HomeMy WebLinkAbout30142050 - PermitCity of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA927O2 Plumbing
PermitCounter: (714')647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 3O142O5O
Pin #: 41086
Proiect Address: 231 5 S Towner Sta
Unit:
Block: NA
Bldg:
Tract 2458
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 140-1 41-04 Lot: 64
Owner:
Address:
DALE DUTTON
2315 SOUTH TOWNER STREET
Santa Ana, CA 92707
(7141 540-6291
01 1 16002 51602
01 1 16002 5160C
01 1 1 6002 51 602
01 1 16002 5777C
Fee Type Amount
Wtr Htr (Res up to 50 ge 23.12
General Plan Update 22.95
lssuance 57.20
Microfilm Records 3.91
Qty
1.00
1.00
1.00
1.00
Fee
$23.12
$22.95
$57.20
$3.91
Phone:
Tenant Name:
Contractor.
Address:
Phone:
Service Champions
3150 E Birch Street
Brea, CA 92821
(7141 777 -7777
State Lic #: 799170
Lic Type. C-36, B, C-2, C-20
Bus. Lic #: 196430
Workers' Compensation I nsurance:Carrier. EVEREST NATIONAL INSURANCE COMPANY
Policy #. RM8WC00044191
Expires: 0 512912020
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Plumbing
Occupancy:
Constr Type:
Code:
R-3
VB
cPc 2019
Notes: Plumbing
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
v Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
web_user 04t0612020
Account#
Every permit rssued 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 site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
N/A
N/A
No Balance
No Balance
Fee Total
Paid to Date:
Balance Due:
$1 07.1 I
$1 07.1 8
$0.00
lnspector MID#: 2020-1 58515
PLUMBING-INSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS OWNERBUILDERDELCARATION .
I hcrcby a{lirm undcr penalty of pcrjury thot I m cxcmpt fKrm the ConlractoN' Licnsc kw for thc following rcasn (54.7031 5
Busincas and Prcfession Codc): Any City or County which rcquircs a Jrcrmit to onstruct, Elter. improrc. demlish or rcpair aiy
structrc. Fior to ils issuare. dm rcquircs the applicant for such permit to lilc 8 signed statcmnl lhat he or slE is lien$d pusatt
to thc lf,ovisions of thc Contretor's Lien$d kw (Chapts 9. Commercing wilh Sslion 7000 of Division 3 of thc Busircss an{
Prcfcssions Code) or that he or shc is excmpt thcrcfrom ild thc h&sis for thc allcgcd cxcmption. Any violation of Sstion 70.1 I .5 by sny
applictrnt for a lrcmit subjsts thc applicant to I civil pemlty of not mre thsn fivc hundrcd dollars ($50o).
_1. as owncr of lhc propcrty. or nly employccs wilh wagcs ts lhcir sole conrpcnslti()n. s,illdo lhc work and lhc slnrcturc is not
irrtcrdcd orolTcrc(l l'or salc (Sec.70.14. Busincss and Proficssions Ccxlc: Thc Contraclor's Liccnsc [-aw does nol apply lo an orvncr of
lhc pnrpcrly who builcls or improvL's lhcrcon. and who does such work himsclf or hcrsclf or lhrough his or hcr orvn cntployccs.
providcd that such irnpnrvenrcnts arc not intcndcd or olli:red ltlr salc. lt. howcvcr. thc huilding or irnprovcrncnt is sold within onc ycar
of conrphtion. thc Owncr Buildcr will havc thc hurdcn of proving lhat hc or shc tlitl rxrt build or irnprovc thc propcrly ftrr thc purlxrsc of
sah).
-1.
asownero[the propcrty. anrcxclusivclyconlrrcting wilh liccnsctl contraclors to conslntcl lhc'projcct (Scc. 71A4. Busincss
and Pnrli:ssi<llrCoclc: 'l'hcCorrtractor'sLiccnsc[,awdocsnotapplyloanowrrcrot'propcrtywh<lbuildsorimprovesthcrcon.
arxl who conlracls ttrr such projccts with a Contractor(s) liccnscd pursuanl lo lhc Contraclor's Liccnsc Law).
-latttcxcmplundcrScction-.B.&P.C.t.orlhisrcasrrn.
fl6t6. (lr.,nar.
WORKERS' COMPENSATION
DECI ARATION
I hercby affirm under penalty of pcrjury onc of thc following declarations:
-l
havc and will maintain a Ccrtificale of Conscnt to Self-lnsurc for workers' compensation. as provided for by Section 3700 of thc
Labor Code. for the pcrfornrance of the work for which the Jrcrnrit is issued.
-l
havc and will maintain workcrs' compensalion insurance. as required by Scction 37fi) of lhc labor Codc. for thc performance of
thc work for which this prmit is issucd. My workcrs' com[rcnsalion insurancc carricr and plicy numbcr are:
Carricr:
Policv Number: Exoires:
_l ccrtify that in the pcrfornuncc of the work for which this pcrmit is issued. I shall not cmploy any person in any manncr
so os to bcconrc subject to thc workcrs' compcnsat ion laws of Culifornia. and agrcc that if I should bccome subjcct to the
workcrs' compcnsation provisions of Section 37fi) of thc lxtnr Code. I shall. forthwith comply wilh thosc provisions..
WARNING: Failure to secure workcrs'compensation coverage is unlawful. and shall subject an employcr to criminal pcnalties and
civil fincs up to one hundrcd thousand dollars ($100,000). in addition to thc cost of comJrcnsation. damages as providcd for thc
Scction 3076 of the latnr Codc. intcrcst and attorncy's fees.
I ):r I r':
I ICENSED CONTRAC'I'OR
DECLARATION
I hcrcby aftirrn undcr pcnalty of pcrjury that I anr liccnscd urrdcr provision of Challtcr 9 (comrtrcrtcing with .Scclion 7000) ol'l)ivision 3
of lhc Busincss and Profcssions Codc. and my liccrtsc is in full lorcc and eltcct.
License Class: License Number:
flolo.
W
I hcrchy affirm under Jrcnrlty of Frjury thst lhcrc is a construclion hnding agcncy for thc psformancc ofthc sork for which this Jrcrmit is
issucd (Scc. 3097, Civ. C.).
kndcr's Nam:
kndcr's Address:
Appl tclnl nrct.lR.lrloN
I lrrcby aflimr under pcnalty of prjury onc of thc following dcclarations:
Dcnmlition Pcrnrits-Asbcstos Nolification Fedcral Regulations (Titlc 40. Part6)
-Rcqu
ired Lcllcr of Notification
-l
ccrlify thit thc fcdcral rcgulations EgardinS asbcstos rcmvaluc nol applicablc to this pmjcct.
-l
ccnify that I hrvc rcad this application 8rd statc that thc atnvc infomllion is coret. I a8re to @mply with all City 8nd Counly
oKlinanccs and Stalc kws rchting to building construction. ild hcrcby authoria reprcsntstives ofthis Cily and County to cntcr utFn the
ahovc mntioned prcpcrly for inspcrtion purposs.
Applicant or Agent Signature:
I'erilrilN ilililrc (pritrll:
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf Ioor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ CIarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trao/Drain Line
[Vlain Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heaterlcas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCao
Back Flow Device
Rouqh Plumbinq
Final Gas Test T\
Meter Release ,rt \l
FINAL la-lb.h D P)UI
EtcRemarks