HomeMy WebLinkAbout30139377 - PermitProiect Address: 1545 W Seventeenth St
Lot: 11
Unit:
Block: 293-38
Bldg:
Tract MABURY
Address Range: 1311-'1601
Historic: No
Suite Range:
Zoning: C2
E
city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 30{ 39377
Pin #: 71701
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
Justin Storm
777 S, Harbor Blvd.
La Habra, CA 90631
(916) 893-1s36
CVS Pharmacy, lnc.
Bryon James Hamad
7952 Chaffee Rd
NORTHFIELD, OH 44067
(2161 s44-3O72
01 1 16002 51602
01 1 16002 51602
01 I 16002 51602
01 1 16002 51602
01 1 16002 5160C
01 1 '16002 51602
F6e Type Amount Qty
Water Closet 14.22 2.00
Sink 12.70 2.OO
Drink'g Fountain 8.95 2.00
Min Fee Adj 1.64 1.00
General Plan Update 22.08 1.00
lssuance Bo[,:h+:41199 - 58rfl7 /zt.tt$ 1100 (:(:UE
0ffire: (TYH Trqnsi: 167 i l,Ac,:t*: Ref+r Jr_r139:17
tii:p t i r tt2363741 - 8/?7/2(llg :ir33 r'f1
Tronsa,:t isn Toto I *911,6?
Fee
$28.44
$25.40
$17.90
$1.64
$22.08
$56.04
Phone
State Lic #: 944312
Lic Type: B
Bus. Lic #: 370385
Workers' Compensalion lnsurance:Carrier: Exempt
Policy #:
Expires;
Brgon Jaies H0 0d
Gefierol Plqn Updote Fee
01116002- 51600000-
Plurb ing
01116002- 51602000-
ICL Check 00010895
ICL Check 003131
$
$
Building Use:
Job Type:
Nalure of Work:
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial
Tenant lmprovement
T.l. - Accessibility
Occupancy:
Constr Type:
Code:
M
VB
cPc 2016
Noles: auth on file
Date
Date
Date
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
pr Hernandez, Kathy
Every pemit issued shall become invalid unless the wo* gn the site
authoized by such permit is commenced within 180 days aftet its
issuance, or il lhe work authoized on lhe sile by such pemit is suspended
or abandoned for a peiod of 1 80 days aftet the time the work is
commenced.
04t2712018
Account#
01116002 51600
011'16002 51602
Fee Total
Paid to Datei
Balance Oue:
$22.08
$'t28.42
$150.50
$0.00
$150.50
Assessor'sParcel: 399-121-39
lnspector MID#: 2018-143056
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
UNDER GROUND
Waste & Vent
Water-Under Iloor
Buildinq Sewer
Area,/Storm Drain
lnterc eptor/ Clarif ier
TOP OUT
Water Pipinq
Gas Pi ptng
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
IV ain Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Gas Service
Lawn Sprinkler
Sanitary SeweriCap
Back Flow Device
Rough Plumbinq
Final Gas Test
Meter Release
FINAL 1 bl/+b4arz /62,
Noles, Remarks Etc.77-
tC--(f '1o,^,stEZIfr O- -^, Y,tilLtrm 7o'lGtt n,teuEssh,oa
\ 2c,st 'or-s(2D
owNiti EutI_DFiR DFtL( aRA-l-toN
I hcnby rlili u crp. lryoI t^-rjury rhi I u.rcnr hnn rh. Conka.r)^ Lic!tr* b* nn rhc taftrwi'rg rc!\on (Scc7011.5
Busnn\ ral Prolision Cod.): Ary Ciry or Cou ry rvhtch rcq!rc\ r lrrmir k, c.nqrucr, !hd. nnpro\c. dcnrrlsh or epd r.y
!fl.lurr, lritrx, ir\ i$rmcc, rho rcqrircs rhe llptllcrnr Lr sx.hFirnir r, filon \i!iL{ {rrc'tunr rhrr hcor !h. is lnuscrl ru6u3nr
h rhc nmlni(nr\ ol rrE Conrm(rn'r Li.cn\cd bw (Chrpr.r 9. Com'ncncins trirn Sccrion TlXn oi l)ivninn.l o, rhc Bu:incss itrd
Itolt\sn)ns Codcr or ihir h.or\hc i\crcnrDt lhurclron d rhc bs\i\ turrhc rlldgcd c{cmpri{Jn Any!iololionotSc.rionT0.ll5hy!n,
lmli.ror f.r trNnn[ suhjc.r{h. lppli.anrr, a.i\ilpcnrhyofnornrrcrhM fi\. hundrcd dottr^ (9500).
-1.
os owrcr ofthc prcpcn, o. ny .rlr,loles enh w!8$ s thcn sb o"{Ensdion. *ill do tlE sdt .ln 0E n@rm h mr
inici&d trof.rcd for $L (Se.7044. SusiEs ood Ptofcsiors Codq Ttc Co rachis Lisrs t w docs ml spply lo !n owmr of
rhc !op.'ry who boilds or allIrcB dEen. ltd *tD dB trh wd( hinc.tf o' h.Mlr or $Dush ti" or hn.w; eilpby;6.
p.orihdlhar slch iqmvmnrse mr hrc,n.d o.ofrsrd for sb.Ii lF'fu. rlE l,uildinBor inplNm Ls $E virhin om J&
ofonphlbn. lh. Owncl Builto will har thc hndo of |'olinB th.r hc or sh. dtl mr build or inrprow 0E !6,Ely for *E purFc of
-1.
I owrer of rh. llq,cny. d ciclurircly contr.crine rirh liccnsd .onrsdoB ro mnsh.r rlr p..irr (Scc. 7014, hses!Br hrft$ionCodc: Tte CofllEctols Lic.ns. Li* d@. nol !0ply to ownf of prcn ny *ho buil& or imFmws thcrcon.and who conrreh lor skh F!}rts wnh r ContEtor{, lic.rcd pu6Ml b lhc C..rdols LkcrE tjw).
I iDcxc rt, untfur Sccr B & P.C. lnr dis rcasotr
wof,r(Fts,coMPE{saTroN
DECI,If,AIIOII
I hcrcby !ffirn urdo petulry ol pdju,y onc of rhc fouowin8 dcltralions:
-l
lrvc dtrdwill nhn .in rCcdilicurcolco!\cnt lo Scllhsurcl'or workc cotrrtctrernnr.nsproviLdnrbySccrn,n3T0Oolrhc
ljhor Cod.. tur rhc lcrfornEm of rhc sorl fir*hichrhc nqn t h\!cd.
_lhatandwilltui ain wortcn comF.n$lion in,umnc.. &r oq!i&{ bySdion l?00of tlr Libor Cdc. for lh. pcrf()lmmc of
rtc worl for *hi.h rhis pcmn is hsicd. My qorlGt onlPcns.tion i.suMe @tr dBt polt, runb.r e:
I c.dityrhar inrh. lcraortunccofthc work fo. whih'hhtcrnl h iqsmd,I ahau mr cdrloyanylcd,n inlnynunrts rs to hrsm subjN' b
'h.
w(,&ds conFnrarion hk ofcalifornir, and a8m rhal if I should t com subirr ro rrE
worlrcs'o'npcnsoliohpoviri,on\orSelion3TO0ofthcL{tnrC.dc.ls\!ll.forth*ith$ry,lywithltbsImvhio.s..
WARNINC: F.ilurc lo Burc workcm .odpcn*rion olc
civil fincs u! lo on. hundad rhouslrd dolla {Sloo.mo)
lor.r lo aihiMl Fmlti.s trnd
&mr8d .s pruvid.d aor ih.
Sccriotr :1016 ofrhc tilxtr
I2[!:I.A&!LIIAN
, hercby !i_'rn undcr pcnrltyol'ncrjury lhd I nn! lians.d undcr pn!ki(n, olCh fld I (.omnrE-ins silh Scction 7Ul)) or Divisn,n 3
.I rh. Busir.ssrtrd Prulc\sn,n\Codc, l nry liL.n\c i\ inTullfo(rudclttct
I heeby rlfrm und.r l.tulry of r.riury rhlr rlErc is . o
irsucd (Scc. 109?. Civ. C. )
,sc..y rdrrh.r.ifore.ccofrhc*ort ru which rhi\ lcrnir rs
AETLIQTNLDDIIABAIDN
I lftby alitnr undcr Fnihyorp.rjurt onc orrhr aol!,wins dcclarations:
l)cmlirion Pcrmnl^sb.nos Norin.ari.n Fcdcrul Rcs!larions (Till..l0. Pon6)
-Rcqlircd
t lrcrof Notiticario.
I.cniryrhtrr rh. tcdcrd rcgulario.\ rcAardin[ ^hcios l3r. nor orplicablc
'o
rhh lrojNr.
-l
ccnify rhol I h,vc rcad rhir rp karion dd infomrion is.m.d. I agre ro 6nll)ly wirh .I Cny lnd C6! y
odinlnccs atrd Shlc tr*s Nld ine ro bu
sv. ftnriofld pell.dy for inrp.ction "uhorize
rcprcscnloriv.s ofthn CilyMd Counryro cnt.r utxln thc
Appliclnl or Arent Silmlu
Gas-Underfloor
Waste & Vent
Miscellaneous
Water Service
$.u. '.-JLs ) "ijia,
Policy Numb.r:-Eidrcs: _
.-''-)
c-'-"*4
Pemilee mnc (prinl l: