HomeMy WebLinkAbout30142315 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana,
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Plumbing Permit #: 301423{5
Pin #: 79701
Proiect Address: 3401 S Timber St-a- -
Unit:
Block: NA
Bldg:Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 410-161-05 Lot: 19 Tract:
Owner:
Address:
Phone:
Robert Giannini
3401 S. Timber Street
Santa Ana, CA 92707
(7141 497 -7714
1 6002 51 602
01 1 1 6002 51 60C
01 1 1 6002 51 602
01 1 16002 5777C
Fee Type
Bathtub
General Plan Update
lssuance
Microfilm Records
Amount
23.97
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
Fee
$23.97
$23.79
$59.30
$4.05
a
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Botch* : 561 12 - 8/ 6/2fi2tr I0 : (:CUELLAR
0ffice3 CTYH Trqnsi: 1 2 of 3
Acct*:
Rcpriloruzsss$ - r, rlil'ii *lllnfn'=
Trsnsoct ion Tbtot $486 .?6
Robert 6ionnini
lnstallation of bathtub. Owner-Builder form previously
on file.
$11 1.1'
$0.00
$11 1.11
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By.
Permit lssued By:
Subject to Field:
Zuniga, Allissa
Date:
Date:
Date: 08/06/2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
Single Family Dwelling Occupancy:
Miscellaneous Constr Type:
lnterior Bathroom Remodel Code:
R-3, U
VB
cPc 2019
Buirdins Permit #: 101100087 01 1 1 6002 51 600
Every permit issued shatl become invalid unless the work on the sife 01 116002 51602
authorized by such permit is commenced within360 days after its 01116002 57770
rssuance, or if the work authoized on the site by such permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector tvt! D#'. 201 9- 151456
a
$23.79
$83.27
$4.05
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILI'ER DELCARATION
I hcrcby affrm undcr pmlty of ;rrjury that I m cxcmpt frcm thc Contracton' Licenr Law for thc ftrllowing rc&$n (Sd.7031.5
Businss ard Profession Codc): Atry City or County which rcquircs a pcmit to @trdruct, alta, impmvq dcmlish or rqnir any
slructure, prk r to its issecc, al$ rcquircs thc applicant hr such pcmit to filc a signcd rtatcmml that hc or 3hc ii liccnsd pumant
to thc pmvisioos of thc Contractor's Liccnsd Law (Chaptcr 9, Commercing with Sction 7000 of Divisioo 3 of thc Business and
Pmfcssions Codc) or that hc or she is excmpt thcrefrcm 8nd t]rc b6iir for thc allcgc{ cxcmption. Any violation of Section 703 | .5 by 8ny
applicant for a pemil sbjcts thc applic.nt to a civil pemhyof mt mE th6n fivc hundrcd dollars ($500).
-1,
as owner of the property, or my employees with wages as their sole compensation, will do the work ard the structure is mt
intended or olferd for sale (Sec.7(X4, Busirrcss and Professions Code: 'l'he Contractor's License Law does not apply to an owner of
the progrerty wtn builds or impmves therqrn, ard wtn does ruch work himself or herself or thmugh his or her own employees,
provided that such improvernents arc rnt interded oroffeled for sale. l[, however, the building or irTrrovement is sold withinon€ ]tar
of completion, th€ Owner Builder will lrave the burden of proving that h€ or she did mt build or impmve the propcrry for the purynse of
sale).
-1,
as owner of the property, am exclusively contracting with licensed conlraclors to construct the pmject (Sec. 7M4, Business
ald Profrsskln Code: The Contractor's License Law does not apply to an owner of property who builds or improves thercon,
pursuant to thc Clonlractor's License Law).and who contracts for such projects with a
-I
I hereby allirm under penalty of perjury one of thc
-l
have ard will maintain a Certilicate of Consent to Self-lnsure for workers' conrpensolion, as pmvided for by Section 3700 of the
Labor Code, for the performance of ttle work for which the permit is issued.
-l
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfonnance of
the work for which this permit is issred. My workers' compersation insurance carrier and policy number are:
Carrier:
Policy Number: Expires:
a
-l
certi& that in the performance of the work for which this permit is issued. I shall not employ any person in any manner a
so as to become subject to the workers' compensation laws of Califomia, and agree lhat if I stnuld become subject to thc
workers' compensation provisions of Section 3700 of the Latnr Code, I shall, forthwith comply with tlnse provi.sions. .
WARNING: I;ailure to secure workers' compensation is and shall subject an employer to criminal penahies and
civil fines up to one hundred thousand dollars ($100,000),to the cost of compensation, damages as provided for the
Section 3076 of the interest and h
I hereby aflirm under penalty of perjury that I am licensed 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
License Class: License Number:
Contractor:
W
I hcrcby alfm under peultyof pcrjury that therc ir I onstruction lcnding agf,cy for thc pcftrmncc of thc work for uhich lhis trmil i$
Civ. C.).
Lender's Address:
APPLICANT DTCI ARA'TION
I lrerebyaflimrunder penalty of perjury one of the following declarations:
Denrolition Permits-Asbestos Notification l;ederal Regulat ions ('l'itle 40, Part6)
-Required
Letter of Notification
r -l
certi&that the federalregulations regarding asbestos removalare not applicable to this project.
_l ceaify that I have read this all City and County
ordinances and State Laws
above mentioned property
Applicant or Agent
Pernritee nanle
the
,
lrt tulxrn llrc
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ CIa rifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOUSPA
P-trap/Drain Line
Main Drain/Pool Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back FIow Device
Rough Plumbins
Final Gas Test
Meter Release t
FINAL tl IltoYl,,t Dkrks,,I
,Notes, Remarks, Etc.
l)ate:
Name: