HomeMy WebLinkAbout30133381 - Permit;Jb-
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 #: 30{3338{
Pin #: 5675{ila
Project Address: 613 S Halladay St
T
Assessor's Parcel. 404-061-24 Lot: 41
Unit:
Block: NA
Bldg:
Tract: 31 13
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Rene Olivares
613 S Halladay St
Santa Ana, CA 92701
(7141 e064371
Fee Type Amount
01 1 16002 51602 Wtr Htr (Res up to 50 gi 19.19
01 1 16002 51600 General Plan Update 19.04
01 1 16002 51602 lssuance 47 .48
Qty
1.00
1.00
1.00
Fee
$1 9.1 I
$19.04
$47.48Phone:
Tenant Name:
Contractor:
Address:
Fast Water Heater Company
11715 North Creek Pkury So
Bothell, WA 9801 1
(4251636-7054Phone:
State Lic #: 987398
Lic Type: C-36
Bus. Lic #: 319396
Workers' Compensation lnsurance:Carrier: Truck lnsurance Co
Policy #: A0g3044Ss
Expires: 1210112014
Building Use:
Job Type:
Nature of Work
Single Family Dwelling
Miscellaneous
Water heater
Occupancy:
Constr Type:
Code:
R-3
VB
cPc 2013 Notes: Direct change-out. Mail-in permit.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Amsden, Julie
Date:
Date:
Date:0412412014
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit issued shall become invalid unless the work
on the sife authorized by such permit is commenced within
180 days after ifs issuance, or if the wofu authorized on the
01 1 16002 51600
01 1 16002 51602
$19.04
$66.67
Fee Tota!:
Paid to Date:
Balance Due:
$85.71
$0.00
$85.71
''e by such permit is suspended or abandoned for a period
'80 days after the time the work is commenced.
ctor MID#: 2014-1 13899
APPROVALS DATE ID/SIG.COMMENTS
UNDER GROUND
Water-Underfloor
Gas-Underfloor
Waste & Vent
Building Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Pi
Gas P
Roof Drain
Tub/Shower Test
h Water Heater
POOUSPA
LineP
Main Drain/Pool Pip
Fill Line/Back Flow
Pool Heater/Gas Line
Misc
Gas Service
Water Service
Lawn Sprinkler
Sewer/Cap
Back Flow Device
Rough Plumbin
Final Gas Test
Meter Release
FINAL
Notes, Remarks, Etc.
Declaration
I hecby rllirm uode pcuhy of pajury thrt I m qcmpt folm tho corti.cror!' Liee Lrw for rhc folh*ing rasr (!e.7031.5 Bsin6.lnd Profsion codc): Ary cily o. couoty which rcquirq r pcmir ro @utrucl rltcr, improvq dcmolish or rcpair;y rncruyrlor o ltsirrurncg rko rcquirc thc rppliqnt for luch pamit io 6lc r iigrcd rtatcmcnt thrt hc or rtre ir iiccroJ prrrrJnr m
-i,
prori.iotr of rhcconrrd.q'! Li@BGd hw (chlpts 9, conmcrcing with Setion 7000 of Division 3 of thc Buinsr rnd profaiou Codc) or rh[ hc orshc is acmpt thac&om rnd thc b.rit for. thc rllcgcd *mptior .Any vbhrioo of sctio" uol r.i uyi"y "-ppii-iloi. pcrmir
"uo1c"6
rtrcrppliqnr to r ciyil pculty of not mrc th$ Iivc hundrcd dollrrr (tifi)).
- Irs omcrofrhcpropaty'ormycmployaswithmgcrrtlEirmLompcsrtiorlwilldorhcworlrndrhcstrucrucunotinrrtrdcd
or offecd for nle ( src.704d Builg rnd Profarioro co&: Th€ conarctori Liccm hw doc mt rppiy o u ouu orrlrc prcpay
.who buildr or improw thaeq ud who doa rwh worl himlf or turclf or rluough hir or hq om Gmploy€, providcd thI luchimProvcmcnt rrcrcthlondcdorotfGrcdfor.lrlc-lf,how.vs,rhebuildingorimprovlmiJlr-rJ*,trrir'.rilylriiomprcrtn t"owrBuilds will hrvc the burdcn of proving thrt hc o, lhc not build or impovc for thc purporc of slc).
-1,
u owt-ofihc propcrty, rm cclurivcly @nroditu wi& liccEcd @ntncro[ to @utrua rhc Eoj€t ( 56. 7044, Burin6! mdProfqsion Codq Thc Coflrraor'! Lienrc [rw doo not rpply ro rn omcr of propcty who Uuilar oi irirpro"i uuon , .nd who@nrrdt for ruch ptojett with r Cootncior(!) limrcd puruor !o thc Conrndor't Limc Lrw.).
_-l rnr cxcmpt undo S6iioo .B. & p.C for lhi! ,a!on.
Date: -- owncr:
I hcrcby a0irm undr O.^n, orr.rlu' onffi
-,-l havc rnd will mrintrh r Cstifiqlc of CoEnt to Sclf-lEure fot worlcrs' ompcurioq rs providcd for by Scrion 3?00 of thcLrbor Codc, for ihc performne ofthc work for which the pcrmit ir issucd.
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havc rnd will mrintrin mrkcr' ompcHtion inrurrre, I rcquircd by scction 37oo of tho Lrbor codc, for thc pcrformne of theworl for which this pcrmit is irsued. My worher' compcmtion irourme onicr and poricy numbcr rrc:
Crrricr:
Policy Numbcr:_ Expires:
('l-his section need "* b" *rnpl*d , ff*, tirOO| or less)
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certify that in the pcrformancc of the work for which this pcrrnit is iscucd, I shall not employ sny pcrson in rny 6aons so as tobcceme subject to the workcG ' compenHtion hwc of Californiq and egrcc rtut if I should b;r. cuU.;""t ro tho worke6,
comPcnsation provisions of Scction 3700 of the L^abor Codg I shall, forthwith comply with those provisions..
Drte:
-r--
fines up to one hundred thousand dollars
the l^abor Code, interest and attorney's fees.
License Class:____
Datc:
compensation
($100,000),in
Liccnse Number
covers8e is unlawful, and shall subject an employer to criminal penalties and civil
addition to the cost of compensation, darnages as provided for the Section 3076 of
IherebyafTirmunderpenaltyofperjurythatIamlicensed,ncing
the Business and Professioru Code, and my license is in full force and effect
with Section 7000) of Division 3 of
-_Contrector:
Ihcrebyalfirmunderpen.ltyofpqjulythr,.*ffirformnccofftcworkforwhichthisp*mitis
issucd (S*. 3()!)7, Civ. C.).
l.cndcr'i Nanlc
l-ender's Address:
Dcmolition Pcrmits-Asb*lor Norilicrtiotr Fedr,., *ffiffinttffi*
__ Rcquired Lcrtcr of Notifiqtion
__-l ccnify thrt thc fcdcrel rcguhtions rcgarding ubetos ronovrl rrc not rpplioblc to this projet
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ccrtify thst I hsve rad this rppliotioo rrd strtc th8t thc rbov€ itrformliion fu @rred. l.gre to @mply with all city.nd countyordimncsend statc lrs rcbting to boilditrB @6tructior\ .nd hcrcby ruthoria repr*notiio ortmt ity
",rd
County ro *t", ,pon th.rbovc nrentioncd propdty for itrsp€riotr purpo!6.
Appliort or rtot rig.:_ Drtc:
Pernrittee name (print) :
PLUM BI NG-I NSPEGTOR RECORD
05
Sanitary
Applicant:___
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