HomeMy WebLinkAbout3700-3710 S Raitt St - Misc. Permit (4)APPLICATION AND
PLUMBING PERMIT
(TYPEWRITE OR PRINT IN INK)
O o CITY OF SANTA ANA
206 W 4lh Street
667-2738
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APPLICANT FILL N AREA BELOW
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JOB AODRESSXruX 3704 s. Santa Fe Villaee
Sunflower Assoclates
OWNER PHONE
3315 Falrview Rd.
MAILING AOOBESS
Gosta Mesa
CITY STATE/ZIPcA 92626
olrnr-Bulld.r O.df,dlon
I hereby alirfi that I am exempl lrom the Contraclor's Lrcense Law for the tollowrng reason (Str
T03l5.EusrnessandProt6sronsCode Anycrlyorcountywhrchregurresapermiltoconslruct.
aller. rmprove demolrsh, or reparr any struclure, pflor lo rls rssuance. also requrres the applrcant
for such permrt to file a srgned stalemenl lhat he rs lrcensed pursuant to the p.ovrsrons ol the
Conlraclor's Lrcense Law (Chapter I (commencrng wrth S&tron 7m0) ot Orvrsron 3 ol the
Eusrness and Prof6sions Code) or thal he rs erempt therelrom and the basrs lor the alleged
exemptron Any vrolalron ol Sectron 7031 5 by any applrcanl tor a permrl sublecls the applrcanl lo
a crvrl penalty ol not more than ive hundred dollars ($500)
E S*t,on 7044A I. as owne. ol lhe properly. or my employes wrlh wages as therr sole compen-
satron. wrll do the mrl. and lhe struclure rs not rnlended or oltered lor sale
E S*t,on 70448 l. as owner ol the propeny, am exclusrvely contractrng wrlh lrcensed
contracloG lo conslruct the proi*l
Dale
-
Owner (Sig.)
ContrEton L,!a Only
CONTRACTOR
Eaele Pacific Ventures 75r-3222
PHONE
P.O. Box 11388
AOORESS
Costa Mesa
CITY STATE/ZIPcA 92627
I hereby allirm that I am lrcen*d undar the provrsions ot Chapter 9. Orvason 3ollhe Busin6send
Prolessrons Code. 8nd my lrcens rs
42065t
Lrconse No
-
ClBs
9 09
2 15 9
Cily
in lull
Date ocontracro, 1s'9 1
Residential !lndustrial !Commercial NO.EACH TOTAL
each plumbing fixture/trap
Dental Unit or Medical Gases
SEWER
1st 100'+Conn.15.00
Ea. Add'l Conn.5.00
Ea. Add'l 100' or Fraction 5.00
Private Sewage Disp. System 30.00
GAS PIPING
GAS SERVICE't to 4 Outlets 5.00
Ea. Add'l Outlet 1.00
Repair or Replace Gas Piping 5.00
Temporary Gas Service 100.00
MISCELLANEOUS
Water Heater - Electric or Gas 5.00
Water Piping Ea. 100'10.00
Rain Water Piping (buried) Ea. 100'8.00
Water Softner 4.00
Alt. or Repair of Drainage - Vent Piping 10.00
Lawn Sprinkler 6.00
Rain System - fur Drain 10.00
lnd. Waste lnterceptor 8.00
Pool Traps 5.00
Deck Drain System - Fer Drain 3.00
Repair/Alt. Drainage or Vent 10.00
Vacuum Breakers 1-5 5.00
Orcr5 1.00
Backflow Device 2" or Less 5.00
Over 2"10.00
Water Service Ea. 100'10.00
Subtotal
Penalty Fee (when applicable)
Violation Fee (50.00)
Plan Check 65% of subtotal (minimum 20.00)
Receipt l'.1o.Pc#Date
Plan Check (Adjustment)
lssuance Fee 10.00
TOTAL PERMIT FEE
2 15 90
5.00
10.00
Sbrtm Comp.illbn Dclr.lbn
I heteby attirm lhat I have a certrfi@le o, @nsmt lo sll-rnsure, or a
I ce.lrty thal rn lhe perfo,mance ol the work lor which lhis permil
p€7aon in ,ny manmr so oB to bocome subiocl to lho Wtrto/3 ComporEalion Lff3 ol
Caliromia
Notlc. To APPllcxl:
It aller makrng lhrs Certrtrcate ol Exemptron. you should become subjet to the Worker's Compen-
salron provrsrons of lhe Labor Code. you musl lorlhwrth comply wrlh such provrsrons or lhrs
permrl shall b€ demed revoked
,;l;",,"" lnsurmFgce.t'r'ed copv rs ,rred with
6sued. I shall
o, workoas Com-
deparlment
Etprres
- Verified By (Sig
o.ru 2 / 15 / 90 Appr'canr (sre ) i
Osle
-
Applimnl (Sig.)
Erpliatlon
This pe.mit shall expire by limitAion and become null and void il the work aulhorized by this
pe.mrt 6 nol commancad withan l80 deys lrom the dsle ol thii permil q if work tuthtrized by thig
permat is susponded or abandoned al any time atttr the wort is comrencod ,or a period ol t8O
days. A new parmit shall be obtained li6t belore such work can b€ recommencod.
I certity lhal I have raad this application and gtalo thal lhe abov6
comply wilh 8ll city ordinancG and slate lam ralaling lo
authorized rep.6entalion ol this city to ents upon lhe
outms6.2/Lsl90
to
Oate Applicanl or Agant (Sig.)
L4
VERIFIEO BY (Sig )
BurLorNG 54608-
PERMIT No
PL
PERMIT ISSUED BY (Srg )
P. Lomeli
A11 fees paid M-11s8s 0] ')l t ? 0
vALroATroN (oFFrcE usE oNLY)
(ACCOUNT rr 1-412)
Oistnbution: 'l lnspector Copy 2 File Copy 3 Frnance Copy 4 Applicanl Copy
cs-61 1
I 6.00
(minimum $35.00)
,5. OO
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)
+_
o O
PLUMB!NG INSPECTION RECORDS
Remarkg
Ground Work (Soil)
Ground Work (Water)
Water Service (Ground)
Gas Service and Unclerground
Lawn Sprinklers
Waste lnterceptor
Pool Traps
Sewer
Roof Drains
Water Heaters
Water Soltner
Rental or Medical Gases
Rough Plumbing
Final Plumbing
Temporary Gas Service
Notes
Ortc ln!poctor Approval
(Slgn!tuio)
)
%a 1.
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