HomeMy WebLinkAbout30139739 - PermitProiect Address: 701 W Park Ln
Assessor'sParcel: OO2-O32-32 Lot: POR 80
Unit:
Block: NA
Btdg:
flad 1471
Address Range:
Historic: No
Suite Range:
Zoning: Rl
q
city of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAI27O2 Plumbing
Permit Counter: (7141647-5800 lnspection Requests: (714],667-2738 lnspector Section: (714) 647-5853
Permit #: 3O139739
Pin #: 15,447
Owner:
Address
Contraclor
Address:
Kerry Dang
701 W Park Ln
Santa Ana, CA 927061636
(949) 382{107
Ameri-Cal Repipe & Plumbir
6900 Knott Ave ,U
Buena Park, CA 90621
(714) 694-5954
Fee Typo Amount
01116002 51602 Repipe Res (Each 100' 44.5'l
01116002 51600 General Plan Update 22.08
0'1116002 51602 lssuance 55.04
Qty
1 .00
1.00
1.00
Fee
$44.51
$22.08
$55.04Phone
Tenant Name:
Phone
State Lic #: 928649
Lic Type: C"36
Bus. Lic #: 338619
Workers' Compensalion lnsurance:
Carrier: Security National lns Co
Policy #: SWC 1163597
Expires: 09/01/2018
Sqtchi:+4945 - 7/2t/2u18 I0: CCUELOffi.er CTYH Trons+: 5{ 1 ofAcct+: Ref+: 301J9739
Rcpt+30?330.{89 - 7/?3/?Ol8 12247 tl1
Tronsoct ion Totol t121.63
Arer i-Col Repiee & Plurbins
Generol Plon Updote Fee
01r 16002- 51600000-
Plurb ins
01116002- 51602000-
ICL Che* 05847(l
I t:rg
Building Use:
Job Type:
Nature of Work:
R-3
VB
cPc 2016
Planning condltlons:
Plan Checked By
Permit lssued By:
Subject to Field
Building Permit #:
Every pennit issued shall become invalid unless the wo* on the site
aulhoized by such permit is commenced wilhin 1 80 ddys aftet its
issuance, or if the wo* authorized on the site by such permit is suspended
or abandoned for a penod of180 days atler the time tha wod< is
commenced.
lnspector MID#: 2018-144840
o7l23t2UA
Accou nt#
01 1 16002 51600
01 116002 s1602
$22.08
$99.55
Fee Total:
Paid to Oate:
Balance Due:
Date:
Date:
Date:
$121.63
$0.00
$121.63
Single Family Dwolling
Alteration
Repipe
Occupancy:
Constr Type:
Code:
Planning Approval By:Misc. Receipt:
Misc. Receipt;
Misc. Receipt:
Total
Notes:
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
UNDER GHOUND
Waste & Vent
WaterUnder Iloor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipino
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Lawn Sprinkler
Sanitary SeweriCap
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release
FINAL tn6hs Sl sv
Notes, Remarks, Etc.
OII'NER BUILDER DELCAIATION
I hccby a,Ii.n u.d$ Foalry ol pcrjury rhll I u .x.npr tom dE ConlmloE LLtn* k* for llE tollo*ina eatn (Ss.70:r1.5
Busine$ ad Pof.ssion Co{te): Aiy Cn, or Coltny *hich r€qlircs r IEmi lo coo{n(t. !ltc, inflovc. dc@lish or qrat any
srocl@. !rio, ro irs tsuec, sls ,cquiEs rh. arpliclnr ro, such Fmir to ,ilc a si8md srtrtcwnr rhal h. or shc is li.cnsd pu^ua
ro rhc l,Bvhhns of ItE Conmcrols Liens.d tiq (Chq,rcr 9. Conftnchg wilh Se.lion 7000 of Division 3 of lne Busincss ed
Prcfessh.. Codc) or rh6r lE o, rhc i5 .r.qr lhqetom od Oc b{ri! for ft. rlh8 d .x.trrption. Any viohlion of S.nion T0l l .5 by any
rppli.a.l for ! Fmi subj.ds rlf, ll,plio lo!civilF llyolno! mElhln fivc hundEddou&s (55@).
-,.
N o*tr.r of ih. lmpcrry. or my .mploy.cs wilt waScs as rh.ir Fl. comt)cnsrion, sill do th. qot ud $c rhdG is mt
i cn t€d tro0crcd rn sle (56.7044, Btrsi,.s a.d Ptbf.$ions Corlq Thc Cont!.loas LicDk l,w do$ ml q,!ly h.n awrcr of
rhc rolrcny who buil.ls or nr{,ors rh.mn. aid who dirs skh s* tinlscll or hcuclf or thmueh his or hn ow. .mrhroi
l,rcvided rh0r och imrmwmnls m ml hl.ti.d orofcEd Lr eL. Ii hoEt.r. thc buildinB or iry,ffift neUsnhinon.Fd
ofon?klh'! rlr o'xrcr BuilLr w nlw fi. hltlen of tDtanE thar hcd sh. dit mr hlld or ilproE O. pmFny for dE FrFos of
-1.
as owrcr of rhc Ino06ry, am cx.hiirly conmcrins snh licensd co.rie!.n tr onnrud rh. pmiel (S.c. 7041. Busims
0nd fiDfc$in Codc: Thc Conlrelor's Liccn$ tiw docs nor,pplyb eowncr ofrmpcnyuho builds or iml,rows rhcrcon.
lid qho @ntrucrstbr such pmjets sirh d ConrturodI lkensed !!Bun rorhcCoorrcbis Li$nsc tlw).
-l
am cicn hdo Scct B & P.C. {orrhh rcuson.
Dere' Orner
llaf,E8S:!0M?ASArIllN
DEC!.A8AIIOX
I h.rcby afljrm undcr Fnrliy of reiury on. of thc tollowing dccl,ralions:
Ihrwr willrMinuinrCcnrfl.orcofCons bSclr-lnsuref.rworkcs.onrfc.srlion,rs povidcn lor b, S.crn,n:1700 olrhc
l*or Codc. nn rhc ll.nbrmnce of rh. uo* r..which rhc prmir is h\xcd
,fn* ,".r " '
rr ."*,
' ".rrc^' cornncn{rr r.tr in{urrncc. ,N rcqutcd hy Scclion l?OO ol ltc ljhor Code. for rh. l)crrrmnlnc. or-rhcwo n{whEhth'sncmurtrr*udM)wqls.cnn'I)cn.rrionir\d'Jn.".Jnidr'lp.li.J umhlr r.
Sacu&, rz l)t* rztpa t
zo o
-l
ccnify lh.r in fi. lcrlormrc oflhe work lor qnich lhis lElmn is issucn.l sh.ll tur corloyany pc&n in ony manrc.
$ ai ro h.otu slbjed ro rhc wrl6r' oftpcnelion Lwr 6l Calilomia &d a8m rhd if I should tEiom subjecl lo thc
wo,ke6'onFcnsorionpDlisions.fScd .lT00.rrhc Lnbor Codc.l dEll. forthwithmmply *ilhlhos lmvisions..
WARNINC: F.ilurc ro sw so c6 .onqrnsalion o!cr!8! is unhwtul- ! l shall slbixl !n Bployr ro aimiMl lrMhis ond
civil fircs up ro o* nundEn rhouslnd dnllas (5100.000), ii lddirion ro rhc.osr oa conFnr.iio.. d!.88.s as povilcd for lhc
,a
L&DNI&OJONINACIOB
DI;CIABAI,I!.}N
I h.{byarfirmuidcr p.nJrloftr.lu.yrhd I anlicctrql undcr pmvisio.olChlprcr9lro rmncin8wirhsNr n T(xn)ol Dilhion.1
df rhc ll!\inc$ r.d ftofcsb.r Codc. ind myli.rn* ic ir lullfor.c exl clficr
?A 6{7
I t-
CAIEIBII{JIONIENDIITCAGENCI
I hmby I"n uhdo Fnally of Fiury thd dsc ir 0 oi(ruclion lcndnE {Bcncy n{ rhe F,fortui.c nr thc *or* ro. which lth lcmil it
iisu.d (Scc 1017, Civ C.).
AE&&ANLDETLABTII)N
Ilrt6yr,)nr tulrrn.trrlrloll,crjury.ncof rhclnlk)s ltdc.hrlnrn\:
Dcnnlirio. l,cnnirs-Ashcslos Norificrrion FcJ.rrl Rc8 Ltn,,s l'rith 40. Pnn6)
Rcquncd lr(cr.f Norillcrhon
-l
cea if, lhat rhc fcdcEl rcs!!,!ionr egrJdiig a\bdsroi rmval ft nor ,lrli.rbk ro rhn Pmjcd
Water Service
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