HomeMy WebLinkAbout30141085 - PermitProiect Address: 2229 112 W La Verne Avea
Assessor's Parcel: 109-1 21-15 Lot: 15
Unit:
Block: NA
Bldg:
Tract: 1346
Address Range:
Historic: No
Suite Range:
Zoning: Rl
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 047-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 3O141OE5
Pin #: 353OO
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
DAVID & ANGELICA MEDRANO
2229 W LA VERNE AVE
Santa Ana, CA 927043509
(7141 501 -7269
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
51 602
51 602
51 602
51 602
51 602
51 602
51 602
51 602
51 600
51 602
Qty
1.00
1.00
2.00
1.00
1.00
1.00
1.00
1.00
1.00
100
Fee
$14 22
$22.25
$2s 40
$13 97
$10.66
$44.51
$44.51
$65.s7
$22.08
$55.04
Fee Type Amount
Water Closet 14.22
Shower/Bathtub 22.25
Sink 12.70
Clothes Washer 13.97
Garbage Disp 10.66
Sewer Alter/Repair 44.51
Gas System 1-4 44.51
Tankless Water Heater 65.57
Genera! Plan Update 22.08
lssuance 55.04
Onl.e.hlrrit.lElfi llnq, lnfilO TI\. lOn(]Altreartau!-ra t - L.rr!. , !i' va -!.pa Lt'a . a9 - r-rtlJlr,,a-t-r,
n0f ira. f'TVU Tnar*rlt ll n af I
va a I!.t-- ir,, ata a a $iaalr'a' aa .L Lr, .
Aprllr ClaClr ?fitI{t.|Q:i
tast-if a ' ,lSa a - IJV^ a acJtrl'
DrnlrrfinllnqAq, - Llnq, lnfil0 ltlrEn nFtrit-Ft a't a.9rr-!2}rt, Va *L'r a.L'-, at'-L'.1, .tla
T+raf,rlrrl iarll Talnl C-rl I ll?, a SaaJiar-9 t lJta a uY$- ?, ua a, ,
n^trTn t AH/:rl Tf.A Hrnc,ANn
t.aar aU st arattJL.l-.4 t.t, taL. l, lllarat,
Building Use:
Job Type:
;Nature of Work.
Accessory Dwelling Unit-C Occupancy:
Conversion Constr Type:
ADU Code:
Date:
Date.
Date:
R.3, U
VB
cPc 2016
Genlrcl PIan Urdrt: F*r *:l:,:-t:i
:-! 1 1 13.tll!?- 51 s!-tilt-tt-tlt-Plurbin: *??9. L,i
conve$SAaffiEBeduditgBrttlaDu (487sf) with 1
oearo6'fi!! bathroom, kitchsr.u living roem- &-l+yh-{fi,,r','
and "to'iId.! Ai6i tfdttitf.".frrth7&, fit;.lu*- h : : !:! * - L-, -
t Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Buildins Permit #: 1 01 988 34
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days afrer ifs
issuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2018-1481 30
Chavez,rrryr*06t25t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
01 1 16002 51600
01 1 16002 51602
$22.08
$2e6 1 3
$31 8.21
$0 00
$3t 8.21
PLUMBI NG.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS ( )\l', N t.:tt tltr I l,l) litt l) 1,. l.('..\ ll,\'l l( ) N
I hcreby aflirm undo poalty of perjury lhat I dn exempt from (he ConlradoE' Licosc Larv for the follou'ing re3en (Ss.?01 1.5
Businss and Profsion Code): Any City or Coonty \r'hich requirc a pmir to construct. altq. improvq dcmiish or rqhil any
shlctulq pdor to its isuance. also requirs the applicanl for such FEnnit lo file a signed statement that he or shc is licenscd ptmuant
te thc Fovisions of lhc Contractor's l-icenrd Law (Chapts 9, ('omnencing N'ith S(tion 7000 of Dif ision I of lhe Busincs and
Pmfesions('odc)orlhatheorsheiscremptthrcfromandlheb6sisforthcallegcdexonJ,tion. AtryviolationofsectionT0Sl.tby8ny
applicantforapmitsubjctslhc applicanttoacivilpcnahyofnotmorcthanfir'e hundeldollus($500)
A. *, osne of lhe popeny. or my employm sith $s!6 as their $lc cornpqstion. rvilldo thc trcrk od lhc slrucim is not' intmdql or offqcd for sle (S(.7044. Businss and Pref6sions Code: I hc (bntraclor's l-icms lalv do6 nol apply lo an orvf,s of
thc trolEty s.ho huilds or inrJrevs thmn. and rvho do6 srrch rmrt hinself or herslf or th.ough his or hs own employed.
prcvidedlh0tsuch imlnovqlmtsrcnotintadqlorofllrqlformlc. lf.horvqs.thebuiHingorimprovemcnlismldrvithinone)ry{
ofcompletion. thc o$'no Builds rvilt have the burdm ofpo|ing that hc or shc did not birild or impro\r thc Impoty for thc puryxrr of
sle).
_ _l.asoNn6oflhetmpoty.anexclusivelyconlrscting\rithliceilsdconlracloNloconslrucllhcprojEt(Sc.7M4. lltrsins
and hrrltssirnCode:'l'he(bntraclor'sl,icenscLarvdosnotapplytoano\r'nqofpropertyrvhobuildsorimprovGlhdeon.
and $ho conlracls for such ltrojsls \r'ith a Contracto(s) licffil puBuail lo lhe Contraclor's Licse krv).
- I arn e.\ctnpt undcr Scction . ll. & l'.('. lirr
Drr". .C- X- l7
I hereby affirm under pmalty of perjury one of the follorving
_ I haye ancl rvill rnaintain a ('ertificate of Consent to Self-tnsure for \\'orku's'compeflsation. as provided for by Section .1700 of the
labor ('ode. for the perfonnance of the \\'ork for rvhich tlre pcnnit Ls issued.
t havc antl s'ill maintain \\'orkers' conlpensation insurance. as required b),Section .1700 of the l.abor Code. for the perftrnnance of
the rvork for rvhich this perrnit is issued. My s'orkets' conrpensation insurance can'ier and gxrlicy number are:
( 'rrr r icr
Policy l:rl'itt's
|Ar*iS that in the performance of the work for which this pennir is issued. t shall not employ any person in any manner
so as to become subject to the u'orkers' compensation laws of California. and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code. I shall. forthrvith comply with those provisions..
WARNING: Failure to secure workers'
civil fines up to one hundred thousand
and
the
Section 3076 of the Labor Code. interel and attorncy's fecs.
orr", (- r0-T- l7 o
I hcreby aflirm under penalty of perjury that I arn licenscd of Chapter 9 (cornmencing with Section 7000) of Division .1
of the Business and Professions Code. and my license is in full force and effect.
\,
II.iccrtst' Ntnttt'ct:I . iccrrsc ('lirss:
('orrlractor:I
('0NS'l'Rl,lc'l l0N l,ENplN(; AGEN('\'
I hcby a{Iim undo penslty of psjury that lh6e is I construction lmding agmcy for thc pcfommcc of the work f(,r shich this ]Elnit is
isstrctl (Scc. 1()()7. ('it. ('. ).
l.crrrlcr 's Nittttc:
Lender's Address:
AfIIICANLDECI.ABAIION
I hqlty afm unda poahy of pctjury onc of thc follot'ing dclratioro:
Dcmolition Pmils-Asb6tos Notification Fcd6al RcEul.iioN (Thlc 40. Pill6)
-Rcquircd
lrtto of Nolificatioo
-l
cqtify lhal thc fedaal rcgulstioN tl?Eding cbetos rmoval rc not @plicablc to this pmjcr.
Pl& "otiry
tf,a I havc red this application and statc that thc above infonnation is corcl. I agr@ to comply withall City and County
ordimnc6 8d Statc t s alatirg to building cordruc{ion. od h6cby authorirc rcpt6snativ6 of this City ud County to mtq upon fir
above mentioned property for
Applicnnt or Agent
Permilee nanle
orr", '6-ZY tr
UNDER GROUND
Waste & Vent o lzt 1,">FS t*l /a?
Water-Under floor
Gas-Underfloor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ CIa rifier
TOP OUT
Waste & Vent Llr- /ra ,V< t>tt ,arA,
Water Pipinq
Gas Piping glnlrt Drkdloi
Roof Drain
Tub/Shower Test
Rough 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 Sewer/Cap
Back Flow Device
Rough Plumbing ilu ltr,,wP lo9
Final Gas Test
Meter Release I -^,
FINAL
Etc.Notes Remarks
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