HomeMy WebLinkAbout30140223 - Permitcity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Plumbing
Permit Counter (714) 647-5800 lnspectaon Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Permit #: 30140223
Pin #: 6,9778
Project Address: 936 W River Ln Unit:
Block: NA
Bldg:
Tract 1160
Address Range:
Historic: No
Suite Range:
Zoning: Rl
q
AssessoisParcel: 001-232-19 Lot: 7&POR6
Olvner:
Address
BRIAN BUSLEY
935 W RIVER LANE
Santa Ana, CA 92706
(714) 33s-8186
Fee Type Amount
01116002 51602 Wtr Htr (Res up to 50 g. 22.25
011'f6002 5160C General Plan Update 22.08
01116002 51602 lssuance 55.04
Qty
1.00
1.00
1.00
Foe
$22.2s
$22.08
$5s.04Phone
Tenant Name:
Contractor:
Address:
Fast Water Heater Company
11715 North Creek Pkwy So
Bothell, WA 98011
(425) 636-7084Phone
State Lic #: 987398
Lic Type: C-36
Bus. Lic #: 319396
Workers' Compensation lnsurance:Carrier: Liberty Mutual
Policy #: WC2z91464563027
Expires: 12JO1|2O1A
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Plumbing
Occupancy:
Constr Type;
Code:
Notes: Plumbing
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subiect to Field:
Building Permit #:
Date:
Date:
Date:11102120'18
Account#
Misc. Receipt:
Misc. Receipt.
Misc Receipt:
Total
Every permit issued shall become invalid unless the worl< on the site
authorized by such permit is commenced within 1 80 days aftet its
issuance, gt if the wo* authorized on the site by such permit is suspended
ot abandoned fot a period of 1 80 days after the time the work is
cofimenced.
$99.37
$99.37
$0.00
lnspector MID#: 2018-147428
N/A - No Balance Fee Total
Paid to Date:
Balance Due:
R-3
VB
cPc 2013
web user
PLUMBING.INSPECTOR RECORD
APPROVALS DATE COMMENTS OIVN ER BU I I,DfR D}:LCARA'I'I('N
I h.rehy fliirn !n{lq peMlry ol Fr.Nry rhd I nh ex.mnr annn rte Conrric'ors'Lkctrs.l.aw itr rh. n)lhwh8 tersn (S(70115
Business nn1 Proltss()n aqlef Any C y or Coudt wh'ch rcqon.r i ltm b coNNcr, .lter, Dport, d.dnfh .r *ljnr My
srru(ure, rrnb rs rssumcc, ih, r.qutrrs rh..Ppli..nr f.r strch rEnnn lo fil.r silncd srarche rhd h.orshc is liccnsc<l lum l
kJ rh. povhioN olrhc Conuacrois l,icc *d b{ lc&Ilrcr r), ConoctuinS wirh S.clion 7000 of Dn hion I ol rhc Business .nd
Pniacasi(]ns Cod.) ot thrl h€orshc ircien[l rhtrcr.onind rh.hisiq nrrh. il lcserl cxcmpr r o Any vk ,Lonoasedi(,n70-11 5 hyany
orphc2nr tirrDcmn tubJekih. rrr[canr ro.cNrlp.nrlryoln.r nMc lhon fiv. hun Edd.llam($500)
-1,
as oNm. of th. pmncny, o ny .rylorc! wirh {!s6 !s rh.r $1. confcnerion. * ill {to rfie 'ol( srxi rrE {rudne MI
inlod.d or ofi.r.d aor sl. {s< 7044, au.,n6. and Poa.ssons Co(lc I he Contdcroi3 Ltdk L0w do.c mr 8pl,lv ro o. osnd dr
rh. pmp<ny s,hn hoilds or impmlh rllsrn,.nt who do6 sch rbi( hims.lfor h.*.lfor thmwh iiu or hc, own.nDloy..s.
Dtuvd.d rhd slch inDmrmnts e ml inroddl.r.ll.rtd tu$1. lf, hostvd. lh.ltrlditrs .t r.{mva*d is sld wrhin on. )m
.tconpLrbc rhc o*8. BuitLr will tuE lh. tudcn ohrcvinr lll1l h. or dE dd ftn hoild or iq,mv. rhc ,mFrry fot lh. ou.nor of
-1.
owB6frhcnmp.ny, am excl$rcly co,{rsctins *1th licmretconitmronro snsrocl rh. Ptojsr (s- 7M4. Bus'N
a PNlsion Codc 'l h. cdtrlrr.roa s l-i..Nc Law do.s mr onDly t. 0n owncr o l rrop.d y qh. burldr or imtn'!.r l tursn.
ind sh. md6.h lo. such pmj{c wirn! Coormdo(, li..n*d pnBum b lhe(ontroclor't Lic.n€ L.N)
I .n.x.md und.r Sd6r .B &Fc forrh r6sn
ort : Oln.r:
]!a85E8$gl!tfrNsAll9!
DECIABAITON
I IEEby o,Itrm under pdltyofpdrry6Eoflh. following dmldnlions:
lh.vcnkl\illm.inrnin,( en'firar.orcon...r b selHntur. Ji,r Lvorkc6'.o petrern .3r nnnd.d nnnySeclon llT0rrolrhe
l-1l!tr (inl., i* rhl ,rri)nnarce oI r lE snrl t r trich rM ncmnr F Fn'cd
_l h,k and will mri.hin qortdt .oftn nierio! im@r.. ai ,c!tri(d by Setion 1700 ofthc Llbor C.&, fot th. Dirfomm. of
rlE e.t for *hth this Dmil is is.d. Myw6k4 @npd.rion in EN. oricr 5rn Oolcy numb.. r.:
Polry Numh.r-!ipircr
-l
c.niry d6t itr lh. tl.rftlmtr of rh. work tu which lhi Frmir h i$u.rt. l il6ll m| mphy.ry p.rs. i. a.y @.F
s s 16 b.om subFcr b rtE ed.m'oqEtrqlion L$ oacaliaomi,, r.d r8c lhal if I slsuld h..oG sbirct lo lh.
"brk6l €mp.Nalion pmvisioN ols.dion l7m 6f rhc t!tn. Cod.. I dhll. fonh*ilh 6dnly tnh ih* pDvisioB..
WARNINCT railuE t6 c@ mrtd' omn.Nllion ovcms. it u.l.wtul. dd shatl subj(l 6i onlolt, ro diniml p.Elli* 5nd
cMl lio.. up ro oG nudFd lhousnd dollan (!100.000), i. lddni.n ro lh. cocl ofcoq,.nlalio., damgcs ts frcvid.d fot lh.
S*rion 1076 oflhc ldnr C6d., inl.rcn lnd ,lld*y ! fes.
rlcExs[DtotrrtAqraa
DICIABAIION
I h.Eby dflirh nnd.. pen llyolperjurylhll I am lienEd unds pmltnnofch.prd 9(omn]mins *ilh Setion 7000) of Divhio.l
of rh€ au,iNsr .Dd lmf6ri6nr c..L. fun oy lic.nk k in nlll aorcc tud .llst
Lic.N. Ch$:-Lie@ Numb.r:
D.t: Co n tor
ca!flrBtcr&rJ.]:liuNriA!;rlc.1
I hcEby inth undcr p€oaltyolpcrJorylhal rh6. s d s.ifldsn kndirs i-leflcy fo. rhr ll.rli,mn.! olrh. {ork lor *hich lhN rs.fl ir
*iurdlSr 10s7, Civ. C.)
ITLTC NI.DICTAAAI&L
I lEElry alUnn undc. pemlly.tr.rJuryoR ollhc li)ll,,qr+ drclimr ons
D. r,l{trnr Pci,nds shc{os Notificrri{n,l'.dcnlltrAuhrnns( I l3,tl,, Prd6)
R.qurcd L{cr oi Nor'licxron
-l
ccflify $dl rh. fdrl.6l cgulations Esardins !,b.stos re'novol lrc ml +plicNhl. to rh6 tmFr
Ic.nrfyrh lh$.rcadthn.rrlrcrlnnml(xr.rlr,ihcnl ci nm xii r.on{r lryftthomnlyw h.llCiry. lC.uni!-
o^t ninc.s and Sr.r. L.\s el.rng lo hurld'n-! con(nrcrion. aftl hcrrhyrtrrlvn2c r.rusenldtres o,'rht Cilyand Counry h tnrcr trlmnrhc
rhrve ftntoncd thndy itr msndrnr luqises
Aml.rnr or At 0r sErturc:_
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
Area/Storm Drain
lnterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P{rap/Drain Line
Main Drain/Pool Piping
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 /z-t.-/r",.//4>aatr)
Notes, Remarks, Etc
ID/SIG.
UNDER GROUND
Gas Service
LdJd r Ad&Hs
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