HomeMy WebLinkAbout30139202 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19)' Santa Ana, cAgzToz Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: 1714) 647-5853
Permit #: 30{39202
Pin #: 32459\.-)
-_t
Project Address: 3317 S Bristol St
Assessor'sParcel: 410-222-24 Lotr NA
Bldg:
Tract NA
Suile Range:
Zoning. Cl
Owner:
Address
Phone:
Tenant Name:
Contractor
Address:
So Cal Pizza Holdings
1 City Blvd West #750
Orange, CA 92868
19511254-7407
Pizza Hut
S&JVentureslnc
2767'l La Paz Rd Ste 200
Albuquerque, NM 87107
(951) 96s-1400
Commercial Occupancy:
Tenant lmprovement Constr TYPe
Tl/roof mtd equip/storefront Code:
A-3
VB
cPc 2016
01116002
01116002
Foe Type Amount
51602 Water Closel 14.22
51602 Urinal 10.87
51602 Sink 12.70
5160i Dishwasher 11.97
5160i Floor Drain '16.14
5160i Floor Sink 16.14
51602 New Sewer (First 100') 64.60
5160i Each Add'l 100'Sewer 22.25
5160i Gas System 1-4 44.5'l
5160i Gas Outlet. each Add'l 7.06
51602 Tankless Water Heater 65.57
51602 Water Piping (Each 100 44.5'l
5160i Wtr Conditioner 44.51
51602 Backflow < 2" 22.25
5160i Hose Bibb 15.47
51602 GreaseMaste lntercept 37.56
53602 P/C - 65% 0.65
5160C General Plan Update 22.O8
51602 lssuance 55.04
Notes: water cgrtrdlliB!?tJt:ff,:'{rlri , ,.(lffrir: /rYH 1I ,;
t\'-:,:l,f:
R,:r,ti: [r?f,I{rri-:g r. ,.,
lrqn,,r:l,:t irln ToL0l
01 1'r6002
01 1 16002
01 1 '16002
01 116002
0'1 116002
01116002
01116002
01116002
01116002
01116002
01116002
011't6002
01116002
01116002
01116002
01116002
Qty
3.00
1.00
9.00
'l .00
6.00
5.00
1 .00
1 .00
1 .00
8.00
2.00
2.OO
1.00
1.00
3.00
1.00
882.49
1.00
1.00
Fee
$42.66
$10.87
$114.3C
$11.97
$96.84
$80.70
$64.60
$22.25
$44.51
$56.48
$131.14
$89.02
$44.51
$22.25
$46.41
$37.56
$573.62
$22.08
$55.04
State Lic #t 792398
Lic Type: B
Bus. Lic #: 370216
Workers' Compensation lnsurance:Carrier: State Natlonal lns Co lnc
Policy #: AMX0820031001
Expires: 1ol01l2018
Building Use:
Job Type:
Nature of Work
1116002
I{
1
5H
0f
rl?
R
t
Planning Conditions;
Planning Approval By: Dale;
Plan Checked By: West, Glen Date: 0412512018
Permit lssued By: Chavez, Dave Date: OalO7l2O18
Subject to Field: n-a' Account#
Buildins Permit #: 10195923
Every permit issued shall become invalid unless the wotu on the site
authoized by such permit is comoBnced within 180 deys aftet its
issuanr8, ot it the wod< authoized on the site by such Wnnit is suspended
ot abandoned fot a peiod of 1 80 days after tho time the work is
cofimetrced.
01 '1 16002 51600
l8 l:1
t97
1J9?
2Pn
4 ,6rJ
Misc. Receipt: 7O74O
Misc. Receipt:
Misc. Receipt:
Total
$22.08
$952.52
- 9??. i9
$9t?.5:
$1,566.q17i,. En
Auil' r1;51ff!,f .1
$974.60
lnspector MtD#. 2018-142210
01 1 16002 51602
Fee Total
Paid to Date:
Balance Due:
Unil:
Block: NA
AddressRange: 3309-3365
Historic: No
Phone:
5&JVenturesInc
Generol Plon Updote Fee
01116002- 5t60000tr-
Plurb ing
01116002- 51602U00-
llosten Cnrd
CC+ ! ***r********3?ig
PLUMBING-INSPECTOR RECORD
APPROVALS DATE rD/srQ\COMMENTS
UNDER GROUND
Waste & Vent 1*q-ttr 1"ttP4,I
1 -5 _ttr \J,{,IL tL* er\tagg"
Gas-Underfloor
Building Sewer
Area,/Storm Drain A
lnterceptor/ Clarilier 1-z1r V,W)h ve.-l. "?Ae-b
TOP OUT
Waste & Vent 1-Z,t-ly V.IYA
Water Pipino 1-"!-tY
Gas Pipinq 1-7e8 tS)
Rool Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler ./\
Sanitary Sewer/Mp IJ. I 6.t.n-!Ltpa.,.
Back Flow DeviCe -a4.
Rough Plumbinq
Final Gas Test
Meter Release
FINAL ll- lr- t1
Notes, Remarks, Etc N7
rE$ uzipl auyscQD
-9
OWN [:R Ii TIILDI]R DI'LCARATION
I hcrcbyllfir und€r Ptnrlrv ofFrrury rhar I d.i.frp! lmnr rhc C,n a.t)R Licctr{ ljw lirr thc i)U.wir! r.rv lS&70115
Bu\iricsl rnd Ptufc\\ion Codr): Any Ciry or Cootrrr_ shf,h rrquirc\ r Fnnir ro mtr{rxcr, !lr.r, inuor, dcnni\h or rcBrir rn"
{n.ttrc. tnorr) \ ir!uM.c. JsJ rcqun.\ rhc rrpli.ld n* {.h Fmir b lih! \i8trcd {rrcNnl r( fuorshc t licrn'..| r ^urn '.
n, rlN p'ovntnN .i rhc Conrrrctr's l.i.cn\cd lls (ChrDrcr r). (innnrmnrg *irh Sc.rn 7(XX) .f Division I oi rh. llhtr,c$ rnJ
!pIli.ullnr a |rilnil su6jccr\ rhc rpplicanr ro a.i!ilprn!lry.lD.rnnnc rhrn fivc hrndrcd doUr^(S5m).
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ac ownf of tlE prcpcny. or my G,rploylca *irh ws8lr &\ rh.t soh otrp.nsdion. qiu do tlE qdk old tlE sLr.r@ i! mr
intql(hd troficEd lor sk (Sd.?(x4. ausies aM Ptuf.$io8 Cod.iTIE Co dtols Llrn* tjw do.s rcr qlply lo sowmrof
th.ImFny wls ti{ildr or iqmB llEmn. r,n vho dfts Mh vort hiru.lf or lENlf or llmus} hii or ltr om cnploy.<.
proviicd rh.r sh inipreltmnlr e mr ,{c.iLd domsEd f.r{lc.l( lbM. dE trililin8 q inFlvmnl it $ld -nhin orc )M
of.on?kioo tlE 0*6 Blild will haw th. br&n of leving lhd lE .r stE da d hrild or iqmr thc FoFry for dE puryos of
-l,.sownd
oirhctnicdy, amdclusivclyc.nrEcrirg wirh liocnscd .o.racroN ro condrucl rhc pmr.t (Scc. ?044, Businss
nd PiDfc\sion Codc: Thc Contraclols Liccnsc La* d.cs nol applylo anowrc! otpmrcrrywno huilds or ioproks rho@n.
snd eho .onrEcrs fo, {ch poier wirh a coire'o(9 liccisc{ nuNMr ro rhc conradois Licctre L!w).
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amcrcn undcr S(lio B. & P.C forrhi\ Er$n
wonxFxs, coMpENsaTroN
DECL/ISAIIO!
I hcEbt arfim undf p.Mxy of Frrury.rc of the lollowir8 d(Iffllio.s:
I rhor ao,l.. ntrrll p.rlomrmrolrlr unk |,tr Nl],.I, rtu ltnn '\ a{ial
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havc rnd will nBiflltrifl wortcrs comp.nsalion insur!rcc. 0s rcqlncd by Sd io. l7O0 o, rlE Libor Code. lo, rh. Idloruftc oI
rhc *ork for qhich rnis pcflnit t tsucd My*ork6 smrtnqtion in\urarcc kr
.^J^.{c.-J 6s,5&*C,O
.lVhX - o8;) - oo3l ' oo t I /8
-lenilyrhqr
in thc te1forourcc ol Uc work tor whi.h lhk p$eir is issu.d.l sh l.ol employa.yF6on inrnytunmt
s ns h h.sm subFct lo dr worl@R omlcns ion laws ofc.lifomi.. da8slh if I should h.foft subjd 16rh.
wollcm snqEnerion pmvisions ol SNion lTO0 of rhc lltm Codc. l nD[. fonhwith omply *irh rhos povtions.,
WARNINO: tuihre ro sc!rc {orkr^ compcnsaln,n co{risc is !trhsfxl znd shrll \ubl.cr 0n cmtlo}tr ro dmiml p.mllics and
hudrcn rhoosrnd dolle {5100,000). in ldd aon ro rlr @st ot.omFnerion, dame.s 3s providcd for lhc
inlcrc( and alromy\ lce\.
rB
PEII,AAAII!'N
I hc,cl,y ltltm uder pcnllry ol pcrjury rn l m lie.sd lndcr po!i\b. oachxrrr 9 l.onnkn.ing *irh se'iotr ?our) ol Divirion .l
of lhc BusiR$rnd Prclcsions Cndc- ond nry liccnr n in lulll'oremlcl cr
7?? )?e
COISI8ICITONIENDEG.{CENJJ
I hcrcby efiirn und., F.rlry of p.rjury lnar r|..rc t a co.ndcrio. !.ndi.g agcncy tbr tlE pnformncc of lhc worl lor which lhir Frmil is
isucd (se.1097. civ. c.).
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Water-Under lloor
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L.ndcls Ad<l,es:
-
APILICANI.DECLAAAII(IN
I ffiy alltrm uftdcr pcnahy of pcrjury otu of thc lbllosing dccleorions:
D.rmlirion Pcirnn$Ash.stos Nolificslion Fcdcral Rc8ulllions (Tillc 4n). Pfln6)
-R.qun
d kner of Mrificalion
_l ccnir, rhd rh.fcdflrlrgulartr,n\ NCrdihB 6b.{o\to'mrrlr( nor lfplrJblc brhBpmFtt.
KLEnrfy thot lhovc rcrd rhF lFllicari.tr ad {arc rhar thc atnvc rtrrnrrurion h comcr I aslrhmnlly
^rdmunccs
and Sl{c L!* s Fld ins t, hurldrtrE con\rructiotr ond hcrchrlurEnie r|tr*nhrt.( ol 'haC y
,r!tr'\ r !,1 rL,|a \rr rrr,!,{rtintri1^-
\rDrrnn,i .rrH,,si! r,tr,.: *
''y'(-'.'f,(,n,i,(nnrr,l,nnl, x' -/ 'J11t.r/ U)t lllt
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