HomeMy WebLinkAbout30142519 - PermitProiect Address: 1830 E Nineteenth Sta
Assessor's Parcel: 396-352-19 Lot: 7
Unit:
Block: NA
Bldg:
Tract NA
Address Range: 1g2g-1934
Historic: No
Suite Range:
Zoning: Al
City 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
Permit #: 301425{9
Pin #: 77382
Owner:
Address.
Phone
Tenant Name:
Contractor:
Address:
John Johnson
1830 E 19th St
Santa Ana, CA 92705
(7141 483-1 217
Pro Star Builders
17412 Ventura Ste 151
Encino, CA 91316
(866) 772-6161Phone
State Lic #: 1053661
Lic Type: B
Bus. Lib #. 376410
Workers' Compensation I nsurance:Carrier: State Fund
Policy #: 9266353
Expires: 1213112021
Building Use:
Job Type:
Nature of Work:
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Alteration
Bathroom Remodel
Zuniga,^rV
Occupancy.
Constr Type:
Code:
Date.
Date:
Date:
R-3
VB
cPc 2019
10t15t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Plumbing for guest bathroom remodel.
Fee Total
Paid to Date:
Balance Due:
Building Permit #: 1 01104959
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the sife by such permit ts suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Inspector MID#: 2020-1621 80
01 1 16002 51600
01 1 16002 s1602
01116002 57770
$23.79
$1t227
$4.05
$140.1 1
$0 00
$140.1 1
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
51602
51 602
51602
51 60C
51 602
5777C
Fee Type
Water Closet
Bathtub
Sink
General Plan Update
lssuance rr _r,rtL,:hi::i{
Microfilm BppQr* (
A - -L.L r
Hl.-l-- L v .
Amount
15.32
23.97
13 68
23.79
59i30
I 4,05
Qty
100
100
100
1 .00
1.00
100
Fee
$ 1 5.32
$23 97
$13.68
$23.79
$5e.30
$4 05
oLo
tJ 1 1 l6ttt:t2
PLUM B!NG.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER DUILDER DELCARATION
I hmby affm unda pcnalty of pct'ury thrt I m cxcmpt from thc ContracloB' Licre tiw for thc following l@n (Sc.7031.5
Buincs ud Profsion Codc): Any City or Cowty which rcquira a pomit to @nstruct, altq. improvc danolish or rcpoir my
3tructurc. Fbr to its isumcc. also rcquire thc eplicmt for such pcnnit to filc I signcd stdqmt thal hc or shc b licq&d plmut
to thc provisiom of thc Contrctor's Liccnscd lzw (Chaptq 9. Commmcing with Setion 7000 of Division 3 of thc Buhs ud
Prcfsions Co&) or that hc or shc is smpt thactom ed thc bssis for thc sllcgcd qmprion. Any violation of S€rioo 7031.5 by ey
spplicutforapcmitsubjetsthc applicuttoacivilpcn8ltyofmtmorcthafivchundrcddollm($500).
-1.
as owner ofthe property. or my cmployees with wages as lhcir sole compensation.
intendod or offered for sale (Sec.7O44. Business and Professions Code: The Contractor's Liccnse Law does not apply to an owner of
the property who builds or improves thcron. and who does such work himself or hcrself or through his or hcr own employees.
provided that such improvonents are not intcnded orofferod for sale. lf. howcver. the building or improvement is sold within one year
of complaiorL the Ourner Buildcr will have the hrden of proving that he or shc did not build or improve the propoty for the purpose of
sale).
-1.
as owner of the prop€rty. am exclusively contracting with licensed contractors to construct the project (Sec. 7044. Brsiness
and Pnofession Code: The Contractor's License Law does not apply to an owner of propcrty who builds or improves thereon.
and who contracts for such projects with a Contracto(s) licenscd pursuant to the Contractor's Licensc taw).
_l am exempt under Section-. B. & P.C. for this reason.
I ):tlt' ( )tr rtcr'
WORKERS' COMPENSATTON
DECTI\RATION
I hereby affrrm und€r penalty of perjury one of the following declarations:
-l
have and will maintain a Certificate of Conscnt to Self-lnsure for workers' compensation. asl pnovided for by Section 3700 of the
Labor Code, for the pcrformance of the work for which the pcrnrit is issued.
-l
have and will maintain workcrs' compensation insurance, as required by Scction 3700 of the labor Code, for the pcrformance of
the work for which this pcnnit is issuod My workcrs' compensation iruurance carrier and policy number are:
Policy N"^b*, -/ q2-(9b\t> Expires:tZ-Z)-Zc
_-l certi& that in the performance of the work for which this permit is issued, I shall not anploy any person in any manner
so ,rs to become subject to the workers'compensation laws of California. and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code. I shall. forthwilh comply wilh those provisions..
WARNING: Failure to s€rcure rvorkers'is unlawful. and shall subject an onployer to criminal groraltics and
civil l-rnes up to one hundred thousand ($addition to cos of compensation, damages as Eicvided for the
Section 3076 of the tabor Code. interest and attorney's
o -\5-
I hereby affirm under penalty of perjury that I am licensed 9 (commencing with Section 7000) of Division 3
of the Business and Profcssions Code. and my licensc is in full force and effect,
Numbcr:5>abl
-
W
I hatby affmudr pqultyof pcjurythd thft b a onnrudbn lcoding agmy for thc pqforrltmc ofthc rcrt 6r whichthis psmit b
issuod (Sc. 3097, Civ. C.).
lrnder's Namc:
I-ender's Ad&ess:
APPLICANT DECLARATION
I hereby affinn under penalty of pcrjury one of the follorving declarations:
Demolition Pennits-Asbestos NotiFrcation Federal Regulations ('l'itle 40. Pan6)
-Reauired
Lctter of Notification
-l
certi$ that the federal regulations regarding asbestos removal are not applicable to this project.
_l certi& that I have read this application and state that
ordinances and State Laws relating to
above mentioned property for
Applicant or Agent
Permitee neme
orr", lo-6'u
UNDER GROUND
Waste & Vent #
Water-Under floor
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent'f
Water Piping
Gas Pipins
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back FIow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCao
Back Flow Device
Rough Plumbins
Final Gas Test /
Meter Release tl I AI /d/
FINAL u//6/4t lffrltfr I6/6tJ
Notps, Remarks, Etc.t\
I /
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