HomeMy WebLinkAbout30136931 - Permitcity of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 PIu
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
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Permit #: 3O13693{
Pin #: 63056
Project Address : 1951 E Dver Rd
Assessor'sParcel: 430-221-13 Lot:
Unit:
Block:
Btdg:
Tract:
Address Range: 1951-2OOl 5 Suite Range:
Dver Rd
Historic: No ' Zoning:
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
Phone:
Heritage OC LLC
450 Newport Center Dr #550
Newport Beach, CA 92660
(949) 706-8487
Alliance Residential Builderr
450 Newport Center Dr #550
Newport Beach, CA 92660
(s49) 706-8460
01 I 1 6002 51 602
01 1 16002 51602
01 1 1 6002 51 602
01116002 51602
01 1 16002 53602
01 1 16002 51600
01116002 51602
Fee Type
Water Closet
Sink
Dishwasher
Garbage Disp
PIC - 650/o
General Plan Update
lssuance
Amount
13.69
12.23
11.52
10.26
0.65
21.25
52.98
Qty
2.00
3.00
1.00
1.00
83.70
1.00
1.00
Fee
$27.38
$36.69
$11.52
$10.26
$54.41
$21.2s
$52.98
State Lic #: 897318
Lic Type: B
Bus. Lic #: 362720
Workers' Compensation I nsurance:Carrier: Travelers Property Casualty Company of America
Policy #: TRJUB4245B187
Expires: Ogl15l2017
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Other
New
Leasing Office
Occupancy:
Constr Type
Code:
B
lllA, sPK
cPc 2013
West, Glen
Link, Patricia
Date: Misc. Receipt: 68369
Date: 0112512017 Misc. Receipt: 70524
Date: 0112512018 Misc. Receipt:
Account# Total
Notes: fees pd on M-70524
Fee Total:
Paid to Date:
Balance Due:
Building Permit #: 10190038
Every permit issued shall become invalid unless the work on the site
authoized by such permit is commenced within 180 days after its
lssuance, 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.
$214.49
$214.49
$0.00
lnspector MID#: 2016-129880
N/A - No Balance
PLUMB!NG.INSPECTOR RECORD
APPROVALS DATE ID/S!G.COMMENTS
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildi Sewer
Area/Storm Drain
ClarifierI
TOP OUT
Waste & Vent
Water Pi
Gas
Roof Drain
Tub/Shower Test
Rou h Water Heater
POOL/SPA
rain LineP
Main Drain/Pool Pi
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn er
San
Back Flow Device
h Plumbin
Final Gas Test
Meter Release
F!NAL
Notes Remarks Etc
afplicintli)rnpcrnrilsnhicct\thc rl)plicilrltorcivilpcnrltyolrx)ttrk,rclhxnlivchun(ho(l(killnrs(S5(I)).
srlc ).
irrtl $h() (()nlrrcls lin'su(ll D!(,iccls \!ilh x (-orilrn(lor(\) Ii(cr\.(l plrr\uili1 k) lhc (irnlril!lois I-ircnsc l,iw).
-lunrcxculntUldcrscclhn-.B'&P'C.t,orlhisrcason'I)rle:--()wner:
WORKER-I' C0NIPI.'NSATION
DI'CLAIIATION
I hcrcby aflirnl undcr penohy of perjury onc of thc following delsrations:
l,xlxil' ('(x,c. lirr lhc pcrl()rnrrncc ()l lhc work lirr which lhc pcrntil is issucd
lhc s()rk l'r)r u'hi.h thir pcrnrit ir is\lrc(l I\ly r\()rkcr\' (()rnl)cr\xti()il iilstrrrncc (xnicr ril(l lr,lict_ rrunrhcr arc:
Policv Numbcr: Exnires:
_l cenify thel in thc Jrcrfornuncc of lhe work for which lhis lrcrmil is issued. I shall nol employ any pcrson in any manner
s as to tx{orc rubjsl to the workss'compcnsation laws ofCalifornia. and agm lhat ifl stmuld bcrom subjcr'l to the
workers' comJrcnulion provisions of Scclion 3700 of thc Latnr Codc. I shall. fonhwilh comply *ith llns pmvisions..
WARNING: Failurc to wurc workcrs'comlEnsalion covcmgc is unlawful. and shall subltct an cml,loyer lo ciminal FEnalties and
civil fines up to lhouund dollars (Sl00.0OO).thc cosl of provided for lhe
Sslion 3076 l-rhn intcrcst [nd allorrcy's fccs.
allirnr trcnalty ofpcrjury lhal I pmvision of Chaptcr 9 (comrrcrcing wilh Scctkrn 7000) of Division 3
of lhc Busirrcss and Proltssions Codc. uxl lill lorcc aftl ctlccl.
Liccnse
I)rte:
I hercby affirm under ;rcnally of JErjury thal
issued (Ss, 3097. Civ. C.).
lcnding agency fo, the JErfomncc of thc work for which this Frmit is
Lrndcr's Namc:
[rndcr's Addrcss:
APPI.ICANT DECLARATI(TN
I hscby amml undcr Fnally of Frjury one of thc following dcclorolions;
Demlition Permils-Asbcshs Nolificstion Fcdcral Rcgulations (Titlc 40. Part6)
-Rcquired
lxtlcr of NolilEalion
-l
rcrlil-r lhrl lhc l'c(lcrxlrcgulnliorr\ rcgrtrliog il\lt\lo\ rcrr()vnlilrc rxil npplicilhlc l() lhi\ pr(Uccl.
_l ccdily thrt I hnvc rcad this applicxtion nnd \trtc thrt lhc fllx)vc inlirtrndtion i\k) comply with illl Cily und Counly
ordinarccs and St8le kws rchling to
ahovc nrcnltnrcd propcrty for
Appli(snt or Agcnl
Pennitee ngnre . ret)
ofthis Ciryand lo thc
J)eJalz w)
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