HomeMy WebLinkAbout30143025 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 3O{43O25
Pin #: 7424|5
Proiect Address: 1206 N Evonda Sta
Assessor's Parcel: 100-223-09 Lot: 60
Unit:
Block: NA
Bldg.
Tract: 6588
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
JoseA&CeliaCardoza
1206 Evonda Street
Santa Ana, CA 927031134
(7141 623-3941
Quickshot Pool Constructio
16787 Beach Blvd Ste #
Huntington Beach, CA 9264
(657) 301 -2602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51600
01 1 1 6002 51 602
01 1 16002 57770
Fee Type
Pool Trap
Pool Heater
Pool Piping
General Plan Update
!ssuance
Microfilm Records
Amount
23.97
78.27
47.95
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
1 .00
1.00
Fee
$23.97
$78.27
$47.95
$23.79
$5e.30
$4.05
State Lic #: 820869
Lic Type: C-53
Bus. Lic #: 375620
Workers' Compensation I nsurance:Carrier: Wesco lnsurance Company
folicy #: WWC3 512910
Expires. 0113112022
Batch+:58718 4/6/2t121 ID: onor(
0ffice: CTYH Trnnsis 65 4 oiAccti: Ref i: 30143rJ2:
Rcpt*: tr3243736 1/ 6/2021 I :39 F n
Transoction Totql t1r42?.S'
CIu ickEhot PooI (:ongt r'uct ion
Genercrl Plqrr Updste Fee
tr1 1 I6tt02- 516(tt t(r00-
llicrolih & Docurents
ttl 1 16002- fl777fittlt[t-
Plurb i ns
trl I 161102- :;16(r2tt0tt-Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Swimming Pool/Spa
Swimming Pool & Spa
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3, U
VB
cPc 2019
04t0612021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
Add a sWirnming pool and spa,.,..,Y'Aut, h *
Verduzco,
Buildins Permit #: 101 106349
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 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
$209.49
$4.05
$237 33
$0.00
$237.33
lnspector MID#: 2021-1 65338
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER I'EI.CARATION
I hacby alfm und6 pqulty of pojury that I m qmp Gom thc Contr.clon' Licm t:w for thc following tEen (Sc:7031.5 .
Bwine ard hofsion C.ode): Asy City or Couty which roquire a pcmit to @rdrud, alts, improve <imlish or rpeir uy
structuq Fior to its iwcc, also rcquirc thc applicet for sch pqmit to filc a signcd staoot tha hc or Cp b licosod plmsn
to thc prcvisioB of thc Cotrtreror's Limscd Law (Chaptq 9. Comming with Scrion 7000 of Division 3 of thc Buins ud
ProfBsioG Codc) or thsa hc or shc is qmpt th6c&om 8td thc b6sis for tbc allcgcd soptioa Any violarioo of Sclbo 7031.5 by uy
8pplicut for r psrmit subjels thc applicsrt to . civil pmlty of not mrc tho fivc hundrcd dollm (5500).
-1,
ES owner of the propcrty. or my employecs with wages as their rcle compensation, will do ttrc work md thc stnrture is mt
intcndod or offcrcd for sale (Sec.7O44, Business and Profcssiors Code: The Contraclor's Licquc [aw does not eply to ur owner of
the property who builds or improve tlrcroru and who does zuch work himself or hcrsclf or through his or her own employees,
provided that such improvanrcots are not intended orofuod for sale. I[, howerrer, ttrc hlilding or impovqn€nt is sold within one ]rcar
of complaiou the Orvner Buildcr will have th€ hrdcn of proving ttra he or shc dkl not build or improve ttrc propcty for thc purposc of
salc).
-1,
os owner of the propcrty, am exclusively contracting with licensed contractom to construct the projec't (Sec. 7044, Business
and hofirssion Code: Thc Contractor's License Law does not spply to an owncr of propcrty who builds or improves thcreon,
and who contracts for such projccts with a Contracto(s) licemsod pursuant to the Contractor's Licensc l-aw).
-l
am exempt undcr Section-, B. & P.C. for this reason.
flo tr.'
WORKERS' COMPENSATION
DECLARATION
I hereby alTirm under penalty of perjury one of the following declarations:
-l
havc and will maintain a Ccrtificate of Consent to Self-lnsure for workers' compcnsation. as provided for by Section 3700 of the
Labor Code. for the pcrformance of the work for which the p,errnil is issued.
V, n^u"and will maintain workers' compensation insurance. as required by Section 3700 of the l-abor Code, for the pcrformance of
the work for which this permit is issued. My workers' compensation insurance carricr and policy numbcr are:
L/, Jca /rtjrrrlnlo.t CC
Policy
IA I cerrify that in the perforrnance of the work for which this permit is issued, I shall not employ any person in any manner,-
so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the
workers' compssation provisions of Section 3700 of the Labor Code. I shall. forthrvith comply with those provisions..
I
WARNING: Failurc to sccure workers' compensation coverage is an anployer to crimrnal penalties and
civil fines up one thousand dollars ($100,000). in damaq as provided for thc
Section 3076 Codc, intcrest and attorney's fees.
I hereby aflirm under pcnalty ofperjury that I am licensod of Chaptcr 9 (commorcing with Section 7000) of Division 3
of the Busincss and Profcssions Code. and my licerse is in full forcc urd effect.
License Nurnbc'r:
W
I hwby affm undc pcf,alty of psjury that thqe is a @nslructiotr Lndirg agdcy for thc pqfomce of the rcrh for which this pqrnit is
issued (Se. 3097. Civ. C.).
[ands's Nmc:
lrnder's Address:
APPLICAI{T DECII\]TATTON
I hcr'*Draffirrr under perulty of perjury one of the following declarations:
Demolition Pcrmits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Required
lrtter of Notification
-l
ccrti$ that the federal regulations regarding asbestos rcmoval are not applicable to this project.
-l
certi& that I havc read this application and state all City and County
ordinances and State Laws relating to building
above mentioned property for inspcction
Applicant or Agcnt
Permilee
the
upon the
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor f ,/7-?1 fuc','/)
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/SPL
P-trapffi \frOat [) ,/ z,-w
NAdfn-praifr/Pool Pipinq ,/r' tl g.I (
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release
FINAL lo-s -?rt t -se ttr.
Notes, Remarks, Etc.
xile .Expires: /- 3 f -LZ .