HomeMy WebLinkAbout30143348 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 3O143348
Pin #: 81 26-7
Project Address: 301 E Stevens Ave
Assessor's Parcel: 411-121-04 Lot: NA
Unit:
Block: NA
Bldg:
Tract NA
Address Range:
Historic: No
Suite Range:
Zoning: Ml
Phone:
Tenant Name: The Grow Generation
Owner:
Address:
Contractor:
Address:
Phone:
The Realty Assoc. Fund XII Portfolio c/r
625 The City Drive South
Orange, CA 92868
Environmental Contracting t
880 East lst Street
Los Angeles, CA 90012
(213) 620-8008
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
51 602
51 602
s1 602
51 602
51 602
51 602
53602
5160C
51 602
5777C
Fee Type
Water Closet
Sink
Drink'g Fountain
Wtr Htr (Comm up to 50
Water Piping (Each 100
Appl Not Listed
PIC - 650/o
General Plan Update
lssuance
Microfilm
Amount
15.32
13 68
9.64
23.97
47.95
70.64
065
23.79
59.30
4.05
Qty
2.00
4.00
1.00
2.00
1.00
2.O0
332.17
1.00
'''99'. 1.00
Fee
$30.64
$54.72
$e.64
$47.94
$47.9s
$141.28
$215.91
$23.79
r.1nr*r-'f,?B'9.Pr
*i "r ft1.05State Lic #: 491 028
Lic Type: B
Bus. Lic #: 371131
Workers' Compensation lnsurance:Carrier: Everest Premier lns Co
Policy #: 260002061 6211
Expires: 0710112022
ACCB; i
tcpt,*:
Tr on st
.f, Jl6I Al1
'4.7ia
v I r'Gr, meli t (
. '; :
Plumbing for'T.l-
APPLIANCE NOT LISTED = EMER EYE WASH &
TEMPER VALVE
t23
t+
$28r
t 3&1
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
lndustrial
Tenant lmprovement
T.l./Storage Racks
CSG Consultants
Amsden, Julie
110721 I
08/1 6t2021
08/1 8t2021
Account#
Misc. Receipt: 75730
Misc. Receipt:
Misc. Receipt:
Total
Notes.
Fee Total
Paid to Date:
Balance Due:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B, S.1
ilt B
cPc 2019
?
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
rssuance, or if the work authorized on fhe site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 s1600
01 1 16002 51602
01 1 16002 57770
$23.79
$281.86
$4.05
$635.22
$325.52
$309.70
lnspector MID#: 2021-167026
PLUMB!NG.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
UNDER GROUND
Waste & Vent t*lf"a
Water-Under floor l/r \Jr
Gas-Underfloor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ Cla rifier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test /
Rough Water Heater \
POOL/SPA
P-tra plDrain Line
Main Drain/Pool Piping
Fill Line/Back FIow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back Flow Device
Rough Plumbins
Final Gas Test
Meter Release rI
FINAL L \'frA -Dt dY
t!aNotes, Remarks, Etc.
I hacby affum unda panalty of pcrjury that I m cxmpt ftom lhc Contracton' LiccN Law for thc following r*on (Se.7031.5
Buins ard Prcfesion Codc): Any City or County which rcquiB I pqmit to coNlruct. altq. improvc. &molish or rcpair uy
structuq prior to its issumc. also rcquire thc applicut for such pqrnit to filc I signcd stdomt thst hc or $c b licqa€d pEusril
to thc fovisioN of thc Contrctor's Licmscd Law (Chapt6 9. Comming with Sction 7000 of Division 3 of thc BuineS md
PrcfBioN Codc) or that hc or shc is cxmpt thqcfrom od thc bBis for rhe allcgcd crmption. Any violalion of SElbn 7031.5 by any
applicantforapcmitsubjctsthc spplienttoacivilpcnaltyofnotmorcthsfivchundrcddoltua($500).
_1. as owner ofthe fopcrty, or my emplolrccs with wagcs as their sole compensation. will do the wort ard the srudurc b not
intcndcd or offered for sale (Scc.7044, Buiness and Professions Code: Thc C-ontracror's Liccnsc Law does not apply to an owner of
the property who hrilds or improves thcron, and who docs strch work himsclf or herself or through his or hcr own employccs.
provided that such imp,rovenrorts are not intended oroffued for sale. If. however, tlrc building or impnovanrcnt is sold within onc ),ear
of cornplaion, the Owner Builder will have the hrdcn ofproving thd lrc or she ditl not build or improve the propaty for the purpose of
salc).
-1.
ES owncr of the propcrty. am exclusively contracting with liccnscd contraclors to construct thc pnoject (Sec. 7044. Business
and hoftssbn Code: The Contractor's License Law does not applyto an owner of propcrty who builds or improves thcreon,
and who contracts for such projects with a Contracto(s) liccnsed pursuant to thc Contractor's Liceruc law).
-l
am exempt under Section-, B. & P.C. for this reason.
l)irlt'
WORKERS' COMPENSATION
DECLARATION
I hercby affirm undcr ponlty of perjury one of the following declarations:
have and will maintain a Certificate of Consent to Self-lnsure for workers' compcnsation. as provided for by Soction 3700 of the
Labor Code. for the performance of the rvork for rvhich the perrnil is issued.
91,
thc
have and will maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. for the pcrfonnance of
work for which this permit is issued My workcrs' compemation ircurance carrier and policy number are:
Erct*+( Prnrsc,CL
Nunber. 76aoo 206/62// Expires:tf zo
_l ccrri$ that in the performance of the work for which this permit is issued, I shall not cmploy any pcrson in any manncr i
so as to become subject to the wortcrs'compensation laws of Cdifornia. and agree tha if I should become subjecr to the
workcrs' compensation provisions of Section 3700 of the l-abor Codc I shall. forthwith comply with thosc provisions..
c
WARNING: Failure to sccure workers' compcnsation coverage is unlawful, and shall subject an onployer to criminal penahics and
civil fines up to one hundred thousand dollars ($100.000), in addition to the cost of compensation. damage as provided for the
Section 3076 of the Labor C.ode interest and attorrry's fe6.
I hercby affrm under pcnalty of perjury that I am licenscd 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my liccnsc is in full force and effect.
W
I hmby alfim unda Falty of pcrjury that th@ b I couruction larding agacy for thc pcfome of thc wL for which this pamit b
ilsucd (Se. 3097, Civ. C.).
Lendcr's Name:
l cttilcr 's ,,\tlrlt css
APPLICANT DECLARATION
I hereby affrm under pcnalty of perjury one of the following declarations:
Dernolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
_ Required Lctter of Notification
_l certi& that the lbderal regulations regarding asbcstos rernoval are not applicable to this project.
certify that have read this application and state that the above information is correct.agree to comply rvith all City and County
and State Laws relating to huilding construction.enler upon
above rnentioned property for inspection purposes.
or Agent
Pernrilee nanre
and hereby authorize represcnt at ives of this City and County to
u
the
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LicenseNumber: Ca ^€
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Signalure:_
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Date: