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Home My WebLink About30338300 - PermitProject Address: 1155 W Centra! Ave Assessor'sParcel: 410421-01 Lot: NA Bldg: Tracl: NA Address Range: Historic: No Suite Range: Zoning: C2 b?unit: 201 Block: NA city of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Plumbing Permit Counter: O14) 647-5800 lnspection Requestsi (7141667-2738 lnspector Section: 014) 647-5853 Permit #: 3O33E3OO Pin #: 5667E Owner: Address: Phone: Tenant Name: Contractor Address: AMUSEMENT INOUSTRY, INC 5665 LONG BEACH BL Long Boach, CA 90805 (310) 639-7130 Owner-Builder 011 16002 51602 01116002 51602 0'l t16002 51602 01116002 51600 01116002 5'1602 Fo6 Typâ‚¬ Backflow < 2" Oental Unit Field Verification General Plan Update lssuance Amount 21.42 3'l .10 't5/..26 21.25 52.98 Foc $85.68 $124.40 $ 154.26 $21.25 $52.98 Qty 4.00 4.00 1.00 1.00 1.00 Phone Stale Lic #: Lic Type: Bus. Lic #: Workers' Compensalion lnsurance: Carrier: Polic, #: Expires: Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permil #: Evory pom,it issued shall becgme invalid unless tho '!toi< on the site aulhotized by such pemil is commencid within 1 80 days aftet its issuanco, or if lhe wo* authoized on the site by such pemit is suspended or abandoned Igt a peiod ol 1 80 days afrot the tme the wod< is cdnnpr@d. lnspector MID#: 2017-137434 Commercial Alteration Dental units Date: Date: Date:Chavez, Oave_?.Q-07 t17t2017 Account# Botchi:39(30 - 7/17/2917 JD: ororolâ‚¬el5 0ilicer CTYH hsn5!: 100 I ol I Accti I Reft: 3033S304 Rcati:01943129 - 7/17/2017 12.22 Pi Tronsact ion Totol t438.57 AliUSEllE[T II{DUSTRY, IHC 4 backflows and 4 denial units. Owner authorization on file. $438.57 $0.00 $438.57 Building Use; Job Type: Nalure of Work Occupancy: Constr Type Code: B V B, SPK cPc 2015 Notes Misc. Receipt: Misc. Receipt: Misc. Receipl: Total 01 1 '16002 51600 01116002 5't602 $21.25 $417.32 Fee Total: Paid to Dale: Balance Due: PLUMBING.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS otrnr8 tul|.DEn DErrananol I h6dr.trm ulda parl, ofrdi6y d'r I 6 dar$ tDE dE Coe(d Li.e Ls 6r rh. 6lbet ra, (s6.7011.5 tl6ic! !d Pbili@ Coit ): ry Ci, d CoIn, sttt r!$ri6 . Fla ro o6*r. .16. iq.oE, &DLt d lE.b ,, ouru.. Fi, lo n! iDd... .ho ,!qrn6 rlE Tdid 6' sh FDi to 6l . .t!.d ,io6r $. lt d rlE i li(ir.d Fqlr b ln. Feviiod ot lt Co!rr.16l LicaEd rre (Ouplc 9. Comdina witn Serb6 ,000 of Divitio! I ot {E BEind $d Ptulirbo Co&) 61 tlr h. d 1! i ddpr tha*of, !!d rl'. b.i. for rh..lb.d aadbtr Aly violrio! of Sario. T0l1.5 t, uy ali<{ hr.Ful surd. rt olilr lo..til pd.ryofd DErLt rrc hliH.bllr! (lto) f. *r* ^Flr. d Ey dplo)E Mh *q6 ! rh.t DL orlpolrbr *i! & rtcwl.i rlE rlxrE i er iira.Ld d otuld aG.l. (Sc 7044. AuiE ed PtoisiE Codc Th. 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E!c:, ,9.9 -9 . .3 1;od) ':J6oiocc( i oL!oo-a(1ovoo(LaF.:6oF. 9o : 9o ) (] O a -v i o,S ACKNOWLEDGMENT State of California county of Los Angeles , On )une 6,2017 before me, Sarah Garcia, Notary public (insert name and title of the offlcer) personally appeared David Kracoff who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) isiaresubscribed to the within instrumen t and acknowledged to me that he/she/th ey executed the same inhis/her/their authorized capacity (ies), and that by his/her/their signatu re(s) on the instrument theperson(s), or the entity upon be half of which the person(s) acted, executed the instrument I certify under PENALTY oF PERJURY under the laws of the State of California that the foregoingparagraph is true and correct. s ARAH GARCIA WITNESS my hand and official seal.Commission * 2OlO12t llota.y Public - Ctlitorria tos Argalrs Comn 2017 Signature (Seal) notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attac validi he d, and not the truthfulness, accuracy, or of that document. l