HomeMy WebLinkAbout30143689 - 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 #: 3O143689
Pin #: 74165
,)1 n
Proiect Address: 215 E Warner Avea
Assessor's Parcel: 403-1 42-15 Lot: 24
Unit:
Block: D
Bldg:
Tract: 638
Address Range:
Historic: No
Suite Range:
Zoning: R2
Owner:
Address:
- Phone:
Tenant Name:
Contractor:
Address:
Phone:
City of Santa Ana
20 Civic Center Plaza
Santa Ana, CA 92701
(7141 647-5641
J&Glndustrieslnc
18627 Brookhurst St #302
Fountain Valley, CA 92708
(7141 903-2002
01 1 16002 51602
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01 1 16002 5777C
Fee Type
Cap Sewer
Fee Exempt
General Plan Update
lssuance
Microfilm Records
Amount
107.65
-194.79
23.79
59.30
4.05
Qty
1.00
100
100
100
1.00
Fee
$107.65
$-194.79
$23.7s
$se.30
$4.05
State Lic #: 571859
Lic Type: ASBS, A, HAZ, C-21
Bus. Lic #: 160248
Workers' Compensation I nsurance:Carrier. State lnsurance Fund
Policy #: uguag4t
Expires: 10101 12022
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Demolition & Clear Lot
Demo & Clear Lot
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R.3, U
VB
cPc 2019 Notes. Plumbing for SFD and detached garage demo - Cap
sewer. ***NO FEE-CITY PROJECT/LETTER ON FILE***
Zuniga,rurissa(09t29t2021
Account#
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
Total
Buildins Permit #: 101 108093
Every permit rssued shall become invalid unless the wort 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 permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
N/A - No
N/A - No
Balance
Balance
Fee Total
Paid to Date:
Balance Due:
$0 00
$0.00
$0.00
lnspector MID#: 2021-169075
,
-
PLUM BING-INSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS OWNER EUILDER DEI.CARATION
I hercby affrm undcr Fnally of [Erjury thlt I m exempl ftom lhc Conrrctm' Licenrc lrw for thc following rcen (Se.7031.5
Busincss and Prcfcssion Codc): Any City or County which rcquircs a Frmit to @nstrucl, altq, imprcre, &mlish or rcpah my
stlucrurc, prior to ils i$uarcc, af,so rcquircs the sppltet for such pemit to file I sitncd stalerent thal hc or dE ir licensd pu$&r
to lhc prcvisions of the Contrrctor's LLrcns{ t w (Chapts 9, Comrcing with S6tiotr 7000 of Division 3 of thc Busircss ud
PrcfcsionsCodc)orthstlEorsheisexcmptttwfromaldthcbosisforthealhgcdcrcnptbo. AnyyiolstionofS6tbnT03l.5byrtry
applicsot for 8 pemil suhj$ts Ihe applicsnt 1o r civil pcn8lty of ml mrc thstr fivc hundrcd dolles ($50O).
-1.
as owncr of the prolrcrty, or my employccs with wages us their solc compcnsalion, will do tlrc work snd the stnrturc is not
intcndcd or offered for salc (Scc.7044, Busincss and hofessions Codc: The Contractor's License lxw docs not apply to an owner of
thc propcrty who builds or improves thercon. and who does such work himself or hersclf or through his or her own cmployees.
providcd that such improvcnrcnts are not intendcd or offered for sale. If. however, thc building or improrrcnrnt is sold within onc ),ear
of complctiou the Owner Buildcr will harrc thc burdcn of proving that he or she did rrct buiH or inprove tlrc property for the purynse of
sale).
-1,
as owner of thc propcrty. am exclusively contracting with liccnscd contractors to conslruct the projcct (Sec. 7W. Business
and Profcssion Codc: Thc Contractor's Licensc Law docs not apply to an owner of propcrty who builds or improvcs thercon.
and who contracls for such projccts with a Contracto(s) liccnscd pursuant to thc Contraclor's Liccnsc [:w).
-lamcxcmptundcrSc'ction-.B.&P.C.forthisreason.\
hola. f lunar.
WORKERS' COMPT'NSATTON
DF'CLARATION
I hcrcby affirm undcr pcnalty of pcrjury one of the following declarations:
-l
have and will maintain a Certifrcate of Conscnt to Self-lnsure for workers' compcnsation, as provided for by Section 3700 of the
I-abor Codc. for thc pcrformancc of the work for which the pcrmit is issued.
_l havc and will maintain workers'Scction 3700 of the [abor Code. for the pcrformancc of
the work for issucd.carricr and plicy number arc:
Policy O aouL :la Itl .-l-?
-l
ccrtify that in thc performance of thc work for which this pcrmit is issued, I shall not cmploy any pcrson in any monncr
so as to bccomc subjcct to the workers'compcnsation laws of California. and agrec that if I should bccornc subjcrct to the
workcrs' compensation provisions of Section 3700 of the [:bor Codc. I shall. forthwith comply with thosc provisions..
WARNING: Failure lo sccurc workcrs' compcnsation covcragc is unlawful. and shall subict an cmploycr to criminal pcnaltics and
civil fincs up to one hundred thousand dollars ($100,000), in addition to the cost of compcnsation, damagcs as providcd for the
attorncy's fccs.
{,G^\
DECLARATION
I hcrcby affirrn under pcnalty of pcrjury that I anr liccnscd undcr provision of Chapter 9 (commencing with Scction 7000) of Division 3
of thc Busincss and Pnrl'essions Code, and nry liccnse is in full force and cffect.
\ Dscr *rrr* ,Liccnsc
W
I hcrcby 8ffrm under pcnslty of perjury that tlre is a @nstruction lenditrg agcrcy for thc pcdomc of thc mrk for which this pemit is
issuei (Se. 3097, Civ. C.).
Lcnder's Namc:
l-cnder's Address:
A PPLICANT NE' CLA RA-.fION
I hercbyafFrnnunder pcnalty of perjury one of thc following declarations:
Dcmolition Permits-Asbestos Notification Federal Regulations (Title 4O, Part6)
-Rcquired
l.etter of Notifrcation
-l
ccrtify that the federal rcgulations rcgarding asbestos removal are not applicable lo this project.b
_l ccrtify that I havc rcad this application and statc that the abovc information is corrcct. I agree to comply
ordinanccs and State l-aws rclating to building construction, and hcreby authorizc rcprescnlatives of this City
with all City and County
above rncntioncd propcrty for inspcction
Applicanl or Agent
Permitee name
\
'n
Y'
County to upn the
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf loor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ CIarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
N/ain Drain/Pool Pipinq
Fill Line/Back FIow
Pool Heaterlcas Line
Miscellaneous
Gas Service
Water Service
LawruSnrlnkler_-flanitary6werlrffi /o-/l -u 2.L(g Jq1Oa> 2, I
Rough Plumbinq
Final Gas Test
Meter Release
FINAL /04V-A fLCl s aJet@, Vfl
Notes, Remarks, Etc.
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