HomeMy WebLinkAbout30139741 - Permitcity 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 #: 30139741
Pin #: 30068
Proiect Address: 121 E St Gertrude Pl
AssessoasParcel: 403-164-15 Lot: POR 24
Unil:
Block: B
Bldg:
f lact 284
Suite Range:
Zoning: R2
E
Owner:
Address
Phone:
Tenant Name:
Contractor:
Address:
Anthony & Rachel Hovorka
2774 Mallend Dr
Costa Mesa, CA 92626
(310) 266-3447
Owner.Builder
Fee Type
01116002 5'1602 Cap Fixtures
0'l116002 51602 Cap Gas Outlet
01116002 5160C General Plan Update
01116002 51602 lssuance
Amount
6.95
8.47
22.O8
55.04
Generol Plsn Updote Fee
ul1 1600?- 5160(r(10(r-
Plurb i ne
01116002-:160?000-
ICL Check 1203
Qty
1.00
1.00
1.00
1.00
Fee
$6.9s
$8.47
$22.08
$55.04
Phone
Slate Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Cafiiet:
Policy #:
Expires:
Eotchi!44990 - 7 /21/2ALS
off i ce: CTYH Tronsi: 2Acct+! Ref+:
Rcpti:02331(r25 - 7/21/?tttg
Trongoct ion Totol
lll
Anthons & Rochel Hovorkcr
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By
PIan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Duplex
Miscellaneous
Cap Fixture
Occupancy:
Constr Type:
Code:
R.3, U
VB
cPc 2016 Notes:
\0$
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Hernandez, Kalhy
Every pemit issued shall becone invalid unless the work on the site
authorized by such pemit is commenced within 180 days after its
issuance, or il the wo* authoized on the sile by such permit is suspended
ot abandgned fot a period of 1 80 days after the time lhe wo* is
commenced.
o7124t2014
Account#
$92.54
$0.00
$92.s4
lnspector MID#: 2O18-144857
01116002 51600
01 1 16002 51602
$22.08
$70.46
Fee Total
Paad to Date:
Balance Due:
Address Range: 119-121
Historic: No
Date:
Date:
Date:
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS oWN!]R AUN,DF]R DTI,CA&TTI('N
I hcrby rmrfr undcr p.nnhy (,r r.rjury lhd | tun cxcru fn, rhc C.nl.i.to^ L,i.ctrB 1,* ior rh. nnhwi'rg r.i$tr lsc..?0r1.5
Busirc\s rtrd Pronssion Cod.): Any Ciry or County shtch rcquircs r Ninil kr q,n{ cr. trlrcr, infmec, dcnrlitn or rFrn rny
(ructuc. Dri(tr1{' irs isuMcc. o rcqutc\ rhc sDrrlic l nn such pcrnn t, nLa rirn.d {trrcmtrr tlur lt or shc h licc.scd Pur{anr
ro rhc fmvisions of rh. cotrracbls l-iccn*d hw (Chanr.r l). Co.nncn!ins nilh Sccrn,n ?0(n ot Divnn,n .r ol 'lr Busincss 0nd
Prons\ion\ c{xh) or lnlr ncor\hc kci.r.pr rhcrefro'nrnd rhc hn\is ro! rh. lcecdcrcnfltun Any violariotrofsccriotr 70.115 hy,ny
aprlicur tar ap.rmir \uhj.crsrhc 0ptli.dnr r. a(ivilpcn,lryornor mJnthM firc hu.drcd dolhrs (5500)
-1,
r, owns of th. t openy. or m, .nploy*s wirh e.gs &r rlEt $!c ontE.$ri.r. will do 0E wort .,n dE srEr@ L 6l
inrqd.n d offcEd t6. nk IS6.1x4. aBiB and Pr.fB.ion. Cod.: Thc C..lraclm s LienE L3w docs mr rprly ro u o*ic. of
rh. pmFrry wts tiilds m irpoB rhclr4 ud *lD {&B tuh mdr him*lf or h.sclf or lheudr hL{ or h., own cmplorci
rreridcd rhar rBt inprtllmls c mr i'{cnd.d orotu aor slc. lf, lb*cE rE hriUirg or iop@wn ir sld wilhinom
'tsor 6n{,lcrion. rlr OwEr auiBs *iI hlr di hd.n of Ploving lh, lE or dr dU mt hoiu o, inFok rhc Fbpcny ror th. purFrc or
l. n\ o*Nr ot rh. oopcn y, 3'n cr.lu\iycly .ont&riig sirh li.ctrkd coftadon ro conirucr ltr lnjcct (Sc 7M.1, Br\rn.*
an<l Pntssim Codc: Thc Conl,.clols l,tctrsc L{u docs trol lprly ro an owncr ofp,op€n,l,uild! or irprMr dcrcon.
ard {ho @nrek fo, ikh pej(k wnh a Conrracro(, lk n*d purumr b rh. Coni
-I
oncxcn+t undcr Sccl
DECr.68A:ltrt!
I h.rcby lftrrn oid.r Fnrlry ot !.rjury oft of thc folh$ing &rhBraoei
l hr\.nrkl$rllnhi r rCcdil-r.nrcolCon!cnlk,Scllln\urcLr*or[.rr.omF-n\rri(,n,as!n,vidtdaorhyS.cri.n]TUrofrhc
Lrtxtr a'dc. in rh. Ndnmrrc ot rhc sork r'or w[ ich rhc ncnnir is i\$rd
_l h,rc md will maintsin workcft cohpcn\ari.n inslancc. as rcq!ilcd by s..rion l70o ofrh. tabor Codc. for thc lcrfomnce .i
rhr solk fo. which thh pcmir is tsucd. My {orLcs conF.sdion in\!ruc. .mic. ard plicy nu,ft.r m:
Po!icy Nunber:Ji,!ir.
I c.niry rhd in rhc r.rrorroncc oflh. *.rt hr whi.h lhis Frnln is ksucd- I shall mr cmploy an, Ilcrsn in My mnat
so N ro bccom slbJccr ro rhc so ol @npcnqrion Lws of Caliaomia du8m rhr irI should hc.om subjd lothc
eorkcls.omrcnsorionpnlisn,nsofsftrionlT0oofrhcljhnCGL,lrhll.lonhwilhomplyrilhr
WARNINO: failurc lo sulc workctr coq,.n\nrion covcmsc
.i!il fincs !r ro orc hundrc.l rhoosand dollm ($100,00.J). in
S(ln,n -10?6 oflnc lrtio, Codc. ior.,.sr tud a ortuy s ter
)s ro qimin l Fdhts 3nd
ion, damsss $ phlidcd fo. rhc
I hcEby amm !.der ,cialry of pcrjury rhar t a6 lici*d lido lFvisio. olchlFo 9 {ommine ,ilh Scdhn ?il)o) of Diviiior l
ol lhc Busin.$ md PmfcsioB Codc. lid hy lic..* is in tull foc an tff*l
!:olgn!]clJlllt.L[NDlriii.&clNll
I h.rby f6.n und$ p..rlly of pcrjury ln{ tlmc is r onsiruction Lndn's lgctuy r,tr rhc Frrormmc or rlr work lor which tht IEmir t
i$ocd (S.c l(rr7. Civ C )
AIPIISAIfD}:ILABAIIO!
l lEr6y.Ifirnr u dcr pcnuhy of pcrjury onc otthc followins dslsolhns:
Dcft,lirion Pcrnirs-Asb.nos Norificlliotr Fcdcrrl RcSuhrn,ns ('rnb.10, Pnd6)
_R.quircd Lctr.. or Norifi.arirn
_l ccrrify lhar thc fcncnl rc8llarions
-l
cc ilirhrr lhnlr rcrdrha rfnricr'ui a d cotrccr. l 4re rocomplysirh allc
o'Ji0nn.c\ rnd srsrc ltrs\ rcLrin! r, huiklina
atnvc mnrt'ncd rroDcny tr in\
rclrcscnr$ ivcs otrhi\ CirY 3nd
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Waler Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouoh 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/Cap
Back Flow Device
Rough Plumbinq
Final Gas Test
Meter Release II ,/'J
FINAL Elbl lts'l lvt*tWt (vy
Notes, Remarks, Etc.II , uJ
lrah'r Addls
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rlPrv ?
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