HomeMy WebLinkAbout30143267 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
PermitCounter: (714)647-5800 lnspection Requests:QM)667-2738 lnspectorSection: (714)647-5853
Permit #: 30143267
Pin #: 45989
Project Address: 1420 W Memory Ln
Assessor's Parcel: 001-293-01 Lot: POR 25
Unit:
Block: NA
Bldg: Address Range:
Tract POTTS, BORDEN &]llistoric: No
Suite Range:
Zoning: A1
Owner:
Address:
Phone
RODOLFO CARBAJAL
1420 W MEMORY LN
Santa Ana, CA 927061421
(7141 605-9892
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01116002 5777C
Fee Type
Sewer Alter/Repair
General Plan Update
lssuance
Microfilm Records
Amount
47.95
23.79
59.30
4.05
Qty
1.00
1.00
100
100
Fee
$47.95
$23.79
$5e 30
$4 05Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
, Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
PoliEy #:
Expires:
6/ l8/2fi21Trnns*: iRefi: 3g/2lt2l S
$1
ben er'o r
Ll1116tlt-t
PIurnb iri
Lt l I l,ttlu
I'l i r.rof i
Lt t I 16lll.
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
Sewer
Zuniga, AllissaY
Occupancy:
Constr Type:
Code:
Date:
Date:
Date.
R-3
VB
cPc 2019
0611 8t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Alter/repair sewer. Auth on file.
Fee Total
Paid to Date:
Balance Due:
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 the site by such permit is suspe nded
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
$23.7e
$1 07 25
$4.05
$135.09
$0 00
$135.09
RODOI
Inspector MID#: 2021-166873
,TT
APPROVALS DATE ID/SIG.COMMENTS
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor --,
Building Sewer th, lz,
ArealStorm Drain I \7
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
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
Sanitary SewerlCao
Back FIow Device
Roush Plumbins
Final Gas Test
7Meter Release /l
FINAL 1l Tlzt 2L) trt|'lNotes, Remarks, Etc.\i/
OWNER BUILDER I'EI.CAR TION
t hqcty alfm ud6 pqElty of pqjuy thrr t m qmpt ftom thc Contracron' Lic@ kw for thc following two (Se.7011.5
Buine srd Profesion Codc): Any City or Cour*y which rcquirc a pamit to @ostrucl, altc, improvq dsmlish or Epsir ey
structurc Fior ro its iswcc, also rcquirc thc applidt for such p6rdt to filc 8 sigord stslmt thd hc or shc b licsrd pueErr
to thc prcvisiom of thc Contrrctor's Liccnrcd kw (Ch8pt6 9, Commcing with S61ioo 7000 of Division 3 of thc BuhB md
Profcsions Codc) or that hc or shc is qmpt thqcfiom ud thc bosb for thc allcAcd q@ption. Any violation of S€tiotr 703 1.5 by uy
applicat for s pcrmit subjcts thc applicut to a civil poalty of not morc the fivc hundrcd dollm ($500).
_1. os owner of thc prop€rty, or my employees with wages as their sole compersation, will do thc work and the stnrcture b not
intcnd€d or offercd for sale (Sa.7044. Business and hofessions Code: The Contractor's License l-aw does not apply to an owner of
the propcrty who hrilds or improvcs thcreon srd who docs such wort himsclf or hcrsclf or through his or her own cmployees,
provided that such improvanents are not intendod oroffcred for sah. I[, howcver. t]rc building or improvanent is sold within onc ],car
of complaion, the Ovyner Build€r will have thc hrdcn of proving thd he or stre did not hrild or imp,rovc the property for the prqposc of
salc).
_1. as owner of the property, am exclusively contracting with
The Contractor's License Law does not
licensed contractors to constnrct the project (Sec. 7044, Bwiness
and hofession Code:apply to an owner of property who builds
the Contractor's Liccnse
or improves thercon.
and who contracts for such proje,cts with a Contracto(s) licenscd pursuant to Law).
_l am P.C.this
DECI,ARA'I'ION
I hereby alTirm under penalty of pcrjury one of thc following declarations:
-l
have and will rnaintain a Certificate of Consent to Self-lnsure for workers' compensation, as providcd for
Labor Code. for the performance of the work fior which the permit is issued.
of the
-I
have and will maintain workqs' compcnsation insuraoce, as roquired by Scction 3700 ofthc Labor Codc, for the pcrformance of
the work for which thb pcrmit is is$€d My workcrs' compcasdion insurarcc canicr od policy numbcr re:
Carrier:
Policy \'
_l certi$ that in the performance of the work for which this permit is issued. I shall not employ any person in any mdlncr
so as to bccome subject to the workers'compansation laws of California, and agrec that if I should becorne subject to the
workers' compensation provisions of Section 3700 of the l-abor Code. I shall. forrhwith comply with those provisiory..
WARNING: Failure to scctue workcrs' compcnsation coverage is unlawful. and subjcct an onployer to pouhies
civil frnes up to thousand dollars ($100.000). in to thc as for
Section 3076 Labor interest and attorney's
Dti('1,AttA't'toN
I hereby affrrm under penalty of pcrjury that I am licensod under provision of Chapter 9 (commencing with Section
of the Business and Professions Code, and my license is in full forcc and effect.
3
License Class: Licerue Numbcr:
f )o to'tf\ aat oa at at,
CONSTRUCTION LENDING AGENCY
I h@by sffm undtr p€natty of pcrjury thal thqc is a @nstructiotr larding agmcy for the pqfolrmcc of lhc work for which this pqmit is
isucd (Sc. 3097, Civ. C.).
lsrdq's Nmc:
l.eodcr'B Ad&ese:
A PP LICAI\T DEC LARATION
I hereby alnrm under pcnalty of perjury one of the following dcclarations:
Dernolition Permits-Asbcstos NotiFrcation Federal Regulations (Title 40, Part6)
_Required Letter of Notification
-t
certi$ that the federal regulations regarding asbestos reanoval are not applicable to this projoct.
_l cenify that I have read this application and state that with all City and County
ordinanccs and State l-aws rclating
above mentioned property for
Applicant or
hcreby
is correct. I agrce
and County to upon thc
PLUMBING.INSPECTOR RECORD
,
I
I
6l ,s/t(
E=e:ei e tf e E ,E E$
E:Eii E gE E tu fiEE
gEE
EE
s tgtg] I EE E =fi ;EE a;E
'E*tEitEfl;*EEgE=E=H*sc; sc;ps E +E 5 +t !5-1 5Fs Er
,trlirlFa[g;g$ggig;$gg
EligEEE*iiagtgagggg*cE*
Br ; cacai aE E, ; pfi EtE tEE $i
EI $ E E$ 3E Ef EE E H: IEE EEg* Ei
3I E 5IESE EE gi E ;t* E 18 EEfi E Efl
gE ggiig
iE EE
gt
iEE tEr EiEg Eg,
El
-$Eti.$*
$E J- Ji* $Ea$tIs";
.9,--(l)
OC9=
=ofrer- (l)
E3oa
EOo-cc+'
.o) =ao
E3.aa
9=o-o
-.o8troL.t .aOs
P;- {-'P3
..cg2o
3E
-I-L F
-
L_,(U
=oJ
g..E
EA.Go+t i,
c+t
E;
9tsa9.Ubro = -c
=(u9..E P
=8EFf rcl t;.= bE a o-
EE9['-I- l- -sE!
Ep Ets,9 g
oE 3Or-o
=fr-ul-OOA+r'E';(Uo-
P 3e
=o:g5€
=o
'ao
Eo
Hg
a
--, .-o:l>moJ--Yofi,CE}oO
Er .PEl *'ol aLLI (U
=laol o
EI Er=l L':-l r-
gl i.cl -ol .=
El xtl r
EI Scl *,
-lr-,ol E
-l
l-
hl 8.+tlc.l aol '=
El =ol otr:l col '=
EI E
-Yl -ool -<l r
'-l ()
ol .E
'=l (U
+l E
EI E
sl ;
-l-6o,- -A5.=a
=g13
Pf;PE>'Eo_:h-soPEH
-o7f
=E
Eo
'o
oo-a
o
-C,
o
o
=-oo
.C,
a
(U
c
.9,
0)
E
Gc
t-
:f
.s
Eo
E
-ofa
C
=f
-oo
E.o-(I,
c
Uq)c
=o
Eoo-ol-
o-
ooo
G,l!z
3o
FE,
UJ
o-o
G,o-
oF
UJ(J
-Foz
(.or-oNooo
(A
!F
I(L
(L
(J
trO.-E"=
sE$r$ B
EBtgta t
Ef,HrH3g
t'
t:a
i,
aI
a
e
cn a.R{8:i{5g: il's,'(DO.C_
.,^.C f E\46a
S*trflri3fla
lEgeJ
la?4e
lililHr
tlcYf=
'3+[Hjq3=
q3d=
a3 hi go o =.o=< O =JJ,^TJ
+ 3.t'fi$ gog
H=ga
-?r^-tJ_- \, f \<
R 9o'o
g 35a=
8 q,39+id$
H il =AXc) O o)f-1+*-,v.A,-,
a ; ts.,;-= =Aa )^
.+ <r \.,
At-a-Ll, ,+. A
sEtgaioF=
8e il
E d.=o+d
t J
6tD j
cnoo
E3a
9= d
-r' 0) =&ud
FF: q
P
0)
3
o){o
(D
o{r
0)fo-
oo
=ao
=
o
o
=o{
=o
Iu,C
o-o
-luC
e
=(o
Eo
3
0)E
E.
6'o-
o-
='3
JD
0)
=o-
C
=o-o
@
o)
=o-
:,
0)r+
o)
3
=o
o-
6-
o
E
oroo
CNoo-
C)*.o
=
fo
j
0)(o
oo
=o)r
o)
@
Jo
E
TD
=
o(oo
0)
=o-
-h
=o)
=a.
0)
oaoo
=9..(t
6-
o-
f
a'
ro
oEoaoo-
c)o
=a
Eo
o'f
0)o*.
5
{:
0)q
o-o(,
gt
o)op-
6'
o)o
6-
6t{
@
0)
=o-
-lo
_oc
o
3o
=a
=(D
(oo
o
-lf
o{fo
I
@C
o-o
o
{
E
o)
@
o
3:o
6-
o
?
o)
@
\=X\ilr\Eilo
E' 0)6'eo' ai
OO).+
,-i O-, '-
U, O
,aF
q^€...l.+
==r'o
@'
U'Co
-lo+r
=@'
-{ro
-l3
=3oo-
6',+o
o_+r
q):,
oo-o-
++
6'
=
-@
o-oitf.o
=-a
o
-lo=TD:f(oo
@
t+o
o
=
o<r
a->
f,o
='<ro
-t3
o)f.o
=-
{ ==$ =f
*rlgfi fi
^ -r ) q; .+ O-: E,.31d s
iE Q;q3
d E -s
= t'86 oeq$
g;q:u, d
**+e#ca r r-0)@=o.pbA
ItHafrEd r.6-c wP
E il"6 =8;-=33 A ie
H ig g*e
8-PaY= 6
lgrg*B6=;ads
g;jEms6=:.ogEq6'3.9= ('
+iE: 5 P Fgd;?==
5 q3tilE
q[#=3q
ao5-==
AJ i;H H
EP,=#u=q=oo6-=
r =: es 8arP E-E
d;gE 9r e
g;EgE
=
() o:= o a Froit..<cil6
8 aP d= E
E E-e ai
=O<'ood o q)
,= 3gq5eda'
Ipo
-ho-o
0,
ETtr
-a-CL
I'-J(ct
'tEoa
3
IIr+
o
A'-J
ETo
-aooe-oI
F}-J
6'
rio-3
3e-o
F}
Eo
oo-3g
o
F}o
CL
A'
I
J
CL
o
-aGI-Jo
EL
ET
Fl.5o
!,-o!,ot
ot
=o-qt-J
CL-o
F}tr--Joct
F}o
F}-Jo
gt
GIo
=o
-oot,o
IJ
2.cr
o
-ho-l
I'ao
F-='J
GI
F}-Jo
!,o.l
3
-aF}
;o
F}'oat
a(o'
f
0)
C
o
o
!
oEo
=
U
0)
(D
!
=.=
f
0)
3o
o
o{
=o
C{-ov
IN
=oz
o.Tl
o
rnz{{o
'tnoT
rn7{
o
€z
rn
4
U'
TD
rn-
l-.Tl
!fofozc
3uo
o-{r
C
=o
=.Noo-
(oof*
1;oo
=ot-dE
=OOPr=
oo-foo- -r
rrEidq
=f. q1'-r
--<€
dc
-rO) zr!-l ro(, -.r
-
L.:.
ga
5=
0)
=o)
3
=o
E
oroo
=o
€
=o
_+to
.+=o
q)
o-o-
oaa
a
oo-
o)uo
o
0)f,ioo
aof,
o)
_lt:oo-
oC.+.+fo
0)uo
o
!
ooo
=ot
=o
aa6'
=q)
C
I
!
=z
0)
3o
o
o{
=o-
HF
$i
Bi\Yio
8.t
sq
S+o='
Eq.ICa
*.8-
-.Oto5
B's
e$
Fl{o\Y
Eil{.\*P N'
r$rF
$:eilo\
=6ra\qii
o..8
,$'$
$O)$o
r$
su
o
F}'o
Fl-Uo
A)aoIo\
\ro\o
-u+rnq65
3 o^.
=: O-,A +r \,, -I =d..r=r-rJ<o =Ix 2-eAg
E-i B
'AFF\t_' O6'!olAorclFF(D(I)-ro.{30
o)=(oo
O --rA=
.A.
-,igoooxgB-o=<o'
41 J9o
--li
9.. €(o=
_rofD
=o-E_,
=qoo,*$
Jt+oo)
g- 3.
8a'33o*<Ir:6o
=dOOcl=o0)aqs
<E
?1. Oof
o 9,.6rU
$=
=':<$
=rfe8
d;w=c=:oo- =.ONo
@
c)o'rf,o
o
oo
=@
.l
Co*.of
!
-l.9.oo
o
-l
Uoao
=.E
=.of
o.{i
€o
-lx
!
-9.oo
t-o
C)
o)3.of
o
o-o-
oa
@
z
0)
3o
o
c)o
=.Noo-
(oo
=*
o-o-
ooa
o
C
:to
=.Noo-
(oo
=-