HomeMy WebLinkAbout30136932 - Permit/.#_\ City of Santa Ana 20 Civic Center Plaza (M-1e), Santa Ana, CA s27oz t,rT]f
ery Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section. (714) 647-5853 W
Permit #: 3O{36932
Pin #: 654{9
Project Address: 1951 E Dyer Rd Unit:
Block:
Btdg
Tract:
Address Range: 1951-2001 E Suite Range:
Dyer Rd
Historic: No ZoningAssessor's Parcel: 430-221-13 Lot:
Owner:
Address:
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
01116002 51602
01116002 51602
01 1 1 6002 51 602
01116002 51602
01 1 16002 51602
01 1 16002 53602
01116002 51600
01 1 16002 51602
Fee Type Amount
New Sewer (First 100') 62.18
Add'l Sewer Connection 21 .42
Gas System 14 42.85
Water Service (Each 10 42.85
GreaseMastelntercept 36.15
PIC - 650/o 0.65
General Plan Update 21.25
lssuance 52.98
Qty
1.00
1.00
1.00
1.00
1.00
199.44
1.00
1.00
Fee
$62.1 8
$21.42
$42.85
$42.85
$36.15
$129.64
$21.25
$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: Ogl15l20'17
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Other
New
Commercial Shell A
West, Glen
Hernandez, Kathy
01t25t2017
0112512018
Account#
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B
IIIA, SPK
cPc 2013
Misc. Receipt: 68369
Misc. Receipt: 70524
Misc. Receipt:
Total
Notes: fees pd on M-70524
Buildins Permit #: 10190039
Every permit issued shall become invalid unless the wo* on the site
authoized by such permit is commenced within180 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.
$409.32
$409.32
$0.00
lnspector MID#: 2016-129880
N/A - No Balance
Phone:
Fee Total:
Paid to Date:
Balance Due:
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildino Sewer
Area/Storm Drain
lnterceptori Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
[t/ain Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SeweriCap
Back Flow Device
Rouqh Plumbinq
Final Gas Test
Meter Release
FINAL 2.??.?lu,Dd"b a)
Notes, Remarks, Etc.
()lVNUR UtJil,l)t;R t)tit,CARATt()N
rpflicrnlli)raFrnril\uhjccl\lhc rpplicxnlk)ilcivilfcnilhyol'noliil)rclhinllvehundrcJdollnr\(S5(X)).
_1. &s owrer of the prclErty. or my emplo)es with wagcs as lheir $le comlf,nstion. will do lhe worl ard thc smfurc is ml
interdcd oroffercd for sl€ (Sa.7O44. Busircss and Pmfessions Codc: Th. Conlmdor's Licens lrw dcs nol agply lo sn owrcr of
thc profEny who builds or irpmm 0E@tr Ed who d6 sh mrt himsclf ot hcNlf or thrcugh his or hcr own crnployccs.
prcviied that such imprcremnts m mt interded or offercd for sh. lf. howew, lhe building or inprcwmnt is sld within orc ,tu
of @r{,btion. 0E Owrcr BuiHc will harc thc burdcn of proving that hc or sh€ dU ml tuild or iqrcw thc Imfrrry for the purlns of
sle).
anrl $ho conlrncls li)r snch pfiiiccts qilh n ('()rilrilclo(\) liccilsc(l pnr\uilnl k) lhc Conlrircl(n r l-iccn\c l.irrv).
lilnlcxclnnlundcrScclb[-.t}'&P'C.lirrthisrcason.
WORKFRS' COIIIPFNSATION
DECLARATION
I hcrchy aflirm under pcnahy of pcrjury onc of the follow ing dcclarut ions:
_l havc and will mintain a Ccnificalc of Conscnl lo Sclf-lnsurc for wotkcrs'compcnsalion. fls providcd for bySstioil l7U) of lhc
titx)r Code. for thc pcrfonmncc of lhc wotk for which lhc l--rmil is issucd.
_l havc and will maintain *orkcrs' compcnsrlion insurancc. 0s rcquircd by Scction -1700 ofthc tntDr Codc. for thc pcrfornunrc of
thc work for which lhis pernit is isscd. My workcrs' cofllrcnsalkrn insurance caricr ilxi lmlicy nunrbcr arc:
Policv Numhcr: Exoircs:
_l ccnili thal in thc pcrfornrrncc of lhc ivork for which this pcrmit is issucd. I Nhnll not cnlpk,y rny pcrsoo iil any nlilnncr
so as k) trcoilE subjcct h lhe workcrs'c(,nrl)cilsrlion laws ol'Crlilbrnin. nnd agrcc lhal il I shoul(l hcc()nN silh.iccl lo lh('
workcrs'conlpcnsati(rnprovisirmsofScclir)nJ7(X)oflhcl,ahrrCorlc.lshxll.forlhwilhcomplywilhlho\cnrovision\..
WARNIN(;: Frailurc k) scure workcrs'conrlEnsrition covcragc is uillawful. and shall subjcct an cilrpk)ycr h qirnhul FEmllics dld
civil fincs up to hundrcd dollnrs {$l(X).0(X)). iil hn to cost of compcnsation.for the
Seclion 3076 I -atxrr inlcrcsl rod slk)rncy s l'ccs.
I htlr:
I hcrchy aflirm undcr Jrcnally ofpcrjury lhal I am Uer{d pmvision of Chapter 9 (comrcrcing wilh Sccthn 7fin) of Division .1
of th€ Busiress aod Prcfessions Codc, and my flccnsc full fore and cffccl.
[.iccnsc
I hcrchy al'lirnr undcr [Enrlty ol pcr iury thrt lhcrc
issucd (Scc. .1097. Civ. C.).
agcncy for thc pcrform{ncc ofthc work for which this fEnnil is
lIndcr's Nailic:
lrnrlcr's Arldrcrr:
-
APPLICANT DECI ARATION
I hcruhy aflinrr undcr penally of pcrjury onc r)f lhc folkrwiilg dcclarations:
Dctrr)lilion Pcrmils-Asbcstos Nolificatiol Fcdcral RcSultrlionl ( l'illc 40. Pan6)
-Rcquircd
Lcttcr of Nolificstion
_l certify thar the federal rcgulations rcgading asbcstos rcrmval are ml applicablc to this pmjccl.
-l
cedify lhol I havc rcad this applicalion ud statc lhal lhc abovc infornulion is I agre to comply wilh all
ordinarces and State hws rclatirg to
atx)vc mnlioned pmpcny for
,\ppliciltrl or,\gcnl
Pemilee nanre (
ofrhis City rnd
and County
thc