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HomeMy WebLinkAbout30441920 - Permitcity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Plumbing Permit Counter: (714\ 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714\ 647-5853 Permit #: 3o,44192lJ Pin #: 46359 Project Address: 2434 S Broadwav Assessor'sParcel: 410-381-03 Lot: NA Unit: Block: NA Bldg: Tracti NA Address Range: Historic: No Suite Range: Zoning: M'l Phone Tenant Name GENE L FELLING 2220 S LOARA ST Anaheim, CA 928023914 (7141775-773s Owner: Address: Contractor Address: 0'1 1 '16002 51602 01 1 16002 51602 01 1 16002 51600 01 1 16002 51602 01116002 57770 Amount 7.22 252.69 22.95 57.20 3.91 Fee $28.88 $252.69 $22.95 $57.20 $3.91 Fes Typo Cap Fixtures Penalty General Plan Update lssuance Microfilm Records Qty 4.00 1.00 1.00 1.00 '1.00 Phone Botch+:5{335 - 2/I.L/2O2O I0: nnoroleslF office: CTYH Tr$ns+: l?l 2 of ?Acct+: fiefi: 30{41??0 Rcptt:02892048 - 2/ rL/?tt20 12:57 F',fl Tronsoct ion Totol t970 ' 48 6EHE L FELL IHG Genenol Plan l,pdote Fee 01116002- 51600000- n icrof i li & oo(unents 011160u2- 5777(1000- f'l u6b ins 01116002- 51602000- Visn CCi: ****rrr**r*r9669 t??.9s t3.91 $338.7? $97tr,48 Auth+: (rg$7?1 Building Use: Job Type: Nature of Work Planning Conditions: Planning Approvai By; Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: lndustrial Tenant lmprovement N/V - Bathroom Chavez, Da Occupancy: Constr Type Code: B VB cPc 2019 Notes: Remove unpermitted bathroom facility and restore back to point of origin. Date: Date: Date:4o"o211112020 Account# lVisc. Receipt: lvlisc. Receipt: lvlisc. Receipt: Total 104103093 Every permit issued shall become invalid unless lhe wo* on the site authoized by such pemit is commenced within 360 days aftet its issuance, ot if the wotk authoized on the site by such petmit is suspended orabandoned for a peiod of 360 days aftet the time the work is commenced. lnspector MID#: 2020-157689 011'16002 51600 01116002 51602 01116002 57770 $22.95 $338.77 $3.91 Fee Total: Paid to Date: Balance Due: Owner-Builder State Lic #: Lic Type: Bus. Lic #; Workers' Compensation lnsurance: Carrier: Policy #: Expires: $365.63 $0.00 $365.63 PLUMBING-INSPECTOB RECORD APPROVALS DATE ID/SIG.COMMENTS oTVNER AUILDER DI:I,CATA'I'I('N I hc'chy rfinm 0id.r fnrht., FrjrtrJ" rh l rm llcflrfl li.m rtu Onnrn ttq Li..n{ Lnw l.r rhc lnllrsi'rt rcN$ (Sc.70ll5 a$i'rcss nid ltoltsim (-rxlc): Any Cily or Counry *hich mqun.\ n Nnnir ro cotr\lnrl. lirrr. nnPtulc, d.arolish .r rcl'n rry {r.nrc. nri(r hr ilr hnr rcc. rl\o rcquircs rhc ntnlirx r r,tr \uch Frnrirk' lilcr sirtrcd (trlcnfnr rhrrrfor \hc i\ llccned Pur$mr b rlE p(ni\i,,n\ of rh. Conk rr's l-i.cn*d t-nN lchi0cr 9. Connn.n.i'!! sirh Sc.rion 7(Ix) ol l)ivi\ion :r .f rh. 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PDrer (Sc.. ?0.l4 Busirc$ and Plofesion Codcr Th.Contrclols Licc.sc tj{ docs nor lrplylo.nowncrorPmr. ywho huildsor imFovcs rh.rcon rnd who co m.]ls for such pn,rcrs wirh a co.rn.bd, lic.ns.d l)Ununl to rnc c6nrro.roas Liccn* bw) B It-U o\$.r DECIdIAIIqN I h.Eby !flirm lidr p.uxy or Frjury om of llE followinB &.lmrionr: -lhlru \eillnuinrrinrC.diitrrrcofonrstrrn,S.lllnsuan{sork.^.o rf.i\rrinr.!s pmvidcd tuthySc.ri.n:17(X)tl rhc Itrhor Colc.lo' rh. lrrfontun.c.f rh. wnrk tu which rlrr{nnil i\ i\{'c,l rl[ $orI hr w[ich rhn pcnnil i\ nskd ltly $ork$f .o.rtt \rri($ irr{trrtru. (ri.' x'xl F,ltt trtrNhcr irc] Poln'\ Nun$c' E\n -l ccnilylhlt ir thc pc.nrtun.r ofrhc wod( ror $hi.n fiis Fcrmn n nilcd. LhuU.or cnpn y any Fmn in any nmrr $ as io bcnnB suhjer lo llE rortcN ompenslion hs\ nl C.lia6rnia dnn a8rcc lhd if I should ttcom suhFcl io rlE *od6c.onlFnslionFovishnsoaSftlionlTqJofllrLlhorCod.,lrh.ll.bnhwilhoddywiihrhospmvthns.. WAIININ(;: liihtrc to scurc $ortcr\ conrpcn$ti{ni corcrS. is unrr{lul, rnd shall sut}cr an cmllortr k, sinrinal ,En0ltts !trd civil fincs ut lo onc hun&cd lhousard dolla6 (5!O0.OO0). i. nddiion lo the^HriY' t)tr(t 1BrluQN oi rlE Bu\inc$ !.d lrofc\.i,in\ ftdc. d yli.crsc i! ir titll ln'.t rDd.llicr Li.cn.cchs: Licns. Ntrtrrb.r: Conlrn(lorl gNqIaUSII()I{I!!DI!!iIGENCT I hr.by .r0nn uMcr lEnrxy of pcrjury Inal rhcrc is a co.srtucraon t ndinS nScmy for lhc lrnb.tuftc 6r rhc *ort for whah 'hh nc,nil ir issocd (56. 1097. Civ. C.) ATPI,IIANIIECLAEAISN I hcr6, afl'm u.d.. pctrllry of pcrjury orc of lnc followint delelionsl Dcmlition Pcrmns-Asti. .s Norific ion F.d.El RcBlbrionr (Tilh 40, Pfi6) -RcquiEd L.u.r of Norili.lti,n I.cnilirh.t rhclcdcrulrcrul ion\ rsrdinB $h.(ori.n^!lnrc nor llpflicll,L lo rhn proicr dt"Fr*tm;l*;'lr*u ,hovc nrnrn'ncd F)rcny for ins!.crior n rtlrnrcrlrrrh.ruircinli,nnrli,)nn oSre tocomply*irh lll Ciryrn.l Counly FslA a b rhir Ciryunl Countyt, cnr$ uFr rlr -,,,,L-L-aQ UNDER GROUND Water-Under floor Gas-Underfloor Buildino Sewer Area/Storm Drain lnterceptor/ Clarif ier TOP OUT Waste & Vent Water Pipinq Gas Piping Roof Drain TubiShower Test Rouoh Water Heater POOL/SPA P-trap/Drain Line Main Drain/Pool Pipino Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Gas Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Device Rough Plumbing Final Gas Tesl Meter Release FINAL Llt>70 VKMV .*fl Notes, Remarks, Etc. -I> o^", tL Waste & Vent