HomeMy WebLinkAbout30141696 - Permitl
city of santa Ana 20 civic center Plaza (M-19), santa Ana, cA927o2
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Plumbing Permit #: 3O141696
Pin #: 4554lJ
Project Address: 2148 S Bristo! St Unit: D
Block: NA
Bldg:
Tract NA
AddressRange: 2104-2160
Historic: No
Suite Range:
Zoning: C2Assessor's Parcel: 408471-17 Lot: NA
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address.
Phone:
Au Zone Santa Ana Llc
5850 CANOGA AVE 650
Woodland Hills, CA 913676573
Thomas lnternational Comp
15030 Goldenwest Cir #'l t61
Westminster, CA 92685
(657) 365-9978
01 1 16002 51602
01 1 1 6002 51 602
01 1 16002 5160C
01 1 16002 51602
01116002 5777C
Fee Type
Clothes Washer
Min Fee Adj
General Plan Update
lssuance
Microfilm Records
Amount
14.52
57.83
22.95
57.20
3.91
Qty
1.00
1.00
1.00
1.00
1.00
Fee
$14.52
$s7.83
$22.95
$57.20
$3.91
,22.91
$12?.55
t3. ?l
i772.23
Eqtciri:i37LL - l/3/2fJ2(t I0: CCUELLAR
Oif ice: iT'l'H Trurr:i: ?2 4 of 4Acci*; Refi: 311141696
ncpii102657316 - iisl?tt?tt 3:48 Pll
Tronsaction Io[aI 1772.23
State Lic #: 876125
Lic Type: A, C-10
Bus. Lic #: 367085
Workers' Compensation I nsurance:Carrier: Exempt
Policy #:
Expires:
Iitotos internaL iirrrui Compnrrg
,ieneroi Pion Updste Fee
r.ri i iri0trZ- 5i60ii00ii-
Piurb ins
rli i iriuuZ- 5i6'i200t-iiicrofiir & Docunents
r"ri i iti0u2- 5777006ii-iul uheci: 011S9
Notes: lnstall new washer within existing utility room
Building Use:
Job Type:
Nature of Work.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial
Miscellaneous
Washer lnstallation
Soto, Ricardo
Zuniga, Allissa
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B
VB
cPc 2016
09t12t2019
01to3t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
lssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01116002 51600
01116002 51602
01116002 57770
$22.95
$129.5s
$3.91
Fee Total
Paid to Date:
Balance Due:
$156.41
$0.00
$1s6.41
lnspector MtD#. 2019-154342
PLUMB!NG.INSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS OWNF:R BUll.l)llR l)l;L(:ARA1'lON
I hcrchy rffirm undcr pcnally ol pcrjur), lhill I urn cxcillfl frotrr lhc Conlrncl(trs' I-iccnsc l-ru for thc tbllosiltg rcason (Scc.70-1t.5
Ilusincrs and P(,lission C(ilc): Any City or County which rcq[ircs r lrennit l() construct. ahcr, inprovc. rlcnxrlish or rcprir any
\truclurc. prior k) its issuancc. also rcquircs thc lpplictrnl ti)r such rcfinil to lilc i signcd slrlcnrnt th:il hc or shc is liccnscd purruant
b thc provisi(rrs of lhc Coillrack)r's l-iccnse(l Lils (Chrptcr 9, Cotnnrcncing u'ilh Scction 7(XX) ol Dirision 3 of thc llusincs\ and
npflicanlli)rapcrnlitsuhjcct\lhc xpplicanln)acivilpcnxhyolnolmorclhrnlivchundrcd(lollars(S5(X))
-1.
as owrcr of lhc pmpcrty. or my cmployecs with wagcs as lhcir $lc compcnsalion. will do the work and lhe stmrc is ret
inlcndcd oroffcrcdfi)rsle(SN.7044.BusinesssndhofcssionsCodc: ThcContrsclor'sLicensLswd@snotspplylornowrcrof
lhcpmFrty whobuildsorimprorestlEmn.Bndwhodessuchrcrthimsclforhcrelforthmughhisorhcrownemployecs.
providcd thal such imprcvcmnls @ ml inlcrded orofM for sh. lf. howevs. thc buiHing or inpmvemnt is sld within orc ,cs
of onphlion. thc Owner BuiHer will haw lhc burdcn of provinS thal hc or shc did nol build or in{,mve lhc prcFEly for lhe purFrcof
sb).
-1.
us owncr of lhe prepcny. am cxclusivcly conlracting wilh liccnscd contracloF lo construct thc pmjccl (S(. 7(X4. Busincss
and ProfssionCodc:ThcContraclor'sLiccnseLawdocsnolapplylornowncrofpro[rcrtywhobuildsorimprovcsthercon.
and who contEcts for such pmje{ls with a ConlEclo(s) licensed pursunl to lhe Conlractor's Licensc Law).
lanrcxcntptun(lcrsccli()n-'B,&P'C.li)rlhisrcilsotl'
Dttc: _ , Owner:
WORI(ERS' COMPENSATION
DECI.ARATION
I hercby affirm undcr penalty ofpcrFry onc ofthc following declarations:
l-ahrr Crxlc. li)r lhc pcrloriluilcc (,1 thc rvork lirr shich lhc pcrmil i\ is\uc(l.
_l havc and ss rcquired by Seclion 3700 of lhc labor Code. for lhe lErfolmnce of
lhc work for insurancc canicr arxl g)licy numbcr ilc:
Policy
_l ccnify that in rhe pcrforronce of thc work for this FErnlil is issucd. I shall not cmploy any persn in any milner
ofCalitbrnia. and agre lhat if I slnuld bccom subjccl to lhem us to becorc subjel to thc worke6' comlrcnsation laes
workcrs'comFnsalionpmvisionsofSalion3T0OofthchtnrCodc. lshall.forthwithcomplywilhlhoscprevisions..
Scctbn 10?6 of thc tjtxrr Corle. irlcrest and
o"o, . lo 3- ?i7c
oi lhc BrciDcs{ nod Prolcssions Crrdc. aml mv liccnsc is in ltll li)rcc an(l cll'cct.
l,iccnsc Nunrltr:&Aa ll(/ l -11n
CONSTRUCTION LF'NTUNG AGENCY
lhcrchyrllirmundcrpcntrltyofpcrjurythsllhcreis.conslntclionhndilgagcncyforlhclrcrlirrmanccofthcworkforwhichlhi\fErmilis
issucd (Scc. 3097. Civ. (:.).
lrndcr's Nanrc:
kndcr's Addrcss:
APPLICAN'I' i)ECLARA'I](IN
I [r*hy allirnr untlcr pcn{lly of perjury onc of thc lirlkrwing rlcclarat ions:
I)cmolition Pcrnrirs,Ashcstos Nolillcatioil Fedcrr! Rcgulations (Titlc 40. Prn6)
_Rcquircd [.ltcr ol' Notilicrtiul
_l ccrtili'thal thc fcdcrnl rcguliltions rcgarding ashcskrs rcrmrval rrc nol upplicahlc n) this projcct.
!l.",rity rt,,n I huvc rcud Ihis rpplicxtion dnd strlc thnt thc iltnlc in,i)rnution as corcct. I rgr!rc k) comply with all Cily an(l CounIy
ordinances and Slate hws rclating lo building construction. ard hcrebyauthorizc represnlativcs ofthis qillSnd County to enlcr upon lhc
above renlioncd pmFrly for
/\pplirilnt or Agrnl
Pemile nanle
uiu, l-1-7.to
UNDER GROUND
Waste & Vent lt tllut 1 ?l.'fiM v9)
Water-Under floor L I UI,
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipino
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
[/ain Drain/Pool Pipino
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbinq
Fina! Gas Test
Meter Release
F!NAL 7t lM\...d %
EtcNotesRemarks ,I ulI