HomeMy WebLinkAbout30139621 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (7141647-5800 lnspection Requests: (7141667-2738 lnspector Section: (714) 647-5853
Permit #: 3O139621
Pin #: 3{O39
Project Address: 2424 N Tustin Ave
Assessor'sParcel: 396-261-55 Lot: 8
Unit:
Block: A
Bldg: 24-A Address Range:
Tract: A.B. CHAPMAN Historic: No
Suite Range: Unit A-12
Zoning: R4
Owner:
Address
Contractor:
Address:
Phone
Tenant Name:
Katerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-r065
Fee Type
011'16002 51602 Sink
01116002 51602 Dishwasher
01116002 51600 General Plan Update
01'116002 51602 lssuance
Amount
12.23
11.52
21.25
52.98
Generol Plsn Updote
8111600?- 516n0000-
Plurb ins
fil116 0:- 5168?0r:rn-
I6L Che,:l: 00Jttl
Fee
$48.92
$11.52
$21.25
$52.98
Phone
State Lic #: 1009989
Lic Type: B
Bus. Lic #: 366547
Workers' Compensation lnsurance:Carrier: Midwest Employe/s Casualty Company
Policy #: BNUWCo139070
Expires: 01101/2019
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ct ion Ioto I
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Kntenro Renovot ions, L[
rhi
ice
ns(t
$113.4?
i4 r 1?? .?11Building Use:
Job Type:
Nature of Work
Planning Condilions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subjecl to Field:
Building Permit #:
Multi-Family (5 or more uni Occupancy:
Miecellaneous Constr TyPe
Fixture change outs (unit 12Code:
R-2
VB
cPc 2016
Notes: Fixture change outs (unit 12)
Date
Date
Date 0612512018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every pemit issued shall become invalid unless the wo* on the site
authoized by such permit is commenced within 180 days after its
issuance, ot if the work authoized on the site by such pemit is suspended
or abandoned for a pedod of 180 ddys aftet the time the wo* is
commencgd.
$2',1 .25
$113.42
$134.67
$0.00
$134.67
lnspector nAlD#: 2018-144266
Fee Total:
Paid to Date:
Balance Due:
The Bascom Group
26 Corporate Park Drive, suite 200
lrvine, CA 92606
(866) 695-5591
Qty
4.00
1.00
1.00
1.00
Chavez, Dave
0 1 'l 'l 6002 5'1 600
01'116002 51602
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
UNDEH GROUND
Waste & Vent
WaterUnder floor
Gas-Underf loor
Buildinq Sewer
Area/Storm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipino
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbinq ?/b/6 ,t\f,c
Final Gas Test
Meter Release I '4,0q1"1\ ,(,U{qA6)FINAL filq\$ .t 6-
INotes, Remarks, Etc.
otvNulr Eult,DER DEt,cARA noli
I h.Ehy lmm unr penalry of pdjury ttd I sn.rcry1 fiod llE Co.lrdoR Lius L!* for lhe folloeing Een (Se.7djls
Blri.es !,i B'of.sion Cod.): A,y Ciry o, Counly vhich rcquiEs a I'6mn lo otriroct, .llci imprct, demlnh or Epan &y
srucns. p.ior Io ns is$dc.. alro rcquircs rhc lrplicsnl for su.h IErmn lo [k a ii8rcd alcEnl lhll lt ot ilrc ic lisied P!runl
ro rh. ,rovlrion. of dE Conl@lor's Liensd Lr* Ichaold 9, Conmming *ilh S.clion 7000 of Division ! of dt A$i..s ud
Pof.sio.s Codc) or lhrl lE o the ! .r.n9l rhcrcf@m and lt€ hash for rla llk8cd cr.q,tion. Ary viohrion of selion ?03 I J by !n!
,ppli.dt Lr s p.mit subjKls lte spplkafl io a citil !.ntrlly ol lol mrc lh& Iivc hudbd do0rs ($500).
l.r\.si$.lrhcpn'Fn!.orrrycmpkDlc\*irhNagc\r\ihcirs)lcconrFrNirotr.*illJorlks.rkr rh. nMiur n r
drklcd orolircd lhr \alc (Sc..7ol.l. Bu\ircsr dnd lhnar\i \ (( c lhrfnnrrdor's l-i.cnsc l-rs doc\ nor JPPly b d0 o$tct ol
rhc pmtf,ny s k' blilJ\ or inlnrn$ rhcrl\n. twt wlr n,r\ \u.h \ o hnnsclforhcr{ll.rrhroulhht r h$ o*tr cnrllo)$\.
In,v cd rh{ n'.h i prrcnxnsaru or cfrlL\l DruficrL\t tr ub Il. lanvcvcr. ih. hniuiis or nntn,vcntnr n dd tirhln ' (J1r
-L
N owkr ol ihc pmpchy. !'n siclusiv.l, coolra.li,S wnh lenccd conhdoN lo .onnruct rhc Poic.l (56. ?044. Busim$
atd PrDfNion Codc: Thc Co Dclol3 Liccnsc Lrq dm Nt aprly lo tn ownn of prorcny *ho blild! ot anprov.s thcr@n.
ard wno conrack for st Foj.d. wirh, Corlsclo,(s) larn*d pusul lo th. Codmtol, Li.cN L3*)
Lincxc.rfl undc! S.cl B & P.C.lbrrhi\ rcr$n
SO8trE8I:COMSINIAIION
DECI.AXAIION
I h.Eby.rfirnund.rrEnahyof pcriuryoncof thc follosirS&.hr ions:
t hrv. { will minrlin a Ccnificrrc of Cons.nr ro sclf.lnsrrc fot *orksa coon nrdrion. * lmvilcd for h, S..rion l?(x) of llE
bb.. C.dc. for thc pcrforM.c ol rh. wrl( foi which lh. pnnil is isu.i
-l
havc and will monn.in work.n compcnselion insurarcc. &s rcqnircd by Sdion 3700 of rhc ljbar cbdc.lor thc l,craorl1mc of
Tiil
tri ompcnsrnrn inrxrmc .!ntr ad Poli.y nunbd .:
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ifyrhar i. rtE pcrforluna oflhc *o* fo.qhkhth Frmir i! ksu.d.l rhall ml cniploy any P.mn ina.insm
s $ lo bcsm snbier lo llE m*6 @ntl4.!dion l,$ of Crliforni., ud !8xe $ar if I sho!6 hocod sbjccr lo rlE
woikcr'oogcrsalion!rclisionsofSEionST00ofth.tihotCodc.lshlll.fonhsirho,rll,lywilhlbsl,ovisiotr{
14ARNINC Failu,c ro wnrc *orkcr' .omrcnsalion otdgc ir rrlnwtul. snd sholl slhitl dn.mploycr lo aimidl ltelri.! ud
.ivil [,cs up ro o@ hundEd lhousand dollN ($lOO.OOl)). in a.ilirion lo th. cos or compcmarion, damB.s as lo{dcd for thc
Salion 1076 orrlE Lbr C!dc. inrcEsl lnd arroftr'i fe4
.1.oo
I hcrcb, ufifln undcr lcnrkrorpcrjury lh( l6n' licctrsd u n ofCh,Drcr 9 (comftncinE wirh s..lion r0OO) ofDivilio' l
of th. Busifts and Pmfcsrions Codc, t my li.c.r k in tull fore dd cfl(l.
S yOofical .
un , 1.L.loo &a'lr./c^-
(IoNSTRUCTI()N t trNDlN(l I(;FNCY
I hcrhy nlfinn und( FnrltyofNrlurylhrl lhcrc is a con{o.rt,n l. d,n8 agcnry lir lhc pcrfortui.c ofthc wort irx which rhi\ pcrnnt is
issucd (Scc -1097,Cir C )
ATELICANI.DECLABAII{IN
I ffiydlmundd Dcnshyof p.rjury onc ol'hc followiry &rlmlirnsi
Dcmliion Pnmils'AstEsros Norifi.arion Fcd.hl R.gularions (Tnh 40, Pun6)
-Rcquncd
Letrcr of Notfkdbn
-l
c.diry rhlr lhc lcdcral rcBulationr egddinB *h.sos t mval ac flol ryplicrhlc m $is pmiel
9-l ccnily rhlr I livc rcad rhis applic,lion !d slarc rhrr rh. llnvc i.toimtion ir corer. I acxE lo otrtply wid all Cnv and Cou.tv
ordinnrccs and Srarc Liwi rbrinS !o huildin8construclion. !.d here rhi\ Ciry ond Counry x' cnrc !F,n rh.
nhovc .f,nlidrd pm,lcny for ins!.crioi
9fi8
Water Service
tJ"'t.' \ AdJ'c..:
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Applldlr or ag.nl shmluE:
Prmlte ,l.m (prlnr):_5--->*21 t*l
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