HomeMy WebLinkAbout30139736 - Permitcity of santa Ana 20 civic center Plaza (M-19), santa Ana, cAg27o2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 3O139736
Pin #: 4E22E
Project Address: 830 E Fourth St Unit:
Block: A
Bldg: Address Ranger 826{34.
Tract HALL'S AOD Historic; No
Suite Range:
Zoning: SD84
q
Assessor'sParcel: 398-483-07 Lot: 8&POR7
Salvador Jimenez
16551 Ridgefield Dr
RiverBide, CA 92503
17141913-7647
01116002
01116002
011'16002
01116002
01116002
01116002
5'160i
5160i
51602
5'160i
5'160c
5'1602
Fe€ Typ6
Water Closet
Sink
Alter Drain^/ent
Min Fee Adj
General Plan Update
lssuance
Amount
14.22
12.70
44.51
1.95
22.08
55.04
Qty
'1.00
1.00
1.00
1.00
1.00
1.00
Fee
$14 22
$12.70
$44.s1
$1.95
$22.08
$55.04
Phone:
Tenant Name:
Conlractor
Address;
Owner-Builder
Commercial
Tenant lmprovement
TI
Occupancy:
Constr Type
Code:
M
VB
cPc 2016
Notes:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:\I Hernandez, Kathy 0712012018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Buildins Permit #: 10196540
Every petmit issued shall becgme invalid unless the work on the site
authodzed by such pernit is commenced wilhin 1 80 days alter its
issuance, or il the wotk authoized on the site by such permit is suspended
ot abandoned fgt a patiod of 1 80 days altet tlo time the wo* is
commenced.
$'150.50
$0.00
$150.50
lnspector MID#: 2018-143546
01 1 16002 51600
01 1 16002 5't602
$22.08
s128.42
Ownerl
Address:
Phone;
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
I
tltoln
lufib ir
t 11601
:L (:h{
Building Use:
Job Typel
Nalure of Work:
Fee Total
Paid to Date:
Balance Due:
Date:
Date:
Date:
PLUMBING.INSPECTOR RECORD
APPROVALS DATE rD/srG.COMMENTS
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underlloor
Buildinq Sewer
AreaL/Storm Drain
Interceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
lvlain Drain/Pool Pipino
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanilary Sewer/Cap
Back Flow Device
Rough Plumbing 8/n/ff z vk1tt,
t
Meter Belease t,0
FINAL I
Notes, Remarks, Etc.t- 1UZITT
0WNER BU!I,DI,R DBI-CARA'f ION
I hrr.by il,n tr d$ |rnrlr)_ ol Nrjury rlrrr I m c\c ri,r nofl rlrc CotrtrMa Liccn\c l-trv f.r rhc tnlbuin8 rcr\on ls.c 7o.ll 5
Bu\itrc\\ r iPn,L\r.nCorlc) Atry Ciry or Co!trry shich rcqui.c\ r Fnnir l,i..n(ncr. rltcr. im!trnt- dc'to,|i\h or htrn ri,
nrucrur.. I)'rrt) ik i\surn c. ]lv, rqrncs rhd qrplicrtrr lnr \uch pcmrir t, ,llc r !!ncd iarcnrnr rhrr hr.r rhc i\ lrcns.J pur\umr
r, lh. f'visnnN ul rtE Co nr.rtr \ t,icctrscn li* (( hrfu 9. Connncmirg wlih sccri,in 7(Jtn ol Di\isn,n .1 .f rhc arrnc\{ ond
rltli.rnr ftrrt^-^nnn !1hjc.i\ rh. rnfl'u.r k, rcivilp.fulr),otnor nbrcrhri ftc huidrtrl d.lln( r55{D)
-!.
N oeftr of rhc pmFrrr. or ny chployes Nith *!8cs &s thcn sb comp.nsdion. *ill do tlE wl .rn UE {.aie is mr
inrodcd or oflc'rd for $le (s6.?o14, Busim$ ed Profe$io.s cod.r Thc c.nrmrors Li...F kw doca nol arply ro d owrcr of
llE pnllcny *ho hrilds or inprcB thce( ,!d who dc rnch s* himrcir o. hcBlror lhDuah his or lEr own ct{rlor*s.
r,rcvidcd fiar such imprDwmnrs @ tur inrsd.d oroffe,Ed lor sb. lf. horE E lDildins or ir{erft is sld wi{u om rsr
of@rpl:rh.! dE Ownfi Builb sill hrE 0E h!&n of rnbviie rnd h or lhc did rcl hild or inprDE the popcly for dF pulDs of
_1, N owrc. of rhc tmpenr. M crclusiEly conlBclin8 wirh li.ctrcd .ofidoR lo mr.ld.l llE Fmj(l (56. 7OU. Busim$
rd Eofsiof, Conc: Tnc Cotrtrcrols Lic€n$ Lav d@s mt lpply to ai owncr oftrcp.ny who builds or impmv.s lhcrcon.
-I
*ho .o.hck tnr su.h Inrirk wnh o 6mmcto(9 li.cncd puBunr b rhc Codndtr\ l-iccnE lj*l
I hcrcb, affinnund.r p..ohy of pcrjury onc olthc rbllowing dccl&ations
I rtxtr (nd..l,nih.t{rl.nnrrd ofrh. $.rk lnr qh'ch rh. t^-nn ^ ^\urd
,, hsvc ond will mintrin workcft compcnsarhfl insorsm., os rcquiEd by Sdlion :l7m of lhe Lrb6t Co&, for ltE FftlrMe oa
lnc work for which lnk pcrnil is iseEd. My wort6 @rrFns.lion insurue ceid t t loli.y .umbo ecl
_l ccdifyrhd an rhc Frformncc ofrh. $ork ro. shi.h thn FmI k issu.d.I rnrll ml.mploy any pcrsn in uy tuM
v, s to bccom subiLrr ro rhc wolknc conp.nsarion laws of Californi&. lnd oEEc rhor if ! sholld h..oN subj.d lo lh.
qorl@n' onlFrelio. pmvirions of SNtion 3?00 of lic L.bor Cod.. I shlll. fodhwilh @nply wilh lt s lmvisio.s..
lurc to surc wortcrs' ompcnso'ion covcm8c t nnh*tu|. and shnll sub }[r b fininrl Firhf,\ md
onc huhdr.d lhousand dollac (S100.fiD), in ddniotr ro lhc cosl d!m96 I prcvt.d ior rh.
I hcreby aafiirn utrd.r ,Enahy ol Frjury thar I um liensn ondcr Imrilioo ot wirh Sdri)n ?fir) ol l)ivis n:l
of lnc axin ss lbd Pof6sions Codc. ard my liccn* t in full aorc ud cffccl
Li..NcCh\s l-ic.nsc NumlEr:
Dele Conlrrclor:
cQNra]JcloNrflDllcicl)NcY
IhrchyalirnrundcrncmlryolFrjuryrh rhcrc i\ r connrurlioi Ltrdiig r[cn., rorrhc t ]tfDrnrmc ol rh. Eotk br *hich rhis n rnl n
i\sucd lSec. llr97. Civ C.)
AIIIICANLDECI,IBAIIO!
I torty dim undcr pmalry of tErrrry onc o, rhc foUowing d(ladions:
Dcmlilhn Pcrmirs-Asb.sros Norifi@rion Fcdcdl RcsularioN (TilL ,o. Pan6)
-R.quircd
L.ttcr o, Ndifrurbn
-,
enilyrh0t I hlvc rc.d rhnarFlt nnud {alclh.t rhc rmr'oF n.nn..r l,g'e r" ouInl) uirh JllCir) Jntl (-,,un,)
ordnrtucs md Sbrc tiws Elnling to huildingconsh.t rc!rcscnrsrivcs ofrhh Ciry ond Couoryt, cnru ull)o trr
alxnc Drnrioncd pn,pcny td i'!spc.rion
,\ppliMnl or,\xrtrr Silnrl &za4L
It ufriala,zal
Final Gas Test
*r.?'
t tr&i' Nam.
-
I dily rhn rhc fcd.ml ESuhrioff Eg.rdinS Nsh.sros rcmvd m nor lpplk.bk lo fiis ,rmFr.
I
f------T------