HomeMy WebLinkAbout30242613 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 302426{3
Pin #: 99884
Project Address: 1915 N Linwood Avea
Assessor's Parce!: 396-221-51 Lot: 31
Unit:
Block: NA
Bldg:
Tract 1727
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
I Tenant Name:
Crystal Ryan & Phyllis Force
850 S Yorba St
Orange, CA 92869
(7141 538-0378
01 1 16002 s1602
01 1 16002 s160C
01 1 16002 51602
01 1 16002 5777C
Fee Type Amount
Wtr Htr (Res up to 50 ge 23.97
General Plan Update 23.T9
lssuance 59.30
Microfilm Records 4.05
Qty
1.00
100
1 .00
100
Fee
$23.97
$23.79
$se.30
$4.05
Contractor:
Address:
Owner-Builder
Phone.
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Water Heater
Zuniga, nflirsff
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cPc 2019
12t10/,2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Total
Notes: Water heater replacement. Auth on file.
Fee Total
Paid to Date:
Balance Due:
Every permit rssued shall become invalid unless the work on the site
authoized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the site by such permitis suspended
or abandoned for a peiod of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23.7e
$83.27
$4.0s
$1 1 1.1'
$0.00
$11 1.11
lnspector MID#: 2020-162911
I o
PLUMBING.INSPECTOR RECORD O a
APPROVALS DATE ID/SIG COMMENTS OWNER BUTLDER DEI'ARATION
I hqcby atfm unda panalty of pajury that I m ampt ftom thc CorlBcloB' Licre Lrw for thc hllowing ren (Sc.7031.5
Buins and Prcfeion Code): Any City or County which rcquic a pcmit to ontruct, alta, imprcvg damlish or rcpair uy
structw, Fbr to its isBmcc, also rcquiB thc applicot for such pdnit to filc s signcd ststmat thd hc or slrc k licqNcd pumad
to thc Fovisioru of thc Contractor's Licascd L:w (Chapta 9. Comocing with Sction ?000 of Division 3 of thc Bwins ud
Prcf*ions Codc) or thst hc or she is cxmpt thsrtom ed thc bosis for thc allcgcd umptior. Any violation of Serion 7031.5 by 8ny
applicut for I pcrrnit subjcts thc applicmt to a civil poalty of not morc thu fivc hundrcd dollm ($500).
_1. I oms ofthc prcpary. or my cmployB with wag6 E thcir mlc compcrsaion, will do thc w* ed the stnrctE is not
intandad or offcrcd for slc (S€.7(X4, BBins ud Profeiore Codc: Thc Contrsclor's Licre t w doe not 4ply to e om6 of
thc prcpqty who hrilds or inpros ttEEtr fld who dc mh w* himsclf or hwlf or thrcugh his or ho om mploye,
prcvidcd that such imprcmr rc rct irtodcd or olfqod for sh. lf, how, thc hrildirts or hprovsffin ie sld withia m )ry
ofcorplctior! thc O!vr6 Buiklq wil haw thc hfda ofprovhg thd hc or strc dil rct tuiH or inprcw lhc propqty fu thc Frpo* of
slc).
-1.
as owner of the propqly. am exclusively contracting with licensed contractors to construct the project (Sec. 7U4, Brsiness
and Pnofission Code: The Contractor's Liccnse Law does not apply to an owner of property who builds or improves lhereon,
and who contracts for such projects with a Contracto(s) licerscd pursuant to the Contractor's License l-aw).
-l
am exempt under Section-. B. & P.C. for this reason.
I
WORKERS' CONTPT',NSATION
DECLARATION
I hereby alTirm under pcnalty of pcrjury one of the follorving declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation. as providd for by Section 3700 of the
I-abor Code. for the performance of the work for which the permit is issued.
_l have and will maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. for the performance of
the work for which this permit is issued. My rvorkers' compersation insurance carrier and policy numhr are:
_l certi& that in the performance of the work for which this permit is issued. I shall not employ any person in any manner
so as to bccome subjoct to the workers' compensalion laws of California. and agrec that if I should become subject to the
workers' compcnsation provisions of Section 3700 of the labor Codc. I shall. forthwith comply with those provisions..
WARNING: Failure to secure workcrs' compdsation coverage is unlawful. and shall subject an €rnptoyer to criminal pcnalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of comp€nsation, darnagcs as provided for the
Section 3076 of the Labor Code, interest and attorncy's fe6.
I hereby affrm under penalty .1
of the Business and Professions Code, and my license is in full force and effect.
License Class: Liceosc Numbcr:
W
I hftby amm unds pcnalty of psjury thst thsc is a constructbn lcnding ag6cy for thc psfomucc of thc wrk for *tich this Fmil b
issucd (56. 3097, Civ. C.).
kndo's Nmc:
I clttlcr's r\tlth t'ss.
APPLICANT DECLARATION
I hereby aflirm under penalty of perjury one of the following declarations:
Demolition Permits-Asbcstos Notification Federal Regulations (Title 40. Part6)
-Required
Letter of Notilication
-l
cEtify thal the fedEal regulatioN regilding rbctos rmoval uc not applicable to lhis prcjcd.
- I cgtiry thd t havc rad this application ed stalcthat the sbovc infomation is corcrt. I agrcto comply with all Cityand County
ordinancG ild Statc lrws rclating to building comtruc-tion. md hcrcby authorize rcp.6cntaliv6 of this City ud Counlyto 6tq upoo lhc
abovc motioncd prepcrty for impelbn purposa.
Applicant or Agent
Permitee nnnre
flolo'
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
ArealStorm Drain
I nterceptor/ CIa rifier
TOP OUT
Waste & Vent
Water Piping
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 Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing
Final Gas Test I
Meter Release ^ I -,1 ^l_
t^)ra,
F!NAL tqry/{/a(t0w1 wo0
Notes, Remarks, Etc.at
Owner:_
Carrier:-
Policv Number:l:rpit cs.
Date:_Contractor:
I