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Home My WebLink About30137540 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa A na, CA 92702 Plumbing Permit#: 30137540 Permit Counter: (714) 647-5800 In spection Requests: (714) 667-2738 Inspector Section: (714) 647-5853 Pin#: 98311 Project Address: 3101 S Deegan Dr Unit: Bldg: Address Range: Suite Range: Assessor's Parcel: 412-152-31 Lot: 26 Block: NA Tract: 7434 H istori c: No Zoning : A1 Owner: Add ress: Phone: Tenant Name: Contractor: Address: Phone: State Lie#: Lie Type: Bus. Lie#: Veronica Eggers 3101 S Deegan Dr Santa Ana , CA 927046612 (949) 545-4100 Owner-Builder Work ers' Compensation Insurance: Carrier: Policy#: Expires: Building Use: Job Type: Single Family Dwelling Addition Occupancy: Constr Type: R-3, U VB 01116002 51602 01116002 51602 01116002 51602 0 1 116002 51602 01116002 51600 01116002 51602 Fee Type Amount Water Closet 13 .24 Whirl pool Tu b/Foot Spa 20 .73 Sink 11 .83 Sewer Alter/Repair 41.46 General P !a'rl'-Upd~te ~< ·' -20.56 ·· U :·. -' ., . __ ; 51 .26 Issuance •. l ~ -.. - '' -:: ; •; r:-. j • I ._ :. \,.,•I , .' ~• u •~ • _ I ,:.-~ 6•~i;.[ _t _; • Qty 1.00 1.00 2.00 1.00 -• i. . 1.00 1.00 Fee $13.24 $20.73 $23.66 $41.46 · ;,$20:56 · , $51 .26 Nature of Work: Addn Code: CPC 2013 Notes: Bathroom addition at rear of house. Owner-Builder form on file. Pl anning Conditions: All materials to match existing. Planning Approval By: Date: Plan Checked By: Date: Permit Issued By: Subject to Field: Chavez, Dave -y~' Date: 12/06/2016 Account# Building Perm it#: 10189183 Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 180 days after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of180 days after the time the work is commenced. Inspector MID#: 2016-128634 01116002 51600 01116002 51602 Misc. Receipt: Misc. Receipt: Misc. Rece ipt: Total $20.56 $150.35 Fee Total: Paid to Date: Balance Due: $170.91 $0.00 $170.91 APPROVALS DATE ID/SIG. UNDER GROUND / Waste & Vent Water-Under floor PLUMBING-INSPECTOR RECORD COMMENTS OWNER BU ILDER DELCA RATION I hereby a ffirm under penalt y ofpe1ju1)' thnt I run e:xcmp t from 1he Co n1r.ictors· License La w for lhe followin g 1·enso n (Sec.703 1.5 • Ousiness and Pro fession Code): Any Cit y or County which requires a pcnnit to cn11stn1ct, a lter , improve. demolish or ,repair any s tructure . prior to its issuanc e. a lso requires the app li canl for such pennit to file a signed stntcment thm he or s he is licensed pursufmt to the provis ions o f the Contrnctor's Licensed La w (Chapter 9. Commencin g with Section 7000 of Division 3 of 1h e 13usiness and Professi o ns Code) or that he or she is exempt therefrom and the basis for the all eged exemp tion. Any violnt ion of Section 7031 .5 by any applicant for a permi t su bj ects th e applican t to a civ il penaltyofnot more th an fi ve hun dred do llars ($500). Gas-Unde rfloor _r. .is owner or1hc pro pe1ty. or my em ployees w ith wages ilS th eir sole compcns.u ion. w ill <lo the w or k and the st rui:llwc is not intended or offered for sale (Sec.7044. Business and Pro ressions C'ode: The C'o ntn1 ctor ·s License Law d oes not apply to an {lwner of Bui Id i nq Sewer the property who bu ilds or improves thereo n. and who docs such work hi mself or hersel f or through hi s or her own emp ](lyees. provided tha t such improvements are not intended oron'ered for sale. Jr. however. the building or improvement is so ld wit hi n one year Area/Storm Drai n of co mp letion . the Owner Builder will have the burdt.'n o f proving Ihm he or she did nOI build or impro,·e lhe pmpe11y fort he pllllX)SCof t-l_n_t_e_r_c_e_i~pt_o_r /_C_l_a_r_i_f _ie_r ______ --lf---------+---------+--------------------1~ as owner o f t he propct1y, a m exclus ive ly contracting w ith li ce nsed contractoi, to co11st111ct the proj ect (Sec. 704 ,1, Ou,incss \. VU-Pro rcssio n Code: The Co111rnctor·s Lic en se Law llocs nol apply to mi owner o r property wh o buikl s c1r imprtH·cs thcrctin. TOP OUT Waste & Vent Wate r Piping Ga s PipinQ Roof Drain Tub/S hower T est Rouqh Water Heate r POOL/SPA P-trap/Drain Line , Main Drain/Pool PipinQ Fill Line/Back Flow Pool Heater/Gas Line Miscellaneous Ga s Service Water Service Lawn Sprinkler Sanitary Sewer/Cap Back Flow Dev ice ... h1 Rough Plumbing Final Gas Test V ( \_./ Meter Release FINAL Notes, Re marks, Etc. a nd w ho contracts for s uch projects wilh a Co11trn cto1~s) licensed pursu.mt to the Contrnctor ·s License Law). _I run e xempt uJ der s.7_11011 ~· B~ rnr t l~·eason_:_ / Date • / / //,,, // f/7 Own er:~~ --~ ~ ( l """"woii"KERS' CO1\l l'ENSA TION DEC L A RATION I he reby affi r1n under penalty of perjury one of 1he fo llC>wing dcclarnt ions: _I have nnd wil l maintain ,1 Ce11ific:ue of Consent 10 Self-I 11s11re for workers ' co111pensntion. ns pro\·idcd for by Section 3700 o f t he Labor Code. for th e pcrfonnance of th e work for which the pcnnit is issued. _I have and wi ll maintain worke rs · compensation i11surance. as required by Scrt ion 3700 nf the Ln bor Code, for 1he performance o f the work for whic h this pcnnit is iss ul.'d. My workc.1'5· compcnsntion ins urance c.:11Ticr am.I policy mnn bcr are: Ca.Tier: __________________________ _ o I Numbcr: _____________________ Expircs: __________ _ ce11ify tha t in th e performance oft he wo rk for whi ch this per mit is issued. I shall not employ 1111y person in any nrnnncr s o as lo become subject to lhc workers' co mpensation laws orCaliromia. anti agree that if I sho uld become subject to the workers' compensati on prov isions o f Sectio n 3700 of th e Labor Code. I shall. fo11hwith CC'lmply with those prodsions .. WARNING: Failure to secure workers' compen satio n covern ge is unlawful. and shall su bject an employer lo crimi n<1I penalties and civil fi nes up to one hundred thousand do ll ars ($100.000). in addition 10 the cost of compensat ion. damages as provided for th e Sectio n 3076. <;.L!j i~abor ~c. interest and all omcy 's fees~-/!~.: _ = ~ _ Dale: / d/6?///4 A 1i 1i lica11t : ~~ ~ ( ( -T LICEN ') 'ON TRACTOR D ECLARA TION I he reby affirm un der penahyof pe1jur y that I am licens ed under IH·ov is ion of Chapter 9 {commencing with Seel ion 7000) c,flJivision 3 of the Business and Profess ions Code. and my license is in fu ll force and cfTcc t. License Class: ______________ Liccnsc Num ber: _______________ _ Date: ___________ Conln1cl or: _____________________ _ C ONSTRUCTION LENDING AGEN CY I hereby affirm under pena lty of perjury th .11 there is a constmclion lendin g ;ige ncy fo r the pe:rfon nance of1 he work for which this pennil is issued (S ec. 3097. Civ. C.). L cndcr ·s N nmc: _________________________ _ Lende r·s Address:------------------------~- APPLICANT DECL A RATION I hereby nffi1m under pen nh y of perj ury one of t he follow ing declarmions: Demolitio n Permit s-Asbestos Not ificat ion Federal Reg ul ations (Tit le 40, Pm16) _Required Let ter of Noti fication I cet1 1fy that th e fcd ernl 1ci;ulatmns 1cgmdm g asbestos 1c rnoval me not appl1c.iblc to this project i--------------------f---------+--------+------------------A---\,...e.l c111fy th at I hme read tins appli cat1on and state th at the above m fommticm 1s conect I agree to compl y w1th .tll C11y ,111d Coun ty ' ces and State Laws relating to butldm g. constme11on. and he,cby nuthow.e 1cp1csentnt 1vcs ofth1s C1ty and Cou111y to enter upon the above mentio ned prop e11y for mspectlo n ~)' ,_.._ '/? .J' _ _£,,__ ~,, ~ -// / A p1i licant or Agent Sig nalnre: 7' "{ A _,_,, ~ ~--D,lte ' / 'c:;, L£-b P ennitee n a m e(print) X / /_. ~ 'i t.LV ~~~Y--C::::, ( • V ///) .?'"