HomeMy WebLinkAbout30142626 - PermitCity of Santa 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 #: 30142fi,26
Pin #: 39336
Project Address: 510 W Park Ln Unit:
Block: NA
Bldg:
Tract: 1|471
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 002-037-39 Lot: 40
Owner:
Address:
Margaret lsom
510 W Park Lane
Santa Ana, CA 92706
(7141 558-027s
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 1 6002 51 602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type
Water Closet
Bathtub
Shower
Sink
Sewer Alter/Repair
General Plan Update
!ssuance
Microfilm Records
Amount
1s.32
23.97
23.97
13.68
47.95
23.79
59.30
4.05
Qty
2.00
1.00
1.00
3.00
1.00
1.00
1.00
1.00
Fee
$30.64
$23.e7
$23.97
$41 .04
$47.95
$23.7s
$5e 30
$4.05
Phone:
Tenant Name:
Contractor:
Address:
Edy's Plumbing, lnc.
8650 Katherine Ave.
Panorama City, CA 91402
(818) e84-2584Phone:
State Lic #: 1031830
Lic Type: C-36
Bus. Lic #: 373219
Workers' Compensation lnsurance:
Carrier: Exempt
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Alteration
Repair Sewer/Fixtures
Occupancy:
Constr Type:
Code:
R-3, U
VB
cPc 2019 Notes:direct change out of fixtures
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Verduzco, Violet .is
Date:
Date:
Date:11t25t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
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 rs 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
$23.79
$226.87
$4.05
Fee Total:
Paid to Date:
Balance Due:
$2s4.71
$0.00
$254.71
Inspector MID#: 2020-1 62959
a
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/S!G.COMMENTS OWNEN BUII,I)ER DET.CARATION
I hacby affm uadc poulty of pcrjury thd I m qmpt from thc ContrrtoB' Licge Lrw for thc following mn (Soc.7031.5
Buins ard Proftssion Codc): Any City or Cou[ty which rcquiro a pomir to @rdrucl. altc, imprcvg &rnolish or rpat uy'
struclurc prior to its i!ffic slso rcquic thc sppli(rut for such pcrmit to filc 8 signcd nd6ot tha hc or rlp b licqsed pmant
to thc prcvisios of thc Contretor's Licascd L:w (ChsP6 9. Comocing with Sctiotr 7000 of Division 3 of thc Buiae md
Prcf6ioB Codc) tr thst hc or shc is ampt th@from ud thc bdis for thc sllcgcd umpaion. Any violation of Setiotr 7031.5 by my
applicmt for s pcmit suqiers thc 8pplicut to a civil p€nrlty of not mrc tha fivc huorH dollm ($500).
_1. a om6 of thc pmpary. or my mplolc with wag6 a thcir $lc @mpcnsstion, will & thc work ad thc stnrctw b rct
intandod or ofircd for sslc (Se.7044. Buitrs md Profciom Codq Thc Contractor's Lic@ law do6 mt apply to m omc of
thc propqry who builds or inTos tlEEc ad wlE d6 srch wrl himrclf or hqslf or thmugh his fi hq om cmploycq,
providcd that sch impromts m mt htardcd or oftrod for slo I[ hoM, tlE building tr inprcHmt is sU wfuhin onc ]a
of conplabo thc Ovma Builda wil hlw thc brd6 of povirg 0u hc u shc dil mt build or in4rcrc thc propsty 61 0E Brpoe of
sb).
_1. a owM of thc Fopsty. m acluivcly contractitrg with licqEcd contrac-toF to oruilrud tlE projct (S6. 7044. B6in6
ard Prcftssbn Codr: Thc Contrctor's Liccffi kw doB ml spply to s om6 of propqty who builtls or imprcvB th6@n,
md who ontmcls for such lrojcts with 8 Contrrcto(r) lknlcd pumnt lo thc Crntrrlor's Licre L:w).
-l
m cxcmpt udg Satioo-. B. & P.C. for thb ra$n.
f lo lo'
EOBTEBSSOMfTNSAIIAN
DECIdBAITON
I hcrcby affrm unda poaltyof pcrjuryonc of thc following d6lu8tioE:
[i[-l havc md will miilain a Cqrificarc of Conmt to SclfJmurc for rcrkss' compcosation. u prcvidcd for by Sction 3?00 of thc
tabor Codc. for thc pqfommcc of thc wort for which lhc pqmit b isucd.
€.5r
the
have and will maintain 3700 of the Labor Code, for the performance of
\\'ork [0r u'hich this and policy number are:
3 tl - l t4'/4?-l
fut certi$/ that in the performance of the work for which this p,ermit is issued, I shall not employ any pcrson in any manner
so as to become subject to thc workers'compe$dion laws of California, and agree that if I should become subjcct to the
worters' compc.nsation provisions of Sec'tion 3700 of the L^abor Code, I shall. forthwilh comply with thosc provisions..
WARNING: Failure to sc'cure workcrs'an anploycr to oiminal penalties and
civil fines up to one hundred thousand damages as provided for the
Scction 3076 of the Labor Code. interest and attorney's fees.
erru, l\-?5'24?A
I hercby affirm under pcnalty of perjury that I am licensed (commencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
Number: \0 St rF o
r jkz,cALicense
W
I hcrcby affum unds p€nalty of pcrjury tha thrc ir a coNiruc{bn knding ag6cy for th€ pGfomilcc of thc rcrt for which thb p6mit b
issued (Ss. 3097, Civ. C.).
Lcndq's Nmc:
Lcndcr's Addrcss:
APPLTCANT DECLARATION
I hereb)/ aflirm under penalty of pcrjury one of the following declarations:
Dernolition Permits-Asbcstos Notification Fcderal Regulations (Title 40, Parr6)
-Required
Letter of Notification
_l ccrti$ that the federal regulations regarding asbestos removal are not applicable to this project.
_l ccrti0 that I have read this application and state thal the
ordinances and State Laws relating to building construction.
above mentioned propcrty for inspection purposes.
Applicent or Agenl ^,"i-L\-?L{L 0
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT ,tl
Waste & Vent rZlr u1 D4417
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Piping
Fill Line/Back Flow
Poo! Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCao
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release
FINAL
Notes, Remarks, Etc.
,
Dr.". l\-Lr -?-0?O ConlrRctor:_
Permiteenrme tprtnO, h1 F.'tl L-O,l'f 2
)r