HomeMy WebLinkAbout30141641 - Permitcity of santa Ana 20 civic center Plaza (M-19), santa Ana, cA927o2
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Plumbing Permit #: 30141641
Pin #: 95 174
Project Address: 1122 W Curie Ave
Assesso/s Parcel: 410-212-54 Lot: 104
Unit:
Block: NA
Bldg: Address Range:
Tract 7000 Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Dorris Grigley
1122 W Curie Ave
Santa Ana, CA 927073837
(7141 957-2871
Crestmark Construction lnc
6746 Valjean Ave Ste 250
Van Nuys, CA 91405
(818) e46-1 254
01 1 16002 51602
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01 1 16002 5777C
Fee Type Amount Qty Fee
Pool Trap 23.'12 1.00 $23.12
Pool Piping 46.25 1.00 $46.25
General Plan Update 22.95 1.00 $22.95
lssuance 57.20 1.00 $57.20
Microri,, tFFfH;
tlff,i tfff{ft],|,, orff -$,Tibfldd,
Accti: Ref*: 3u14 1 64 1
Rcpti:02928095 l2/3/?trl9 4: 18 PI1
Tronsoction Totql $1r122.5+
Crestnnrk (:onstruct ion Inc
State Lic #: 1046910
Lic Type: B
Bus. Lic #: 374520
Workers' Compensation lnsurance:Carrier: ACCREDITED SURETY AND CASUALTY COMPANY INC
Policy #: 1ATCA16001 233
Expires: 0311112020
Generol Plan Updote Fee
01 t 16002- 51600000-
Plurb i ng
01 I 16002- 5160200(r-
ICL Checls 010186
t22.95
t126.57
tl r 122,5{
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Swimming Pool/Spa
Pool
Occupancy:
Constr Type:
Code:
Date:
R-3, U
VB
cPc 2016
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buirdins Permit #: 1 01102335
v::,12103t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Plumbing for new pool
Fee Total
Paid to Date:
Balance Due:
01 1 16002 51600
01 1 16002 51602
$22.es
$126.57
$149.52
$0.00
$149.52
Every permit rssued 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 permit is suspe nded
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 201 9-156263
TV
PLUMB!NG-INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrcby sffrm under Fnrlty of lrcrjury thll I m ercmpt ftom the CootrrctoE Licus hw for the folhwing mrco (Se.7O3?.5
Busircss ard Profession Codc): Any City or Couily which rcquircs a pcmh to snstruct, alt6, iqmw, dcmlish or Ep6ir any
struclurc. pri.,r to its rssum. sls rcquircs llrc rpplicsnt for such pcmit to filc s sigrcd slalcmil that hc or CE is lisroed pwsnt
to thc pmvisions of thc ContBctor's Licensd lrw (Chaptcr 9. Comercing wilh Sstion 7000 of Division 3 of the Busiress rnd
PrcfcssionsCode)orthathcorsh€iscrcmptthcrcfromandthcbasisforthcalhgedcxemplion. Anyviol8thnofSathnT03l.5byany
applicantforspermilsubjEtsthc applicsnltoacivilpenrllyofnotmrcthanfivchundrrddolles($500).
-1.
as owncr of the propcrty. or my cmployees with wagcs as thcir sole comFrcnsation. will do thc work and the structune is not
intcndcd or offcred for salc (Scc.7(}14. Busincss and hofcssions Code: The Contractor's Liccnse law docs not apply lo an owncr of
lhe propcrty who builds or inTrrovcs therenn. and who dcrcs such work himself or hcrself or through his or hcr own employccs.
providcd that such improvcnrnts are not inlendcd or offercd for sah. lf. howevcr. thc building or itrprovenrnt is sold within one ),ear
of co:nplction. the Owncr Buildcr will have the burdcn of proving that hc or shc dkl not build or improve the propcrty for lhe purpsc of
sah).
-1.
as owner of thc propcrty. am cxclusively contracting with licensed contractors lo conslrucl the projcct (Sec. 7W, Business
and hofcssion Codc: Thc Contraclor's License Law docs not apply lo an owner of prolrcrly who builds or improves thercon.
and who contracts for such projccts with a Conlracto(s) liccnrcd pursuant lo lhe Contraclor's License hw).
-l
am cxcmpl under Scction_. B. & P.C. for lhis rcason.
I)tlc ( )rr rrt r:
WORKERS' COTVIPENSATION
DF'CLARATION
I hcrcby alf irm undcr penalty of pcrjury one of the following dcclarations:
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havc ancl will mainlain a Ccrtificatc of Conscnt to Sclf-lnsurc tbr workcrs' conrpcnsation. as provided for by .Scction 37fi) of thc
Latxrr Crxlc. for the Jrcrfonurncc of thc work lbr which thc pcrrnit is issucd.
-lhavcandwill
maintainworkcrs'cornpcnsationinsurarrc.as rcquircdbyScction3T(X)ol'lhcLaborCodc.forlhcpcrformanceof
the work lbr this pcrnrit is issucd. My workers'carricr and Jmlicy nunrber ure:\
Policy L o
a
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ccrtify that in the pcrformancc of thc work for which this prmit is issued. I shall not cmploy any person in any manner
so as lo hecomc subpct to thc workers'compcnsation laws of California. and agrce that if I should beconre subject to thc
workcrs' compcnsation provisions of Section .170O of thc Labor Code. I shall. forthwith conrply with ttrose pmvisions.
IVARNING: Failure to securc workcrs' cornpcnsation covcragc is unlawful. and shall subjecl an cnrploycr to crirninul Jrcnaltics and
civil lincs up lo one hundrcd lhousand dollars ($1ffi.ffiO1. in addition to thc cosl of com;rcnsation. damagcs as provided for the
.Scclion .107(r ol'thc Latxrr Crxlc. irrlcrcsl arrd tu r\t*",.\>h{ (l \<.
I hcrcby nllirm undcr ;rcnalty of pcrjury that I am liccnscd 9 (comnrcncing with Scction 7(Xru) of Division .1
of thc Busincss and Professions Code. and my licensc is in full forcc and cffcct.
1 \rrq 6? (o
Licc-nsc
l)ale:I qrLct tt,n
W
I hcrcby allirrn undcr pnahy ofpcrjury thut thcre is a construction lcnding lgcncy for lhc lrcrfornuncc oflhc work for which this lsmit is
issucd (Sa. 3097, Civ. C.).
kndcr's Namc:
-
lrndcr's Addrcss:
APTLICANIJEGI.ABAIITN
I lmtryaffrmundcr pcnalty of ;rrjury onc of thc following dslsrations:
Dcmolilion Pcrmils.Asbestos Notificstion Fcderal Regulations (Titlc 40, Pad6)
R@uircd Lttcr of Notifi cetion
--l
c(dify that thc fcdcral rcguhlions rcguding a{rstos rcm)val arc not applicabh to this Jrojsl.
{-l cmify rhat I haw rerd this applicalion and statc that thc abovc information is cor6t. I agG to omply with rll City and County
ordinares snd Strte [rws rclating to buildin8 construclion, ud hcrcbyauthorirc ]cJtrcscntativcs of this City and Countyto cnts ulhn the
abovc mcntioncd proprty for
Apgrlicant or Agenl
Pernritee n$nre
UNDER GROUND
Waste & Vent ,l I
Water-Under floor 0lttlt4 T)A,{V)4.*N '1
Gas-Underf loor t l-\r
Buildinq Sewer
ArealStorm Drain
I nterceptor/ C Iarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
N/ain Drain/Pool Piping tzl Bl nj NYq-*4t1
Fill Line/Back Flow I
Pool Heaterlcas Line
Misce!!aneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewerl3ap
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release I rl A.
FINAL qYLhl ln Dku.nd .-xgl
arks Etc
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