HomeMy WebLinkAbout30139772 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAI27O2 Plumbing
Permit Counter: (7141 647-5800 lnspection Requests: (7141667-2738 lnspector Section: (7141647-5853
Permit #: 3fJ139772
Pin #: 33952
Proiect Address: 3750 S Bristol St Unit:
Block: NA
Bldg:
Tract NA
AddressRange: 3600-3798
Historic: No
Suite Range:
Zoning C2
E
Assessor'sParcel; 412-131-'12
Owner:
Address:
Contractor
Address:
Phone
Tenant Name:
MCG BRISTOL WEST LLC
PO BOX 28739
Santa Ana, CA 927998739
Goldline Construction
3004 Galnsborough Dr
Pasadena, CA 91107
(6261222-6174
01116002 51602
01116002 51602
01116002 51602
011'16002 51602
01'116002 5160C
01 1 16002 51602
Fee
$14.22
$12.70
$22.25
$24.21
$22.08
$55.04
Qty
1.00
1.00
'1.00
1 .00
1.00
'1.00
Phone
State Lic #: 994034
Lic Type: B
Bus. Lic #; 370002
Workers' Compensation lnsurance:Carrier: State Compensation lnsurance Fund
Policy #: 913431'l
Expires: 06/03/2019
Botctl ! {5077 - 71fi/2018 I0! CCUELLAR
0ffice: CTYH Trone+! {l 5 of 9Accti: Reft! 30139772
Rcpti:{II3{{496 - 7l3i/2tll8 ll:15 Atl
Troncrction Totol tl r 693,20
6oldl i ne Constrrrct ion
Genrrol Plon llDdote Fee
01rt6{El- 516{xrtr0-
PluS lns
0l t rfinz- 5t6tl:1000-
I{L che* (IIX}29
r?2.(N
,t28.12
ll 1693.20
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permil #:
Commercial
Tenant lmprovement
Tl/New Restroom
Occupancy:
Constr Type:
Code:
B
V B, SPK
cPc 2016 Notes: New interior partitions to create an accessilble unisex
restroom.
N.#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Zuniga, Allissa
10195606
Every permit issued shall become invalid unless the wo* on the slle
authorized by such pefinit is commenced within 1 80 days after its
issuance, ot if the wotu authotizod on tfie site by such pemil is susponded
ot abandoned for a period of 1 80 days altet the time the work is
cofimencad.
07/30/2018
Account#
lnspector MID#: 2018-143695
01116002 51600
01 1 't6002 51602
$22.08
$128.42
Fee Total
Paid to Date:
Balance Due:
Lot: NA
Fee Type Amount
Water Closet 14.22
Sink 12.70
v\nr Htr (Comm up to 50 22.25
Min Fee Adj 24.21
General Plan Update 22.08
lssuance 55.04
s\'4tt
INITIAL:
Datei
$150.50
$0.00
$150.50
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG,COMMENTS OWNER trt'ILDER DELCANATION
I hcEh, ilfim odr peely of pcrju.y lhtr t 6 cx.nq from th€ Co r&16 Uens Lr* for llE tolloqilg @s. (S.i.7011,5
Busin.ss md Pmf*sion Codc): Any Cny or Co$ry wii.h Eqtrircs . Fni' lo 6.rtMl. allr. inpb( d.mliih or EFi ey
!rw.lw. prior ro ir, issuffi, ako cquiEi rh. ll)pli.sr for such Fmi ro 6lc ! sigmn srdcd $!r lt d dE ir lt6tu nusrd
to rh. prclisions of rrE CorrE rols Liansd L!* (Ch!pr.. 9. Co,|mEing wilh Scrion ,m0 of Division 3 or rl. Baituss and
P,bLs.ions Cr<tc) or thli h. o, rhe ls crcnpl thetfren ond dE tosb for rn alh8cd crcnpdon. Any viollriopf Shrioo 7011 5 by lny
lpplicant for a lemil subjcls lhc lpt,ldnt ro r civil Fmlty of not mE $ fivc hudrcn dolG (1500).
-1.
!s owrcr oithc pmp.dy, or fty cnplorEs wnn va8cs a rlFn sb smp€nelion. will do ll* *mt ard dr srnEl@ is mt
ii{cndcd or otrcred fd slc (Se.?O14. Bliituss and Ptoitsions Codd 'thc Conracrols Liccnrc Llw docs nor apply to an owftr of
rh. pmFdy qho boild! o, itreows tlEbn od who dftr s@fi s* himsclf or heMltor fibuBh hh or her own empLr!.!.
providcd rhll such imF.rcmnls m mt inl.nd.d orotrcrEl for eb.If, h.wM. tlE t{ildinS or inprMmd t sld *itnin on. rs
oforplcrion, rlr Ownr B!il!. wiu har tE bu!d4. of Ebviis tiar lr or she dij tur lriu d in{lor rh. pmpdly fo. tlE plrrDc of
-1.
s owrc. of lhc p,oFJly, m crclusivcly conrelir8 shn lened coI tr'o6 lo snslNcl llE pojel (Se. 7014. BEircs
aid Prsturam Codcl Thc Comreroar Liccnsc Lra dNs mr smly r. !n 6qG of lropcfly who blilds or ioprcEr ih.rcon.
and who ontmrs fm sah ,rcj.srF with ! Cor E ro(s) liccn*d pu6wr ro rhc Codr.crols Ltcn$ L3*).
-l
M cxcopl undcr Scclio,-. B & P.C. for rhis rcMtr
Drr. o*n.r:
]1OBf,EELCAMPjNSAIION
DECIAf,AIIQ!
I hcrcby !fitn undcrycnahy of psjul} orc o, lhc folbwinS delmliotrs:
-l
havc nnd qill ,Mitrr.in a CcniaK c of Con*n'
'o
Sclrlnsue for mrkns- .onDcns0rion. .s lmvidcd ior by Salion l?00 of lhc
t hor Codc. for rh. r.rfom.cc of lhc work for whkh rhc JFmn i\ is$dd.
_l h!!c ood Bill maintain workcr' coq'cnsol ion insuEmc. !s rcquircd t y Ssl ion l7m ol lfic bbor Codc. lor tt p$aomncc ol
i. nscq. My*o*er a'mpcnd,un rnumxc tsic, &nFlry Nnbc,m:tul
7
-l.cnilyrh{l
inrhe perfortutue ol lnc work lor w,rich lhh pcrmil is nslcd- I shallnot cmplo, !n, pcson inany@ncr
s as ro h.com subjc! to thc wrkcn omp.n*,rion hws oaCalilnmia, md aBrc rh,r irl should tx.om subrer lo lhc
workcB drnpcnrdlion tmvision\ of Serion l70O of rhc Ljhlr C.dc, I shdl. rodhwilh .dmtly wilh lh.s pmrbions .
WARNINC: Failnrc ro sctrrc worketr $q)cndnrn .ov.Bsc is lnldsful. Md shru {brc.l m .n{'lo}er lo siminrl ,cMxhs and
.ivil itr.s up r. onc hu.drcd rhonqnd dolldrs ($l ).i ion, damgcs as pmrAcd for lh.
S..rn :1076 ol rhc trbr CoJc. inrcicsrutrd.iiom!\
^.,9-3a-t{
DECI,AB6.TON
I hcEhy ualir undcrr.n.hyofpcrjurrrhir I lrn h..n{i undcr pbvision of ( hrrrn 9 (comnrmin8 sirh S.dhn 7(l()O)ofl)ivtt'n l
of rhr Bo{mssnnd Pbt rsnrnJ Cdd.. md my li.cn\. ir in tullf(nenddcfir.r
./ a-?.-taf-'7:-'rV
g}NIiIX.IICIOITIENIAJ;.AGENCI,
I hcEhy trlftr undcr lEntrlly of pcrjury lhll rhnc h a.on$ru.rion Lnding a8cncy for rlE Fslhmnce oflhc solt tor whi.h lhh Ilcmil i\
issucd(Scc. :1097.Civ. C ).
AP&IJITNU,ECI.AMIIO]!
I hoEiy lnim undcr ,.oalry or pcrjury un. .r rhc followine dsl@rions:
Dcnblirii,n Pcrnirs Asbcsros Norificarion lrcdcralRcEuhtions(litlc 40, Pea6)
-Rcrt!ircd
Lcrrcr of Norilica!ion
I ccn tt rhrr rhcfcdcrrlrrlrhri,,i\rsdin! r\1.{o\r.nxtrnlxrd nor npplica6lc h rhl\ F,,jccl
-l
ccnify rhll I havc rcld thG appl
odinuc$ ond Sralc L,*s relarios ro
!d sr.rc rhor rhc ow i.fomEtion t corsr. l a8rc ro comply wilh all Cny lnd Counry
ion. !d hcrcby ourtnriz rc!rcsnhriEs of thh Cny and Colnry ro cnrs llnn rhc
rn,vc mnln,ncd lop.ny for 4 7-3o-r{
UNDER GROUND
Waste & Vent
Water-Under lloor
Gas-Underfloor
Buildinq Sewer
Area,/Storm Drarn
lnterceptor/ Clarilier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Rool Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P{rap/Drain Line
Mai n Drain/Pool Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Gas Service
Water Service
Lawn Sprinkler
Sanita ry SeweriCap
Back Flow Device
Rough Plumbinq
Final Gas Test
Meter Release
FINAL
Notes, Remarks, Etc
Miscellaneous
tfldd 3 Ad&B*
-