HomeMy WebLinkAbout30139992 - Permitcity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Plumbing
Permit Counter: C/14) 647-5800 lnspection Requests: (714).667-2738 lnspector Section: (714\ 647-5853
Permit #: 3O139992
Pin #: 9427X{
ProjectAddress: 2112112 N Ross St
Assessor'sParcel: 002-112-14 Lot: 36 & POR 33
Btdg:
Tract 788
Address Range:
Historic:YEa
Suite Range:
Zoning: Rl
Owner:
Address
Phone:
Tenant Name:
Contractor:
Address:
Gary & Julie Humphreys
2112 N Ross St
Santa Ana, CA 927062508
17141541-3452
Owne.-Builder
01 1 16002
011 16002
01 1 '16002
01116002
01 1 16002
011'16002
0'1 1 '16002
01 1 '16002
5'1 60i
51602
5'1602
51602
51602
51602
5'1 60C
51602
FeeType Amount
Water Closet '14.22
Shower/Balhtub 22.25
Garbage Disp 10.66
Sewer Alter/Repair 44.51
Gas Outlet, each Add'l 7.06
Tankless Water Heater 65.57
General Plan Update 22.08
lssuance 55.04
Qty
1.00
1.00
1.00
1.00
2.00
1.00
1.00
1.00
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
SingleFamilyDrvslling occupancy:
Addition Constr TyPe:
Addition to 2nd Dwelling UnCode:
R-3, U
VB
cPc 2016
Planning Conditions:
Planning Approval By Fregoso, Vince Date:
Plan Checked By: Date:
Permit lssued By: \*YHemandez, Kathy Date:
Subject to Field:
BuirdinsPermit#: 10197129
Ewry pormit issuad shall become invalb unless the work on tho sile
authodzed by such pormit is commencad wihin 180 days after its
issuance, or if the wo* duthoized on the site by such permit is suspended
or abandoned tor a peiod of 1 80 days afret the time the work is
commen@d.
09119t2014
09/19/2018
Account#
$248.45
$0.00
$248.45
MID#: 2018-143158
01116002 51600
01 116002 51602
Fee Totat
Paid to Date:
Balance Due;
Unit:
Block: NA
Fee
$14.22
$22.25
$10.66
$44.5'l
$14.12
$65.s7
$22.08
$55.04
9/t?/2ttl8 ICTronsi:33
Ref+: j
- 9/t?/?fitg 1
Misc. Receipt:
Misc. Receipl:
Misc. Receipl:
Total
Notes:
$22.08
$226.37
lnspector
PLUMBING-INSPECTOR RECORD
DATE ID/SIG.COMMENTS OWNER BULDER DELCARATION
I hcEby !fiim uidcr Fnahy of Frjury lhsl I m cMpr frod lhc Conra.loN Liftns hw lor lh. follosinS E&$n (Ss.'7031:5
Blsiness and Prcfession Codc): Ary Cny or Counry whi.h Equies r Frmir io mnstrocl, rllr. imprcrt, &mli$ or rrEi. oy
rlrudm, rir lo irs hiur.cc, !l-s EquiEs ih. q,plksr for such Fmil lo frh . siemd shlcft $ar lE o. dE b lic.ncd pummt
b $c lmviions of tlt Co @ror's Lid.sn Llq (Chqncr 9. Comming snh S..lion ,000 of Dilisio. 3 of rtltB!.iic$ and
Pmlcrsions Cod.) o. rhd lE or shc h .r.mpl thcEfrom ond lh. b.sis for lhc lllcErn crsmpfion, An, viohrio. oasdhn 703l .5 by rny
sl,Flicsnl for ! pcmir slbj$rs rhc apnlic. to s civil pcMhy of mrc rtun litc hundrcd dolhrs ($500).
l. as owtrr olrhc popcny. m q.lusivcly co mrinS with liccnsd conrE lor ro .onnrud E poid (Se. ?o44. Busims
dtd Aoftssion Cod.: Thc Conrdrd\ Li..n* Law dc nor amly to e 6wn.r or r,ro,,cny pho builds or ihlmwr rhd6..
and who con@h lor such p'oirls *ilh a Conhcro(r) lietrsd puG@r ro tlE Conr&ro. s Li(.nrc bs).
74 6u*".
DECIdIdIIO!
I hcrchy !firn utrdn !.nrlly of Irsjury otu ofltc,ollowins d(ldolionrl
-lheE
a willnuinrdn o C€ni,trrc of Con\d bsclf l.\trrc fn sorkch .onl|).trs.rbn. as fovidcd f(tr by s&1n,n .l7lx) o, rhc
tjhtr ( odc, aor rhc ,rnnmumc oI lnL w.r[ nn which rhc Ilcnni is nsucd
-l h!!. ond sill mintdn so cn .on{Ersrrio! insmftc. a. nqniEi by Selion l7O0 of llE tjhor tu . for lhc pcrfollrm. of
rlr srk for *hich rhis ,cmir ir iNrn, My wdk6 ompcmdhn inru,@. ortr un l[lty tudt r d:
I ccdi(yrh in thc p.foirnrmc olrhc qork for whict lnis pernril t issucd.I shulln.r cnploy tny pcson in any,unncr
$ N ro b.Bom subrcr ro rhc w(,rtc6 .onlcnsriioo law. 6f Caliromin. rnd 088 lhol i, I should be€om ilbrc.l ro rh.
wortcs' compensario. polni.nr .f Sdrion 3740 of $c rjhor Codc, I sh{]l bnhwilh conuly wilh th.c pbtisions..
WARNINC: F,ilur. rd sln workcB onlFctrs0tion .ovcEgc is unl{etu|. rnd shall sutjccr an mll)loy.t ro .n riflal Irfllltis lnd
cjlil ljnc\ up to onc hlndrcd rhousanl dollus (Slt[.u[), in nddnion ro lh. cosl of cnnr4r*rion. .taro8es !s nrovidcd for lhc
Scd'un 1076ul thc tibtr Celc. nrcrc{ antl anarm\ t rev ,
,",". iltt/zqi ^pp,e,l Lret ' ugEsEP-glNrxag!f,
D0ctntrArrol!
I hctul,y uilrn undcr pcn.lryol Frjury rhar I .tr! li(ned undcr amvision ofChaptcr 9 (ommrcins sirh sccrt o 70oo) orOivhn'n 3
ol lhc Businessind PmfcsionsCodc.lnd nyliccne is in full a cc andcnrr
SANIIBI]qrcIj.INDIIG.AGENCT
t lEEby .lt6 u*r.r Fodly of Fryry thd Ih@ is ! @irtudbn Lidi.8 arlmy for rlE Frfolrffi of tlE srt for which lhb Fmn i!
i$cd (s6. 1097. civ. c.).
ATILICANTDECLAAAIIAN
I lxrcby .trm uMcr ,.nally of p.ljury oic of ltc follo*inB d*ladrions:
D.mujon P.mits-Asbcsros Notiricarion Fcdcrll Rcpul,tions (Titlc.lO. Prn6)
Rcqurcd hrrcroiNotili( i,rr
-l
cslify rhar rl* f€nc l rclxlrrion. Eg.rding.rbcsb! nmv.l m ml.pplicrbh lo this pmj6r
-l
.6rify rh.r t hrw rcad lhic rppli..rio. rsl sl!r. rhd tlE ltrw i.fo,mtion is corer I slre r. 6.Dly wirh {ll Ciry a.d Counly
onlinrmc\rid SrId l rs\nL i'r! r, huildi.F rucrion. n hcEby luthorizc rcFcentdivcs olrhir Cny ed Counry lo cnrs ur'.|lE
.hovc Bnrioncd DrorEny lor insDdi,)"
Appllo or Ase slsMlue /K--,",(n(\ao
UNDER GROUND
Waste & Vent qla,lhy /zrtYtlftD-- lt 'l -/
Water-Under floor
Gas-Underlloor
Building Sewer
AreaiStorm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent alotltt b a,w trt,/
Water Pipino v td r.1r
Gas Piping 2- t"- ")0e-&g
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
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbinq 1-tz-t\J),lrh io
Meter Release
FINAL l-7 - /9 J/rt'l-'fr)
Notes, Remarks, Etc.
APPROVALS
Miscellaneous
Final Gas Test
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