HomeMy WebLinkAbout30139133 - Permitcity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requestsr (714\ 667-2738 lnspector Section: (714) 647-5853
Permit #: 30{ 39133
Pin #: 93152
Proiect Address: 3941 S Bristol St
Assessor'sParcel: 410-301-18 Lot: NA
Unit: D
Block: NA
Bldg:
Tract: NA
AddressRange: 3701-3941
Historic: No
Suite Range:
Zoning: CR
q
Owner:
Address:
Contractor
Address:
Phone:
Tenant Name: Ding Tea
Greenville Ranch LLC
2125 E Katella Ave #100
Anaheim, CA 928066078
Ngoc Ky Nguyen
8822 Kennelly Ln
Anaheim, CA 92804
(714) 261-3361
01116002
01116002
01116002
01116002
01116002
01'116002
01'116002
51602
51602
51602
51602
51602
51600
51602
Fee
$73.38
$31.06
$46.59
$42.85
$z',t.42
$21.25
$52.98
Fee Type Amount
Sink 12.23
Floor Drain 15.53
Floor Sink 15.53
Sewer Alter/Repair 42.85
Wtr Htr (Comm up to 50 21.42
General Plan Update 21.25
lssuance 52.98
Qty
6.00
2.00
3.00
1 .00
1 .00
1 .00
1 .00
P hone
State Lac #: 1O147O4
Lic Type: B
Bus. Lic #: 369377
Workers' Compensation lnsuranceCarrier: Exempt
Policy #:
Expires;
IO: JGUD IN
lleoi K9 llgusen
Generol Plon Updote Fee
r:rr I16002- 51600000-
Flu b ine
r:r1116002- 51602000-
ICL Ch€ck 1056
Bualding Use:
Job Type;
Nature of Work
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial
Tenant lmprovemenl
TI
Occupancy:
Constr Type
Code:
B
VB
cPc 20r6 Notes: Tl for new boba/tea reatil shop
'A
Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Hernandez, Kathy
10195787
Every pernit issued shall becorne invalid unless the work on the sile
authorized by such perfiit is commenced within 1 80 days after its
issuance, ot il tho wotk authodzed on the site by such peinit is suspended
or abandoned fot a period o1180 days after the time the wo* is
conmenced
lnspector MID#: 2018-143143
05121t2014
Account#
01116002 51600
011 16002 51602
$21.25
$268.28
Fee Total:
Paid to Date:
Balance Oue
$289.53
$0.00
$289.s3
Estchi:{3884 - 3/21/28180ll ice; (:TYH Trons+: 76Accti: Refi:
Fcpt+:022681(17 - Y2f /2OLg
Tronssct ion Totol $l r2t-t
APPROVALS DATE tD/stG.COMMENTS
UNDER GROUND wldlWaste & Vent qlnlto,'Jr{ )
Water-Under Iloor \t--/
Gas-Underfloor
Buildino Sewer
Area/Storm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipino
Pool Heater/Gas Line
Miscellaneous
Gas Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
,.\
Rough Plumbing 5/Y//8 <fFar 77\hv)
Final Gas Test
Meter Release rA
FINAL 7-zrlr kWt).
Notes, Remarks, Etc.
PLUMBING-INSPECTOR RECORD
orvNl:ll DUIt.DER DFL( ARA r()N
I turcby dflirr uiJcr pcixlry (,r prqury rhir I dr crcn1Pr kom rhr C.ntdo^ Li.ctr\c bw fd thc n,lk,si 8 rci\in rs..r0:11.5
lusirc\s r Prntssiotr Cdc) Any airy or Counry Ehi.h r.luncs r tcrnir ro con{n'cr, rlrcr, iDDn,vc. dcnmhh ,tr n'n!n itry
nddu'c. pritrl.' il\ n\u .c. rk. rcqunc\ lhcq'rli.rnr li,r.u.h Ennir n, fil.r \isrrd (lllnxor rhll hcor shc i\ li.cn\rr N^urii
ro ihc nmvisnff ol rhc (in mcnni l-icc.scd l-rs (Chrnlcr 9, C.nnncr.in8 *ilh Scdiotr 7(xn oi Division I olrhc &rsnE$ rtrd
lroli$bnsCoJ.rorrhlr t( or\tu i!cxcnrnr rhcrcliomrnnrhc hrsis lorric rllcgd crc lprnr Anyvn,Lri,,nofS(rihl0ll5hyrny
rtpli.r rturn rnrir \!hjr.nrhc frli.rnr!) rrivilrcmlrtolnornrftrhd fivc hrndrud dollr\ ($500).
-1.
ss opncr of rnc pmp.rly. or my cmployces wilh w.8cs ec lheir soh ohFnsqlioo. wiu do dE tulk sn de sttulm ir nol
iin.ldcd or ofcrcd fd slc (Se.7044, Busiese lnd PtDf.ssiom Codci Thc Co.r&,rdt Lixn* tlw dds ml ,pply b D osmr oa
rh. nn En, who tuilds or irymws r*p.. ard *no d6 ffh srl lihscl or h.Nlf d threugn hk or h( o*f, .q)loyas.
prcvned fid such ifrpsEmB @ d Lrcn Ld d oficr.d for $lc. lI tbEE, dE trildtr'g or inprcwd.l b eld Dirhii 6m )E&
ofotrnk
'on.
rl* Ovn( Suil,.r will lurc rhc tDdcn orF.ving dlr h. or dr di, mr tuild or in9roE thc nNrcly for 0E purP$ of
l. tr\ ow .r of ihc f,op.ny, m .xclu\ivcly .ontkri.g snh liccnscd .ontdo^ tu .onirucr tlr lroFt (S.c. ?Ul.l. Busrncs
!d PDfssimCodc Tnc Conl6clol s Liccnsc Llw docs mr orpl, ro un owrcr of Iml]cny sho t uilds or imp.orci ih(con,
and who co.trLrs for such pmjcds wnh & Con,tucbrls) ltcn<d nuBuni k, $.Contmror! Lkcns hw).
-J
m cx.mpt undcr Sccrion-, B. & P.C, for rhh rce..
I .cnify fiar in rhc p.rrorMrcc ol rhc work aor which rhi* pqnir h ilsucd. I shall nol employ .nt pcAo. in any mnnc,
$ as lo bcom subjd to lh. eo*sl .ompcnsarion hws of Cllifomin. ud s8E lhlr if I should hccoft $bi6l 16 llE
*ortn3.onp.n$lionlJmvisionsofSetion3?moflhckhorCodc.Ishrll,lodnwnncompl,*ilhlhosprovliio.s,.
WARNIN(; Iirilurc t, {curc $o*.r{ comnti\r'i,,n covcn.[c i\ trrL*r!]. id ntll suhi.r nr cnrrloycr ro dmiml rnllri.s urd
civil firs up k, orc huo{jrcd rhou\rnd dolh^ (Sl(x).txx)). ir lddirdr to rhc co{ of.onrp.isatnnr. d, D!c\ !1F,ridcd lor rhc
Srrn,n.10?6olrhc l.rtn' Codc, i'nqc( andr ortuy s tur\
I h.nht affirm und.r FMhy or pelury thd I !m lie.rn und.r I,m ofChlt 16 9 (commftin8 sith Sdion,000) ofDivkio.l
of rhc Busi6s and Pmfcr ioni Codc, ard my lt c.sc h in tull aor.e arn catccr,
</2, /rt.\ I / -\t
cttustnuctin r orontt; lt,ENcv
is\ucd rsN l(D7 cn c r
I ccniltrh ih. ltd.rrl reguhrioN mgsding ash.no\ rcnr,vrlarc.or 0pflic0blc Io lhnrroJccr
l.cnilvrhrr I hrvc rcxd rhi\ rlr|]liutoird {rrc rl rlr rd.raon ic conrcr. I .816 lo comply wiln all Ciry and Counry
ordiidnei rnd srar. Ires nhrinS ro blihira con{dcrion.
rho\..rrirbncd F)p.n, tur i.\
lpDlic.nr rr ,{[ctrl Skn!lrn:
ofrht Ciry lnd Cou.ryro cnr6!I.nrtE
Fill Line/Back Flow
Water Service
}IIBf,EBS.I;I}IIIETAIIAN
NIiCLAf,ATION
I h.rcb, ariirm ondr Fn,lry or Frjury om of lhc lollowinE d..hraiions:
-I
h.vc .id will minldn a CcnifMl. ofc.nscnlo s.lfinrur. ro. workeB mn{Enstion. I pmvitcd lor b, Sccrion l70O ol rh.
t hor C.de lor rh. p.domftc ofo. wod( ror which rh. Fmh ir ksu.d.
-l
lEvc,ndwill mointoin sorkc conpcnsatior insursrcc. s mquird by Sccli.n 3?0O of lhc L.bor Code. for thc ll.rfollj1i@ of
lnc rcrk for whth lhis Fnnil Ls ks.n. My wo*c6 mnD.nsar ion insur c cekr ard lblicy numbd E:
CaEs
qfzr(ry
Lxndci\ Addrcss
A.TTUIANLI)ICLA.BAIIOX
I lrnbylnlmrund.r J*Nhy orlxrjury onc ofrh. tulk)wing d..ld{n (:
DcN,lirn,n Pfini( Albrno\ Norin.ari tcd.ral R.AUhti,nr\ ( l'irlc4l), PLn6)
Rcqnirud t.rrcr of Norifi .rri,rr
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