HomeMy WebLinkAbout30242664 - PermitProiect Address: 913 S Bamdal Sta
Assessor's Parcel: 407-062-30 Lot: 6
Unit:
Block: NA
Bldg:
Tract: 9779
Address Range:
Historic: No
Suite Ranse "il4.fr
Zoning: R1
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 30242664
Pin #: 93456
Owner:
Address:
J. Guadalupe Vazquez
9402 W. Brook Street
Santa Ana, CA 927042801
01 1 16002 51602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type
Cap Fixtures
General Plan Update
lssuance
Microfilm Records
Amount
7.48
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
Fee
$7.48
$23.79
$5e.30
$4.05
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Demo all unpermitted work and restore back to
original permitted use.
Building Use:
Job Type:
Nature of Work.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
N/V - Demo
Chavez, Dave
<O
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-3, U
VB
cPc 2019
12t14t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 201 8-140912
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23.79
$66 78
$4 05
$94.62
$0.00
$94.62
@
I hereby affrrm under penalty of perjury that I am exempt from the Contractors' License Law for the following reason (Sec.703
in addition to cost
t.5
Buioe srd Prcfe:ion Codc): Any City or Counly which rcquiB a pqrnit to omtruct. dl6, iEprovc daolirh or rtpah uy
smctEc. Fhr to fu irsure, ds rcquis thc qptimt for sch pamh to filc a rigrrcd ltd@at lhd h. or lhc b licascd prsu
to thc prcvisioN of thc Contrrctq'3 Liqscd Lrw (Chrpt6 9. Commcing with Setiotr ?000 of Division 3 of thc Buins md
PmfcssiomCo&)uth8thcorlhcisqmplthEr&omedthcbcsbforthcalcgodamption. AayviolntionofsctbnT03l.5byey
8pplicutfor6p6mit$Uictsthc applicmttoacivilpcolhyofnolmrcthmlivchufudollan(t500).
-1,
a owq of thc popaty. or my mployc with w8g6 a thcir rlc compcnsaioq wiu do tlE wod( Etd tlE leudre i mt
intodcd or ofraod fu sk (Sc.7044. BBiK md Pr,ofeiom Codc: Thc Corrrstq's Lirffi kw doa not pply to u ow of
thc popqty who buildr or imFore tlson sd who dq reh rclt himsclf or ls*lf or thrcugh his or hc om mploye,
provid thrt such imprcmts rc mt trtad.d or oftrcd 6r sb. If, how. thc buildiry or inqrcvunca b sld wilhin G )6
of onplabu thc orrm Builda will haw th hrdo of povirg ilra trc or rhc dil mt hdld or iqrorc fic pop.ny br tlE Frpcc of
salc).
_1. B ow of thc prcpcty. m acluivcly oilr8ring with lics!€d @ntrac{oB to onirucl th€ pojcr (Se. 7044, htsitB
aod Protsim Codc: Thc Contraclor's Licmc Law dos not apply to m oMa of prcpcty who builds or imprcv6 th6@!,
md who ontracls for swh Fojds with a Conrrc{o(s) licancd puruan to thc Conbaclot'! LLrffi Lry).
.-l arn exempt under Section-. B. &
Date:lL^ lL(^20
I hcreby alTirm undcr pcnalty of pcrjury one of the following
-l
have and will maintain a Certificate of Consent to Sclf-lnsure for workcrs' compcnsation, as providod for by Section 3700 of the
Labor Code for the performance of the work for which the perrnit is issued.
-l
have and will maintain workenr' compensation insurance, as requhed by Section 3700 of thc Labor Code, for the pcrformance of
thc work for which this permit is issued My workcrs' compensdion insurancc carrier md policy numk rc:
Policy Number: Expires:
_l certi& that in the performance of thc work for which this permit is issued. I shall not ernploy any person in any manner
so as to become subject to the workers'compensation laws of California. and agree that if I should become subject to the
workcrs' comperuation provisions of Sedion 3700 of the labor Code. I shall. forthwith comply with those provisions..
WARNING: Failure to secure workers' cornpensation coverage is unlawful. and shall subject an onployer to criminal penaltics
as providd for
anc
rhicivil fines up to one hundred thousand dollars ($100.000),
Section 3076 of the l-abor Code, interest and attorney's fees.
I hereby affirm under penalty of perjury that I am licensed provision of Chaptcr 9 (commcncing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full forcc and effcct.
f)olp'Conlraclor:
W
t h@by affum undq poaky of pcjury that thoc is 8 construction lcnding agocy for thc po'fomcc of thc wrk for which this Fmil b
i$ucd (Se. 3097, Civ. C.).
lands's Nmc:
-
License Class: License Number:
knder's Address:
A PPLICANT DEC LIIRATION
I herEby affirm und€r poalty of pcrjury one of thc following dcclarations:
Dernolition Pcrmits-Asbcstos Notification Federal Rcgulations (Title 40, P8rt6)
-Requhed
l-etter of Notification
-l
ccrti$, that the federal regulations regarding asbestos removal are not applicable to this project.
ccrtiry that I have read this application and state that the above
and State Laws relating to building construclion. and
above mentioned property for inspection purposes.
with all City and County
and County to enter upon the
/2^/A/- 2o
Date: axApplicant or Agent
Permitcc name
APPROVALS DATE ID/SIG.COMMENTS
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
ArealStorm Drain
I nterceptor/ CIa rifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh 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 SewerlCap
Back Flow Device
Rough Plumbing
A,Final Gas Test
Meter Release /A l
FINAL )YIt+\t
Rema Etc.I
-D
PLUM BING.INSPEGTOR RECORD
Owner:
Carrier:
,",u. '(2^/Y'2o
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