HomeMy WebLinkAbout30139686 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAg27o2 Plumbing
Permat Counter: (714) 647-5800 lnspection Requests: (7'l.4\ 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 2424 N Tustin Ave
Assessor'sParcel: 395-261-55 Lot. 8
U nit:
Block: A
Bldg: 24-F Address Range:
Tract; A.B. CHAPMAN Historic: No
Suite Range: Unit F-12
Zoning; R4
ry
Owner:
Address:
Contractor
Address:
Phone
Tenant Name:
01'116002 51602
01116002 51602
01116002 51600
01116002 51602
Fee Type
Sink
Dishwasher
General Plan Update
lssuance
The Bascom Group, lnc
26 Corporate Park Drive, Suite 200
lrvine, CA 92606
(949) 95s-0888
Amount
12.70
11 .97
22.O8
55.04
Qty
4.00
1.00
1.00
1.00
Phone
Stale Lic #: 1009989
Lic Type . B
Bus. Lic #: 356547
Workers' Compensation lnsurance:
Carrier: Midwest Employer's Casualty Company
Policy #: BNUWCo'|39070
Expires: O1lO1l2O19
Eotchi:44814 - 7llu2gfi ID3 CCUEI-LAR
0ffice: CIYH Tronsi: 60 5 of 14Accti: Ref+: 3013?6S6
RrDtS:02325615 - 7/$/ml8 l?.32 ?n
Tnonsociioa Totol t2 r 18ft.76
Koterro RenovBt ionsr LLC
Generql Plon lbdote Fee
01116002- 5160@00-
Plu.b ine
01116002- 5r6020s0-
ICL Check 00:l0l{
V isa
CCi ! rrrrrlrrr*r*5069
t2,0?9.43
3S1.33
Autha !013015
tl1/.gl
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Date
Date
Date
R-2
VB
cPc 2016
Notes: Fixture change outs (unit l2)
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Chavez, Dave
Every psrmit issued shall become invalid unless tho wo* on the site
authorized by such permit is comfienced within 1 80 days aftot its
Bsuance, or il the wo* authorized on the site by such pefinil is suspended
or abandoned lot a poriod ol 180 days after the time the work is
comfienced.
07t16t2014
Accou nt#
$139.89
$0 00
$13s.89
MID#: 2018-144626
01116002 51600
01116002 51602
$22.08
$1 17.81
Fee Total:
Paid lo Date:
Balance Due:
Permit #: 3Ol396Eo
Pin #: 98464
Katerra Renovations, LLc
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-1065
Fee
$50.80
$1 1.97
$22.08
$55.04
Multi-Family (5 or more uni Occupancy:
Alteration Constr TYPe:
Fixture change outs (unit l2Code:
lnspector
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.oWNER BUII-DEII DEI-CARATloN
I hcrchy 3tlirn uftlcr Fnilry 'l pcrju,y rhnr I am cxcnu fbrn rh. (bnnrtus l-iccnsc Law lor rhc following r.,wr (s..?0.115
Busincs\ nn Pfl,rcsi Codc) An, Ciry or Cou , qhich .crtuncs . !..nir 1,, consrnrcr, lllcr. inrrotc. d.nxnish or ri,'rn jtry
nrudurc. prin b ns is\uan... rl\o 6qunc\ rhc,rpli(lnt tu {rh rcrnril ro filc a sisncd shrcnEnr thar h. or shc is li(cn{d nu^;.un
rorh.,iovh(,n\.lrhtConrrcttr\l-iccoscdttr'w(Chaprcr9,Co.rcncn,B*ilhScdion,O(UolDivisn,nIollhcBu\nr$0nd
holc!\ion\ Codc).rrhat hcorshc iscxcnn rh.rcftnnand rhcha\i\ nn rhc rllclcd crcnprinn Anrviolarn,nofSarion?0ll56yany
.pFl,.rd ftr a Fmir ttrbrr.r\ 'h. trnpliconr ro rcivilpcnilryoinor nntrc 'h livchutrdrcddollan(s50o).
-L
ss owrB of rh. Ir$rEny, or ry rmployei wilh sre.s 3. rhcn $k omF.slio.. wil d. dx *o't s,n $. slrEIm n nor
inrcndcn or oniEd fo. sk (Se.7lx4, BNim$ ,rd PiofBrions Codc: Tnc ContEcrois Li.cn* tis do.s mt appl, lo !n o*rcr of
th. Irltdy Dho hdildi or ir{mws lh6er a eno &Es Mh ,Drk him*ll or txrklfo, $rcu8h hh or he, owo .mtlor*s.
pmvided rhd rkh ioFo\ftits d ml itrLndcd orotrcrcd for sL. ,l howEr. th. hoihinS or ntpbwnEnl is $ld silhin om Fr
or cotrpLraon. $€ Owtur Blildr will htrE rlE hlnl.n 6f rs\in8 firl hc or slr dil mr t{ild or nq'mE thc l,oFrry for lhc ,Ioeor of
-1.
as owM ol rh. !mp.rly, !m cx.lusively cofirading eilh liensd ontturoN ro onstrucl rlE pmic.r (Se. 7044. B6inc$
ard P,trEsion Codc: Thc Conrrsrolr Lkcns. hw dm3 nd !!nly ro d osno of proFny wlro builds or improEs rhmoil.$d who @ 6.r.lor seh !rei*K wirh o Co reto(s) licnrcd puB6r ro rh. Conrreroas Li€n$ (iw,.
-l
an.x.npl u.dd Setion- B. & P.C. for lhir it&n
Dale: owmr:
]4OEf,EXE.TOMTENSAIION
DEqI.ABAION
t h.Etry emro undcr FD.lly of Frjuy onc of thc follouing drbrdioN:
I hrvr nn *illftrinr.in!CcnilicdcofCotrsc k, Sclf l' urc nr workcrr ro'n8i\rrirnr, as prcvn[d br h] Sr{rion :l7rD ol rhc
lf,bor (odc, for rhc Frrbrmincc olthc $olk ior *hi.h rh. Frnrir n i\\&
_l hsv. .nd will @i.rain m,t6 snpens.tion inrlraftc, ei rcqun.d by Section l7O0 of rhc kbor Codc. for rhc l]gfolmre of
thc wort for *hjch lhi! pcmn i. hnEd. My sdls mqrnslrbn inrurlne @i6 en poli.y Nnh.r dc:
c""r. !4rdr.!rfF CUS' Lhs.-
c
-l
ccnifylhar h lh. lcrformrc ofthc qork {or which lhh F nit is iss.d, I shrll nol cniploy any pcMn in ony manm.
s !s lo b.com subixr ro thc vortsd conqEnrarion luqs of Califo,ni., .nd asft lhir if I should bccoft subj.ct
'o
rhe
vorlcB mmpcnslioo povhiong ol Serion 3700 of rh€ Libor Crdc.I dEll, ao tsirh omply wirh ttFs povhions..
WAINING: FBiluB to surc rorkc6'.omp.nsalion .ormgc i\ unlnwtul. and $,]l subjccr nn .mplorrr ro aininal lxehi€s and
cieil nnes u! lo orc hu.drcd lhouFnd dolles ($10o,fi10). in rddkion ro rhc cosl of.onp..sdion. dame.s rs trcvid.d ror rhc
Sccrion 3076 of thc Llhor Cdq inlcE( lnd dromy s lt.s
*",JULIS 2{ll$
I hcrcby dlir undc. tc rlrrofp$jur) rhrr I ar licctrsl of Chaprcr 9 (@mncinB eith Scrrk n 7000) o( Difision l
9.lwlga
?4..".
SOISIAICDON.LENDINCIIiEIqT
, h.rcby rmnn under Fndty of pcdury llBl thcrc is a cons{ru.tion tRli.8 4cncy ror thc Frfttrmnc. of lnc wort for whict this p.mil i,
hrucd (S(.:1097. Civ. C.).
AIILIIANI.IIECI,ABAII!]N
I hc,.ty anim u.dcr pcn.lryoiperjury onc oflhc lollo*ing dRlararn,ni:
Dcmlilion Pcn rlAsh.ios Noriicrrion Fcdcral Rcsui.r ions (Tnh t0. Pan6)
_Rcquircn kncr of Norirurbn
I .cnify rhrr rhc ac!€ral esllarions Esarding asbcsros Ermval aE nor .p!,lkst h lo this tDirt.
Gllfy rhar r h!'c rcid rhis oppriclr
ordimnccs.nd Sl c tiws ElalinS lo bu
rt{w mnrion.d porcny lor iBpcciio.
ion .ln sl.l. thal lnc orc inrorMion is co,Et. I 08rs to
ruffiur'#:fli{'1f
Apdic,.l or t*enr slrnllurei 9a\.
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
lnterce ptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rough 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 Sewericap
Back Flow Device
Rough Plumbing 4"/eu/(,sA6{
Final Gas Test
Meter Belease
FINAL b/2-?tY >\97
RemarksNotes , Etc.
COMMENTS
Gas Service
l.\. \n
or rhc Bnsi.crs aJll Pmrcsrk,n\Codc. ud nyliccns is in tullforccutcficcr
*'dtI[-
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