HomeMy WebLinkAbout30133271 - PermitPermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Project Address: 2130 N Grand Ave Unit:
Assessor's Parcel: 396-19144 Lot: POR G.L. RUSSE Block:A
Bldg: Address Range:
Tract: A.B. CHAPMAN Historic: No
Suite Range:
Zoning: Rl
city of santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Plumbing Permit #: 3O{ 33271
Pin #: 7OAO2
Owner:
Address:
Phone:
Tenant Name:
Contraclor:
Address:
Phone:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Alliance Church of Orange
2130 N Grand Avenue
Santa Ana, CA 92705
17141542-0777
Alliance Church of Orange
Rindtek
1440 E 28th Street
Signa! Hill, CA 90755
(310) 696-8271
01 1 16002 51602
01 1 16002 51602
0'1116002 51602
01 1 16002 51602
01 1 16002 51602
01116002 5'1602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
Fee Type
WaterCloset
Urinal
Shower
Sink
Dishwasher
Garbage Disp
Floor Drain
Drink'g Fountain
New Sewer (First 100')
Add'l Sewer Connection
Gas System 'l-4
Gas Outlet, each Add'l
Wtr Htr (Comm up to 50
Primary/Secondary Roo
Deck Drains E
Hose Bibb
State Lic #: 966844
Lic Type: B
Bus. Lic #: 346862
Workers Compensation lnsurance:Carrier: Benchmark
Policy #: CST50049i l
Expires: 0211912015
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Other Occupancy:
New ConstrType:
New Church/Roof Mtd EquiPCode:
111600253602 P/C-65%
Amount
12.53
9.59
19.62
11.20
10.56
9.38
't4.23
7.89
56.94
19.62
39.24
6.23
19.62
39.24
8.48
13.64
0.65
19.46
48.52
Qty
12.00
5.00
2.00
10.00
1.00
1.00
1.00
2.00
1.00
1.00
1.00
8.00
1.00
7.00
3.00
4.00
919.32
1.00
1.00
Fee
$150.36
$47.95
$39.24
$112.00
$10.56
$9.38
$14.23
$15.78
$56.94
$19.62
$39.24
$49.84
$19.62
$274.68
$25.44
$54.56
$597.56
$19.46
$48.52
A-3
VB
cPc 2013
01116002 51600 General Plan Update
011 16002 5'1602 lssuance
Notes:
Date:
Scott Fazekas & Assoc. Date:
Hernandez, Kathy Date:
09t08t2014
10t02t2014
Account#
Misc. Receipt: 61837
Misc. Receipt:
Misc. Receipt:
Total
:t*:Lt1;J7
RrrSoct r or
\N
Buildins Permit #: 10180945
Every permit lssued shall become invalid unless the work
on the site authoized by such permit is commenced within
1E0 days after its lssuance, or if the wo* authoized on the
site by such permit is suspended or abandoned for a peiod
d 180 days after the time the wo* is commenced.
lnspector MID#: 2014-113352
01116002 51600
011'16002 51602
01 1 16002 53602
$19.46
$987.96
$14.25
Fee Total:
Paid to Date:
Balance Due:
$1,604.98
$583.31
$1,021.67
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.gOMMENTS 0wner-Builder l)eclar8lion
I hereby affrrm under penalty ofperlury thal I anl exenlpl form lhe Conlrsclors [-rcense liw for the following reason (sec ?0:l l. 5 B.sin6s.
and Profession Code): Aily Cily or Counly which requircs a permil lo construct. altcr. improve. denrolish or rcpair any structure. prior to its
issuance. also rcquite the applicant for such petmit kl filc 6 signcd slalenrcnl that hc or shc is liccnscd puBuanl to thc prolisiom oithe
Contractor's l-icensed Law (Chapler 9. Conrmencing wilh Seclion 7000 of Divisfun 3 of lhe Business and Prof*srons Code) or that hc or
shc is exempl thereftom and lhc basis for the sllcgcd excntption .Any violation of Seclion 70.1 L5 by any applicant for I penbit subj.:ts lhc
applicant to a ci!il penalty ofnol morc lhan li!c hundrcd dollars ($500).
_1, s own6 of lhc prcpcny. or my cmploycG with wag6 as lhcir solc compcnsation. will do thc work snd thc atructuc is not iot.nd.d
o, offctcd for $lc ( S*.7044, Busin6r rnd Ptofasions Coder Thc Cootrsclo.'s Licc6c Lrw dos not .pply to an omer of thc prcpcny
who buildr or improvB thqcon. and who do6 $uch work himsclfor heBclfor th.ough hir or hcr own employecs. providcd thsl such
improvcmcnls arc not inlcndcd or offcrcd for ralc. [f. howevcr. thc building or improvcmcnt is sold within on. ycar ofcomplction. thc
Ownq-Buildcr will hrvc thc burdcn of proving thst hc or shc not build or imp.ovc for thc purposc ofsalc).
_1, I ownq of thc propcny. am crclusivcly conlracling with liccGcd cont6ctoG to coNtrucr thc projcct ( Str. 7044. B6io6s and
Profcssion Code: Thc Contttdot's Liccnse llw do6 not apply to .n oM.r ofpropdty who builds or inrprove th.ron , 6nd who
contracts for such proj*ts with a Contractor(s) liceNad pursusnt to lhc Contracto.'! Lic.nsc law )
_l am cxcmpt undcr Scction _____.8. & P.C. for lhis rcason
Datc:()uncr:
WORKERS COMPENSATION DECLARATION
I hc.cby aflirm undfi pcnally ofpcrjury onc ofthc following d(laratios:
_.1 have and u ill mainlain I Ccrtificalc ofConscnl to Scl[-lnsure for workers compensation. as provided for by Section 3700 ofthe
l-atx)r ('odc. for the perforrnance ofthc work for which lhe pennit is issued.
_l have and will rointsin workers' @mpenslion insunnce, as rcquircd by Section 3700 of thc trbo, codq for Ihc performncc of thc
work for which this p€rmit is isued. My workos' ompcnstion irsumce canio and policy numbcr uc:
( rrrrcr
Policy Numbcr:__Ii\pircs
(This scclion nccd nol bc conrplcled iflh. pcrmil is for (he hundred dollsB l$1001 or less)
_ I cenify that in (hc performancc oflhc work for which this pcrmit is issuld. I sh&ll not cmploy any pcmon in any manncr so as to
bec8me subJEl to lhe workers ' compenution hws ofCalilornia, and sgre that rf I should beconre subj(t to the workers'
('rxlc. I forlhw thosc
coverage is unlawful. and shall to qiminal penaltics and civil
fm6 up to onc hutr&cd thoMd dollm ($100.000).in ddition to the cosr of
thc Lsbor Cod., intcrBl and attorncy's f6
damagcs r providcd for thc Setion 3076 of
LICENSED CONTRACTORS DECI.ARATION
I hscby aflim undcr pcnalty ofpetjury thst I m liccnscd undcr provilion ofchsptcr 9 (commcncing with Scction 7000) of Division 3 of
thc Businc$ and Prof6sio6 Codc. and my liccroc is in full forcc md cffcct.?8//Liccnse Nunrbcr 6 6
.Contrsclor:
I hrcby aflirm undtr pcnalty of pcrjury thsi thcrc is a coNtructiotr lcnding agcncy for thc p€rfomrncc of thc work for which this pcmit is
issued (Sec. 1097. ('iv. C.).
Lender's N!mcr
Lender's Address
APPLICANT'S DECLARATION
Dcmolition Pmits-Asbcstos Notification Fcddsl R.gul6tions (Titlc 40. Pan 6)
_ Rcquircd t ttcrofNotification
_l ccnify that thc f€dcralrcgulations rcgarding sbestos removal ilc not applicablc to this projcct.
_ I cc(iry that I hsvc red this applicEtion and statc that thc sbove infomation is concct. I agrcc to comply with all City and County
ordinancB snd Statc lrws rclating to building coNtruction. ud sulhorizc rcprGcntalives ofthis Ciry and
abovc mentioned propcrty for inspection
ApplicEtrt or agcnt sig.:
Pcrmittcc namc (print):
Dalc:p 0
lo upon lhc
UNDER GROUND l) llt,//L -rbWaste & Vent 4'l b///.Ubq,@)
Water-Underfloor
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Misc
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing
Final Gas Test t
Meter Release Jl nl th 'frS/(0//t41 .
I
FINAL
Notes, Remarks, Etc.
Datc:
WARNIN(;
Dale: