HomeMy WebLinkAbout30137831 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing Permit#: 30137831
Permit Counter: (7 14) 647-5800 Inspectio n Reque sts: (714) 667-2738 Inspector Section: (7 14) 647-5853
Project Address: 3417 5 Timber St
Assessor's Parcel:
Owner:
Address:
Phone :
Tenant Name:
Contra ctor :
Address:
Phone:
State Lie#:
Lie Type:
Bus. Li e#:
410-161-11
Tracy Tran
3417 S. Timber
Santa Ana, CA 92707
(714) 334-3170
Lot: 23
Master Construction & Deve
1228 Village Way #A
Santa Ana, CA 92706
(714) 568-5444
532153
B
347001
Workers' Compensation In suran ce:
Carrier : State Fund
Policy#: 1965180
Expires: 05/31/2017
Bu ilding Use: Single Family Dwelling Occupancy:
Unit: Bldg : Add r ess Ra nge:
Block : NA Tract: 7002 Historic: No
Fee Type
01116002 5 1602 Bathtub
0 111 6002 51602 Shower
0 111 6002 51602 Dishwasher
01116002 51602 Garbage Dis p
01116002 51602 Gas Line repair/replace
01116002 51602 Tankless Water Heater
01116002 51600 General Plan Update
0 111 6002 51602 I ssuance
.1;;
Pin#:
Suit e Range:
Zoning: R1
Amount Qty
20.73 1.00
20 .73 1.00
11.16 1.00
9 .92 1.00
41.46 1.00
61.07 1.00
20.56 1.00
51.26 1 .00
,: : ..
28495
Fee
$20.73
$20.73
$11.1 6
$9.92
$41.4 6
$61.07
$20 .56
$5 1.26
Job Type : Alteration Constr Type:
Nature of Work: C/O Fixtures/Fans/Water He,Code:
R-3, U
VB
CPC 2016 Notes: Water heater in ;garage:
Planning Conditions: Neighbor's consent on file. A/C on side property.
Planning Approva l By :
Plan Checked By:
Permit Issued By:
Subject to Fi eld:
Date:
Date:
Date: 02/23/2017
Account#
Building Permit#: 01116002 5 1600
Every permit issued shall become invalid unless the work on the site 01116002 5 1602
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#: 2017-134578
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Tota l
$20.56
$2 16.33
Fee Total:
Paid to Date:
Balance Due:
$236.89
$0.00
$236.89
APPROVALS DATE ID/SIG.
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
Interceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping ;>.,.
Gas Piping '71 F(./tc~J..J
Roof Drain /.J~ VIV
Tub/Shower Test
Rouqh Water Heater
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
Rough Plumbing
Final Gas Test
Meter Release
FINAL
Notes, Remarks, Etc. V
PLUMBING-INSPECTOR RECORD
COMMENTS OWNER BUILDER D EL CARATION
I hereby affirm under pena lty of pe1jury that I run e.xempt from the CC1n tra c1ors· License Law for the following rcasm1 (Scc.7031.5
Business nnd Profession Code): Any City or Coun ty which requi res a pmnit to co11s1 n.1 ct. .i hcr. improve. dcmq l ish or repair• any
structure. prior to its issuance. also requires the ap plicmu fo r such pennit to {i]c a signed stalcmcnt 11ml he or she is licensed pursuant
to the provisio ns of the Contractor·s Licensed Lnw (C'lmp ter 9. Commencing wit h Section 7000 of Division 3 or t he Business and
Professions Code) or t lmt he or she is exempt therefrom and t he basis for the a lleged exemption. Any vio lat ilrn ()fScl't ion 7031 .5 by any
ripplicnnt for a permit subjects the appl icant 10 a civi l pen.illy of not 111o re than fivt: humlrcd dollnrs ($500).
_I. as owner oft he prope1ty. o r my employees with wages ns their sole con1pensation. will do the \\'Clrk and lhc s1111cnu·e is not
intended or offered for sale (Sec. 7044. Business and Pro fe.~s ions Code: The Contractor's License Law docs not npply lo an owner of
the property who bui lds or improves thereon. aml who does such wo rk himself or herself or 1hrough his or her own employees.
provided that such improvemen1s are not intended or offered for sale. If. howcvc.>r, the buil ding or improvement is sold withi11 one year
of completion, !he Owner Builder will have the burden of prnving that he or she did not build or improve the propes1y fur the puq)Ose of
sale).
_I. as own er of the pro peity. am exclus ively contrn ct ing with li censed contractrn"S to construct tl1 e project (Sec. 70--l4. Business
and Pro fl'Ssion Code: The Conlracwr's License Law does not apply to an owner o f prope11y who b\lilds or impnwcs tht.:n.:on.
and who conimcts ror such projects with7ntract or(s) licensed purs uant to t he Controcto(s License Law).
Dnl~17~•~z~1.\rt1Cr: . D. & l'.C . for this reason.
(--,-v-o _R_K~E~ll~S~' ~c-o~~~ll~'E~,N-S~A~.~rl-O_N ____________ _
lllcC LARATION
I hereby affirm under penalty of P;!i 1ry one o f t he fol lowing declara1ions:
_I have and will maintain a Certi ricatc of Consenl In Self.Insure for workers· compcnsn1ion. as provided fo r by Sec1ion 3700 oflhe
Labor Code. for the pcrfonnance o f t he work for wh ic h the pcnnit is issued.
_I have ;md will maintain workers· compensntion in surn.nce. as required by Section 3700 of1hc L.ibo r Code. fo r the performance of
the work fo r which this pcnnit is issued. M y workers· compensation insu ran ce cnll'ier and policy number are:
Ca1Ticr : __________________________ _
Pol icy Numbcr: _____________________ Expires: __________ _
_1 cc11ify 1hat in th e performance o f the work for which this permit is issued, I shrill not employ any person in any mmmcr
so as to become su bjcc1 to the wo rkers' compcns.ition lnw s of('nliforni a. and agree t hat if I should become subject to the
workers' compensm ion provisions of Sect ion 3700 of the Labor Code. I sh.ill. fo1thwith comply wi1h those provisions ..
WARNING : Failure to secure workers' compensation coverage is unl aw ful. and sha ll subjt.:ct an c.inpluyt.:r to 1..,·i111in.il pena lties an d
CIVI i fines u p to om: h u nd1 ed tho usand dollnrs ($100.000). m add1t10 11 t o th e cost of compensat io n. dmnng es as p1(WRlc<l fo r the ::ct~~" ,o;z;•; 7;;,tc,~ and :li:::::s f~/J ,/J ///f -
l f ,..r·,=m coN'rl'tAc,'<hR / (,,,/ 11/' '/ / /
' DECLAU.A'llON..... {;/ I
I hereby afrirm under penall y of pc1jury1 ha t I mn u.: under provisio n of Chapter 9 {commenci ng with Scctic,n 7000 ) of Division 3
of the Bus in t::ss and Proft..-ssio ns Code. and my license is in ful l fo rce and eff~I.
Li cens e Class· / Li cense Nu1nbc r: _______________ _
Dntc:--2-P¥ll.i Cunlrnctor: ___________ _ / tG ONSTRUCTION LENDING AGENCY
I hereby afrirm und er penalty o f perjury that th ere nstmction lending agency for th e perfonnance of th e work fo r which this permit is
issued (Sec. 3097. Civ. C.).
Lender's Name: _________________________ _
Lende r·s Address: _________________________ _
A l'l'LICANT DECL A RA T ION
I hereby nffinn un der penalty of perjury one of 1he fo llowing declnrntions:
Demolit ion Permit s~Asbestos No1ifica1ion Federn l Regul at ions {Title 40. Pmt6)
_Required Lett er of Notification
_I cci1ify ti I the federal rcgulatic,ns reg.trding .isbt.."SIOS rcmovnl arc no! appl icable to 1his project
_I co ·fy nl I have re.id this appl ic ation ,md sl.t\C thnt th e above infornmtion is con·ecl. I agree In comply with all Ci1y nnd County
ordin ance 1d State Laws relating to buil ding construct ion. and he reby aut horize representati ves of this City ::md Count y to i:ntcr upon the
abo\'c me io cd prope11y fo r inspecti~ ~ ~ __... ~ ./4
Applic:~ntorAgc11t ,g11At 11 rc: ~/ X Y ~~ Datc:2~} /I/ .,....L,. -, , I 7-L
1,er,11itce e ri11t): -~ ~----------------
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