HomeMy WebLinkAbout30138590 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
lnspection Requests: (714) 667-27 38 lnspector Section: (714) 647-5853
Permit #: 30{ 3E59O
Pin #: 2o574
Project Address: 2729 N Bristol St
Assessor'sParcel: 232.051-02 Lot: POR 14
Bldg: Address Range: 2707-2729
Tract: POTTS, BORDEN &Hlistoric: No
Suite Range:
Zoning: Cl
EUnit: B-3
Block: NA
Owner:
Address:
Phone:
Tenant Name: La Michoacana Premium lce Cream
ENSIGNIA E S G
1 TECHNOLOGY DR
lrvine, CA 92618
Federal Building
15870 Curtis Ave
Fontana, CA 92336
(909) 428-8007
0'11 16002
011 16002
01116002
01116002
0'1116002
01116002
011 16002
01'116002
51602
51602
51602
51602
51602
51602
51600
51602
Fee Type Amount
Sink 12.23
Floor Drain 15.53
Floor Sink 15.53
Sewer Aller/Repair 42.85
Wtr Htr (Comm up to 50 21.42
Water Piping (Each 100 42.85
General Plan Update 21.25
lssuance 52.98
Qty
5.00
1.00
3.00
1.00
1.00
't.00
1.00
1.00
Fee
$61 .15
$1s.s3
$46.59
$42.85
$21.42
$42.85
$21.25
$52.98
Contractor
Address:
Phone
State Lic #: 374153
Lic Type: B, C-39
Bus. Lic #: 366882
Workers' Compensalion lnsurance:Carrier: State Fund
Policy #: 9038073
Expires: 0110112019
Botchi:{4{66 - 6/2s/2O18 ID: ct:UELt.AF
offi(e3 CTYH Tronsi: 1{4 2 of IAccti: Refi: 3[13859n
Rcpti:f2303349 - 6/21/2fi18 3z56 Pn
Tronsoct ion Totcl tl 1352 '::i3
Federol gu i 1d ins
Generol Plon tlpdote Fee
01116002- 51600000-
Pluib i ns
01116002- 516U2000-Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial
Tenant lmprovement
TI
{0194376
*r .21
,283.37Occupancy:
Constr Type
Code:
B
VB
cPc 2016 rnt".i3l'lo []',i5{i i.p,J'Utf#J,?, to, n",, i"" ".3},ri'tfrop
'
including to remove non.bearing wallw, remove one
bathroom stall and installing new counler tops and
kitchen equipment. No exlerior work.
$304.62
$0.00
$304.62
Date:
Date:
Date: 0612512018
Account#
l\,lisc. Receipt:
lvlisc. Receipt:
N,lisc. Receipt:
Total
sden, Julie
Every permil issued shall become invalid unless the wo* on the site
authotized by such permit is commenced within 180 days aftet its
issuance, or il the wo* authoized on the site by such pemit is suspended
or abandoned for a petiod o1180 days afler the time the wo* is
commenced.
01 116002 51600 $2',1 .25
$283.37
lnspector MID#: 2017-139104
01 116002 51602
Fee Total:
Paid to Date:
Balance Due:
Notes:
PLUMBING-INSPECTOR RECORD
APPROVALS DATE tD/stG.COMMENTS
Waste & Vent z 1 I LlQh,r r\r,U
Gas-Underfloor
Buildino Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent (4\)
warer Pipins I*r)
Gas Pipino
Rool Drain
Tub/Shower Test
Rouoh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbinq
Final Gas Test
Meter Release /,\
FINAL 1-11 ),W!0
Notes, Remarks, Etc \J
(69 fr('t-ar'tra& a^L -,\ol ,o J " hr+{U Pr'lth.
U
OWNER BUILDER DELCARATION
I h.eby afarn udcr Fnahy of Fdsy rhar I m.reqr 6om rlc Contrerou Liens t w for tlE touoeins Er$n (S.c.?011.5
Blsi.cs and Protcsrion Code)r Any Ciry or County whi.h Equirc. r Fmn ro snctrl. allci inq,mE. &tuli.\h or Epst d,
(tuctw. prior ro its isffiq sls Equircr rlE apl,lilnr aor sch Fmn ro fiL a sagncd rd.m ihri lE or slE i lic.sd puN.nl
ro rls Imvisions of ttE C.ntrerols LiNn*d L.* (Ch!I)rs 9. Collmrcirg *irh Ssrion 7000 of Dirision I ot rlr Businc$ dd
Pmfcssions Codc) or rhlr lEorstE ir€rcq,r rhcEfion! th.hlsn for rlE allc8ld.r.i'rrio.. Any riolarhn ot Serhn 7011.5 by ary
llllica.t for a p.mr subjers rtc aprlicrfi ro ! civil Fmlryof tut tue fi.n nr hun.rcd dolla ($500).
-l.r\.$ncrollhc|no|Eny,(rnrycDDloyc.s*ir[*i!c\!srhcns'b.oDrpcn\rri,)n.Nilldorh.warkridrhcdddutonturic,xt(t or.fiar.dhr$lc(SL\.70,1.l.BtrstrcssdndP(,tusnnNCd.'lhc(inffu.nr'sl-ic.n\cLtrwrlocstror{!lyro oqncrut
thcpmnlny Nho builds or npn,vcs rhcron. r whodocssuchNolthi'nscllorncr\clrrrrhfl,u8hhi\orhcrown.mDkDtcs,
Dhvidcd r h{ such nnpolcnrms rm n r i, cndcd or otTcNt n, {L. It ho*cv.r. rlr lNiklirl8 or iDprncm is$Llsirhinon.)r,tr
olcoaplurion. rh(O*!cr Auiklcr {illhivc ihcl,unlciol pnniryrl hc or \h. tlil tror huild .r nnproit $c tmFry turrh:Ntrrol
-1.
el os*r of rhc pDrcnr. m cx.lu.iwly conr6rirg with lkcnEd co.rEcloa ro oBirtrd rhc [mj$t (S(. 7044. Bu,iftas
lnd Eof6sim Codc: Th. ConlEclol s Lic.ns L.w dfts mr .pply lo 3n owncr of ,:rcFrly *ho blilds or improv.s rh.r6r
anil {h6 onrels fd such pr6j.rh wnh ! co @ro(s) ltdsd tlIMor ro 0E conrrach . Lt..* k*).
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m.r.mpl u!d.. Setbn--. 8, & PC. fo.6n t!e!
ll)f,f,EBglllMfENta.rlQN
DECI,ASAUQN
I hcrcb, affi r und.r r..rnyorlEjuryonc of th. folbwhg dc.leations:
Ihrvcod*illnui ii.rCcniii.nrcolCotrrctrrhSclllNurchrworkorconrFn\dion.i\ prolid.d larhySccrnrn lT{X)ofrhc
hhtr (i .. lnrrhct rfonrB..c.f rh. $o&,nr*hi.hrhc n rnrir i\ is{rd
-l
h,vc lnd will mihr.i. work$s compcNalirn insumncc, as Equircd by Sdlion 3700 of llE Llbor Codc. fot lne prfomft. of
lhc work for whi.h thi, Fmil h ileicd. My vort6 onqENlio. i.suEna ortr arn l,olky numbcr 6cl
J.Tfi],e Pufut)l- l-20l ,1
-l
ccnifrrhrr in lte Frrorroncc of rhc BorI fot wnichlhisperfti n iisucJ,I sh,ll nor .nrllity .ny ,cson in,ny'nunncr
$ a io b.&@ subicd ro rhc wolkc( conpcnsalion liws ol Califtn.in, and ngrcc ln ifI should iccom slbjcct rorlr
woil.rJ conp.nsarbn pmlnioB ol Sc.'n,n 17(x) ol ttu tibor Cod.. I shdl. lonhqilh omply wilh thos prcvnions.
WAnNING: Foilurc lo slrc work .l comrc.salion otnsc is urlnwtul. lnd sh,ll subiri d mploycr ro aimlnrl [EMlrics ond
civil fincs ry ro orc huidrcd rhousnd dolls (Sl00,l)00). in addiraon r. rhc coi otcomrcnelion, dmgcs as providcd fo.lhc
ntrh. btIr cade inr€E{ ind[-2t- ttr
^:n:k-
DECLAAdII(X
I hcrhyr|]nmrndcr pcnnlrt o f Frjory rltu I r licc $dundrrItulnn,n.lChrlr0r9(connmncin8silhSr..rior7(ix)rofDiri\n,n.l
ol lh. Busirc$ itrd holcssi,,n\Cdc, a'kl Dy liccnsc i\ i'r f!11lnRrr rlfu.r
lc3 rr tt/t kccfr.
(;ONSIf,ICUANIi DIN{illiENg
I hcEby amrm under Fnrlry of Frjury rhar rh.rc t a $.ntocrion tndinr ls.ncy ror lh. ldfornucc of lne rork lor shich rhis Fnir n
i\qucd (sd.lo97.civ c ).
ATIIICANI.DICLAtsAII!'B
I h.Eby0fiinnu er r.nnlly olFrri&, onc ofrhc tulkrsjng dc.hElions
Dcnx,lnion Pci,nik-Asb.stos Nolilicrlion lrcdcrulRcxuhlions (rirlc.l0. Prna,
Rcquircd Lncr ol rLrifi rhn
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ccnify Inar rh. f.dcr! I rcsllal io.s RErdiry nsh.do\ dmvalirc nor atplictrhk b rhis rrcjccr
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ccnify rh,l I hav. ft.d $k ipllicdrhn a,n sd hll fic !bor. infomlion n con8l. I sE d lo on ,ly *nh all Cily tnd Couory
6rd4.,tr6 r.d Srrl. llws rchinS b blilding .o,nMriotr atn hcrt'y audoriu rcFEs.ntalivcs of lhis Cily tud Couly ro .nrd !po. dE
{hovc mnrioNd pslcny aor inrperiotr
Appli(ml or A*.nl SIf mlure:(*s -a
UNDER GROUND
Gas Service
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L.dci\ Ad&r$:
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