HomeMy WebLinkAbout30139499 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cA 92702 Plumbing
Permit Counter: (7'14) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Permit #: 3O139499
Pin #: 16907
Assessor'sParcel: 396-261-55 Lot: 8
Unit;
Block:A
Suite Range: Unit R-5
Zoning: R4
q
Owner:
Address
Contractor
Address:
Phone
Tenant Name:
Katerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-r 065
01 1 16002 51602
01 1 16002 51602
0'1'116002 5'1600
011 16002 51602
Amount
12.23
11 .52
21 .25
52.98
Fee
$48.92
$11.52
$21.25
$52.98
Fee Type
Sink
Dishwasher
General Plan Update
lssuance
Qty
4.00
1.00
1.00
1.00
Phone
State Lic #: 1009989
LicType;.. B
Bus. Lic #: 366547
Workers' Compensation lnsurancelCarrier: Midwest Employer's Casualty Company
Policy #: BNUWCo139070
Expires: 01101120'19
fr onsoc I
Planning Conditions
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Date:
Date:
Dale:
R-2
VB
cPc 2016 Notes: Fixture change outs (unit 5)
l\,lisc. Receipt:
l\,lisc. Receipt:
lvlisc. Receipt:
Total
Chavez. Dave
Every peinit issued shall becoma invalid unless the wod< on the site
authorized by such pemit is commencod within 180 days aftet ils
issuance, or it the wotu authorized on the site by such permit is suspended
or abandgned fot a peiod of 180 days afrer the time the work is
commenced.
06111t2018
Account#
$134.67
$0.00
$134.67
lnspector MID#: 2018-143632
01116002 51600
01116002 51602
$21.2s
$1 13.42
Fee Total:
Paid to Date:
Balance Due:
Proiect Address: 2424 N Tustin Ave Bldg: 24-R Address Range:
Tract: A.B. CHAPMAN Historic: No
The Bascom Group
26 Corporato Park Drive, Suite 200
lrvine, CA 92606
(866) 695-5591
(terr
i1228 - 6/tL/20lg
CTYH TPons+: 68
Ref+
(renefol rlr(ul16002- |
Plurb i ns
Building Use:
Job Type:
Nature ot Work:
Multi-Family (5 or more uni Occupancy:
Miscellaneous Constr Type:
Fixture change outs (unit 5) Code:
PLUMBING-INSPECTOR RECORD
APPFOVALS DATE ID/SIG.COMMENTS OIVI{EX BUTLDER DELC]ARATION
I hcrcb, a,Im un.Lr pcnolly ol Fdlry th.l I M .xcmpl fmm tlE C.nuelm LianE trr lor lhc folowinS s$. (S€.?ol l,5
ausinc$ lnl Prof€s{ion Codc): Any Cny or Colnly which rcquircs ! F1mir ro.o.rtocr, .ltd. inpror.. d.nbli3h or rlrt 6ry
slrudur.. prior lo ns h$an.c, also ,cquiEs lhc aDplicor ror rucn t*mir ro fik r .igncd {dcmnr rhd h. or stu h li.cnEd pursanr
ro rhc lmvl\ions of rhc Co.rrerofr Licnsed L3{ (Chai'r.r 9, Commrciflg *ith Sccrion Tom of Division 3 ofrh. B.sincss and
Prcfcssaon Codc) or thll lE or .h. ir .rcrw thcErrcn ard rhc t6ir for thc alhgcd crcntprion. Any vi.lrrion ofseti,n 70,i L5 b, {ny
llplkanl for ! p6'En subjats ln lpt,licut lorcivilpcmllyofnol mElhn fivc hundEn do0lrs (S500).
-1.6.wn
of rhe pruFrlr. or my cf,elorEs wiih waec. I rhcn eb omocn$lion, willd. dE rcrt a,ld tE stnriB is ml
inr.D&d doficEd for sk (Sr.?044. Blsitus md PrDfssioNCodc fi. Co mlor's Lt.nF Lr* do.s ml.0ply lo d owftr of
llE pmpdiy wlE brilis or inpioB tlE@tr ,!d who docs *ch wl* hidrclf or hd*lf o, rhougt hi. or ls own cnployccs.
poridcd thol such inl9owrnls e ml inl.dsl tror.Ed for sL.lf, h.*.wi tlx hdd-og or in{rowenr is $ld wnhin om yrd
ofotrplclbc tlEOwM aui!.rwi tus dr bud.n or pmvin8 thd h. or 3h. di! mr boild or inproh dE pbFry ror tlE lr{qbEor
-1.
as owncr of I hc ,,mp.n!, anrcxclusivclr.o.r.din8 wirh lic.nrd cont0cloB ro.onstrud rh. pmlcl (Ss. ror4. B6inss
ad Pnr6sbn Codc:'llc Conlrlof i Liccnsc Lrw drcs nol rtrly to !tr oqncr oap,op.ny wio brilds o, imprcvcs ttcrcon,
and who .onh.c lor such pmFcls wnh aCoorRddnr liccn*d pu^@r l. lh. Co .a.t6as Li.ctr€ 1,*)
*l mcxcmpr undm Serion ,B & P.C. frrhisrcaron.
WORXERS'COMPENSATION
DECI.Af,AIIQIT
I hcrchy amrmundcr pc lty ofIs,try om of rn fouowing delmrionsl
Ihr\rr trnlnui' rinJCcnilicrrrolc{hcnit,S.laln\u'.6rtror[.^.onDrn\ n)n.r\ prtrnbd turbtSccr(,n:]7LUr, (hc
Lahorc{xl.. ktrrhrI)lrlbrnuno oir[c $ork f{tr \hi.hrhc !rn.[ n i$u!(l
_l hlw 8rd qiu minl&in sork6 comFnsllio. insumft.. .r rcquircd by SRlion 3rm of dE L.bor Codc, aor lht p.rf()mkc of
t)crmil is hflcd. My wo cr' sq'.trslhn insuEmc cnicr $d poli.y numlEr 6c
o
-l.cnify
rh in thc pelforme ol fi. *ork for ohtt rhis lcrmir is is$cd. I shall er crnloy a.y pcmn in my @G,e ar lo bc@m .ubtcl ro lne *ortcts'@Dl!.trrorion hps ofcrlifomia. a.d l8mc tll3l ii I should b..o!r subjel lo th.
wod(6.ory)..iarionnnvi.ionsofSccrioolTmofrhcLltniCodc.lrh!U.fonhwirh@mplysirhrh.*povishns..
WARNIN(|: Failur. ro s^.trE sor\cr' conrp.nsll ion corcragc ir unhqitl. lnd \hall tubJlrr rn.mplqtr h mmnrll*tulric!,nd
.ivil finc\ op h onc hundhd rhousrnd doll r\ l$|(n,fi)or. in Jddirioo ro rh. co{ ol conD€n\.1
S..ri({:1016 orrlr Lnhr C(xlc. il crc{ nid rnonu s ttc\
'uuttl1 ?s1L
,r4.,"r"o,,,,
I ncdby !flnn undcr p.nalty of pcrjury lhd I an lions.d udLr lrevnion ofcnrd6 9 (@nmmirg *nh SelbD 7000) ot Division l
of llE aBircs. 4d Prcf.$i.ns Codc. ord Dy lhmc i! in tull foc rrn .ll.d.
^6s^t.ok4 2.
'tuN 1IZuru
IANSIAICIIONIEIDIIi(iTiENCI
I hcrchyalrnuu.rlcr prnrltyol'pcrjryrhrl rhcrc isrcotrsrucrhn Lrtrdin8o8crcyInr lhc nr.lomumc orih$ork rffnhi.hrhA pcnn i\
is{r.d (Scc 1097. Civ C.)
AfPLlgANfDECI BAIION
I lElby anim undcr pcnalry oipcrpry one ofuhc lollowing dNloralions:
Dcnmlition Pcrnrils'Astrnos Notilica'ion icdenl Rc8ulutions (Inlt 40. Prn6)
-Rcquncd
Lctrc! ol Nol ili..riotr
-l
ccnilr rh8r rhc lcdcmlrcBularions Egudins adEsro\ rcmval!rc nor a lic krortisnmjc.l
A en,ry ihar I h.rc cld
'hb
qplicdion nnd !r c rh,l rh. ah.k inforruion t comd. I
ordinamcs .nd Stet tiws El,ri.B ro buildin8 oniE.riol| and hcr.by Mhoriz Eprcs.nla!
,grE ro mn{,ly wirh lllCny trnd Counry
rhrc nEnrn)..J ln)Irny for i'xtccrion
,\ppli!Mt trr,\[.nl SiBnnitrrc t,rr! " r -
UNDER GROUND
Waste & Vent
Waler-Under f loor
Gas-Underfloor
Building Sewer
Area/Storm Drain
lnterceptor/ Clarilier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
tr4ain Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing t /t,1nv 5 \r,t
Final Gas Test
Meter Release
FINAL 1/u /rb Js tot
Notes Remarks, Etc.
Gas Service
y'q{arv>.
Irtdcr. Addrcs:
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