HomeMy WebLinkAbout30138943 - Permitcity of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Plumbing Permit #: 3O{ 38943
Pin #: 99O5EPermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853 ;J
Proiect Address: 1951 E Dver Rd Unit:
Block:
Bldg: A
Tract:
Address Range:
Historic: No
Suite Range:
Zoning:Assessor's Parcel: 430-221-13 Lot:
Owner:
Address:
Heritage OC LLC
450 Newport Center Dr #550
Newport Beach, CA 92660
(949) 706-8487
Fee Type
01 1 16002 51602 Revision
Amount
213.86
Qty
1.00
Fee
$213.86
Phone:
Tenant Name:
Contractor:
Address:
AMPAM Parks Mechanical
17036 Avalon Blvd.
Carson, CA 90746
(310) 835-1s32Phone:
State Lic #: 775747
Lic Type: C-36, C-20
Bus. Lic #: 193982
Workers' Compensation lnsurance:Carrier: lnsurance Co. of the West
Policy #: VWE5035003
Expires: 1110112018
Building Use:
Job Type:
Nature of Work:
other occupancy:
Revision Constr Type
Revision-Parking Structure-Fode:
A-3, S-2
IB
cPc 2016
Planning Conditions:
Planning Approval By Date:
Date:
Date:
Misc. Receipt: 705'18
Misc. Receipt:
Misc. Receipt:
Total
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
West, Glen
Amsden, Julie
01t25t2018
01t31t2018
Account#
Every permit issued shall become invalid unless fhe work on the site
authoized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permit is suspended
or abandoned for a peiod of 1 80 days after the time the work is
commenced.
Fee Total:
Paid to Date:
Balance Due:
$213.86
$213.86
$0.00
lnspector MID#: 2017-139940
Notes: Revision to 30136885-revise pipe schedule
t
PLUMB!NG.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OIVNI,IR lltJll,l)llR lrLl,CARA'l'l( )N
Ilusinc.s an(l Prolc\\ir)n (i)dc): Any City or Counlv rvhi(h rcquircs n lErilril lo cot\lnr(l. rllry. iirprorc. dcnmlirh or rt-pair nnl
upplicantlbrrpcrilritsuhlcctsthc applicrnlk)rcivilpcnaltyoln([nx)rclhrill-ivchur(lrc(ldollar\(S5{x)).
l. x\ owncr ()l thc ptol{rty. or nly cnrphyccs rvilh wrgcs r\ lhcir \olo conpcnsation. sill (l(, lhc work r,il llt slnrlurc i\ In{
srlc ).
_1. as owrer of lhc proIEny. .m cxclusively contraclinS wilh licensd contr.clore lo onslrucI thc pmjcct (S€. 7(X4. Busincss
and Prof6sbnCodc:ThcContraclor'sLicenseLawdmsnotapplyloanowncrofpmFErtywhobuildsorimproveslheron.
and who conlmctr for such tmjccls with I ContBctor{s) liccnsd pursuanl to thc Contraclor's Liccns Law).
I xnr cxcilrDl urilcr Sce tion-. ll & P.C. li)r lhis rcason.
lhlc: ()w[er:
\YOItKI{tS' CONlPliNSAll()N
t)t,rcL,\ti^'il(-)N
I hcrchy al l'ir nr rrrrler lrnrllv ol l)crilrry ()nc of thu lolkrs irg rI:chr rt ionr:
_l havcaftlwill nuintainaCenilicillcofColscnltoSclflnsucli)rNorkcrs'conrpcn{rtirnl.rs providcdforbyScclionlT{x)oflhe
Lahor Code. for lhc lcrli)rilrilncc ol-lhc work frrr *'hich thc pernrit i\ issucd.
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have and will mintain workcrs' compcnsalion insu,ame, as rcquircd by S6tion 3700 of the kbol Code. for the performrcc of
thc work for which this pmit is isnrcd. My workos' comJnnsation insurance @ier ald Jnlicy number m:
T pS rt*-r^rcrsr o t tt+€ tJcsf 7
o
2Lr ccnify that in thc pcrlbrnuncc ofthe work for which lhis pcnnil is issucd. I shsll nol cmploy any pcrson in any mrnncr
s Bs to bccore subj$l lo lhc workcrs' comlEnsatior lsws of California. and agrcc lhal if I should 'e|*om subFct to tl&
workss'compcnsalionpmvisionsofSclion3T00otthctitnrCodc. lshall.forthwilhcomplywilhlhorcpmvisbns..
WARNING: Failurc to surc workers'comfrcnsation covcmge is unlawful. and shall subject an cmploycr to fiiminal Fmllics and
civil fincs up to onc hundrcd thousand dollss ($100.0t0), in addition lo the cost of comfEnsation, drmges rs pmvided for the
Scclion J076 inlcrcst and altormy's fccs.
.q /(f €LAppli$nl:
7o ugso1 ICIiNSID CON'I'RACTOR
l)ltcLARr\1'loN Ll-O.Y o
ol lhc llu\inc\\ nnd I',r)lc\sir)ns Co(lc. {ild nty liccnsc ir iil lirll li)rcc rnd clli'cl.
C-7 c '77f771
Nunrber:n /,+t kf alect*
CONSTRUCIIoN I F:NDINC ACENCY
Ihcrchyal'lirnrrndcrpcnnltyofpcrjurylhalthcrci\{co0struclionlcndingagcncyforthcpcrfr,rnrilnccoflheworkforahichlhilltrmilis
issucd (Scc. 3{}97. Civ. C.).
l-eildcr's Naillc:
lrndcr's Addrcss:
APPLICiINT I)ECLARATION
I hcrcby allirnr undcr pnrlty of pcrjury onc of thc folkrs'iIg dcclarat ions:
[)cnnlilion l'crmits-A\lE\to\ Notillcation Fcdcrrl RcSuhtions {1 ilIc.10. Pan6)
_Rcquircd [-cltcr r)l Nrililicilliur
_l ccrtily thnl thc li\lcrrl re Inlxliotrs rcgil(|iil8 ashcsl(,s rcrnoval arc nol rpl)licrhlc lo lhi\ proir'(1.
-l
ccrlify that I hrvc rcad lhis af,plicalbn aftl slalc lhal lhc sh)vc is corccl. I agre to comply wilh all City afrl County
ordinances and Stste [jws rclating lo huilding conslruclion.rcprcscnlali\rs oflhis City and Counly lo cnlcr lFn llrc
abovc mntiorcd pmlEny for inslEction purlnscs.
Toteqt
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf loor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouoh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill LineiBack Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitarv SeweriCap
Back Flow Device
Rouqh Plumbinq
Final Gas Test
Meter Release
FINAL 7-2*'zaa J).5tf '@
Notes, Remarks, Etc.
(*",-I
Conlre(krr
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