HomeMy WebLinkAbout30143332 - PermitCity 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 #: 3O143332
Pin #: 1
Proiect Address: 2412 N Valencia Sta
Assessor's Parcel: 003-071-05 Lot: 5
Unit:
Block: C
Bldg:
Tract: 390
Address Range:
Historic: Yes
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Marnie Schnabel
2412 VALENCIA ST
Santa Ana, CA 927062064
(4241 352-5247
Aqua Dynamics Plumbing C
3858 Southview Court
Palmdale, CA 93550
(310) 2s2-s066
Contractor.
Address:
Phone:
State Lic #: 1062153
Lic Type: C-36
Bus. Lic #: 378380
' Workers' Compensation lnsurance:
'Carrier: Exempt
PUly;y #:
Expires:
Building Use:
Job Type:
Nature of Work.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Water Main
Zuniga,
Occupancy:
Constr Type:
Code:
Date:
Date:
Date.
R-3
VB
cPc 2019
07 t08t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes. Alter/repair existing water main.
Fee Total
Paid to Date:
Balance Due:
Every permitissued 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 permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23 79
$1 07 25
$4 05
$1 35 09
$0 00
$135.09
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01116002 5777C
Fee Type Amount
Water Piping (Each 100 47 .95
General Plan Update 23.79
lssuance 59.30
Microfilm Records 4.05
Qty
1.00
100
100
100
Fee
$47 95
$23 7e
$59 30
$4.05
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Inspector MtD# 2021-167333
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AISSV
PLUM B! NG.I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER IIELCARATION
I hcby affm undc pcnalty of pojury ihsl I m cxcmpt ftom the Contr.cloB' Licm hw for thc following rcen (Sc.7031.5
Buinss ud Prcf*ion Codc): Any City or Couty which rcquirc 8 pqmit to snstruct. alta, imprcvc danolish or rcpair uy
structurc, Fbr to its ismcq also rcquim thc applicet for such pqoit to 6lc a 3igncd staldat tha hc or shc ir licrscd pwurt
to thc provisiorc of thc Contretor's Licerscd Law (Ch8pt6 9, Comocing with Sclion 7000 of Division 3 of thc Bwirc md
ProfsiomCodc)orthsthcorshcisqmptth@fromudthcbasisforthcallcgcdaopion. AnyviolationofserbnT03l.5byuy
applicut for a p6mit subjets thc applicmt to a civil pmlty of mt morc tho fivc hundrrd dollm ($500).
_1, as owner of the propcrty, or my emplo)€es with wagcs as their sole compcnsation, will do the work ard thc structurc is not
intcndod or off€rod for sale (Sc.7044, Business and hofcssions Codc: Thc Contractor's Licase [^aw does not apply to an owncr of
the propcrty who hril& or irFovcs theroru ard who do6 such wort himsclf or hersclf or through his or hcr own cmployecs,
providcd that such improvonents ae not intcndod oroffirad for sale. If, howwer. thc hitding or improvcmcnt is soH within one )&ar
of conpkxioru thc Oryner Buildcr will have thc hrdca of proving thd he or she did not build or improra the properqy for the purposc of
sale).
-1,
as owner of the propcrty, am exclusively contracting with licenscd contraclors to construct the project (Sec. 7044, Brsincss
and Prcftssbn Code: The Contractor's Liceose Law docs not apply to atr owncr of property who builds or improve thcreon"
and who contracts for such trojccts with a Contracto(s) licenscd punuant to the Contractor's Liccosc l^aq/).
-l
am exempt under Section-, B. & P.C. forthis rcason.
WORKEtrLS' COM PENSATION
DECLARATION
I hereby affrm under pcnalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation, as provided for by Section 3700 of the
Labor Code. for the performancc of the work for which the pcrmit is issued.
_l havc and will maintain work€rs' compensation insurance. as required by Section 3700 of the labor Code, for the performance of
the work for which this pcrmit is issued. My workers' compensation insurance carrier and policy number are:
Policy
_l ccrti& that in the performance of the which this permit is issucd. I shall not amploy any person in any r-n5"'
should become subject to the t\tso asi to become subject
workers' compansation
to the workers'comporsation laws of California, and agree that if I
provisions of Section 3700 of the l,abor Code. I shall, forrhwith comply with thorse prov*ro,s;t-
WARNING: Failure to sccure workers' compensation is unlawful, and shall subjoct an onployer to criminal ponlties and
civil fincs up to one hundred thousand dollars in addition to the cost of damages as provided for the
Section 3076 of the labor Code intercst and fecs.
o,,", J lb/lozl
LI(] I,:N S ED ('ON'I'ITA(''I'O R
DECT AIL{TION
I hereby aflirm under penalty of pcrjury that I am lic€osod under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code, and my licensc b in full force and cffd.
a
License
7 / 0 /toztDate:
W
I hmby alnm mdc psulty of pqjury thai th@ is a @odructbtr kading agacy fur thc pqfomcc of thc rcrl &r which tbis psmit ir
b$.d (Sc. 3097, Civ. C.).
Lendcr's Name:
Lender's Address:
APPLICAI\T DECII\RATION
I hcr*yaffirmunder penalty of pcrjury onc of the following declarations:
Dernolition Permits-Asbcstos Notffication Fcdcral Rqulations (Title 40, Part6)
-Required
l-etter o f Notification
-l
cdiry that thc lidoal rcgulatiom r€garding abetos moval uc not applicablc to this prcjcl.
-l
cdiry that I havc ud this applic{tion aDd state that thc abovc itrformation is conct. I agre to smply with all City atrd County
ordimcB sd Statc llw rclating to building consruclio& sd hEcbyAthori4c rcprealative of this City od€punty to @tq upoo tlE
abovcmmtioncdprcpcnyforirepcrlnpurposgd') LVI -
Apptlcrnr or Ag6r s run rr *n 1 / I i 2 oZ '
,.*n**.",or.r:,
-
UNDER GROUND
Waste & Vent
Water-Under floor /.Rat /c z>|7 ?Mra-/
Gas-Underfloor
Building Sewer
Area/Storm 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 Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitarv SewerlCao
Back Flow Device
Rough Plumbing
Fina! Gas Test
Meter Release lt ,l/,/^
FINAL MIS/A/ru6(f
Notes, Remarks, Etc.tf
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-r4t n A,ale </u J/+J /'tlro b
Z Hrctres
la/./
Carrier:.
_Expires:
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