HomeMy WebLinkAbout30141815 - Permita City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Permit Counter: (714) 647-5800 lnspection Requests: (7'14) 667-2738 lnspector Section: (714) 647-5853
Plumbing Permit #: 3O141E15
Pin #: 2E49|5
Proiect Address: 1122 W Curie Avea
Assessor's Parcel: 410-212-54 Lot: 104
Unit:
Block: NA
Bldg:
Tract: 7000
Address Range:
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 s57-2871
Crestmark Construction Inc
6746 Valjean Ave Ste 250
Van Nuys, CA 91405
(818) e46-1 2s4
Fee Type Amount
01 1 16002 51602 Gas System 1-4 46.25
01 1 16002 51600 Genera! Plan Update 22.95
01 1 16002 51602 lssuance 57 .20
01 1 16002 57770 Microfilm Records 3.91
Qty
1.00
1.00
1.00
1.00
*: FS9E8 L/ It /Zt-r?r-t ID I HG/
Fee
$46.2s
$22.95
$s7.20
$3.91
Ac
Rcpt| i
TrnnsoNj on
(:r est mnr k
Generol
CI1116tttt2-
!rrrr
: (:TYH Tr nn s* : 4
R35 LlI
-1
nl $1
State Lic #: 1046910
Lic Type: B
Bus. Lic #: 374520
Workers' Compensation ! nsurance.Carrier: ACCREDITED SURETY AND CASUALTY COMPANY INC
Policy #: 1ATCA16001 233
Expires: 0311112020
Inr
f-l Fee
P1a\0111
r-t1
11 icro
2t-ttttt-
cument strl &
Ch eck
377 Ttttttttt-
r-rItrrrtrI
Building Use:
Job Type:
Nature of Work:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Swimming Pool/Spa
Pool-Gas system
01 1 02335
01t17 t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Occupancy:
Constr Type
Code:
R-3, U
VB
cPc 2016
Planning Conditions:
Planning Approval By:Date:
Date:
Date:Amsden, Julie
Every permitissued 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.
Notes: Replace gas piping to pool.
Botch*353958-L/17/2tt2trID:NGARCI,-0ff ii*: CTYH Tronsir 6 I of
[icii: Ref*: 3t-t141915
R;;[+ t tr2g66?3? ll 17 lait2tt 9: [t3 Afl
rtoniac[ ion Totol tlStt ';'1
Crestmnrll Construct ion Inc
01 1 16002 s1600
01 1 16002 s1602
01 1 16002 57770
$22.9s
$103.45
$3.e1
Fee Total:
Paid to Date:
Balance Due:
General Plan UPdste Fee
Lll 1 16t102- 51600(tt-t0-
P lunb i ng
Lrl 1 16002- 516tr2[t[t0-
11 icrof i lm & Docunents
011160tr2- 577700[10-
ICL Chech Llllr226
,.,. .
:lj ,'
$130.31i I
$0.00
$130.31
lnspector MID#: 201 9-156263
PLUM BING-INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS
UNDER GROUND
Waste & Vent
Water-Under floor ^,1
Gas-Underfloor 20t
tvWc( #.-ffii;,'.
TTBuilding Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
\
/POOUSPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back FIow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler \
Sanitary Sewer/Cap
Back Flow Device
Roush Plumbins
Fina! Gas Test
Meter Release I ft
FINAL l-ultn VKIJI r./*xt
\lNotes, Rpmarks, Etc,.
tl?,"ru0 ...? Clft -Dt -[Y)qL+wt
I
\
I hcrcby affm undo pcmlty of pcrjury alut I m dcmpt from thc Contrrcffi' Liccm Law for thc followiog rcmn (Sc.7031.1
Buaim: and Prcfcsion Codc): Any City or County whbh rcquircr a pmit to @nltruct, alta, inlpmvc, dcmlish or cpat my
irrudulg prbrro its iw, also rcquim thc qlplicmt 6r sch Imit lo fik t signd $8rmt fttr h.or slE ir licaucd pumul
ro rhc povisioro of thc Conrretfi'r Lienrcd Lrw (Ctupar q Cormrcing with Sccrioo 70fl) of Division 3 of thc Bulincs snd
PofcsionsCodc)orrhilhcorshcirGxcmptrkrcfromsrdthcbaiirforthcrllcsEdqffplbn. Anyviolationofs6{ion703l.5by.oy
applicant for a pcmit sbjels lhc sppli@nt to s civil pcmlty of ml mrc thso fivc hundrcd dollarr ($5ffi).
_1, as owr of thc atopcrty. or my cmplo]Gr with wag6 I thcir mlc orposaion. will & thc wor* &d tlE nndw b mt
irrcndcd or ofu for slc (Se.?044, Buim rnd Prcfcsiom Codc: Thc ContEctor'3 Liffi Lsw do6 ml rpply to m ow of
thc prcpcrty who buil& or inpmu thcmrl ard who doca rut m* himsclf or hcrelf or thrcugh hir or hcr om crPlo]€cs,
pmvidcd that sch impowntr rc mt inlqdcd or oftrcd 6r olc. lf, lnwffi. thc building or inpryeGnt i! sH wilhir orc ,8ar
of onplaiorl thc Owncr Buildc will harc thc budcn of ppving tha lE or ghc dil mt huild or if,prcE thc pmpqry for th. purpos of
sD.
-1,
I owr of thc pmpsty, m cxclusircly @ilmcting with liccnrcd ontracloB to @ndrud thc pmj$t (S@. 7044, Buitw
and PrcGsbD Codc: 't'hc Cont6ctor'! Liccnsc Law doa mt apply to ro owncr of prcperty who builds or imprcvcl thcror\
and who ontncts for mh pmirts with 8 Conttrto(s) licenscd pulwf,l lo ihc ContEctor'3 Lim hw).
-l
m cxcmpt unda Selion-, B. & P.C. br this rmn.
Date'Owner:
DECLARATION
I hcrcby amrm under ;Emltyof pcjuryonc ofthc following delantiom:
_l havc tnd will mintain I Ccrtificatc of Consnt to sclf-ln$rc for rcrkm' conrpenrtion, as pmvided for by Srction 3700 of thc
Latnr Code, for thc pdfomrcc of thc mrt for which thc Jrmit is issucd.
dllhavcandwillmaintainworkers'compcnrationinsumrcgas rcquircdbyScction3T00oflhcLohorCodc,forthcpdforntsnccof
the work for which this pcmit is isscd. Myworker' mmpcnmtion insurancc canicr and gtlicy numbcr ue:
Accuc rAl+ed 9.*ve
b-ll-
_l certi& that in the performance of thc work for which this permit is issued. I shall not employ any lrcrson in any manner
so as to become subject to the wo*ers'compensation laws of California, ancl agree that if I sl'nuld become subject to the
workers' compensation provisions of Section 3700 of the Lahor Code. I shall, forthwith comply with ttnse provisions..
WARNING: I;ailure to secure workers' compensation coverage is unlawful, and shall subject an cmployer to criminal penalties and
civil fines up to one hundred thousand doltars ($100,000), in addition lo the cost of compensatiorL damages as provided for thc
Section 3076 of the Latnr Code, interesn and attorney's fees.
DECLARA'I'I(IN
I hereby aflirm under penatry of perjury that I anr licensed under provision o[('hapter t) (cotnntencing with Section 7(XX)) of Division 3
of the Business ancl Professions C<ldc. arul rny license is in full tirrce and eflbct.
Number:krqCqP
l- I ? -7e2r). y^es+ }larl<rnd v(t(+;c{t ial}
coNs'l'RL'c'l'l(tN LENDIN(; A(;l,N(:\'
I hercby affirm undcr Fmlty of pcrjury that thc is I @N|ructhn lcnding agcrcy for thc psfomrcc of thc work for wiich this Imit is
issued (Sec. 3097, Civ. C.).
Lender's Name:
AfILICANLDSCI.AEAIIAB
I hmbyaflimundcr pcnalty of pcrjury onc of thc following dclamlions:
Dcmlition Pcrmits-AitHtos Notifictrlion l:cdcml Rcgulations (Titlc 40, Psrr6)
-Rcquircd
Lcttcr of Ndificalhn
-l
ccdiry thst thc fcd@l rcgul.lioN rcSarding asb.stos Emval arc mt E plicablc lo lhis prcjet.
€-l ccrriry th.t I havc rcad fhis application lrd itste that thc otnvc infomlion h corc€I. I alrc lo @mptywilh all Ciryard County
ordimmes and Sratc Laws rclating ro building conilructioq and hcrcby autlnrDr rcFcsntativca ofthis Cily and County to cnts utrrn thc
above mentioned property for inspection purposes.
or Agent o*", l1??k
Pernrltee name Orfnt): C)H q Srechori./