HomeMy WebLinkAbout30137565 - PermitCity of Santa Ana 20 Civic Center Plaza (M-1 9), Santa Ana , CA 9270 2 Plumbing Permit #: 30137565
Permit Counter: (714) 647-5800 Inspection Requests: (714) 6 67-2 73 8 Inspect or Se ction: (71 4) 647-58 53
Project Address: 512 S Euclid St
Assessor's Parcel:
Owner:
A ddress :
Ph one:
Tenant Name:
Contract or :
Address:
Pho ne:
St at e Lie #:
Li e Type:
B us. Li e #:
932-610-83
Diemmi Nguyen
512 S Euclid St
Lot
Santa Ana, CA 927041054
(714) 705-3614
Owner-Builder
Worker s' Co mpensation In surance:
Carri er :
Policy#:
Expire s:
Building U se :
Job Type:
Nature of Work :
Plannin g Conditions:
Planning Approval By:
Plan Ch ecked By:
Single Family Dwelling
Addition
Addit ion/Patio Cover
Occupancy:
Co nstr Type:
Code:
Date:
Date:
Unit: •
Bl ock: NA
Bld g: Add ress Range: 502-520
Historic: No
R-3, U
VB
Tract 13723
0 111 6002 51 602
0 111 6 002 5 160 2
0 111 6 002 51 602
0111 6 00 2 5 1602
0 111 6 002 5 1600
0111 6002 5 16 0 2
Fee Type
Water Clo se t
Shower/Bathtub
Sink
Sewer Alter/Repair
General Plan Updat e
Issua nce
CPC 2013
Not es:
Misc. Receipt:
Misc. Receipt:
Pe rmit Issued By: \~Hern andez, Ka thy Date:
S ubject to Fi eld:
12/12/2016
Acco unt#
Misc. Receipt:
T ota l
Building Permit#: 10191244
Every permit issued shall become in valid unless the work on the site
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 per iod of180 d ays after the time the work is
commenced.
Inspector MID#: 2016-132571
0111 6002 5 1600
0 111 6 002 51 6 02
$20.5 6
$1 38.52
Fee T otal:
Paid t o Date:
Balance Due:
Pin#: 42474
Suite Ra nge:
Amount
13 .24
20.73
1 1.83
4 1.46
20.56
5 1.26
Zonin g: R1
Q t y Fee
1 .00 $13 .24
1 .00 $20 .73
1 .00 $11 .83
1 .00 $41 .46
1 .00 $20.56
1.00 $5 1 .26
$159.08
$0.00
$159 .08
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG. COMMENTS O WN ER IIUIL OER OELCAR ATION
I hereby affirm under penalty of pe1jury tha t I am c ,,cmpt from the Contrnc1o rs' Licens e L.tw fo r the following rensn n (Sec, 7031.5 .
UNDER GROUND l3us incss ,md Profession Code): Any C'ity or County wh ich requi res a pt11nit to const111ct. niter, im prove. dem olis h or repair :iny
st n1 c1ure. prior to its issuance. also requ ires the applicant ro r such permit 10 lite a signed sta1eme111 tluu he or she is licensed pursu¥!1 Waste & Vent f'Nt:1 Per ,) K. 3.(. rM lob ~~ to the provisions of the Contractor's Licensed law (Ch.apter 9. Commenc ing with Section 7000 of Division J of the Blisiness a nd
Water-Under floor Z/>, 11,. -Professions Code) or that he or she is exempt therefrom and the b.1sis for the al leged exernptio11. Any \'io lation of Section 703 1.5 by an y
applicant for a permit subjecls the applicant to a civil pcn ahyofnot more than live hundred dollars ($500)
Gas-Underfloor _I. a..:. owner oflhe pro perty. or my employees wi1 h w.iges as their sole compensat io n. will do the wor k nnd the st ructure is not
Buildina Sewer intended or orTered for s..1le (Sec. 7044. Business and Professions Code: Tl1e Contrnc1nr·s Lic en se Law does not apply 10 nn owner of
the prop!,.,i'ty who builds or improves thereon. ;md who does such work h imself o r herse lf or through his or her mvn emr loyces.
Area/Storm Drain provided that such improvemenls are 110 1 intended or ofTt.-,·ed for s.1lc. If. however. the building o r impro,,cmcnt is sold w ithin cme year
of complctKln. the Owner Builder will ha\'e the burden of proving that he or she did not bu ild or improve 1hc propc,1y for 1he purpose o f
Interceptor/ Clarifier s.1le).
_I. :'IS owner oflhe property. am exclusively cor11rt1cling with licensed cont,~ctms to cons1ruc1 t he prnjc1.:1 (Sec. 7044 . B11sim.-ss
and Profession Code: The C'ontrnc to r·s License Law does nC'lt apply to an owner of property who builds or impm\·es the reon.
TOP OUT and who contracts for such projects w ith a C'ontral·tor(s) licensed pursuant to the Con1rnc1or·s License Law).
Waste & Vent _I amemu2unclerSection . . 0. & P.C-. forth/':~
Water Pipinq Dale /& ,?j_ J O {O,,ner J<. ~ /~,
' ,{v()lu<Ens• CO~JP , A"J )N
IJEC LARATIQN ~ Gas Pipinq I hereby affirm un der pennltyof perjury one of the fo llowing dcdnrntions:
Roof Drain . _1 have and will mai ntain a Ce11 ilicatc ofConscnl to Self.Insure for workers· compensat ion. as provided for by Sec1inn J700 of the
Tub/Shower Test rlt-;;( 17 ~V//_uf/1) Labor Code. for the perfonnance o f t he work for which 1hc permit is issued.
Rouah Water Heater I _I have nnd will ma int.i in workers' compensation insurance. ns required by Section 3700 uf1he Labor Code. for 1he perfonnance of
the work for which this pennit is issued. My w ork<..i·s · compcnsillion insurance ca1Tic r and IX'llicy num ber arc:
Ca1rier:
POOL/SPA Poli cy Number: Expires:
P-trao/Drain Line _I cc11ify thnt in the performam.:e of the wo1·k for which tl1is permit is issued. I s hall not employ any person in any 111:umer
Main Drain/Pool Pipinq so as to become subject lo the worh·rs' compcnsmion laws ofC'alifo rni n. and c,gree Ihm if I slmuld become subject 10 the
wor kers' compensation provis ions o r Section ,l,700 of the Lnbor C0<.lc , I slm ll. fcH1hw ith c,,mply w ith thQSC provisiu ns ..
Fill Line/Back Flow
WARNING: l'ailurc to secure w orkers' comre11sa1ion con:rngc is un la wful. mid s hall subject an employer 10 criminn l pena lties and Pool H eater/Gas Line civil r.n,·s up to one hund,·ed thousand dollars ($100.000). in addit ion t,'.-":u'°mpcnsation. damages as prn,·idcd for the
Sectio~,c L.1bor Code. interest and att orney·, fees. . I
• ;J?) ? hi ~ / -~ -Dafe: , r) Applirnnl: t ,,,,.~ r .,,, -/ v 1 Miscellaneous { L"':Jl N°s lm CONTln'"TOI! ~
llJ,:,C:LAl!ATION Gas Service I hereby affirm under penalty of perjury tlrnt I ain lict:nsed under pm vision of C h np1er 9 (commencing with Section 7000) of IJivision 3
Water Service of 1hc Busint!Ss and Professions Code. and my li cense is iu full force and effect.
Lawn Sprinkler License Class: License Number:
Sanitary Sewer/Cao Uafe: Contractor:
Back Flow Device
!:;ONSTR!,!CTION LENIJIN!, AGENCY
I hereby affirm under penally of pe1:jury that 1here is a co11struc.:1ion lcndii1g ,1gency for the perfonn;mce of the work for w hich 1his pennil is
issued (Sec. 3097. Civ. C.).
Rouah Plumbing f l n 1t7 / ~~(f},, Lender's Name :
Final Gas Test -·, ~
Lenclcr·s Address:
Meter Release I A PPLI CA NT DECLARATION
FINAL /''LI ~;7r:; s '/ r-~ ~,;.-~ ,, I herebyaffinn under penally ofpe1jury one of the following dec larations:
, / Demolition Permits~/\sbcstos Notification Federal Regulations (Title 40. Pa116)
Notes, Remarks, Etc. _Required Le11er ofNot ificatio n
j-2.-17; UNIJ~~(Z, CJN/.X
_I certify that lhe federal regulations regarding asbestos removal are not .ipplicnblc to this proj ect.
_I ct.i1ify 1ha1 I have rc;id this .ipplicaiion and slate t hat the abo\'c infonn .ttion is coffee\. I ilgree to comply w ith a ll Cily and Co unty
ordinances and State Laws relating 10 build ing~~ hereby authorize representatives of this City and Count y to enter u po~
a bove mentioned prope11y for ins p~n pw·poses. ,-/4 . ,
Ap1>lican1 or Agent s;gnalure: ~ £4 "'7~ D:lle:R./d 2.._ 7 ul
Pcrmilce name (print): DI r2--,~A_J