HomeMy WebLinkAbout30143611 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cA92702
Permit Counter: (714) 647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714) 647-5853
Plumbing Permit #: 301436ll
Pin #:651212il
Project Address: 1130 W St Andrew PI
Assessor's Parcel:015-221-02 Lot. 26
Unit:
Block: NA
Bldg:
Tract: 1367
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
State Lic #: 775483
Lic Tvpe: C'36
Bus. Lic #: 363285
Workers' Compensation lnsurance:
Carrier: CyPress lns Co
Policy #: SCWC248828
Expires: 0710112022
JOHN ROBERTS
1130 W SAINT ANDREW PL
Santa Ana, CA 927072132
Scott English Plumbing, lnc.
1230 N. Jefferson Street, Suite H
Anaheim, CA 92807
17141 e98-e022
0'r 116002 51602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type
Gas Lrne repair/replace
General Plan Update
lssuance
Microfilm Records
Amount
47.95
23 79
59 30
405
Qty
1 .00
1 .00
1.00
1 .00
Fee
$47.95
$23 79
$59.30
$4.05
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
(,^nChecked Bv:
v Permit lssued By:
, Subject to Field:
Building Permit #:
Single Family Dwelling
Alteration
Gas line repair
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-3
VB
cPc 2019
09t01t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Notes: Gas line rePair
Fee Total:
Paid to Date:
Balance Due
Total
N/A - No
N/A - No
Balance
Balance
$1 35 09
$1 3s 09
$0.00
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 srte by such permit is
suspended or abandoned for a period of 360 days after the time the work
is commenced.
lnspector MtD#'. 2021-1 68592
INSPECTOR RECORD
SITE-WORK DATE !D/SIG.GOMMENTS OWNTR BUILDER NFLCARATION
I hereby affinn under penalty of periury that I am exempt form the Contractors' License Law for the following reason (Sec.70-11.5 Business
and Profession Code): Any City or County which requires a permit to construct. altcr. improve, demolish or repair any structure, prior to its
issuance. also requires the applicant for such permit to file a signed statement that hc or shc is licerued pursuant to the provisiors of the
Contractor's Licensed Law (Chapter 9. Commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he or
she is excmpt therefrom and the basis for the alleged exemption. Any violalion of Section 70-3 I .5 by any applicant for a perrnit subjecs the
applicant to a civil penalty of nol more than five hundred dollars ($500).
[-t. .. owner of rhe property. or my ernployees rvith wages as their sole compensation, will do the rvort and the structur€ is nor intended
or offered for sale (Sec.7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of the foperty
s'ho builds or improves thffeon. and rvho dcres such wort himself or hcrself or through his or her own cmployees. provided that such
improvonents are not intended or offered for sale. If. however, the building or improvement is sold within one year of completion, ttre
Owns Builder uill have the burdcn of p,roving that he or she did not build cn improve tre propertv for he purpGc of sale).
I! l. ". o\.r,ner of rhe prope'rty. am exclusively contraoing u'ith licensed contraclors to constnrct the project (Sec. 7044. Business and
Profession Code: The Contractor's License l-arv does not apply to an os'ner of property rvho builds or improves thereon. and
who contracts for such pro.iects with a Contracto(s) liccnsed pursuant to the Contractor's l,icense Law).
lo-l ,tr', exempt under Section -B. & P.('. for this reason.
WoR.KFRS' COMPFNSATION nFCl ^ RATION
I hereby alTinn under penalty of perjury one of the following declarations:
! I f,r". ancl will maintain a Certificate of Consent to Self-lnsure for workers' compensation, as provided for by Section 3700 of the
L:bor Code. for the performance of the work for which the pernrit is issued.
YES
_l have and will maintain wortcrs' compensation insurance. as required by Section -1700 of the l-abor Code, for the perfornrance of the
rvork for which this perrnit is issued. My workers' compensation insurance carrier and policy number are:
. Cyprrr lnrurance Company( arrer:
Policy Number:_
NO
_Expires:
_ I certify that in the prformance of the work for s'hich this perrnit is issued. I shall not cmploy any person in any manner so
as to become subject to the wod<ers'compensation laws of California. and agree that if I should become subject to the workcrs'
comp€nsation provisions of Section 1700 of the Labor Code. I shall. forthu'ilh comply'with those provisions..
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subiect an employer to criminal pcnalties and civil
Iines up to one hundred thousand dollars ($100.m0). in addition to the cost of compensation. damages as provided for the Section 3076
of the Labor Code. interest and attomey's fees.
LICFNSFN CONTR ^ CTOR NF'('I AR.ATION
I hereby affinn under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division -j of
the Business and Professions Code. and my licerrse is in full force and effect.
c37
License ('lass:7754C3
[,icense Number
CONSTRII('TION I FNDING AGFNCY
I herebl, affinn under penalty of per.fury that there is a construction lending agercy for the performance of the work for which this permit is
issued (Sec. 3097. Civ. C.).
Lender's Name:
lrnder's Address:
\
APPT I("{NT NT'CI A.ITATION
I heretrv allinrr under penalty of per.;ury one of the followrng declarations:
Denrolrtron Pernrrls-Asbestos Notrlicalion Federal Regulatrons (Title 40, Part6)
!o Required l-etterof Notification
YT f cerliB/ that the federal regulations regarding astrcstos removal are not applicable to this project.
ttt f ceai$/ rhat I have read this application and state that the above information is correct. I agree to cornpty with all Ciry and Coturty
ordinances and State Larvs relating to building construction. and hereby authorizc r@rescntatives of this City and County to cnter rpon the
above mentioned property for inspection purposes.
Reroof
Roof (Diaphragm Sheathing/Frame)
Structural Final
Plumbing I .tl
Under FIoor I Under Slab q -,-yl tJ*w f(
Rough
Shower Pan / Tub Test
Water Service
Sewer / Sewer Cap
Gas Air Pressure Test a I t,Dtlt#,7
Plumbing Final
Electrical
Service (Meter I Panel)
Grounding / Bonding
Rough
Electrical Final
Mechanical
Gas Air Pressure Test
Rough
Piping (HW, CW, etc.)
Exhaust Ducts
Mechanlcal Fanal t t\A ,^,
(,I w a T Dfi.+fl
I I
Notes, Remarks, Etc.
071o112022
a //
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