc 9, Commcrcing with S61ion 70OO of Division I of thc BBin63 rnd ProfB3ioB Co&) or thst hc or
shc is cxempt thqctom and thc bssi! for thc rllcgcd cxcmption .Any viohtiotr ofscction 703 1.5 by uy rpplicmt for s pcmh lubjccts thc
applimt to r civil pcmhy of rct morc the five hudrcd dollm ($500).
_1. 6 owncr of thc prcpqny, or my employcd with wagcs I thcir solc coap€ffation, will do thc work ud thc atructuc is not intrndcd
or off€red fo, slc ( 56.7044, Bwin6s snd ProfBsionr Codc: Thc Contractor's Liccroc Law doa not apply to 8n owrcr ofth! prcps'ty
who buil& or improvB thcrco, md who doe such work hiruclf or hGlf or through hb or h6 owtr cmploycB, providcd thlt such
imprcvmcnts uc not intcndcd or otfacd for slc. lf, howcvq. thc building or improvmmt is sold wilhin onc y6 of complction. thc
Owu-Buildq *ill havc thc budcn of proviDg thlt hc or shc rct build or improvc for th€ purposc of elc).
_1. a o*nq of thc prcpclty. m crcluivcly contnctitrg wilh liccNcd contnctoG to @Ntruct thc Fojet ( Str. 7044. Buio6i md
Pofsion Codc: The Contrrdor'i Lienrc bw doa mt apply lo rn omq of propcny who builds or improve thcron , and who
contracs for ruch proj6B with I Contndor(r) lic@scd pursunt to th. Contrador's Liccn* [rw.).
I m cxcmpt under Scction & P.C. for this roon.
Date:Owno:
WORKERS COMPENSATION DECLARATION
I hscby sflim und6 pcmlty of pojury on€ of thc following delsratioN:
_l hsvc and will maintain a Ccnificatc of Coscnl to Sclf-lnsure for workers' com;rcmtion, as provided for by Setion 37OO of the
[:bor Codc. for thc pcrfomncc of thc work for which thc pmit is issucd.
_l have and will maintsin wortcrs' ompemtion insurance. r required by Section 1700 of the Lrbor Code, for the perforroncc of thc
work for which this permit is issued. My workers' compenution insurancc caric ad policy numbcr arc:
Cuicr:
Policy Numbcr:
(This setion necd not bc complctcd ifthc pcmit is for Chc hundrcd dollaB {$1001 or lcss)
_l ccfliry thst
beame subjet r
is i$ucd. I shsll not cmploy any pcron in any manncr so s to
to thc worken' ompen*tion hws agre that if I should subjat to the workers'
compcosation provisiom ofS6tion 3700 ofthc hbor I shall.
WARNING: Failure to secure workcrs' compensation covcragc is unlawful, and shall subjcct m to qiminal pcnaltics and civil
fines up to one hundred thousand dolla6 ($100,000),in addilion lo lhc cost ofcotnpensation. darnflges as providcd tor thc Seclion 1076 of
the Labor Code, interest and attorney s fees
LICENSED CONTRACTORS DECLARATION
I hocby.ffm undq pcultyof pcrjury thal I m licoscd uods prcvision of Chaptr 9 (@mcncing wirh Sectiotr 7000) of Divbion 3 of
thc BBim lod Prcfosioro Codc, md my liccc is in fuU forcc md cff(t.
in lhc pcifomncc of thc work for which this pmh
ofCalifornir, rnd
I rce'nsc'( hss
Date:
CONS TRI'C'IION LENDING AGENCY
I hereby aflirm under pcnally ofperjury that there is a conslruction lcnding agcncy for thc pcrfonnance ofthe rvork for which this perDit is
issued (Scc. 1097. Cir. C.).
Lender's Namc:
APPLICANT'S DECLARATION
Dcmlition Pmib-Asbcstos Notificstion Fcd68l Rcgulations (Titlc 40, Prn 6)
_ Rcqutcd t ttqofNotificrtion
_l ccfliry thst thc fcdral rcSulatioro rcguding sbBtos rcmoval ec not applicsblc lo this prcjst.
_ I ccrtiry that I havc rcad this application and statc that thc above infomation is corcct. I agrcc to comply with all City and County
ordimncG and Ststc lrws rclating to and rcpr6cntEtivcs ofthis City Etrd County to cntcr upotr thc
Pmittc tmc (print):
Fxnir.c.
lrnds's Addr8r