HomeMy WebLinkAbout30138944 - PermitI
city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Plumbing Permit #: 3O{ 38944
Pin #: 446,41
Project Address:1951 E Dver Rd
Assessor's Parcel: 430-221-13 Lot:
Unit:
Block:
Bldg:A
Tract:
Address Range:
Historic: No
Suite Range:
Zoning
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Heritage OC LLC
450 Newport Center Dr #550
Newport Beach, CA 92660
(949) 706-8487
AMPAM Parks Mechanical
17036 Avalon Blvd.
Carson, CA 90745
(310) 835-1532
Fee Type
011 16002 51602 Revision
Amount
213.86
Qty
1.00
Fee
$213.86
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:
Multi-Family (5 or more uni Occupancy:
Revision Constr Type:
Revision-Apartments-Bu ; 161Pode:
R-2
IIIA, SPK
cPc 2016
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Buildins Permit #: 10190037
Every permit issued shall become invalid unless the work on the slte
authoized by such permit is commenced within180 days after its
issuance, or if the work authoized on the site by such permit is suspended
or abandoned for a peiod of 180 days after the time the work is
commenced.
West, Glen
Amsden, Julie
Date:
Date:
Date:
01125t2018
01t31t2018
Account#
Misc. Receipt: 70518
Misc. Receipt:
Misc. Receipt:
Total
Notes: Revision to 30136930-revise pipe schedule
Fee Total:
Paid to Date:
Balance Due:
q
$213.86
$213.86
$0.00
lnspector MID#: 2017-139940
t
PLUM BING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS (xvNER BtJll,lI,)R l)l l.cAl{A I'l()N
rpplicililt'orrpcnnitsuhjcctslhc applicnntkilcivilpcnxllyol'rxrlilt)rclhdnfivchun(lrr'(ldollilrs(55(X)).
_1. a\ os'ncr ol thc pfi)lrrty. or nly crnpl()yccs rvith srgcs r\ ll)cir s()lc coilrpcnsali()rl. Nill&) lhc lvork at(l lhc slrlrclurc i\ nol
thc pn,lEn) s'ho huil(l\ or inrrorcs lhtrr\nl. arrl s'ho (l(rcs such rcrlk hinrsclf or hcr\cll r)r lhrough his or hcr oslr cmployccs.
srlc l.
rnrl *ho conlract\li)rsuchprcjccl\silhi(iililrrchr(s)liccn\cdpur\uailllolhc(i)nlrncloa\l-iccn\cl.rwl.
-l
um cxempt undcr B. & P.C- for this reason.
l)al. ( )rr nt.
UQBtrEBLIIIMPJNSAIIQN
DECLARATION
I hcrcby il[firil undcr pcnulty of pcrjury onc of lhc ltrllo* ing dcclaratirts:
_lhavcilBlwill tnrintriiaCcnillcatco[ConscilthSclLlnsurcli)rsnrkcrs'conlpcnsalitrn.as pmvidedforbyScclion-17U){)flhc
l;rtrr ('odc. lirr thc pcrlbrnuncc oflhc work lirr which lhc pcrnrit is issuctl.
_lhavea[dwillnuitrltinw(,rkcrs'conllcnsatiooinsurrncc.as rcquiledhyScclion-37{X)ofthcLsborCodc.forthcpcrfornnnccol'
thc work lor which lhis pcrmit is issued. My workcrs' conrFnsalioI insurancc caricl ilnd policy nurnhcr arcl
c**, Z.Yitznr+zr.ce oF Tt*; lJgrT /, /rnPolicyoo
)Cl ccility lhill in thc l)crli)nMncc ol lhc work t'or which lhis l)crtrril is irsuccl. I shrll nol cilrfk,y nny pcrson ir any manner
WARNING: Failurc lo wure workers'comJEnstion coveE8c is unlawfirl. lnd shall subjcrt an cmphpr to aiminal Fmllis and
civil fincs up to orc hundrcd thousand dollss ($100.000). in addition to lhc cost of comJEnstion. damgcs rs providcd for lhc
Sectk)n -3076 of thc inlerest and ulkrrrey's fees.
*rn-,,, 4rl /44/nt k! !t/P €t/4 ztc4z
r rcnissn conrnarTotW
DECI.A8AIION
I hcrcby alllrm undcr ncntlry of pcrjury lhut I anr liccnrd untlcr pro!irion o, Chaplcr 9 (cotrnrtlcing s'ilh Sccliil 7(XX)) ol Dil ision .1
r)t' thc llusincss rDd Prrlissirns Codc. atrd mv Iiccnt is in full lorcc dftl cffcct.
3c )>r7L/7LiccnscNutrrhcr:kt Hec
CONS'TRUCTION I I.'NDiN(; AGENCY
i\sncd (Scc. -1097. Civ. ('. ).
trndcr's Namc:
knd$'s Addrcss:
AfILICANLDECI.ATAIIQN
I hcrcbydninnundcr pcnalty oIpcrjury uE oflhc folk)wing dcclaralhn\l
l)cnx)lithn ['crflils-Ashcstos Nolification [;cdcrul Regulillkus (Tillc 40. Ptrf,6)
-Rcquircd
t4tlcr (,f N(ililicdlion
-l
cenify thfl Ihe fcdcral rcEulalions EBEdinS asbcslos rcmval sre noI applicahlc to lhis pmjcct
_l ccrtify thal I harc rcild thi\ irpplicilti([ in(l \lutc lhat lhc xh)\'c iDli)nnxtion is cofcct. I agrcc lo comply wilh ill Cily rnd Counly
ordinarccs and Statc llws rclating to building construction. and hcrchy oflhis City and County lo cnlcr upon lhc
rtnvc rrcntioncd proJrcrly for iospcction purp(tscs.
.\ppli(ntrt or Agcnl I)ale:
Pemlte Dame (pritrt):.-lo occ a)+,/-
UNDER GROUND
Waste & Vent
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
lVain 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
F!NAL z4*.2t2,t J)e,[e #€D
Notes, Remarks, Etc
\.
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