HomeMy WebLinkAbout30142574 - PermitProiect Address: 241 I W Elder Avea
Assessor's Parcel: 109-1 23-04 Lot: 81
Unit:
Block: NA
Bldg:
Tract 1346
Address Range:
Historic: No
Suite Range:
Zoning: Rl
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAg2702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714\ 647-5853
Permit #: 30142574
Pin #: 23415
Owner:
Address:
Phone:
LDM Properties LLC
909 W Walnut Street
Cerritos, CA 90703
(7141 s01 -726s
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier.
Policy #:
Expires.
a
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Addition
Addn/Remodel/Demo
Zuniga
Occupancy:
Constr Type:
Code:
Date.
Date:
Date:
R-3, U
VA
cPc 2019
11t03t2020
I
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes. Plumbing foraddition/remodel.
Fee Total
Paid to Date:
Balance Due:
Buildins Permit #: 101 10281 9
Every permit issued 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 fhe sife by such permit is suspe nded
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2019-152268
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23.79
$2t 1 .08
$4.05
$298.92
$0.00
$298.92
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
51 602
51602
51 602
s1 602
51 602
51 602
51 602
5160C
51 602
5777C
Fee Type Amount
Water Closet 15.32
Shower/Bathtub 23.97
Sink 13.68
Dishwasher 12.90
Garbage Disp 11 .49
Wtr Htr (Res up to 50 gi 23.91
Lawn Spkr, per valve 10.9s
General Plan Update 23.T9
lssuance 59.30
Microfilm Records 4.0S
Qty
2.00
2.OO
3.00
1.00
1.00
1.00
4.00
1.00
1.00
1.00
Fee
$30.64
$47.94
$41.04
$12.90
$1 1.49
$23 97
$43.80
$23.79
$59.30
$4.05
jt
PLUMBI NG.I NSPECTOR RECORD
APPROVALS DATE ID/S!G COMMENTS OWNER BUILDER DETIARATTON
I hacby affm und6 paslty of pqjury that I m qmpt ftom thc Contnctots' Licmc law for thc followirg twn (Se.7031.5
Buine ard Prcfc*rion Codc): Any City or Courty which rcquiB 8 pqtnit to @nstruct, ahs, iqrovc damlish or npeir uy
struclE Fior to its iswcc, alrc rcquis thc appli@t for such pcmit to filc I signcd statmat that hc or $c b licrucd puman
to thc prcvisioN of thc Contrrctor's Liqscd Lrw (Chaptc 9, Comming with Setion 7000 of Division 3 of thc BwitB ed
Prcf6siom Codc) or thar hc tr shc is qmpt thqc&oD and thc bab for thc sllcgcd qartrion. Any violation of Sctiotr 7031.5 by uy
applicmt for I pamit subj*ts thc applicut to a civil pcmlty of not morc thm frvc hundrcd dollrs ($500).
_1, c oma of thc Fopcny. tr my mplo]6 with wag6 a thcir $lc smpqBdion, will do $c wort ad thc stn ctrc b not
intodcd or offqcd for slc (Sc.7044. Buine od ProfcaioB Codc: Thc Cortrsc{or's LiccB t w do6 rct eply to u omq of
thc propqty who hrilds or inpros tltaou md who doq uh w* hiruclf or hmlf or thmugh hb or lE om mplolcc,
providcd that such improEr@ts e rct intqdcd or olfuld for slc. If, how, thc hilding or irproErult is sld within onc 1a
of cotrplrbrt the Ownq Builda *ill havc thc hrdor of poving tha hc u shc rlil mt hrild or itqrcrc lhc poFty for thc FrpGc of
elc).
-1.
I ow of thc propqty, u qclwivcly @trtrrcling with lisscd contrrtoB to @Ntruct thE Folrl (Sc. 7(N4, &BinB
and hofixsim Co&: Thc Contrac{or's Licffi L8w do6 not apply to o oma of propcly who buil& or imprcvB thson,
md who ontracls for such projcB with I Contrrcto(s) licstscd pEuet to thc Cotrtraclor's Licmc ttw).
_l am excmpt under B.&
DT]CI,ARATION
I hereby affrrm undcr penalty of perjury one following declarat ions :
-l
have srd will maintain a Certificatc of Conscnt to Self-lnsure for workers' compcosation, as trovidcd for by Section 3700 of the
L^abor Code, for the pcrformance of the work for which the pcrmit b issued.
-l
have and will maintain worken' compssation insurancc. as roquircd by Section 3700 of the lahor Codc, for the pcrformance of
the work for which this pernrit is issuod- My workers' compensation insurance carricr and policy numhr are:
Policy Numbcr: Expires:
_l certi$ that in the performance of the work for which this pcrmit is issued" I shall not employ any pcrson in any manner
so as to bccome subject to the worters' comp€nsation laws of Californra, and agree that if I should become subjcct to the
workers' comperuation provisions of S61ion 3700 of the labor Code I shall, forthwith comply with those provisioos..
I
WARNING: Failure to secure workers' compexsation coverage is unlawful. and shall subject an anployer to criminal perrahi& and
civil fines up to onc hundred thousand dollars ($ I in addition to the of compensation, damages as provid( b?or the
Section 3076 tabor Code. interesr and\I 0
DECI.,ARATION
I hereby aflirm under penalty of pcrjury that I am liccnsed under provision of Chapto 9 (cornmencing with Section 7000) of Division -3
of the Business and Professions Code. and my license is in full force and effett.
Liccnse Class: License Number:
CONSTRUCTION LENDING AGFNCY
I hereby aflirm undo penalty of pcrjury that th6c is r construction lcndiog agmcy for the pcrfomcc of thc work for which this psmit is
issucd (Sa. 3097. Civ. C.).
Lender's Name:
I-cnder's Ad&ess:
APPLICANT DECLAITATTON
I hereby affinn under penalty of perjury one of the following declarations:
Dernolition Permits-Asbestos Notification Federal Regulations (Titlc 40. Part6)
_Required Letler of Notification
_l certi$ that the federal asb€stos removal are not applicable to this project.
_l ccrti& that I havc read this with all City and County
above mentioned property for
Applicnnt or Agent
Permitee nnme
and state that
and County to enter upon the
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
ArealStorm Drain
I nterceptor/ Cla rifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back FIow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back Flow Device
Rough Plumbing
Final Gas Test I
Meter Release n
FINAL 1'Aa)br(f n
Notes, Remarks, Etc.V
I
(lontraclor:
Pt+*A/
,*", tt lb/oLo