HomeMy WebLinkAbout30143417 - Permit1
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cA92702
Permit Counter. (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: IOl4t4{7
Pin #: zG2EoLtt
Project Address: 3620 S Bear St Unit: C
Block: NA
Bldg:
Tract: 1 1859
Address Range: 3600-3770 Suite Range:
Zoning: R4Assessor's Parce!: 412433-04 Lot: 1-8, A, B, C Historic: No
Owner:
Address:
Lindsey Sundra
3620 S Bear St #C
Santa Ana, CA 92704
(71417s4-7248
01116002 51602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type Amount
Wtr Htr (Comm up to 50 ge 23.97
General Plan Update 23.19
lssuance 59.30
Microfilm Records 4.05
Qt!'
100
100
100
1.00
Fee
$23 97
$23 79
$s9.30
$4.05
Phone
Tenant Name:
Contractor:
Address:
Orange County Services dba Mil
Phone:
3801 Lenawee Avenue
Culver City, CA 90232
(310) 838-0408
State Lic #: 765436
Lic Tvpe: C-36, C-20
Bus. Lic #: 164117
Workers' Compensation lnsurance:
Carrier. lns Co of the West
Policy #: WSD505257101
Expires: 0110112022
Building Use:
Job Type:
Nature of Work:
Condominium
Miscellaneous
Water Heater
Occupancy:
Constr Type:
Code:
R-1
VB
cPc 2019 Notes: Change out existing water heater
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #.
web-issrN
Date:
Date:
Date:08t02t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
rssuance, or if the work authorized on fhe sife by such permit is
suspended or abandoned for a period of 360 days after the time the work
is commenced.
N/A - No
N/A - No
Balance
Balance
Fee Total:
Paid to Date:
Balance Due:
$11111
$1 11.11
$0.00
lnspector M ID#: 2021-167788
Plumbing
INSPECTOR RECORD
SITE.WORK DATE !D/SIG.COMMENTS OWNER BUILDER DELCARATION
I hereby affirm under penalty of pojury that I am exempt form the Contractors' License Law for the following reason (Sec.7031.5 Business
and Profession Code): Any City or County which requires a pcrmit to construct. alter. improve. demolish or repair any structure. prior to its
issuance. also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the
('ontractor's Licensed Law (Chapter 9. Cornrnencing with Section 7000 of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption Any violation of Section 70-l I .5 by any applicant for a penmit subjects the
applicant to a civil pnalty of not more than five hundred dollars ($500).
*9 t. * owner of rhe prop€tty. or m)'employees rvith rvages as their sole compensation. rvill do the wort and the surrcnre is not intendod
oroffered for sale (Sec.7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of the property
rvho builds or improves thereon. and who do,es such wort himself or herself or through his or her orvn employees. provided that such
improvernents ane not intended or offered for sale. lf. however. the building or improvfirent is sold u'ithin one year of complaion. the
Owner Builder rvill have the burden of proving that he or she did not build or improve tre propertv for the purpose of sale).
Ni l. ,. owner of the prop€rt),. am exclusively contracting rvith licensed contractors to constnrct the project (Sec. 7044. Business and
Profession Code: '[he Contractor's l,icense l-aw does not apply to an owner of property who builds or improves thereon. and
rvho conh'acts for such prr{ects rvith a Conh'actor(s) licensed pursuant to the Contractor's License Law).
No I .rn exempt under Secrion - ---. B. & P.C. for this reason.
WoRKFRS' COMPENS ATION DFCL ^ [tATlON
I hereby' alTirm under penalt"v of periurv one of the following declarations:
!o I nu". and rvill rnaintain a Certificate of ('onsent to Self-tnsure for rvorkers' compensation. as provided for by Section 1700 of the
I-abor ('ode. for the performance of the work for which the pennit is issued.
YES
I har.e and u,ill rnaintain rvorkem' compensation insurance. as requited by Section .1700 of the [.abor Code. for the performance of the
work for which this pennit is issued. My'workers' compensation insurance carrier and policy number are:
. lnlurance Company Of Thc Wert('arrier':
wsos05257101
l)olicr Nrrrttber.
01to1,2022
Expires: __
NO
I cerrify that in the performance of the rvork for rvhich this permit is issued. I shall not employ any person in any mann6 so
as to become subiect to the rvorkerc' cornpensation laws of California. and agree that if I should become subiect to the workers'
compensation provLsions of Section -1700 of the Labor Code. I shall. forthrvilh comply with those provisions..
WARNIN(i: Failure to secure rvorters' compensation coverage is unlawful. and shall subiect an employer to criminal pendti* and civil
fines up to one hundred thousand dollars ($100.000). in addition to the cost of comp€nsation. damages as provided for the Section 3076
of the l-abor Ccxle. interest and attomey's fees.
LICENSTn ('ON'I'RrAC'[OR nF('l { RJA'[!ON
I hereby affirm under penalty of grcr.iury that I am licensed under provision of ('hapter g (commencing rvith Section 7000) of Division J of
the Business and Professions Code. and m1' license is in full force and effect.
c-36
Liccnsc'('lass:
7C5430_ l,icense Number
CONS-I'R[ICTION I FNNIN(: AGFNCY
I hercby alfinn under penalty of per.iury that there is a construction lending agcncy for the perfonnance of the work for which this permit is
issued (Sec. .1097. Civ. C'.).
I-ender's Name:
l.cnder's Address:
APPI I('ANT NFCI AR.ATION
I heretry affinrr undel penalty of per1ury one of the followrng declarations:
I)enxrlrtron Pernrrts-Asbestos Notrfication Federal Regulatrons (Trtle 40. Pad6)
!o Required Letterof Notification
tt1 I certib/ that the federal regulations regarding asbestos removal are not applicable to rhis project.
tlt t cefliS' that t have read this application and state rhat the above informarion is correct. I agree to comply with all City and County
ordinances and State Larvs relating to building construction. and hereby authorizc represenlatives of this City and County to erter upon thc
ahove mentioned property for inspection purposes.
Reroof
Roof (Diaphragm Sheathing/Frame)
Structural Final
Plumbing
Under Floor I Under SIab
Rough
Shower Pan / Tub Test
Water Service
Sewer / Sewer Cap
Gas Air Pressure Test
Plurnbing Fina!€<t-Lt 1- -Dd^-
Electrical
Service (Meter I Panel)
Grounding / Bonding
Rough
Electrical Final
Mechanical
Gas Air Pressure Test
Rough
Piping (HW,CW, etc.)
Exhaust Ducts
lVlechanical Final
Notes, Remarks, Etc.