HomeMy WebLinkAbout30142263 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 30142263
Pin #: 11450
t Proiect Address: 2845 S Fairview St
Assessor's Parcel: 931-67649 Lot. 1
Unit: I
Block: NA
Bldg:
Tract: 10220
Address Range: 2901 -Zgll
Historic: No
Suite Range:
Zoning: R4
Owner:
Address:
Phone
Elda Ochoa
2845 S Fairview Street # I
Santa Ana, CA 92704
(7141 329-8606
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 1 6002 51 600
01 1 1 6002 51 602
01116002 57770
Fee Type
Sink
Dishwasher
Garbage Disp
Genera! Plan Update
lssuance
Microfilm Records
Amount
13.68
12.90
11.49
23.79
59.30
4.05
Qty
2.00
1.00
1.00
1.00
1 .00
1 .00
Fee
$27.36
$12.90
$1 1.49
$23.79
$s9.30
$4.05
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
b{08 f h
0f f ic
Acct i
Rcpti
Trnns
ben er oI
IJl l l6LtLr2
Plumb i ns
11I6t
i crol
1116t
U
n
U
l]tBuilding Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Condominium Occupancy:
Alteration Constr Type
Si n UDishwasher/Garbage PCode :
R-2
VB
cPc 2019
oster (:nrd
C(:* : *** **r
Verduzco, Violet cl 07120t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Tota!
Notes:
Fee Total:
Paid to Date:
Balance Due:
Date:
Date:
Date:
Every permitissued 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 fhe site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
79
05
05
$23.
11$t
$138.89
$0.00
$138.89
lnspector MID#: 2020-160220
$+.
PLUM BING.INSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS 0WNER BUILI'I:R DEI,CARATI0N
I hcrchy allirm undcr pcnnlty of perjury that I {N cxcnrpt fmm thc Crnilrilck)rs' I.iccnrc hw for thc followirrg rca$n (SccJ0-11.5
Busincss lnd Profcssion Ctxlc): Any City or Counly shich rcquircs a lf,rllit k) construcl, ahcr. improvc. dcnmlish or rcpair ony
slructurc, prior to ils issuutrcc. {lso rcquires thc 0pplic0nl for such Frmil k) lilc n sigrcd slalcnEnl lhat hc or shc is liccnsd pursuanl
lo lhc provisions of lhc Conlrdchr's l,iccnsd ljw (Chilptcr 9. Commcncilg s'ilh Scclion 70(X) of Division J of Ihc Busincss aul
PRrfcssionsCode)orlhrthcorshciscxcmpllhcrcfromnndthcbasisforlhcilllcgcdcxcmption. AnyvkrknionofSationTO.ll.5byany
applic{nl i)r a Jf,rlrit suhjccls thc applicant lo a civil pcnrlly ol nol rmrc than fivc hundrcd dollffs (!is(D).,/lI-1. as owncr of lln' floJrc]ty. or my cmployccs with wngcs as thcir $lc coorlEnsali(nr. will do thc work dnd thc slructm is not
iucndcd orollcrctllirrslc(S('.TO44.BusimssandPrclbssionsCodc:'lhcCoflrilclor'sLhcnscl,uwdocsnolapplyloanowncrof
lhcpmFny whohuildsorirymrrrsthcmn.Mlwlmd(Essuchrrrrlhirnstlforhcrsclforthnrughhisorhqowncnrployccs.
providcd lhat such imp(llctrrnls arc nol incnrlctl or ollcrttl for slc. Il. hoc'clrr. thc buiHing or iilpro\cnrcill is $H wilhin oilc }{tr
ofcofiplclknr. Ihc Owncr l]uildcr will lHvc llE hurdcn ofproving thill lE or shc (lid not build or hrpn)vc thc pft,Frcdy li,r thc purF)s of
*rlc).
_1. ns owncr of lhc propcny. am cxclusivcly conlracling wilh liccnscd coilruclors k) construcl llrc prejccl (Scc. 7(N4. Busincss
anl Ptrrfcssiu Cirdc: 'l'hc Cbnlraclor's l-iccnsc L{w docs trol apply lo an owocr ofpropcrty who builds or improlcs lhcrcon.
and who conlRclslbrsuchprojccts$'ilhaLbnlmcto(s)liccnscdpursuanttrthcCoilraclor'sLiccnshw).
-l
an cxcnrpt undcr SBlion-. B. & P.C. for lhis rcrson.
Oc,Waoarc, 1 20 -LO Owner:-
I hcreby affirm undcr Fnelty of perjury one of thc folkrwing dcclarations:
-l
havc und will maintain a Ccrtificatc of Conscnt to Sclf-lnsurc for workcrs' comgrensalion. Bs providcd for by Scction 37U) of thc
Labor Codc. for thc Jrcrfornrance of thc work for which thc pcrmit is issued.
_l havcandwill maintainworkers'corngrcnsalioninsurancc.as requiredbySection.lT0Oofthc[:borCode.forlheperformunceof
thc work for which this prmit is issucd. My workcrs' conrJrensation insurance carricr and grclicy numbcr are:
Carrier:
Policv Number: ' Exoircs:
-l
certify that in thc pcrformancc of lhc work for which this Jrcrrnit is issued. I shall not employany person in any manrrcr
so as lo bccomc subjcct to lhe workers' compcnsnlion laws of California. and agrcc lhat if I should bcconrc suhjcct to the
workers' compcnsation provisions of Scction 37fi) of thc l-.atnr Codc. I shall. forthwith comply with those provisions..
WARNING: Failurc lo securc workcrs'compcnsation covcragc is unlawful. and shall subjcct an employcr to criminal gnnaltics and
civil lincs up to onc hundred thousand dollars ($100.fiX). in addition t<l thc cosl of compcnsation. damagcs as providcd for thc
t and attorney's fccs
o*", 1-2o 20 Appucanr: € td-a 0clu"a
LICENSED CON'TR/T C'TOR
DECLARATION
I hcreby atllrrn undcr pcnulty of pcrjury that I arn liccnsctl undcr provision of Chaptcr 9 (commcncing with .Scction 7firu) of Division .l
of thc Busincss and Professions Codc. and nry liccnse is in t'ull frrrcc and ctlt'ct.
License Class: License Numbcr:
Date: Conlractor:_
W
I hcrcby lmrm undcr ]Enalty of pcrjury lhat thsc is a snstruction lcnding ogcncy for thc pcrformarcc of thc work for which this lrcmit is
issucd (Ss. 3097. Civ. C.).
lander's N{mc:
Lcndcr's Addrcss:
APPI ICANT DT'CLARATION
I Myatrirmunder pcnalty of perjury one of the following declarations:
Dcmolition Permits-Asbestos Notification Federal Regulations (Title 40. Parl6)
-Required
Letter of Notifrcation
-l
ccnify th0t thc fcdcral rcgulations rcgarding asbcslos rcmovalarc not applicablc kr this prejsl.
-l
ccrtity lh{l I havc read lhis applicaliur and slatc lhal lhc atxrrc infrrrmtkrn is corNl. I a8re k) comply wilh all City and Counly
ordinanccs lnd Slalc liws rclilting to building constructkln. {nd hcrchy aulhorirc reprcsentuivcs ofthis Cily and Counly to entcr upon lhc
atxrvc mcntioned propcrly for
Applicant or Agenl
Pernritee nnme
7--o*", 1'20'70 -
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf loor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ CIarif ier
TOP OUT ,,1
Waste & Vent 0 7
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 FIow
Pool Heaterlcas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release (^l a.
F!NAL \1/!1fl41 t1 WT
INotes, Remarks, Etc.ll
lDrrrg