HomeMy WebLinkAbout30142126 - PermitO City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 30142126-
Pin #: {295E
Proiect Address: 1918 112 S Svcamore Sta
Unit:
Block: B
Bldg:
Tract: 289
Address Range:
Historic: No
Suite Range.
Zoning: R2Assessor's Parcel: 015-063-1 1 Lot: 5
Owner:
Address:
Ana Castillo
1918 S Sycamore St
Santa Ana, CA 92707
(7141 317-e681
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type Amount
Water Closet 14.78
Shower/Bathtub 23.12
Sink 13.20
Sewer Alter/Repair 46.25
Gas Line alter/extend/ar 68.14
Wtr Htr (Res up to 50 gi 23.12
Water Piping (Each 100 46.25
General Plan Update 22.9s
lssuance 57.20
Microfilm Records 3.91
Qty
1.00
1.00
3.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
Fee
$14.78
$23.12
$3e.60
$46.25
$68.1 4
$23.12
$46.2s
$22.95
$57.20
$3.e1
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work
Single Family Dwelling
Miscellaneous
Plumbing
Occupancy:
Constr Type
Code:
R-3
VB
cPc 2019
Notes: Plumbing
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
web_user
Date:
Date:
Date:06/01 t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
N/A - No Balance
N/A - No Balance
Fee Total:
Paid to Date:
Balance Due:
$345.32
$34s.32
$0.00
lnspector MID#: 2020-1 59 170
PLUMB!NG.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNEN BUII,DER DETARATION
I hscby affm uoda pculty of pcjury ttd I m smpt fiom lhc CrdrrlN' Licw try for tlrc fo[owing rctdrit (S.c.703tt
Buhs md Prcfeion Codc): Any City or Courly which rcquiB r psmt to @Euuct, altc, imprcvq dcmolish or rpah ray
stuclucpriortoits irslmqd$rlquh6thcrylicmtforsuchFrnittofilcEligncdltdoqrt thtth.orCrcblimscd puman
to thc provbiom of th. Coob<r's Licas.d kw (Chapta 9, Comtring with Setior 7000 of Division 3 of thc Buim ud
ProfsiomCodc)orthdhcorlhcisqmptth@ftommdthcb6sbforthcallcgcdq@ptioo. AnyvhluiorofsEtb!703l.5byuy
spplicut for I pcrmit subjGts thc rpplimt to a civil pa8lty of mt mrc the 6vc hun&cd dollars (t500).
-1,
s oms of thc prcpqty, or my mplolE wiah weg6 s thcir slc ompaBdbn, will do rhc wL ad tlE dnnre b mt
inradcd or ofrcrcd for slc (Sc.7044. Buire md Profsioc Codc: Thc Cooaaq'r Lkre lrw do6 not eply to u ow of
thc FDpqty who builde or inproc tluurl. od who d6 grch rc* hiroclf or h*lf or thnud his or lE om cmploya.
prcvidcd that such imprcwrats rc mt intadod or oltrcd 6r sh. lf, how, thc hrildirg or ir4rowmt b mld within orc )a
of onphb+ thc Ovm Buildc will ]urc tlE hrda of poving thi hc u dE did not hrild u irqrow tbc popoty 6r th prpos of
sb).
-1,
s oma of thc Fopsty. m qcluiwly coltncliru with lifficd @atrlcloB to oNtruct thc Fojet (Sc. 7044, Buin6
and Pmftsin Co&: Thc Contrelor'r LicGN Lsw do6 mt eply to m owa of propaty who buikls or inprovG th6on,
ud who @nFets for iEh Foj*rs with . Codractq(s) lLrEcd pmuot to thc Conbelor's Liffi [rw).
-l
m crmDt und( S61ion-, B. & P.C. for this @tr.
WORKERS' COMPENSATION
DECLARATION
I hereby affrrm under pcnalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure fior workers' compensation. as provided for by Section 3700 of the
Labor Code, for thc pcrformance of the work for which the perrnit is issued.
_l have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code. for the pcrformance of
the work for which this pennit is issued. My workers' compensalion insurance carri€r and policy numk are:
Carrier:
_l certi& that in the pcrformance of the work for which this permit is issued, I shall not cmploy any person in any mann6
so as to become subject to the workcrs'compensation laws of California, and sgree that if I should become subject to the
workcrs' compensation provisions of Section 3700 of the labor Code. I slnll. forthwilh comply with thosc provisions..
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an snployer to criminal panhics and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as providod for the
Section 3076 of the Labor Code interest and attornsy's fees.
Dnte: Applicent:
LTCENSED CONTRACTOR
DECI.,ARATION
I hereby affirm under pcnalty of perjury that I am licensed under povision of Chaptcr 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
License Class:- Liccrse Numbcr:
I)o I o'
CONSTRUCTION LENDING AGENCY
of perjury that there is a construction lending agency for the performance of thc work for which this pcrmit is
Lender's Address:
APPLICANT DECLARATION
I her*y affrnn under penalty of perjury one of the following declarations:
Dernolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
-Required
Letter of Notilication
_l certi& that the federal regulations regarding asbestos removal arc not applicable to this project.
_l cqriry thal I havc ud this application ud statc thd thc sbove iofomation is cor*l. I agc to smply whh all City md County
ordimncG ud Statc kws rchting to hilding construction and h6cby authorirc rcTr6otativ6 of this City md County to mt6 upon thc
8borc motioncd pppsty for iNpcdion purpos6.
Applicsnt or Agmt SiSmturc:_ Drlc:_
l'crlrrilct, n:unc ( ;lrirrt ).
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCao
Back Flow Device
Roush Plumbins
Final Gas Test
Meter Release I t1 ,o
FINAL \rfffr
Notes, Remarks, Etc.I'
Policy Number:Expires: