HomeMy WebLinkAbout2202 N Poplar St - Misc. Permit (2)APPLICATIONAND
PLUMBING PERMIT
ITYPEWAITE OR PRINT IN INK)
o O c'r"orsoNTAANA
20 CIVIC CENTER PLAZA
834-4186
@c
ozo
l"
a
P
=
NO.TOTALEACH2pQ2 p6. p6plar
JOSADOR€SS
FIXTURESPHONE
547-14q 1Iirrner 4.006ach plumbing f ixture/trap
10.00Dontal lJnitor Medical Gases
MAILINGAOOBESS
S'IIIE
SEWERSTATE/ZIPCITY
Santa Ana CA 10.00lst 100' + Conn
3.00
3. O0Ea. Add'l 100'or Fraction
Private Sewage Disp. System 30.00
GAS PIPING
5.00GAS SERVICE 1 tc 4 Outlels
1.00Ea. Add'lOutlet
20.00Temporary Gas Service
MISCELLANEOUS
OU|E-aad..D..ffi.r
I h.@by afftm $.r I .m exompt lrom dE Cfirelor's U6.36 L.w lor rh. following Ms (S6c.
7O3l ,5, Eurn63s and Prot$sio.s Cod.: Any ciry or cdniy which EquaEs . osftit ro cd$Mr.
6lbr. amp|@, &Folish, or Ep6jr sny.iirrcrurs, lnor ro its issurM, d$ roquiB. rh€ 6ptli5.r lot
such Fml ro fih s $omd ll.tElmr rha tl6 a! licons.d AirJa.t to ltE prdisims ol rh6 Conrrac-
ro/s Licons. La* (Ch.pr.r I lcmltr@ing wjth S€cli@ 70OOl ot DMton 3 of dto 8lsimss 6nd
Prcfessi<ns Code) d tEt h€ is ex@pl rhor.Irom and 6€ bris d riE alhlEd axmpton, Any tiola_
tb. ol s€clio. 7031 .6 by any 6pdic6nt fo. 3 p€mn subio.ts rh€ aCdica.r ro . cMl Fndiy o, nor
m@ the^ liw hundBd dolhrs l$50O1:
E S""ri- rO4+a l,I @nor ol 01o p.opeo, o, my emdoy€ss wio wases.s th6n sob com'
p€ns€rion, will do rho wo.t, and rha ll'lJciJre B not i.r6nd6d or ot .r6d lor 3ah.
E S*ti* ZO&e l, as owior ot rhr p.openy, am etelusiEly c@u&ring wiih li.smsd c*
t&1o.s io @.tuct rh6 prc*Fr.
D.ra- owftr(Sio.
1 500 5-00Water Heater - Electric or Gas
Conrrrcror Ulo Onty
4.00Water Piping Ea. 100'
Mack PlLnnber
PHONE
859-9005 4.00Bain Water Piping {buriedl Ea. l0O'
WaterSottener
*R Mr.T.aran IIni + H
ADDFESS
3.00Alt. or Bepairot Drainage-Vent PipingCITY
Irvine
STA-TE/ZIP
CA 92714 3.00Lawn Sprinkler
4.00RainSystem- Per Drain (inside)
8.00lnd. Waste lntorceptor
5.00PoolTraps
I h6r6by affnn lhd I .m ic6m.d {ndsr ltts p.ovisi-s ot ch6pt6. 9, Di'.s'@ 3 oI tlo Bltlla 3nd
Preies*ss Codo, lnd my lirc is in tull torc€ an<l sfl€ct.
u*/Odq87 cr"* C-16 siy L,.**-J.25I53--
see at5-14-85
3.00Bool Drain System - Per Drain
Bepair/Alt. Drainage or Vent
5.00Vacuum Breakers 1-5
1.00Over 5
5.00Backflow Device 2" or Less
10.00Ovet 2"
Waler Service
lh.ra ComFllaadoo Mo.r
I h@by atli m tul I hav€ a cotuficaro ot coosonl to sell-in$r€, q . c6niricars ol \ivo(or's CoDp6._
sation lns{r8nco. Conifiod cow is fil.d wirh dE City boildi.g arspaclioh doOarrmdl.
rs,o , I.r+i€ 3i€kl-cr--
I @nit th.t in tE p€nomanc. of lho m.t lor which rh6 porhrl B issu€d, I $ell nol €mploy any
p.rson in 6ny manner so as ro be.mo $bjet ro lhe wdkei's c@p..slion Lr6 of cslirm6
o.r.
-
aDolh..r lsh.l-
oth. To apdc-t:
f, .ft6. mitinq $ir C€rrificsro of Ex6mpto., vou sholld b€.lino $biFl lo th6 l b.r€.'s Comp€+
s.lio. prdbids ol irE Lltor Cod6. you flun fo.rhfi$ cdnply with sjch p@ii6is or lhis psmir
JBll b. d.3iEd Evor6d.
sig )see at
oae erpira. (-] 7-r86a ey
p"t" 5-14-85 appri""*r
s.00Subtotal
Ponalty Fee (when applicable)
Violation Fee {minimum 335.oo)
Plan Check F€e (mininum $15.OO)Acct.* t 1'4O2
PC NoRoceipt No
10 00lssuance Fee
TOTAL PERMIT FEE (minimum S35.oo)
PEBMITNO 5A R4 .. nn
Erpddt
This pemii sh.ll .xItB bV limii.t on snd bsorn6 null and vord it lho wo.k autndizod bY this pamn is
.or cohmic€d stnin 18O days trom lho &r. o, rhb pomil d , wort sutio.iz€d by $B p.mn i3
srsp6.x,.d or.b.i&r6d .r anv rim€ ,lrs, lho ,ort is cmmrcod lc a poiiod ol l8O &y3. A lw
Fmir shall b6 oDtriBd ftrst h.toro such wo.t ca. bo €cnmon@d.
aefac.rt'3M.r
I coniy rhar I h.E ,o!d tnis appli@ud a6d sr.b lhbt ths sbow inrmldd is cffel. I 6groe ro
@ndy with all ciw odina..€s and srare |rws ,6hli.g to boilding co.rstructon. and hoEby autnc
,i.6 6pE$.t6riv63o, this city ro 6nt r upon lhs abo@€nti@d p.op€rty lor insp.clid pu.poss.
o"" 5:-L4=85 Appricanro,Aqo ls€
,--^^-l/-'*-'R---!.-P"-.--lPEBMII ISSUEOBYISig.)
BUTLoTNG N/A
PERMIT No.------LvERIFIED BY (S's.lCfrr-
l 3500 : b 1322tsAVALIOATION IOFFICE USE ON LY)
tAccouNT111,4r2l
Distribution: l.lnspoctorCopy 2. FileCopy 3. FlnanceCopy 4. ApplicantCopy
APPLICANT FILL IN AREA BELOW
E Besidonrial n lndustrial ! Commorcial
Ea. Add'lConn.
4.00
3.00
oarr- 5-22-85
. S,iIR
o o
PLUMBING INSPECTION RECORDS
Remarks
Ground Work (Soil)
GroundWo.k (Water)
Waler Seruice (Ground)
Gas Service 6nd Underground
Lawn Sprinklers
Wa6le lnterceptor
PoolTraps
Sewer
Roof Drains
Waler Healers
WaterSohner
Rentalor MedicalGases
Fough Plumbing
F nalPlumbing 2
Temporary Gas SeNice
Noles
Dale Inspector Approval
(Signaturel
-82