HomeMy WebLinkAbout30137432 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing Permit#: 30137432
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 In spector Section: (714) 647-5853 Pin#: 46735
Project Address: 3417 S Timber St Unit: Bldg : Address Range: Suite Range:
Assessor's Parcel: 410-161-11 Lot: 23 Block: NA Tract: 7002 Historic: No Zoning: R1
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
State Lie#:
Lie Type:
Bus. Lie#:
Tracy Tran
3417 S. Timber
Santa Ana, CA 92707
(714) 334-3170
Master Construction & Deve
1228 Village Way #A
Santa Ana, CA 92706
(714) 568-5444
532153
B
347001
Workers' Compensation In surance:
Carrier: State Fund
Policy#: 1965180
Expires:
Building Use:
Job Type :
05/31/2017
Single Family Dwelling
Addition
Occupancy:
Constr Type :
R-3, U
VB
01116002 51602
01116002 51602
01116002 51602
01116002 51600
01116002 51602
Fee Type Amount
Shower 20.73
Sink 11.83
Clothes Washer 13.01
General Plan Update 20 .56
Issuance 51 .26
Ba tch~:36108 -11/2/2016
Office : CT YH Trans~: 50
Qty
1.00
1.00
1.00
1.00
1.00
RcPt~:01657535 --11/2/2016 3~35 ~~;
Fee
$20.73
$11.83
$13.01
$20.56
$51.26
Tr ansaction Total ¢1,~~A.o~~
Mas ter Construc~ion ~ DeveloPro
General F:~n UPdate Fee
01 116002-~1600000-
PluMbins
01 116002-5:602000-·
i'la·::.ter C:c,;-·,:i
cc~=~*****~-~~~**9428
Nature of Work: Addn-1st/2nd Floor Code: CPC 2013 Notes: New shower & sink for 2nd floor bath.
Planning Conditions: All materials to match existing.
Planning Approva l By:
Plan Checked By: Date:
Permit Issued By: Date:
Subject to Field:
11/02/2016
Account#
Building Permit#: 01116002 51600
Every permit issued shall become invalid unless the work on the site 01116002 51602
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of180 days after the time the work is
commenced.
Inspector MID#: 2016-130238
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
$20.56
$96.83
Fee Total:
Paid to Date:
Balance Due:
$117.39
$0.00
$117.39
APPROVALS DATE
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
Interceptor/ Clarifier
TOP OUT
Waste & Vent
Water Pipinq
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater I /
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
J
Rouah Plumbing
Final Gas Test I
Meter Release
FINAL
Note s, Remarks, Etc.
PLUMBING-INSPECTOR RECORD
ID/SIG. COMMENTS
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OWNER llUILUEll l)ELCARATION
I hereby arfirm under penalty of pe1j u1y 1hat I am e.'<ctnpl from the C'ontn1c1ors' Lic e nse Law for !he fol lowing n:n.si,n (Sec.7031.5 a
B usiness m,d Professio n Code): J\ny C'ity or County which requires a pennit to constmct. alter. improve. de!n olish cw repair an y '
structure . prior to its issu ance . .ilso requires lhe .i ppli cnnl for s uch permit 10 file a signed s tatement that he o r sh e is licensed p ursuant
to t he provis ions o f the Contractor·s Licc11scd Law (Clmp1cr 9. Ccu nmcncing wit h Seel ion 7000 o f Division ., of the 13us iness and
Profe~ions Code) or that he or she is exempt therefrom and the basis for lhe all eged e.xcmption. Any violation ofScclK'n 70~ 1.5 by any
appl icant for a pe nnit subjects !he ap plicnnl to a Ci\'il pennlty of not more th an live hundred doll nrs ($500).
_I. as owner of the property. or my employees with wag es as their sole compcns,ui on. will do th e work ;md t he sln u.:tun: is 1101
intended or offered fo r s.1le (St-c. 7044 , Bus i11ess and Pro ft-ss itms Code: The Contractor's License Lmv docs 1101 nppl y IC1 nn owner of
the propcr1y wl10 bu ilds or improves thcn:o n, and who docs sud1 work hi111 sclf or herself o r through his or her uwn emplC1yet..c.s.
prov ided th at such im provements are not intendt..'CI or ofTere<.I for snle. If. however. 1he bu ilding or improve111en1 is sold wi1l1in one year
of completion. the Owner Builder will have the burden of proving thm lie or she did not lx1ikl or improve th e propc.,1y for the puq')()sC of
~,le).
_I. rtsowner of the propct1 y. am exclusivel y contrncting with li censed conlr.ictors to conslruct the pmjc<.:t (Sec. i01M. Bus iness
and Profession C'ode: The C'ontrnctor·s Lic ense Law <loes 1101 .ippl y to an owner of property who bu il ds <ir im prv,·cs the reon .
.1nd who contracts fo r such prnjccts ,vith a Contrnctor(s) licensed pu rsuant to 1hc Contrnctor·s License Lmv).
_I am exempt under Section. ________ . 0 . & P.C for this renson.
0:1t,c: __________ Owncr:~========-==c-------------
lVOllKF.l!S ' CO~ll'ENSATION
D ECLARATION
I hereby rtffinn under penn llyof pcijuryone of th e fo llowing declarat ions:
_I ha ve nnd will ma in trtin a Cc11i ficntc o f Consent to Self-Insure for wc.,rkcrs ' co mpensatio n. ns provided for by Section J 700 of t he
La bor Code. for 1he pt."ffonn.mcc of th e \\'Ork for which the permit is issued.
_I have rtnd wi ll mrtintai n workers· co1 111:,ensa ti on insu rnncc . .is required by Seclic.,n 3700 of the L;1bor C'udc. fur th e pcrfi1rmnnce of
the work for whic h this pcnnit is issued. M y workers· compcns.i tio n insurm1ce cmTier and policy nu mber nre:
Carrier: __________________________ _
Policy Nu ,n bcr: _____________________ Cxpires: __________ _
~I ce11ify th at in the performa nce of the work for which this permit is issuc<l. I slmll not employ any person in any rm111m.:r
so as to become subject to the workers· eo mpcnsm ion laws o f Californ ia. and agree th at if I should bernm~ subjc..:1 to lhc
workers' compensat io n provisions of Section 3700 oft he Labor lode. I shal l. fm1h\\'ith comply wit h tho se prnvis il111s ..
WARN ING : Failu re to secure workers' compc1 tion Cllvcmgc is unlaw ful. and sha ll subject an t..-,nplClycr to 1..,fo1in al penalties and
civ il fine s up to one hundred thousand c.lollar ($100.000)~dition to 1l1c cost of cornpcnsmion. dm1mg cs as pro\·idcd for the
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UE(.l(e;\R A 1 ION
I hereby affi1111 11n nSed under pro\ 1~Cha~ommencmg \) ilh Section 70( O~__::i 3
of the Busmess 15e IS 111 full fo • and effect \ )~
License Class / 1ccnsc N r ' _ ____,,,
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NS UC'TION LENDING AGENCY
I hel'eby affirm under pe,mlt yof pe1jury that there is a conshr-t.1 ction lending. ngency for 1he performance of the \\'Ork for wh id 1 lhis penni t is
issued (Sec. 3097. Civ. C.).
Lender's Nc1mc: _________________________ _
Lend er's Address: _________________________ _
A PPLI CANT UECLARA TION
I hc.i ·eby affinn under pena lly of perjury om: o f the fo llowing <lccl.ir.itic.llls:
Dem olit ion Permits-Asbestos Noti lic.tt ion Federal Regulations (Titl e '10. Pm16)
_Required Letter of Notificatio n
I ce11 ify 1at the federal regulat ions rcgording. nsbest0s removal are not npplicablc to this project.
I cct v hnt I hrt\·e read this npplicatio n nnd state that th e abo ve info nnat io n is com::ct. I agrt..>e h) com ply \\'ith ri ll City and Co unty
ordinanc m State Laws relati ng to buil ding const ru ction. and hereby authorize rcprese111:itin~s of thi s C'ily and Cou11 ty lo c.·ntcr upon the
above m nt mncd prnpc ,ty fo , mspcct,..po~ • ,· / ,! !
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