HomeMy WebLinkAbout30340299 - PermitProiectAddress: 1920 E Seventeenth St
Assessor'sParcel: 400-011-03 Lot: 3
unlt: 120
Block: NA
Btdg:
Tract 6313
Address Range:
Histoic: No
Suite Range:
Zoning: C5
city of Santa Ana 20 Civic Center Plaza (l\4-'19), Santa Ana, CA,27O2 Plumbing
Permit Counter: (714r 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 30340299
Pin #: 3896$
Owner:
Address
Conlractor:
Address:
Alex G Gladkov Dental Corp
6818 S La Cienega Blvd #203
lnglewood, CA 90302
Foe Type
01116002 51602 Sink
01'116002 5'1602 Min Fee Adj
01116002 5160C General Plan Update
011'16002 51502 lssuance
Amount
12.70
47 .98
22.O8
55.04
t.lIi.'':t'.1t
Qty
2.00
'1.00
1.00
1.00
Fee
$25.40
$47.98
$22.08
$5s.04
Phone:
Tenant Name: Orthodontic Center of Orange County
vcD&soNstNc
526 S Ross Street
Santa Ana, CA 92701
(714) 80'l "7604
Refir 3U
Phone
State Lic #: 596135
Lic Type: B
Bus. Lic #: 38/2
Workers' Compensalion lnsurance:Carier: State Compensation lnsurance Fund
Policy #: 1877843
Expires: 1110112019
nte t
toti-
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Sub.iect to Field:
Building Permit #:
Commercial
Tenant lmprovement
TI
Occupancy:
Constr Type:
Code:
B
VB
cPc 2016
Notes:
Misc. Receipl:
Misc. Receipt:
Misc. Receipt:
Total
Legalize unpermitted work - new partition walls to
create dental rooms, xray, office;(2) new restrooms;
new exterior door; demo patio cover.
$'150.50
$0.00
$1s0.50
11119t2014
Account#
10396696
lnspector MID#: 2018-143892
$22.O8
$128.42
Fee Total
Paid to Date:
Balance Due:
16935 Auth+
Building Use:
Job Type:
Nalure of Work:
ar",r",^,,.."*4:j:'
Ewry pemit issued shall become invalid unless the work orl lhe slle
authotized by such permit is connenced within 180 days allet its
issuance, or il the wotu authoized on tho site by such peftnit is suspended
ot abandoned for a peiod of 180 days aftet the timo the work is
commenced.
01116002 51600
011'16002 51602
PLUMBING-INSPECTOR RECORD
DATE rD/srG.COMMENTS OWN I]R BU I I,D}:R I}},I,CARA I'l()N
IlNrehyalliirnunderpcnrlryoillcrjrr_vrhar I im.rcn'ni ln,n rhc (onlmclors l-rcense l.aw Inr rhe nnnNrnr r.a$n (s.c7J.ll5.
Brsn.s $d I'rofcsrrn Cod(): Any Cii! or C.unry rhich r.quircs i n.flnil n, !1rn{dcr. rhcr- i nrrrc, irn{rlFh or..ndlny
srnr.rurc. nn.rn, s $urm., lh. r.lutr s rlE.ppi'c!m iin suchr.rnnrb filci nSndn srre rrr rhd htorsl[ ri ncenscd ,'ursinr
lo llE nrnisnns ofrhe Contaclo.s l.rccnscd l.iu lChrnrer r). (innncDcrns w(h s.don 70110 ofDrvr\nn.l orrhc Busines rnd
Pn,L*ronsCod.)orlhrr heorshe is.rempr rhcr.lir)lr and lhchnsi! inrheallegrd Etcmpri,,n Anytiolarbn.lSc.ri Tr)ll Shynn!
rnll'(rrl,,riNmirquhl(rirh.anllrdmt,r.,!,l|1cnilrtor,rdofurhrnlivrl[ndr.iliollr6(S50r))
_1. a owB ofrh. pftpcdn or ny.millorct with wrgd a ft.n sb 6np.@lio.\ will do ilE mrt {td rlE nnEl@ ie ml
i,16.,.d or ofi.Ed for sh (Se 7044, AuBirc$ ard Pmf.*hN Cod. Thc Conl[dtrt Lh.tr€ t w {tB ml lrplr lo e otu of
(h. ,,mFny who hlildt or inpmB th.6n .nd who &B Mh mlt him.lfo. h.Mlf or lhmush h,r or hd ostr .mtl6r!d.
trevid.d rh6r ch inpoldErll! mr i,!.rd.d oro,&!.d fornk,l[ h.wM,0E t aldi.S or nqmwr.l ir$ldeithinoN rEr
of er{,ldioA rlE O**r B!iB6 wil lEh rlt t rrkn otForing ttd lE Md'. di, Dl hlld o. inphE dr FoFry 6r llt pupoiof
-1,
asowNrofrhcl,mr.ny, M.ichsirtlyco ndins wnh lic.d.d conlado* loon$tud ilE pmtfl (sa.7044, Buio6
od PoE$bn Cod.: Th. Conlr!€to!'s Lic..r. L.w doe .or apply to an owf,.r ofrrcn ny eh(, buildi or ihrov.s rh.64
and (hr mnl@t, for s.h lojcts{itha ContEdo(r) lianicd|'u@nt rorh. ConlEcloas Lim* t {).
-l
rhcr.hfl und.r S*rion , B. & P.C. forrhF Ersn
WOIKf, N,S' COMPINSATION
DlCt AEAlll)!
I h*by dmrd !ftt r nmlty ofDsjury oE oflhc fouoqin8 ddoral io r:
_l hav. .d will tuintain ! C.nificar. oacon*nt ro S.lf-lmuE for s.kdt @np.neio4 ai ,Nvid.d for by sdrion 1700 of thc
htor Cod., forin pdfolw oflh. mlk fn qnhh th. pm n i!$.d.
_l hav. .nd will 6!i .in work.m coftp.n..ron
'n
urnrcei d. r.rtuir.d hy sdr io. l?00 o f the Lobor Cod., Io. th. I,.rIomrc. oa
i6urm. cankr aid p.li.y nurbcr &€
/ -r-o /7
-lccnirythatinlhcFrfotmMofrh.vortforwhichrhhr'.mnisir.d.Iihnllmroploylnyr.Nnin8nymnmt$ tri to h.om subjd ro rh. wortdc mota*tion laq of Calif6mi,. and a8B lh.l if Lhould hMnr rubjet lo th.
w.d6 coo{B qrion roaismn. ofsdrioo l70o olrh. Latbr Codc, I ih,ll f.dhwith smply wilh tts* pmvisbm..
IVARNINC: liailurc lo Ecuc work n' comp.nsti.n covcnse
cNil nn€s !p lo om hundrcn lhousnd dollaa (5100.000). in
r rn .htLr$ ro ei iMl pmnis,nd
d.m! r.,mvidcd for rh.
Serion 10?6 ofrh. btx)r Cod.. i.l.r.n ad
*".1/-H'a-ol6 erA
I lFrcby a,it,D under p.Mlty o I D€rrury lhit l.n licensl und.r nmvision.fchmkr 9(comncm'ns sirh sccrbn 7000, ofDirisio. l
of rhe Busin.ss iMl Pmf.$onsCod., r nry liccnsc f rn 6ll nrrc. iftl ciier
L)
I hdby .rtrm u.d.r FMlry o alcrury rhd ihd k a cohnruobb l.nding .8.fty aor rh. pqfomm. of lh. *olt for shich lhir pcmi i.
issu.d(scc 1097. Civ, C.).
aftucAxfuielAts UQ!
I lmlry.fnn und€r ,cna lly of ncrrury on. ofrhc followrnr d(l.mti,rns
Dcnol ion P.imn* Arbdkx Norilic.r bn lred..JlReguldionilTnle 40, Pin6)
Requircd Lcxn olNorincdion
-lc€nilythar
rh.lcdcrsl rerlhrn,nr rsodin! ashc$s .€!nov0l ar. nornpplcsbL r. rhir tmjel
-l
c.niry that I h!v. Ead thh E rrlicot n iscord.l asE to smnly*ith.ll Ciryr.d Counry
ordrMnces and Srar. L0vsrcldiryto huild rcIr.enl.rtrrs .lthis Cilyind ('ounl, n, orcr trFrn rhr
xtxnr nrnttr,ned n.op.n' nrr
App,lc nl or
^srnlSkuturc:
4a
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor rl
Building Sewer *lorll 4 t itn.atA-
Area/Storm Drain r{''t'
lnterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rou gh Water Heater
POOUSPA
Ptrap/Drain Line
Main Drain/Pool Pipino
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing ////0/tr /,/n//Yk,
Final Gas Test
Meter Release
mh-rltlt A'Ahvl fl,( *(A
NoJgsrRemarks, Etc I
4/n//( Mrsz, 2 6116,(-
I
APPROVALS
Gas Service
FINAL
i-