HomeMy WebLinkAbout30143414 - PermitAssessor'sParcel: 001-137.16 Lot: 4
Unit:
Block: NA
Bldg:
Tract: 6007
Address Range:
Historic: No
Suite Ran9e.
Zoningr Rl
s/
city of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAq27O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (7141667-2738 lnspector Section: (7141U7-5853
Permit #: 3lJ143414
Pin #: 97340
Ownerl
Address
Contraclor
Address:
Phone
Tenant Name:
Xim Nguyen
'1227 W. River Lane
Santa Ana, CA 92706
(818) 6594119
Platinum Home Remodeling
'12444 Victory Blvd.
Nodh HollyrYood, CA 91606
(888) 557-5284
01116002 51602
o'11 16002 51600
01116002 51602
01116002 57710
Amount
47.95
23.79
59.30
4.05
Fee Type
Alter Drain^/ent
General Plan Update
lssuance
Microfilm Records
Qly
1.00
1 .00
1.00
1.00
Feo
$47.95
$23.79
$59.30
$4.05
Phone
Eolch+:6U158
0ff i ce: CTYH ia lo
Rel9:
I0: orooole3l:3of3
381{341{
t: {6 All
t{84.58
State Lic #: 1060535
Lic Type: B
Bus. Lic #: 375805
Workers' Compensation lnsurance
Carrier: State Compensation lnsuranco Fund
Policy #: 9158786
Expiresr OU29|2O22
R€eti:u337118U - 8/2129
Ironioct ion Iotol
Plotinul llore Rcrodel ing
Caoarol Plon Urdote Fee
uI116002- 51600000-
PlrraD t09
01116002- 516020cr0-
hicrof iIr & oocurentr
01116002- 57770000-
Viro
CC+: fffi*r firr323(
_ 123..7e
tt07 .25
t4 - 115
t484. :i8
Autha: 1{4368
Building User
Job Type:
Nature of Work
Single Family Dwelling
Miscellaneous
Plumbing
Occupancy:
Constr Type
Code:
R.3, U
VB
cPc 2019
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Chavez, Dave
Date
Date
Date
?.
oatozt2021
Account#
Notes Plumbing - drains changed out (approximately 15)
$135 09
$0 00
9135.09
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
TotalSubject to Field:
BuirdinsPermit#: 101107418
Every pennit issued shall becone nvaltd unhss the wor* o, lhe sile
aulhonzed by such permit is commenced within 3il days altet its
issuancc, ot tl the wo* authotized on tha st',€ by such pefin B susponded
or abandoned fot a peiod of 3@ days after the tme the wod< ts
cqrltalronccd
lnspector MtD#. 2021-167783
01 1 16002 51600
0't116002 51602
01116002 57770
Fee Total:
Paid to Date:
Balence Due:
$23.79
$107.25
$4.05
Project Address: 1227 W River Ln
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNEf, II,ILDAT DEI.CARATION
I h.ESy .fim ri.ti p.n[y of Frr8y $rl I d cr.nqi t!6 llF OlDlr*loB' Lb.4 L.s td ll! fol,owha !!&n (Sd,r0]1,,
AuiBr .!n Plocsb. Co<t): Any Ct, or Cady,n!t rqulB . P6ir lo @i*r.t .Xa. i.'poG d@Bh d EFi ;,
d!dR, rrh.io t. i!,llE..lro t qriEr UE tpplion tu EnFrn io ftL..irrn r&!Er l,lnlEorlEi$..@d F irn
ro $. Flvirios ol ri. connrrG.t Lt.Nd L* (clFa q conmtrint *in sdbn ,m0 ol Divitb! .l of rlE BulEs ud
PtoLri,tu Cod.) d th.r lE d ai i .Er.+r UE friD .d d! tGi! &r tlE .!.a.d .!.,Bbn. ny vioblb6 ol S6lbn lo3l.t b, .4,
rppli.or for . FdnI sblclr UE q,?li.ur io . .ivil Fdlr, of L, tuE lh.n IiE hui<!.d &rlLr (i5&),
-1,
& 4E otrlr FoF,ry.6 my.,plolB wilh *la6 u llEir EL o$ciirbll. *iU ito ltt Et rd 0. rtrEE il tni
id.dLd or o6.nd lot nt (Sc.7or,r, BuiE' rnd Froldbd Cod.: T,'. C.trrdm r Lk nF trq &c!.d $!1, io r owE ol
ri.FFrt *lb tlui d iryoB rlEao. -rl rlD dG rEi Et hnE[ or lE*ll or lt6ur! hn d td M.!Eb)G4
FoviLd {ur uh inpordtE tGlEr t.ld.drolEtd h Eb.l( liffi. dE bildhg a irprtensl t !.5 riltb* }6
oaorphtbr tlr cME BuiUd wil hE dE hrdd! olFovtrU tn h. d t d]d ml bnd d hplll'! Uc pEFry 6( dE p!'po. or
-1.
B o*E ot lh. Fopqly. m crluliwly .odn riB *lrh li4d.d @'rr*14 !o @Baud dE Fjel (5e. 7044. BGnEq
rn A!6in Crd.i Th. Coor.do.'. Lt.@ lrr dG ot .pply lo r o*E of FsFry lho boi!.6 lqeq dEan
Dd wlE @trdr fd trh FDFrr *in r C!if-rd(.) .irrd pust to dr C. n rd! tjec l,*).
lrnr.\rrtru r.r S.\r Ir ,\ l'( n ' rlrr '..r' ,
lr!!r (|$nrr
!:AAEEIN:gAIIENIAIIO!
DEIIJIAIIIJN
I h.rcby lnnm unLr Fnrlry ol F,!ry om ol trE rollorir8 d.clluthtrr
_l hlE.dl sill lililrah ! Cdrllc.rc oacodnr ro s.r.ln,e roi wt6 @nf.Mrion. u Fo$d.d for ty S.crior 3700 ot0E
t$d Coilc fd ilE DqfdrltE of llE wt for wtLh lt ,sDn ir b.t d.
rL Ert fd *htb rhi! p.mn
4q[t wt6 @rqc.di,n llEulre trn.d poli.y mmbd &:5 q7+s r C(^r1-21-zl
-l
enify rh.r h th. Ffotrrrm of 0r *ort fq *hi.h lht pd6ir i! ar$.d. t 3lIll mr.tr?by my ttrs ir Dy ruB
o a 16 b..om .ubj.6 ro dE qrt6 onFEli). lrB of Cdirmir .,xl r8r llIl if ! irruld bctc st al l. rt
rcrt6' o'qEerbnrrevilbBolscrbrSruof iELbd Cod..l drlL fonh*tlorplyeirhtlbtpsvLia,,
WAINING: Ftiturc !o sE wLR @rp<tr rb.6@$ n qL,tuL !n fi! obifl s aryloF io clnb.l pnli, .n
.ivil fB op to c lDtrdF.l U.urd dolLE (tlQ.@). ln .<ldlih t(, r,E 6{ or otpcdrior d.m&t B Fovit d tor D.
1,rli, (i\r, r, L !,r
-2 ^r,r-,(
D&CIJSAII(A
I lrEhy .mrE uid.r FrIy of F rury rld I m lic6.d uirld Fovtid. of clrrrd t (oIll'lritrB with S.dior 7ffD) ol Dinlir l
ol th. a8ims &n PofcsioB Codc. sd ny lic.nc is in tu ll foe .td.lIco
G 9,G
colEEuIJloNlannG.AGEBq
I lEEt, lllrn ud.r Frly of ,crjury Uul ri4 i. . @iinf,ion lidlni ryty rs rh. pafonlle ol tlE wt &t elEt thn Frt I
i.fl.d (Sc, $97. CiY. C.).
AELICANI.IECTdIAI&d
! My iEi unda Fuly of pqiu.y oe ol0E fob-ira &cL.dh{t:
Dcmlibn PmnlAlh.trd tlolltLrbn ttrhEl &!r'lllb (Tilb rO. Itn6)
-R.qrttd
t ra oataodfdi,
_l enlt, d!.r rlr lE&r., EluLliB Etrdiry .s.3oi Emul e ml q,dbbl b di! FDi.(
tlr Grily rhn t hE iad rn..rpr-d{iD,6 .d Sr.lc t s ELilu ro
i..ri,n .rd rtd. fi,r d. .l!E itrforrdbn k corE r I .!rc lo onply eid .U Cry .d Cody
h6Et,rJll,rirEF!*ri.r&r ofrni, Cnyrnl Cody'o cmq upo. E
rhrvc nrtrr(rf,d |n.ltnylnr fl\It.ri,n, ,urllrx\
rU i.nhl.r \!.nl Silntrl nl -2\
Waste & Vent
WaterUnder f loor
Gas-Underfloor
Buildino Sewer
Area/Storm Drain
lnterceptor/ Clarif ier
TOP OUT
Waste & Vent </r,/z /,)fl,
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rouoh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipino
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbinq
Final Gas Test
Meler Release \
(\t t\"IX{P
Notes Remarks EtC
/'t
Itr,tr'',,.,* ' 15-". I z-Lt ,,,.,..,,,,x
L.n !.r'i A.hrr'
-
UNDER GROUND
Gas Service
FINAL
+-
PLA,T!NUM
)uly 29, 2021.
Sivan Azu lay
1-2444 Victory Blvd, Suite 402
Valley Glen, CA 91606
(888) 557-5284
To Whom lt May Concern:
S(..r. rh,^\q/ ,RMO of Platinum Home Remodeling (License fl1060535) authorize Moran Altit
to pull all necessary buildinB permits and city licenses for any city license and county on my behalf.
lf you have any questions, please feel free to contact me at any time
X 7')).or-\
Sivan Azulay Date
il
CALIFORNIA ALL PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who
signed the document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of
that document.
STATE OF CALIFORNIA
before me,Nota ryOn)t
D6te
Public, personally appeared
taset Nor.e ondlitle ol the ollraet
Nome(s) of Siqner(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENATTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct.
W|TNEsS my hand and official seal I a. r-:-- - .i-i{ }! . --I- .::!-, :-: : ar r).-i. r-
! :-;rr'!ii: :r 1.E1.r.:.-r, ii ','q{r.. .:--:.'." r 2r:i:"i i! ''--i7 Y, a:-- 1r:"r r,, l' :a:i )r----.;----t
/J <i_/./r-,'(lSignatu re
OPTIONAT
Ihouqh this section is optionol, completing this informotion con deter olterution ol the document or frcudulent
ottochment ol this form to on unintended document.
Description of Attached DocHme /0,//r'.'/z/n /tTitle or Type of
Number of Pag
Document
es:
Docu ment Date
Signer(s) Other Than Named Above
Capacity(ies) Claimed by Signer(s)
Signers Name
Q Corporate officer - Title(s)
E Partner - D Limited DGeneral
A tndividual CAttorney in Fact
I Trustee OGuardian or Conservator
D other:
0 Corporate officer - Title(s)_
E Partner - tl Limited D G"n"r.-i--
D lndividual EAttorney in Fact
tl Trustee DGuardian or Conservator
E other:
Signer is Representing Signer is Representing
I
ICOUNIY OF
Signers Name:_
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