HomeMy WebLinkAbout30441563 - Permita City of ganta 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
Permit #: 3o,44{563
Pin #: 71773a
Project Address: 309 W Third St
Assessor's Parcel. 398-591-07 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: Yes
Suite Range:
Zoning: SD84
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
DEBORAH GILMAKER
790 N SIAVOHN DR
Orange, CA 928692589
(7141 862-7375
El lndio Botanas Cerveza Restaurant
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
51 602
51 602
51 602
51 602
51 602
51 602
51 602
s1 602
53602
51 602
51 602
51 600
51 602
57770
Qty
1.00
4.00
2.00
1.00
1.00
1.00
1.00
1.00
233.63
Fee
$14.78
$52.80
$33.54
$16.77
$46.25
$7.34
$23.12
$3e.03
$1s1.86
$100.s7
$2s2.69
$22.95
Fee Type Amount
Water Closet 14.78
Sink 13.20
Floor Drain 16.77
Floor Sink 16.77
Gas System 1-t 46 25
Gas Outlet, each Add'l 7 .34
Wtr Htr (Comm up to 50 23.12
Grease/Waste lntercept 39 03
Ptc-6s% 065
lnvestigation 1 00 57
Penalty 252 69
General Plan Update 22.95
lssuance 57.20i. :.MicrofilmffedordS ,t 3.91;
Acct * 3
Rcpt*:t12833579
Trnnsact i on TotslLuiE So
LSR Bu i lders
LSR Builders
225 North Broadway,
Santa Ana, CA 92701
(858) 437 4247
#216
State Lic #: 964743
Lic Type: B
Bus. Lic #: 343456
Workers' Compensation lnsurance:Carrier: Falls Lake
Policy #: FLA00S713
Expires: 0511212020
L2/2LtI9
n s* l, -12
1 .00
1 .00
1.00
1 .00
100
, $57.20
'$3.gt
'5r.t441i16
Building Use:
Job Type:
Nature of Work
Commerciat Occupancy:
Alteration Constr Type:
G rease I nterceptor/S i n ks/W3Code :
Consultants
Date:
Date:
Date.
-l
New sfnks, & Hydro lileChanica] Grease lnterceptor
under siril,pet PW memo filed. Change out exterior
water hgqtef, i, ,,
B
ill B
cPc 2016
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit,
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 permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#:201 8-141277
Notes:
Fee Total.
Paid to Date:
Balance Due:
P /C: Plumb i ns
t rl I l6ltt12- 536trZr-r[t:r-
11 irrof ilm & Documents
f-rl I16fi112- 177 7[r:ulrJ-
I (:L (:hecll 0Ltttttlttt?3
$+7 .67
$3.?1
$l r 2?7 .24121O2t2019
12t12t2019
Account#
Misc. Receipt: 73785
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 51602
01 1 16002 53602
01 1 16002 57770
$22.e5
$644.09
$47.67
$3.e1
$822.81
$104.19
$718.62
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS
UNDER GROUND
Waste & Vent
Water-Under floor Tt(-?A fL sc Lr7
Gas-Underf loor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back FIow
Pool HeaterlGas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back FIow Device
Rough Plumbinq
Final Gas Test
Meter Release
FINAL /28'?4)f2 Ct1 Pilrr< %r/
Notes, Remarks, EIc.rlA ,lI,
t
?II /r 'L, r-*2-r-7
I hcrctry amrm undcr pcmlty of perjury that I m exernpt fmm th6coiaracloB: Licrcnrc tlw for the folloeing rcapn Ga.'tO3l.5
Busincss ord Profcssion Codc): Any City or County which rcauim a pmit to snstfft. altcn imprcrc. dcmlish or rcpoir uy
structurc, ]rhr to ils issurec. alm rcquircs thc applicant for such Fmil to file a sigrcd strlcmnt thst he or slE b liensd pusut
to the lmvisions of thc Contrctq's Lbenrcd lru (Chsptc] 9, Commrcing with Sation 7000 of Division 3 of thc Busiress and
PrcfcssionsCode)othatheorshcisexemptthqcfromandtheb&sisforthcsllcgcdcxcmption. AnyviolationofscctionT03l.Sbyany
applicant for I pcrmit subjsts the applicsnt to I civil pcmlty of not mrc than five hundrcd dollars ($500).
_1. as owner of the propcrty. or my employc-es with wagcs as their sole comprcnsalion. will do the work and the strucrure is rrot
interdcd or offercd for salc (Scrc.7044. Busincss and hofessions Code: T'hc Contractor's Licensc law does not apply to an owncr of
thc prcperty who builds or improvcs thcreon. and who does such work himself or hersclf or through his or hcr own employces.
provided that such impmvenrcnts are not intendcd or offcrcd for sah. lf. howcvcr. the building or inqrrorrcrmnt is sold within one )asr
of completion. the Orvncr Buildcr will harr thc burden of proving lhal hc or shc dkl rrot build or imFnovc thc profrcrty for thc purgnsc of
salc).
-1.
as owner of the proFrcrty. am exclusively contracting with liccnsed conlraclors lo construct the projcct (Sec. 7W. Business
and Prrofcssbn Codc: Thc Contractor's Licensc Law does nol apply lo an owner of property who builds or improves thercon.
and who contracts for such propcts with a Contracto(s) licensed pursuant to thc Contractor's Liccnse Law).
-l
am exemrrt under Section-. B. & P.C. for this reason.
I)ale: ( )r+ ner:
lV()R Kt,' RS' C0t\l PtiNSA'l'l( tN
I)IiCI ARA'I'I()N
I hcrclly'ull-intt urttlcr pcltullY ol'pcrjurv onc ol'thc lirllou'irtrr tlccllrltions:
_l have and will maintain u Ccrtificate of Conscnt to Self-lnsurc for workcrs' conrpensation. as provided for by Scction 37fi) of the
I-abor Codc. for thc Jrcrformance of the work for which the permit is issucd.
-l
have and will maintain workcrs' conrpcnsation insurancc. as requircd by Scct ion 37fi) of thc Labor Codc. for the pcrformance of
thc work for which this pcrmit is issucd. My workcrs' cornpcnsation insurancc carricr and policy numbcr arc:
Policv Numbcr: Exnires:
-l
certify that in thc performance of thc work for which this Jrcrrnit is issued. I shall not cmploy any person in any manncr
so as lo become subjcct to thc workers' compcnsation laws of California. and agrcc that if I strould becomc subject to thc
workcrs' comJrcnsation provisions of Scction 3700 of thc l-ahor Codc. I shall. t'orthwith conrply with thosc provisions..
WARNING: Failure to sccurc workcrs'corrrpensation covcragc is unlawful. and shall subjcct an cnrploycr to crirninal pcnaltics and
civil fines up to onc hundred thousand dollars ($l in addition to lhc cosl of compensation, damagcs as provided for thc
Section 3076 of the [:tnr Ccxlc. intercst and
I
I hcrcby alfirrn under Jrcnalty of Jrcrjury that liccn:rd of Chupter 9 3
of the Busincss and Profcssions Code. and my liccnse is in full forcc anl
Liccnsc Nunrbcr:
Dnte:_)(\
I hcrcby allirm uNlcr Fnally of pcrjury thdt thcrc is a s)nslruction lending agcrcy for thc ptfmrcc of thc work for which this Jrcrmh is
issued (Sa. 3097. Civ. C.).
lrndcr's Namc:
lcndcr's Addrcss:
APPI ICANT DECLARATTON
I Mry atlirm undcr pnalty of prjury one of thc following dc.clarations:
Dcmolition Pcrmits-Asbcstos Notification Federal Rcgulations (Titlc 40. Part6)
$"q""cd Lerter of Notilicarion
_t regulations rcgarding ashc'slos rcmoval itrc lx)l applicahh this projccl.
&"n this application and slillc l hul the utxlvc ilrlorrtntiott is conecl. I agrcc to comply
rcpresentativcs of this City
with all City lntl County
ordinances and rclating to building construclion.
for inspction purynses.
hereby aulhorizc and County lo cnlcr upon thc
abovc nrcntioncd
/t>Applicnnt or
Pernrilee name
arxl
tq
Carricr:
il1Dale: