HomeMy WebLinkAbout30139401 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Sectaon: (714) 647-5853
Permit #: 3Ol394Ol
Pin #: 34177
Project Address: 2414 N Tustin Ave
Assessor'sParcel: 396.261-55 Lotr 8
Unit;
Block: A
Bldg: 14O Address Range:
Tract: A.B. CHAPMAN Historic: No
Suite Range: Unit 14O-l
Zoning: R4
?
Owner:
Address
Contraclor
Address:
The Bascom Group, LLC
26 Corporate Park Drive, #200
lrYine, CA 92506
(949) 955-0888
Arias General Construction
17015 Casimir Ave
Torrance, CA 90504
(310) 350-8198
Fee Type
01116002 51602 Clothes Washer
01116002 51600 General Plan Update
0'1116002 51602 lssuance
Amount
13.45
21 .25
52.98
Fee
$'13.45
$21.25
$52.98
Qty
1.00
1.00
1.00Phone
Tenant Name:
Eatchi:43681 - 5/10/201S
off ice: CTYH Tronsi: 59A(cti: R€f+:
Rcrti:02261169 - 3/10/2018
Tnansoct ion Totol
17 o
0139401
359 Pn
t992.71
State Lic #: 1017936
Lic Type: B
Bus. Lic #: 366738
Workers' Compensation lnsuranceCarrier: Stat€ Fund
Policy #: 921fi5B17
Expires: 051261201A
ID: N6Afi(
63r1
Auth+ r 02iX
3
3
t3
Ar ins 6enerol (:onEtruction In(
G€nerol PIon Updote Fee
01116002- 51600000-
Plurb ing
ul116002- s1602000-
U iso
CC+: i***I*******3176
I
I
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By: Chavez, Dave
Subject to Field:
Buildins Permit #: 101 96349
Multl-Family (5 or more uni Occupancy:
Alteration Constr TYPe
w/D Partition (Unit 1) Code:
R-2
VA
cPc 2015
Notes:
Date:
Date:
Date: 05/10/2018
Account#
lvlisc. Receipt:
N,!isc. Receipt:
i,4isc. Receipt:
Total
Expand coat closet opening for WD in units with 2
bathrooms. No bedroom addition, exterior alteration
and,/or addition of square footage proposed at this
time. Original P/C performed under #10193842.
$87.68
$0.00
987.68
01 r 16002 51600
Every permit issued shall bacgme invalid unless the wo* on the site
authoized by such permit is commenced within 180 days aftet its
issuance, or if the u,ntk authoized on the site by such pemit is suspended
or abandoned fot a peiod ot 180 days afrer tha time the wo* is
commenced.
lnspector
01 't 16002 5'1602
$21.25
$66.43
Fee Total:
Paid to Date:
Balance Due:
Phone:
Building Use:
Job Type;
Nature of Work:
MID#: 20'18-143188
PLUMBING-INSPECTOR RECOFD
APPROVALS DATE ID/SIG.COMMENTS OWNER BI'ILDET DELCARATION
I hcrcby llIm undn p.Mlly of pdury th,l I u.icnpl 6om ttE C., rsdo6 Lttne LlP for ilE tollowitS M$n (S€t.7031-5
Busimsr .d Proa.sior Codc): Ai, Ciry or Coltl|y *hich rcquirci. For lo o.rru.l. rlls. in{,rclo d.@lish d e!6n uy
{rucioe. prir ro ts is3u.G. rlm cquiB lh. imlter for such Fmn to fib . sigftn .urcMl lh.r lr d tlE k lien*d PlNurl
b ln. prcvisions of tlE Conrmld! Ucnsd Ll* (Cltsprc, 9. ComfteitrS wnh Sc.lid ?00O of Division 3 ol r* 8!.imrs md
Ptuf.ssionr Codc) or rhlr h. o, sh. i..rcn{,t ds!.foms.d rhc b.ris fo. thc dhS.d.t plio.. AnyliohdonofSdbn7011.56ye,
alpliclnr ror ! p.mir sbiNls rhc applker ro r civil p.Blry or nor mrc rhs li,e hlndrcd dollas ($500).
l. $ own.r ofth. IrcFny. or my cmplotecs wirh qlgcs as lhcir solc smr.nlarion. will do $. sdk .id llE slrEtE i\ ml
inlcdcd or oficrcd for slc (56,7044. Businc$ ..d &otcsionr Codei l hc Co.a.cbls Licds L!* dNs nol ,!dy lo M owno ol
rh. poFny wh. build\ or in{ms l,Emn. ort who dm srh Mri tims.lf or hcmlf o. rh@ugh his 6r h.r oen employecs,
pFvid.d ihat such iqrroEmntr d nol int.d.<l oiofi.rd forelc.lt howE, rtE buildiB or itrprorcmnt is $ld wirhin onc FU
of€r{,l{ior, 0E Osn.r Built r will harc ttc hidcn of proving lhll h. or shc dil mr hild or inpmE dE FotEry for rhc ntl,. of
-1,
s owr of rh€ pmp.ny. m.rclusivcly conlrdi.S wnh [cnscd mnlmtoE lo onsmcl tlE poir {Se. 7044. Buimrs
lrn ho&sih Cod.: Thc Ci.tnclor's Li.cnic Llw docr nor apply ro u.w.d of pEp.ny who blildr or impret. 1h96..
,id wh6 coi(d3 tor su.h ,mFs wnt r Conrrcro(s) litns.n purtunr ro rle Cofl.&lda. LieB tlw).
I rmcr.'npr undcr Sc.ti0 A. & P.C l'orlhis,c!{,n
UOBTEf,ILS)MTINIAIION
DECId.BAIIQN
I h.r.by rm.nundcr p.nalryof pcrjuryoncof lhc tullouin8dalualiotrs:
I havc dt will roinr.in a CcnifEnl. of Consnt lo Sclf-lnsurc lor wortcF .osntn$raon, .s tmvidd lbr by S(l ion 1700 ol tnc
LsDor Codc. fo,lhe pcdotuc. of fic *ort( lor which th. lcmil is is*u.d.
.fI h,!c rnd s,ll nE,nr,,n worlcs cnmncnsdnnlnsurrrce.!s.cquiEdl,ySdrionlTmoalh.LaborCodc.forlll.poto,lMc.or
th. *ort ror whah this lcmil is iss.n. My sorkos. onqstrerion inruhncc.rfi {n |rlty numb.t uc:
5+a\a FJ\.../
9lZ6 /t1
-lcnilythatinthcpc'ornunccofrhcworklorwhichihis,'crnirhhsucd.Ishlllnotcmplo,uypcroninlnyn'lnror$ aqr. bccom rubiccr ro th. workc!(compcns.iion la*s ofC.lifortri!. Dnd ugB thul itl \hould h..om subiccr to llE
w.rkos odpc.sarioi,mvisionsolscclion37IxJof$ct bor C.dc. I shull. fonh*nh conply wirn tho* ,rcvisions .
WAINING: Failurc ro $cm *trt ra ompcMtion covmgc n unh*tu|. lid shall sbj.cl e cmplo)$ lo 6ini&l Foxa* od
civil aocs up io om hudrcd lho!$nd dolls (5100.000). in addnion ro lhcco of conFMliot. d.m8ct a prcvid.d fo. rlE
Serion 1076ofllEt bor Codc, hrcrcsr and 0rl(,dy s 16.
-'.5\ l()/ ltr
DECI,IAAIION
t h.rb, umlnundcr ncnshyolp.riury rhd I rN li.c.rd undcr Inlvhion oiChaprc.9 (€mmn.ing wnh Setion ?fil) olDivhn$ l
ol' thc Busincssand Pm,bsstun\Codc, drl mylic.n* is in rull aor.u ,i .ilicl
lorf ?3
CANSIBICIXINLENDACTTCEIqL
I hcBby .lIrm uldc, Fo.hy of Fdury lhll lh.rc b ! @nrtudbn hidin8 a$my lor lhc Frfo'rls. of thc *mi fo, Phth rhj3 Fdn is
hsuc{ tse. 1097. civ. c,)
AIELICANLDTCIABAIIIJ!
I rrn$y anim uM.r pcnahyofncrjuryorc orlhc follo*ins dccltrrions:
llcmnirion Pcmirs Astf,{os Norin.dion Fcdcr.l Rcaubrions(Inlc ]0. Pfi6)
_Rcq!t d lru.. or Norirrardn
I ccnify lhar thc fcd.rll rcsrlations esstdin! !srEn.\ icfrrrdl d. nor 0ldiclblc to this tmj.a1.
411(cniayrhd I h.!crcrd rhn.prl*arDn.ndnorcth.t lhe ahovc informlion h cotur I r8,d ro omrly snh lll Cny cd Counry
otrtinanccs a.d Srar. Lies rliiing b buildin8 con(ruclion. lnd tcrcb, lultrrit dpE{nrdiws orrhisCiryand Countyld cme ug,n rh.
above mnrioned pmteny {.r ins&.rion ltrrFsci
Applir nl or /tgrnl SiAmtum:b,,' 6/lOllt
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildino Sewer
lnterceptor/ Clarilier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P{rap/Drain Line
lr/ain Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbinq fii:rt/z ,-El U-a).t*
Final Gas Test
Meter Release
FINAL #Vn 5--re,'t2n+K1
Notes, Remarks, Etc.
Area/Storm Drain
,"., e/n/ll
L.ndst Addt$:
-
I