HomeMy WebLinkAbout30143690 - Permit)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
PermitCounter: (714')647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714')647-5853
Permit #: 301436190
Pin #: 8261 5
Project Address: 2246 S Standard Ave
Assessor's Parcel: 016-21 1-25 Lot: 26
Unit:
Block: A
Bldg:
Tract: 1541
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
City of Santa Ana
20 Civic Center Plaza
Santa Ana, CA 92701
(7141 647-5641
J&Glndustrieslnc
18627 Brookhurst St #302
Fountain Valley, CA 92708
(7141 e03-2002
01 1 16002 51602
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01 1 16002 5777C
Fee Type
Cap Sewer
Fee Exempt
General Plan Update
lssuance
Microfilm Records
Amount
107.65
-194.79
23.79
59.30
4.05
Qty
1 .00
1.00
1 .00
1.00
100
Fee
$107.65
$-194.79
$23.79
$59.30
$4.05
State Lic #: 571859
Lic Type: ASBS, A, HAZ, C-21
Bus. Lic #: 160248
Workers' Compensation lnsurance:Carrier: State Insurance Fund
Policy #: 0g01g4t
Expires . 10/01 12022
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Demolition & Clear Lot
Demo & Clear Lot
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3, U
VB
cPc 2019 Notes: Plumbing for SFD and detached garage demo - Cap
sewer. ***NO FEE-CITY PROJECT/LETTER ON FILE*"*
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permrt lssued By: Zuniga, Allissa
Subject to Field:
Buildins Permit #: 101 108094
Every permitissued shall become invalid unless the work on the site
authorizgd by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
09129t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
N/A - No Balance
N/A - No Balance
Fee Total
Paid to Date:
Balance Due:
$0 00
$0 00
$0.00
lnspector MtD#. 2021-169052
PLUM BING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELC/IRATION
I hcrchy affirm undcr pemlly of Jf,rjury that I u cxempa from ah€ Con&rcto6' Liere Lsw for rhc following ren LSe.7031.5Busincss ard Prcfcssion Codc): Atry City or Conry whhh rcquires ! permir to @nstret. slt6. improw, &mlirh or rcpefu my
structw, prbr to its issre. also requircs lhc spplket for such pcmil to tik I sigrcd stal€mot thst hc or slE b liccnsd plmant
lo the prcvisions of fte Contractor's Licensd lrw (Ctapter 9. Comncing with Setion 7000 of Division 3 of thc Busircss md
PDfcssionsCode)orthailEorsh€ircrcmptthercfrcmsrdlhcbasisforthcrlbgcdcrcmption. AnyviolationofsstbnT03l.5bysny
8pplicsnt for I pemii subj$ts ahc spplicant to s civil penalty of mt mrc lhm five hundrcd dollss ($500).
?
-1.
as owncr of the property. or my cmployccs with wages Bs thcir soh compensation, will do thc work Bnd the structure is rnt
intcnded or offered for sale (Serc.7044, Business and hofcssions Codc: Thc Contractor's License Law does not apply to an owncr of
the proprty who builds or improves thcrcon, and who docs such work himsclf or herself or through his or hcr own cmployees.
providcd thal such improvenrcnts arc nol inlcndcd or offcred for salc. lf. howcver. thc buiHing or inqlrovcnrnt is sold within onc )rar
of complction, the Owncr Buildcr will have the burden of proving thal he or she did not build or inprove thc property for the purpose of
salc).
-1,
Bs owncr of thc property, am exclusivcly contracting with licensed contractors to construct thc project (Sec. 7W, Business
and Profession Code: Thc Contractor's Liccnsc l-aw does not apply lo an owner of propcrty who builds or improvcs thereon,
and who contracts for such pro.ytrcts with a Contracto(s) licensed pursuant to thc Contractor's License [aw).
-IamexemplundcrSection-'B.&P.C.forthisreason.
hoIo.
WORKE'RS' COMPENSAT|ON
DECI ARATION
I hereby affirm under pnalty of perjury onc of the following dcclarations:
-l
have and will maintain a Ccrtifrcate of Consent to Self-lnsurc for workers'compensation, as provided for byScction 3700 of the
labor Codc. for thc pcrformancc of thc work for which thc permit ls issucd.
37fi) of the Labor Code, for the pcrformancc of
and ynlicy number arc:
Policy --()L -.-t /lo -)-z?
-l
ccrtify thal in thc prformance of the work for which this pcrmit is issucd, I shall not cmploy any pcrson in any manncr
so as lo bccornc subjcct to thc workers'comlrcnsation laws of California, and agrce that if I should becomc subict to the
workcrs' compensation provisions of Scction 3700 of thc Labor Code, I shall, forthwith comply with thosc provisions..
WARNING: Failurc to sccurc workcrs'compcnsation coveragc is unlawful, and shall subject an employer to criminal Jrcnaltics and
civil fincs up to onc hundrcd thousand dollars ($100.000), in addition to the cost of compensation. damagcs as providcd for the
Section 3076 of I-abor intcrcst and
C-t
DECI ARATION
I hercby affirm under pcnalty of perjury that I am liccnsed undcr provision of Chapter 9 (comnrrrcing with Section 7m0) of Division 3
of thc Busincss and Professions Code, and my license is in full forcc and effect.
ftl %rqLiccnscNurnbcr:
I hcrcby affrm under Fmlty of pcrjury that thcrc is a onstructhn hnding agency for thc lrcrforuc of thc work for which this lErmit is
issucd (Se. 3097, Civ. C.).
kndcr's Nam:
Lcnder's Address:
APPI ICANT DECLARA'I'ION
I trcrebyafflnnunder penalty of perjury orc of the following declarations:
Demolition Pcrmits-Asbestos Notification Fedcral Regulations (Title 40, Part6)
-Requ
ired l.etter of ltlotifrcation
-lld.rty
that thc fcdcralrcgulations rcgartling asbcstos rcmovalarc not applicablc to this projcct.7(/ I ccrrify that t havc rcad this application ancl statc that thc abovc inforrnarion is correct. I agrec to comply
ordinances and State Laws relating to building construction. and hcrcbyauthorizc rcprcscntatives of this City
abovc mcntioncd proJrcrty for
Applicant or Agent
I I
I'emrilee name
\t
with af City and Qunty
and C{unty to cntf upon the
q lzo, lz (
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf loor
Building Sewer
ArealStorm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
It/ain Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler I ,O-
Sanitary Sewer/Cap le 7t b*Y fl
Back Flow Device I
Rough Plumbing
Final Gas Test
Meter Release I I 2,
FINAL tc I -l '71 DVT?,27
Notes, Remarks, Etc
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