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Home My WebLink About3700-3710 S Raitt St - Misc. Permit (8)APPLICATION AND PLUMBING PERMIT (TYPEWRITE OR PRINT IN INK) o APPLICANT FILL N AREA BELOW CITY OF SANTA ANA 206 W. 4th Street 667-273a a ltt* (! E-q zo ooI m(,(, (.p U\ 3712 S. Santa Fe VilJ-age JOB AOORESS Sunflower Associates OWNER PHONE MAILING AOORESS3315 Fairview Rd. Costa MesaCITY EK"'Tzoz6 Ounr-Bulld.r Dccl*rllon I hereby allirm lhat I am exempt from the Contractor's License Law for the lollowrng reason (S* 703 1 5 Eusrness and Prorssrons Code Any crty or counly which roqurres a pâ‚¬rmrt to conslruct. aller rmprove.demolrsh.orreparranystruclure.p.roatorlsrssuance.alsorequirestheapplrcant lor sch permrt to trle a sqned statemenl lhal he ts hcensed pursuant to the provisrons ot the Contractor's Lrcense Law (Chagter 9 {commencrng wrth Seclron 7mO) ol Orvrsron 3 ol lhe Eusrness and Prol6srons Code) or thal he rs erempt lheretrom and lhe basis for the alleged exemptron Any vrolalron ol Seclron 7031 5 by any applrcant lor a permtl sublels lhe applrcant to a crvrl penalty ot not more than ive hundred dollars (S50O) E S*t,on 7Orl4A I, as owner ol lhe propedy, or my emptoyes wrth wages as therr sote compen- satron. wrll do the rcrl. and the struclure is not Intended or otfered lor sale E S*tion 70448 l, as owner ol ihe properly, am ercluspely contracting with lacensed contract06 to conslrucl the project Date Owner (Srg ) ConlirioD tb. Only Eagle Paciflc Ventures CONTFACTOB 75L-3222 PHONE P.O . Box 11388 AODRESS CITY Costa Mesa {i"'Tzozt Rssidential Dlndustrial nCommercial NO.EACH TOTAL each fixture/trap 5.00 Dental Unit or Medical Gases 10.00 SEWER 1 st 1 00' + Conn.15.00 Ea. Add'l Conn.5.00 Ea. Add'l 100' or Fraction 5.00 Private Disp. System 30.00 GAS PIPING GAS SERVICE 1 to 4 Outlets 5.00 Ea. Add'l Outlet 1.00 Repair or Gas Piping 5.00 Temporary Gas Service 100.00 MISCELLANEOUS Waler Heater - Electric or Gas s.00 Water Piping Ea. 10O' Rain Water Piping (buried) Ea. 10O'8.00 Water Soltner 4.00 Alt. or Repair of Drainage - Vent Piping 10.00 Lawn Sprinkler 6.00 Rain System - Per Drain 10.00 lnd. Waste lnterceptor 8.00 Pool Traps 5.00 Deck Drain System - Per Drain 3.00 Repair/Alt. Drainage or Vent 10.00 Vacuum Breakers 1-5 5.00 Over 5 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 650/" ol sublotal (minimum 20.00) Receipt f.lo.Pc#Date Plan Check (Adjustment) lssuance Fee TOTAL DATE NO. I hereby allirm lhat I am licensed under lhe provisions ot Prot6sions Code. and my licanss is in lull lorce and 9. Orvrsron 3ot the Busrn6sa6d Class42065t lrs /e0 Oate Contractor (Sig.) License No. 2 Worim Comptillbn Dclrrllon I hereby alfirm lhal I have a ce.trficale of consent lo sell-lnsure. or a certricale of Worker's Com- pensation lnsurance. Certrtied copy is filed with the City building t{ollc. to ApPllcsl: ll aller makrng thrs Cerlrtrcate of Exemplron_ you should become subt4l lo the Worker's Compen- satron provrsrons ol the Labor Code, you must forthw(h comply wtlh such provistons or thts permrl shall be deemed revoked Lils ot 4 90 Dare 2l-lr5Jg.OAepricanr (sis ) lhis permit rs rssued. I shall subiEt to the Worker's degartmenl. Veritied By (Sig ) Dalâ‚¬ - Appticant (sig.) lcertit thal rn the pâ‚¬rlsmarceolthework pâ‚¬Eon rn any manner so 6 to bEome Celilornâ‚¬ Osle Exprres Erdradon This pâ‚¬rmil shall oxpire by limitation and beome null and void il thâ‚¬ wort ruthorizâ‚¬d by this pâ‚¬rmil i3 not commoncâ‚¬d wilhin t80 days lrom tha date ol lhis pâ‚¬rmit oi it work rulhorizâ‚¬d by fhis pâ‚¬rmit i3 susponded or abandoned st any time atter the wort is commoncod tor a fEriod ol 18O days A nes p6mrl 3hall be obtained ,iBt bâ‚¬lorc such wort can bâ‚¬ rocommoncod. Arplc.na.. O.d.r.0o.r I certrty lhal I have rsad this appltcatron snd state that the above @mply uth ell oty ordinancE and state laws relaling to rulhorized reprGsntation ol this city to snt6r upon purpos6. is correl. I agre to lor insp*lion end horeby on" 2l 15 l g0Appricanr or rsent s4634-38 VERIFIEO BY (Srg ) PL EUILDING PERMIT No PERMIT ISSUEO BY (Sig.) P. Lomeli rr r-412) Y) Orstflbution: I lnspector Copy 2 File Copy 3 Frnance 4 Applrcant Copy CS-61 1 FIXTURES 10.00 t Ann ,5.On 10.00_T- (minimum 149109 o o PLUMBING INSPECTION RECORDS Romarks Grouncl Work (Soil) Ground Work (Wate0 Water Service (Ground) Gas Service and Underground Lawn Sprinklers Waste lnterceptor Pool Traps Sewer Roof Drains Water Heaters Water Sollner Rental or Medical Gases Rough Plumbing Final Plumbang Temporary Gas Service Notes Ortc ln!pector Approval (Slgn!turol I #sa /..Zfu.Lt.-' 7