HomeMy WebLinkAbout30118726 - Permit20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing Permit #: 3O11 8726
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Cify of Santa Ana
Permit Counter: (7 14)647-5800
Project Address: 2206 S Oak St
Assessor's Parce!: 016-101-03 Lot: POR 1
I nspection Requests: (7 1 4) 667 -27 38 I nspector's Section: (7 14) 647-5853
Suite Range:
Zoning: Rl
Suite:
Block: J
Bldg:
Tract: 668
Address Range:
Historic: No
Owner:
Address:
German R Velasco
2206 Oak St
Santa Ana, CA 927072925
(7141 432-8712
Fee Type
Water Closet
Shower/Bathtub
Sink
Sewer Alter/Repair
Extend Gas Line
lssuance
Amount
8.1 5
8.15
8.15
16.00
23.50
32.50
Qty
1.00
1.00
1.00
1.00
1.00
1.00
Fee
$8.1 5
$8.1 5
$8.1 5
$16.00
$23.50
$32.50
$96.45
$0.00
$96.45
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation !nsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Planning Conditions
Planning Approval By:
Plan Checked
Permit lssued By:
Single Family Dwelling
Addition
Addn
Occupancy:
Constr Type:
Code:
Date
Date
Date
R-3/U-l
V-N
cPc 2001
12t19/2005
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Notes: Lefter of auth on file.
Fee Total:
Paid to Date:
Balance Due:
Amsden, Julie
Subject to Field
Building Permit q
This permit shall expire by limitation and become null and void if the wod< authoized by this permit
is not commenced within 180 days from the date of this permit, or if the work authoized by this
permit is suspended or abandoned at any time afterthe wo* is commenced for a peiod of 180 days.
Before such work can be recommenced, a new permit shall be first obtained fo do so.
Account #: 011 -01-5912 Inspector MID#: 2004-59747
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PLUMBING{NSPECTOR REGORD
APPROVALS DATE ID/SIG.COMMENTS Ownr-Buildr Dclsaion
I hmby alfim sdrr paalty of pajury thst I m €xcmpt fffir thc CmnacloE' Licsrrc Lsv fothc followingmil ($c.7031.5 Butinrs
md Prcfxim Codc): Any City q Cmty whicl rcquiru I pfinit !o mstruct, 8ltcr, imprcvc d€molish or rc?sir uy ltucturq pritr !o itt
isswe, also rcquiro thc tpplicst fq ruch p6mit to filc . liFcd srltcmat thst hc tr shc is limcd puEuut to $c prcvisimr of thc
Conr&ttr's Licocd ffl (Chsptq 9, Commcing with Scaim 7000 of Divisio ! of thc Bwine ud Prcfsiw Codt) q thrr hc s
shc ir gr{npt th@frm ud thc bosir fc thc allcgcd cxmptior .Any violstim of Setio 7031.5 by ay applimt fr a pamit rubjcci tlrc
appllfnt to a civil pcndty of ml lm thu fiw hmdrcd dollm (t500)./
1fi, u owna of tlrc propcrty, o my mploys with wag6 I thcir solc ornpcnsation, will do thc work sd thc cructurc ir not intcndcd
-or ofrcrcd fc salc ( Se.70,14, Buincr ud Profsiqr Codc: Thr Cmts&tq't Li6sr Lsw dc not spply to e MGr of ihc prcpcrty
who builds q imFow thctu, ud who dm such wqk hiroclf o hoclf r thrcugh his c hq oM mployc6, Fovidcd thsl tuch
irnprcvmots c not inhdcd tr ollccd for salc. lf, howwr, thc building or imprcvmat is sold within mc yo of cmplaio, thc
Ownc-Builda will havc thc bur&n of prcvin8 that hc tr shc trot build c imprcvc for thc purposc of sdc).
_1, 0s owner of the property, am exclusively contracting with
Profcssion Code: The Contractor's License Law does not apply
to constnrct the project ( Sec. 7044, Business and
to an of propcrty who or improves thcrcon . urd who
contftrcts for such projects with a Contractor(s) liccnsed pursuant to the )
_I anr cxempt undcr Section
Date:
I hmby affim und6 pcnalty of pajury onc of thc following &cluations:
_I havc ad will maiotaitr a Catificatc of Coroqt to Sclf-Insuc for workm' compcnsation, c providcd fo by Scction 3700 of thc
Labor Codc, for thc pcrfme of rhc work fq which thc pqmit is issucd
_I havc md will mitrt8in wqtG' mpqrsatiotr inswue, I rcquircd by S*tion 3700 of thc Lsbq Codc for thc pcrfomue of the
wsk for which this panit is isucd. My workc' cmposatim insumcc wia od policy numbcr rc:
Policy Number Expires:
(ThisscctionnoanffiepGfinitisforonehundreddollan{sloo}oless)
_t certify that in the performance of the work for which this permit
becamc subject to the workcrs ' compcnsation laws of California, and
is issued, I not employ 8ny in any manner so E to
thc worker'become to
compensation of Section 3700 of thc Labor Code, I shall,with thqse
Due:
WARNING: Failure to sccure workers' compcnsation coveragc is subject to criminal pc'naltics and civil
fincr up to mc hudrcd thowd ttollrr ($t00,000),in additid to th€ coct of cmpcnlstin, &magcs c provi&d fc thc Sctid 3076 of
thc Lrbtr Codc, intaBt ed attmcy'r f6.
@
I hmby afiim unda pcnalty of pcdury thrt I m limscd unda psovisim of Chapta9 (mmcing with Scction 7000) of Divisim 3 of
thc Buinas ad Prcfqsim Codc, od my liqsc is in firll fmc ud cfret.
License Class: Licensc Number
Datc: Contractor:
CONSTRUCTION LENDING AGENCY
I hqcby affim und6 pcnalty of pajury thu th6c is a cosmctio l6din8 agficy fa rhc pcrfomacc of thc work for which rhis pcmit is
issucd (56. 309?, Civ. C.).
Lands's Nmc:
Lender's Address:
APPLICANT'S DECLARATION
Demolition Permits-Asbcstos Notificuion Federal Rcguluions (Title 40, Part 6)
_ Rcquired Lcner of Notification
_I ccrtify that the federal regulations asbcstos removal arc not applicable to this projcct,
statc that the with all City and County
and county to enter upon thc
above mcntioned propcrty for
Applicant or agent sig.
Permittec niune (print) :
and
ol-
UNDER GROUND
Waste & Vent *fry/aa I
Water-Underfloor t t E-
Gas-Underfloor
Building Sewer
ArealStorm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipeing
Roof Drain
Tub/Shower Test
Rough Water Heater
POOUSPA
P-trap/Drain Line
Main Drain/Pool Piping
Fill Line/Back FIow
Pool Heater/Gas Line
Misc
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back Flow Device
Rough Plumbing t>lrg6G */d)
Final Gas Test rl \--/
Meter Release
lt I la-
FINAL c +ZL Drrt{")/
Notes, Remarks, Etc.
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