HomeMy WebLinkAbout30441914 - PermitPermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Project Address: 1614 S Standard Ave
Assessor's Parcel: 014-24'l-26 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning: C1
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing Permit #:30,441914
Pin #: { 8O3{
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Nguyen & Pham
10012 E Garvey, #4
ElMonte, CA 91731
(714) 470-6068
Mathew Paleteria
USA Builders & Constructio
791 W. Brookhurst Street
Anaheim, CA 92804
(714) 448-9533
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51600
01116002 5't602
Fee Type Amount
Water Closet 14.78
Sink 13.20
Floor Sink 16.77
Wtr Htr (Comm up to 50 23.12
Penalty 252.69
General Plan Update 22.9s
lssuance 57.20
Qty
1.00
6.00
4.00
1.00
1.00
1.00
1.00
Fee
$14.78
$79.20
$67.08
$23.12
$252.69
$22.95
$57.20
t2?, ?E
t4?6' t-17
t3.91
tlr688.?9
Phone
State Lic #: 1043259
Lic Type: B
Bus. Lic #: 375069
Workers' Compensation lnsurance:Carrier: State Compensation lnsurance Fund
Policy #: 9236070
Expires: OBIO4I2O2O
01 1 16002 57770 Microt"' E38g[$,r4Jln - 1A1tn,;,2,'-, 1r$Q or*.ortlr?l:0ffice: CTYH Trans*: 185 3 of 6Acct*: Refl: 30411916
Rcpti:02891427 ' 2/l(r/2920 3:22 Pn
Tnonsoction Totsl tl16SS,99
USA Builders & (:onstructionr I
Building Use:
{Job ryp",
Nature of Work:
Commercial
Tenant lmprovement
Tl/Walk-ln Coolers
Occupancy:
Constr Type:
Code:
B
VB
cPc 2019
General Plon Updute Fee
01116002- 5160(10110-
PIurb i ns
01 I 16tr02* 51602trtr0-
11 icrof i lr & Doculents
t:rl I 160tr2- 5777otr(r(r-
ICL Check 9419
Plumbing for T.!.
Planning Conditions:
Planning Approval By: Date:
Plan Checked By: Date:
Permit lssued By: Chavez, Dave Date: 0211012020
Subject to Field: <7 ?' Account#
Buirdins Permit #: 104101533
Every permit issued shall become invalid unless lhe work on the site
authorized by such permit is commenced within 360 days after its
lssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2019-154524
01 1 16002 51600
01 1 16002 51602
01116002 57770
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes
Fee Total:
Paid to Date:
Balance Due:
$22.95
$494.07
$3.91
$520.93
$0.00
$520.93
I
I
PLUMB!NG-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS ()lVNT'R BUILDI'R I)IiI,CARATIoN
I hcrcby rllirm undcr pcilalty of fcrjury lhat I rtrt cicnri liom lhc (i'nlriclors' Liccnsc l.arv lirr thc folkr$irg rcavrn (Scc.7o-ll 5
Busincsr and l,rol'('\sion C(xlc)t Any City or C(ilnty \\tich rcqrircs a 1-..nril lo conslntcl. allcr. imprrlc. dcnxtlish or rcprir any
struclLtr.c. pri()r to il\ issuxtcc. al\() rcquircs thc ipplicint lbr \uch lErnril lo lllc r signcd slalcirnl lhat h( or \hc is liccnscd pursuant
k) thc pft)!i\i()ns oI tlrc Contrxcl()r's Liccnscd [-aw (Chrplcr 9. Coilril]cncing rvilh Scclirri 7(XX) ol t)ivisi()n -l ol'lhc Busincss xt(l
applicdntlirrnNrnrilsubjcctsthc ilpplicanlhilcivilpcnrllyofnolnr)rclhdnlj\chundrc(l(lollnrs(35(X)).
_1. ns {rwncr ol lhc prolErtv. or nry cnll)loyces wilh Nascs as thcir \olc conlfcn\ation. \'illtkr thc rok aml tlE struturc is not
thc p()ltrty lvho huilds or iml)rovc\ thcrq)n. ilkl who (l(rs such *ork hirn\cll or hcrsclfor lhr(rulh hi\ or hcr own cillpl()yccs
\xlc l.
_1. as owncr oflhc ptupcny. tnt cxclusivcly conlraclinS s ilh Iiccnscd coDlrtrclors h con\lnrcl lhc Pmjccl (Scc. 7(X4. Busincss
and Errlissir Codc: Thc Conlractor's Licensc [,aw docs nol npply lo an owncr oIpropcrly who huilds or irnprolcs lhcrcon.
and who contracts for such p(r.rccts with a Conlrnclo(s) liccnscd pursuanl lo lhc Conlrncktr's l,iccnsc Law).
-l
{ilIcxcnlil undcr Scclt)n-. Il & P.C-. Ibr lhis rcuson
Drte:-Orrncr:
]1!}8f,8&5:C0UPIINSATIAN
DECLARATION
I hcrcby alllrm undcr pcnahy of pcrjury one of thc following dcclaral ions:
_l havcandwill maintni[u(trlilicrteofC]onsc[lhSclf-lnsurcli,rworkcrs'compensalion.ils providcdforbyScctbn3Tmofthc
Lat{)r Cqlc. for lhc perfornuncc ofthc work for which thc pcrmit is issued.
_lharcandu,illmaintainworkcn'compensalioninsurancc.as rcquircdbyScclion-17(X)ofthclaborCodc.forlhcPctfornunccof
lhe work lir which lhis pcrmit is issuc{. My workcrs' conrpcnsalion insurancc canicr arxl grlicy tlutrlbcr ee:
Policy
_l cenify lhat in rhe pcrforrorcc of the work for which lhis Jrermit is irsued. I shall not employ 8ny Jrcrmn in any manrcr
m as to becom sub.ic<l to thc wotkss' omJrcnstion lsws of Califomia. and sgEc thal if t should bcrom subjtrl to tlE
worksi' comlEnsation provisions of Scrtion 3700 of lhe kbor Codc. I ihall. fonhwilh comply with tlFs Pmvisions..
WARNINGI lrailurc lo $curc workcrs'comJrensalion covcrage is unlawful. and shall suhject 8n cmploycr to oimirul penaltics and
civil fincs up to ore hundrcd thoussnd dollars ($l(n.fin).
Scclion 3076 oflhc trbor Codc. inlcrcst and atlorrcy's fccs.
i0 addilion lo thc cosl of drnragcs as pr()vidcd li)r lhc
t
Appli(snt:
DIICLASAIIQN
('l' lhc []!\incs\ and Pn)lc\\i(,n\ (i{!c. an(l nty liccrsc is in lull li:rcc antl clli'ct.
Lir.ur.cl,rrr, t 6 LicctrscNuilrhcr:
o,,",9--J-qz=.2 2o-
W
I hcrchy {ffirm undcr tEnulty of pcrjury lhat thcrc is a conslruction hnding agcrcy for thc prforroncc of thc work for which this FErmil is
issucd (Scc. 3097. Civ. C.).
kndo's Narc:
-
Lcndcr's Arltlre'ss:
APPI ICAN'I DECLARA]'IoN
I ltru+,) xliirnr urilcr pcnnll) ol l)criury onc of thc lirlkrwing dcclaratirrrrs:
Dcmolirion l'crnrils-Arhcclos N(iliticalir)n Fcdcral Rcguhlions (l'illc.lo. I'rfl6)
-Rcquircd
l,cllcr of N(nillcilli(il]
ccnify that lhc fedcralrcgulations rcgeding {sbcslos remvaluc n(il spplicable lo this Projet.
ccnify thnl I havc rcad lhis applicalion and slalc lhal lhc at[vc wilh all Chy and Counly
and Counly to enter uFFn thc0nd St{tc Llws rclulinS lo building
mntioncd propcrty for inspcclion
ApplirilDl or A,lrnt
Pemite nrme {
D,k,2-ta'Z?-
UNDER GROUND
Waste & Vent Z//i/44/
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm 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 Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbinq
Final Gas Test
Meter Release tl
FINAL t4 l0 w F(KV,o\-*g
I tNotes, Remarks, Etc.I
4;
71t -4
o,c, c c;\-l^'2-o7.'