HomeMy WebLinkAbout30115237 - Permit)
City of Santa Ana
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Plumbing Permit #: 30{'15237
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 /*
r '*.
Project Address: 1802 S Van Ness Ave
Assessor's Parcel: 015-042-20 Lot: 15, 16
Suite:
Block: I
Bldg:
Tract: 531
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Lisa Cangiano
1802 S Van Ness Ave
Santa Ana, CA 927072636
(7141 751-6467
Fee Type Amount
Wtr Htr (Gas) Res/Com 7.50lssuance 30.00
Fee Total:
Paid to Date:
Balance Due
Qty
1.00
1.00
Fee
$7.50
$30.00
$37.50
$0.00
$37.50
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use: Single Family Dwelling - D( Constr Type:
Type of Work: Miscellaneous Occupancy:
Nature of Work: W/H Relocation Code:
Planning Conditions: Enclosure To Be Painted To Match Dwelling.
VN
R3&Ul
cPc 2001 Notes: Water heater relocation to rear of dwelling. Handout
given.
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
ffi,0211212004
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:Janet
Date:
Date:
Date:
Building Permit #: _
This permit shall expire by limitation and become null and void if the work authorized by this permit
is not commenced within 180 days from the date of this permit, or if the work authorized by this
permit ls suspended or abandoned at any time after the work is commenced for a period of 180 days.
Before such work can be recommenced, a new permit shall be first obtained to do so.
Account #: 01 1-01-5912 Inspector
7
PLUMBING.I NSPECTOR RECORD \
APPROVALS DATE ID/SIG COMMENTS Om6-Build6 DccJmtim
f h@by affim udfi padty of pcjury that t m cxmp fm thc Conrrrc6m' Li6sc Law fc thc folloving m (s6,7031.5 Buind
md Prcf*ion Codc): Any City c Cmty which rcquiro a pmit to cmstruc! 8lter. imprcvc, dmoli3h s rcpair my stsucturc, priq to its
isrwe, dso rcquiru thc .pplimt ftr sush pcmit !o Iilc a liFcd slstsncnt thd hc q shc is limscd puEult to thc prcvisions of thc
Cootactq's Limrd L.w (Chatrq 9, Comaciog with Sccrim 7000 of Divirio 3 of thc Buins ad Profsiffi Codc) n that hc G
rhc fu qmpt th@from od thc b6i! fa thc sllslcd cxmptin .Any violstim of Scdo 7031.5 by ily appliui fa Epamit subj€ts thc
sppliot io s sivil pqdty of trd |tW thu fivc hu&cd dollm (5500).
_I, 8!i owner of the or my ernployees with as their sole compcnsation, will do thc work and the structurc is not intcnded
or offocd fq sale ( Scc.Thc Contractor's Licsnse Law does not apply to an owncr of the property
who buildr q imprcvs thm, ud who dm ruch wqk hiruclf q hmlf c throqh hir c ha om cmploye, povidcd dtu ruch
improvmr re not intadcd s olf6d ftr sdc. If, hwcvr, thc building u imprcvmmt is rcld within onc ycu of mplction, thc
Ownc-Duildc will havc thc burden ofprcving 0ut hc tr 3hc not b[ild o impovc for thc purposc ofsalc).
-6*o orn propqty, m cxcluircly mtr&ting wirh lic#d mtreror !o omtuct thc prcj61 ( sc. 7044, Bwitrd ild
Prcfcgim Codc: Tbc Corndfi's Licre lxw d6 not ap,ply ao u om6 of Fopcrty who buildB c imFov6 thm , &d vho
contrircts for such projeca with a Contracto(s) liccnscd pursuant to the Law.).
_I arn
Date:
for
I hatby rfiim uda padty of pajury oc offic foll*iag dcclrrtiw:.
_I harc ud will mintain a Ccrtificac of CoMt to Sclf-Intw ftr wortm'conpanratim, u povidcd fr by Scrtim 3700 of thc
Iabor Codc, fc thc pcfcmcc of lhc waL fc which thc pqrnit ic irurd.
_I have and will maintain workers' compcnsation insurance, as
work for which this pcrmit is issucd My workers' compensation
requircd by Scction 3700 of thc Labor Code, for the performancc of the
insurancc carrier urd policy numbr are:
Policy
(This section nccd not be completed if the pcrmit is for One hundred dollars {5100}
in the performance of the work for which this ls not emPloy in any manner so as to
to the workcrs 'laws of workefs'
of thc Labor Codc, I shall,
WARNING: Failurc to secure workcrs' compcnsation coverage is unlawful, and iu ernployc to criminal penalties and civil
fines up to one hun&ed thouand dollrs ($100,000),in addition to the cost
thc Labor Codc, intcrest 8nd atromcy's feca.
damages as provided fs the Scction 3076 of
LICENSED CONTRACTORS DECLARATION
I hmby sfiim ud.r paElty of pcrjury thrt I u limscd uda prcvilim of Chrpt* 9 (cmacing with Scctio 7000) of Divisim 3 of
thc Bwitrca! ud Prcfsim Coda ud my liccrc is in full fm ud cfiet.
Liccnsc Class, Liccnse Numbcr
Datc: Contrastor:
W
I halby affim uda pqulty of pqjury th.t thft is 8 ffitsuctio l@ding rgacy fa thc pcrfmcc of thc wct fc which this Fmit is
Civ. C.).
Lcnder's Address:
APPLICAT{T' S DECLARATION
Denrolition Permis-Asbctos Notificuion Fcdcral Regulations (Title 40, Part 6)
_ Rcquired l'rttor of Notificuion
rcgarding asbestos removal are not applicablc to this project.
with all City and County
above msntioncd
and County to cntcr upon the
epprican\hgqt
r"r,n@gintl'
tb'
.?.lQ
UNDER GROUND
Waste & Vent
Water-Underfloor
Gas-Underfloor
Building Sewer
Area/Storm Drain
lnterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipeing
Roof Drain
Tub/Shower Test
Rough Water Heater
POOUSPA
P-traplDrain Line
Main Drain/Pool Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Misc
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing *
Final Gas Test
Meter Release
FINAL
Notes, Remarks, Etc.
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