HomeMy WebLinkAbout30139719 - PermitProject Address: 2424 N Tustin Ave
Assessor'sParcel: 395-251-55
Unit:
Block: A
Bldg: 24-L Address Range:
Tract A.B. CHAPMAN Hisloric: No
Suite Range: Unit L-lO, t-tZ \
Zoning: R4
City 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 #: 30{397{9
Pin #: 5ll772
Owner:
Address:
Contractor
Address:
Phone
Tenant Name
01't16002 51602
01't16002 51602
01116002 51600
01 116002 51602
Fes Type
Sink
Dishwasher
General Plan Update
lssuance
The Bascom Group
26 Corporate Park Drive, Suite 200
lrvine, CA 92605
Katerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-r065
Amount
12.70
11.97
22.08
55.04
Qty
8.00
2.OO
1.00
1.00
Fee
$101.60
$23.94
$22.O8
$ss.M
Eotchi:{5194 - 8/3/2018 I0: CCt,El.l.AR
0ffice: CTYH Trons+: I ? of JtiAccti: Reli: 30139719
Rcpti:023{7447 ' 8/3/2018 2:2? Pn
i.onsoction Totol t5r243.53
Koterro ftenovot i0n9r LLC
State Lic #: 1009989
Lic TyOe: . B -ta::
Bus. Lic #: 365547
Workers' Compensation lnsurance:Carrier: Midwest Employe/s Casualty Company
Policy #: BNUWC0139070
Expires: 01/01/2019 t 18t:r . 3r
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subiect to Field:
Building Permit #:
Date
Date
Date
Generol Plcn Updote Fee
0t 116002- 51600000-
Plurb ins
0111600?- 51602000-
ICL Che,:I 003020
Uiso
CC+: rrt*t*rI**r*5069
Fixture change outs (Unit L-10,12)
tir 143.90
s99.63
A.,th*:052017
R-2
VB
cPc 2016 Notes:
08/03,2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Chavez, Dave
Every pemit issued shall become invalid unless the !ryork on fl,e sile
authorized by such permit is commenced within 180 days aftet its
issuance, or if the wo* authodzed on the site by such permit is suspendod
ot abandonod for a period of 180 days after lhe time the wo* is
commencud.
lnspector
$22.08
$180.58
Fee Tolal:
Paid to Date:
Balance Due:
$202.66
$0.00
$202.66
Lot: 8
Phone:
Multi-Family (5 or more uni Occupancy:
Mlscellaneous Constr Type:
Fixture change outs (Unit L-Code:
01 1 16002 51600
01 'l '16002 51602
MID#: 2018-144749
PLUMBING.INSPECTOR RECOHD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby .,Irm hdcr Ftulry of ledury rhal I m cicryr lbn rlE Conhcton' Lh.trc L2s for lhc folloeing M$n (Se.7otll
Blrincss ad Prof.shn Codc)i Ary Ciry o, Courry whkh rcqutcs a IEnil lo mNltud. all6. impovc. d.mli,h or EPat .ny
rlfude. pri,r ro ft i.!uam, .ho Equircs F .pplianl lor !u.h p.rmi lo nb s ,isrcn slde mnt ihd lE or shc is lic.N.d PlNonl
b rhc phlisions of rL Conk&|or'. Liccnsd hw (Ch!pr..9, Co'mcncinB *ith Sccaon ?000 ol Diviiion I oflh. Busincs and
Pmf.ssio.s Co.lc) or thrt lr or sh. is cxcmpl lh.rciiom atrd rlE hasis ior lh. alkged .xcnpri.n. Ary viohtionofsdlion ?011,5 br.ry
lt{,licanr for s pemn sobjds rlE !ppli.!.r io a .iral pe@lr, ot er @rc the fivc hudEd doll6 (1500).
l. r!.strcrorrhc ptuFny.or mycnr!loyccs wilh*rsc\rslhcn v'h co'n,tNarnn. willdo rhcsork:u lhcsrMrurcnn r
nc cd oriirltrcd forslc(Sc 71uJ. Brsinc$xnd rt,rc!\i{nN C( c Th.Cunt c!tr \ l-iccn\cLawdoc\torrpplyro!no\ru,ol
rlkrniF-ny stu hoilds or mrr.s rtEmn. !ftluho des such wi. iinsclfor hc^clfor rhrorgh his or hcr onn rnDkryct$.
prcvnhdlh such in,l)r(rkmnh m nn inrcfrkd or offccd for \nc. lt hotr cvcr tlt fiiilJi',! or inl|nov.'L- nn,[,sirhin N )(tr
ol'.onucrion.thcOwtr ljuildcr willhrvc rlt hrddtr.lllr6vi'r! Ihrr hc ur \hc dil tror htrili or impr'rc rhc pn,rdy rrtrrtr lu,i,*or
-1.
!sowrcrofrh. pmFny, an.xclorirclyontBcrins *arh lketred.onu.cloN ro mnndd tlr,mj.!l (Sft 7ol:l. Busmrs
dnd Brftsir Cod.: ThcContBcrols Liccn* Low docs nol otply Io ano$ner ottop.ny*ho builds or inr,tmvcs thcreon,
and *ho Nnftcrs for slch Abj&( wirh a C.mEcto(, Ii..ncd ptrnuMt lo lhc ContEloii Ltc6. b*).
-l
! cxcmrl uoderScclio
-
ordr-
IIIBtrEXJI-CAMf,ESAIION
DEILIIBAIIO!
I hcrcby afiim undcr Fnalry of pdjury .nc of lhe following d.cla.iions:
-l
hle 0,n wiu tuinl.in r Ccnifr.t. of Co.e lo S.lf-l.sw for vorl6 .otrpcn lrion. a protidcd fd by Scdi,n 3700 of tlt
t hor C!dc. fo.llE llrflrlllEfu of llr wor!. fr *hbh tlt FmI h h$.d-
-l
hrvclnd*illnui rin woikcr' .onwnearn n inru6nc.. d rcquircd bySccliofl l7(D olrhc Llbot C!dc, for rhc p.tfon,uncc of
h tti\ pc,nir k L*kn. My workm snlEnsdion insurlmc cuicr a.d Fnty ouolE. m
UVJ . \(
-l
ccnit, tliar in rh.,'.rlormnc. of lhc work for which lhn Frmil is issocd. I lhrll nor e6plo, ony pctso. io !tr, frdtut
m s ro bcLonf, slbjc.l lo rtc worts\'comrcnsi' io. hws of Califodir. d a8@ lhol if I sholld lrroe slbjccr ro rlf,
workcF onrrEnslion pmlisions .f Sdrion lT(xJ of llE ljhot Cod.. l dtrll. fonh$ilh coml,ly virt lno* phvl\io.s .
WARNINC: hilurc ro scm {otk.ts conp.nsllion cov@ge is unh*ful. lnd shill slb.icd an cmplorcr
'o
dmitut lcnahics 6d
civil lincs up ro om huidrc{ rholend dollds (SI00.000). in rddilion to lnc cosl of.ohpenslion, da@g$ as Prolid.d for tltc
:::,"iijilT's"Ifflu
I h.6by afllrn uhdM ptMlly of pcrjury that I an I pmvhion olchapin 9(commm ins wilh Sation ?UD) ofDivisio.l
of thc Busincssand PrcfcssioiqCodc. ind my liccn* k ir tull lom and cilcct
Io011t-L
c'".1-(." l;-?.rk .^^^
CANEIAI&I TNIINIUNC.f,AIIII
I hc(byrffirnondcr pcnrlryorpciuyn thcrc is u.oNlruction lcndinslsctrcy ror rhc rc bnmnccofthcwo to, *hi.h rhis Fnnir i!
asucd (Scc 109?, Civ C.)
ATILICANLDIICLISAIIOI!
I no*y rtttn undcr p.ndlry oit'crjuryonc ofthc iollowin8 dccla,olhns:
Dcmolition Pcmrir\ Asbcsros Notin.ariun Fcd.hlRcsuhrn'ns (Tirlc 40. P!n6)
_Rciltrircd Lr(cr of Ndifrdion
I ccnily rhlr rhc lcdcral rcsllurionr rcsadin8 dlx{oi rcmral dc nol 0pDli..hle lo rhls PnJer
Wt.:t',I harc .cad thn lpnltrrn,i ulr skr. rhnr rh. rh,vc inbmurion iscotrccl I ugrc h.orln lt *irh ll Cirylnd (ou.ly
iEs olrhi\ Ciry snd C.un(yt, cnrcr ulonrtrralc tjws rchr ils ro buildin3 c.nnddn,n, d
!ho!c tunrioncd nror.ny for
_*
I P"-r**n"r.rr,r'
'- - : .
Water-Under Iloor
Gas-Underfloor
Buildino Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Rool Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Gas Service
Water Service
Lawn Sprinkler
Sanitarv Sewer/Cap
Back Flow Device
Rouqh Plumbins *l?-5lla/l*7\1*
Meter Release
FINAL t/o14 q\w
Notes, Remarks, Etc.
UNDEB GROUND
Waste & Vent
Pool Heater/Gas Line
Miscellaneous
Final Gas Test
L.n&l! N.ft:
-4 h4