HomeMy WebLinkAbout30143722 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 30143722
Pin #: 373{5
Project Address: 2132 N Flower St
Assessor's Parcel: 001 -201-07 Lot: 38
Unit:
Block: NA
Bldg:
Tract 4611
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Linda Mesesan
2132 N Flower St
Santa Ana, CA 927062526
(714)- 815-1 187
MVP Plumbing
6U N Poplar Ave #A
Orange, CA 92868
(888) s01-s367
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01 1 16002 5777C
Fee Type Amount
Gas Line repairlreplace 47.9s
General Plan Update Z3.lg
lssuance 59.30
Microfilm Records 4.05
Qty
1.00
1 .00
1 .00
100
Fee
$47.95
$23 79
$5e.30
$4 05
a
State Lic #: 998986
Lic Type: C-36 r
Bus. Lic #: 379074
Workers' Compensation Insurance:Carrier: Norguard lnsurance
Policy #: MVWC2B3698
Expires: 0110712022
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0fr ice: (:f Y
Accti:
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301 43722
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Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By.
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Repair Gas Piping
\(t Hernan dez, Kathy 10t06t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cPc 2019
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Flunbrns
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57770tt[ttr-
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$23 .7V
*+.0:;
$ 1tt7,25
5241 .0?
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
lssuance, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2021-1 69280
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23.7e
$107.25
$4.05
$13s.09
$0.00
$1 35.09
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PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrcby affirm under Fmlty of pcrjury that I m exempt frcm the ConrrctoE' Liccn$ kw for the following wn (Sc.7031.5
Busincsr atd Profcssion Codc): Any City or County whkh rcquircs a permit lo onstnct, alts. imprcvq &mlish or rcpair my
structurc, Fior to its ksure, also rcquires thc applicmt for such Jmit lo [ile a signed stslemnt lhal lrc or shc is licensd t)lmant
to the prcvisions of thc Conrrctor's Licensd kw (Chaptcr 9. Collmrcing with Sstion 7(m of Division 3 of the 8usircs ud
Pmfcssiors Codc) or thsl he or shc is cxcmpt t|rcrcfrom and thc basis for the alleged cxcrplion. Any violatk n of SEtion 7031.5 by oy
applicanl for a pemit subjecls lhe aprlicrnt to 8 civil pcmlty of not mrc than five hundred dollss ($500).
_1, as owncr of the propcrty, or my cmployecs with wagcs as thcir solc compcnsalion. will do the work and thc structure is not
intendcd or offcrcd for salc (Scc.7044, Busincss and Professions Codc: The Contractor's License law does not apply to an owner of
the propcrty who builds or inproves thcrcon. and wln does srch work himself or hersclf or through his or her own employees,
providcd that such improvenrcnts are not intcndcd or offcred for sale. If. howcvcr, the building or improverncnt is sold within one year
of complction. the Owner Buildcr will have the burden of proving that trc or she did not build or irqnovc thc propcrty for thc purposc of
sah).
_1. as owncr of thc propcrty. am exclusivcly contracting with licenscd contractors to conslruct thc projcct (Scc. 7W. Busincss
and Pmtbssion Code: Thc Contractor's Liccnsc Law docs nol apply to an owner of property who builds or improves thcrcon.
and who contracls for such projccts with a Contr"rctor(s) liccnscd pursuant to thc Conlraclor's Liccnsc kw).
-lanrcxemptundcrScction-.B.&P'C.forthisrcason'I\.rra.
WORKEIIS' COM PENSATION
DECLARATION
I hcrcby affum under pnalty of pcrjury onc of the following dcclarations:
_lhavcalxlwill lnaintainuCcrtilicatcofConscnttoSclf-lnsurcforu'rlrkcrs'comJ^-nsation.as providcdtbrbyScction3T(X)ofthc
Labor Codc. for thc pcrttrrmancc of thc work filr which thc pcnttit is issucd.
4 nur"and witl maintain workers' conrpcnsation insurancc. as rcquircd hy.sccliorr 3700 of rhc Labor Codc. for rhc Jrcrlbrnnncc of
lhc work for which this pcrrnit is issucd. My w<lrkers' corrrpcnsatiorr insurancc carricr and policy nutttbcr arc:
L:of (auan4. =q^sw C,D
l
Policy k
_l ccrtify that in thc grcrformnncc of thc work for which this ;rermit is issucd. I shall not employ any person in any manncr
so as to bccomc subjcct to the workers' compcnsation laws of California, and agree that if I should bccome subjcct to lhc
workcrs' compcnsation provisions of Scction 3700 of thc labor Code, I shall, forthwith comply with thosc provisions..
WARNING: Failurc to sccurc workcrs' comJrcnsation covcrage is unlawful, and shnll subjcct an crnploycr to criminal pcnaltics and
civil fines up to onc hundrcd thousand dollars (S100,m0), in addition to the cost of compcnsation. damages as providcd for the
Scction 3076 of thc Latxlr Codc, intcrcst and eltorrrcy's
NECLARATION
I herchy affirrn undcr pcnalty of prjury that I anr liccnscd undcr provision of Chaptcr 9 (cornrncncing with Scclion 7Un) of Division 3
of thc Busincss and Profcssions Codc. and rny liccrtsc is in t'ull forcc ard cffcct.
Liccrrsc
(o 2,-\
W
I hcrcby 8ffrm under Fndty of pcrjury thst thcrc is I @ostrution Lnding rgcrcy for the psfoffi of thc rcrk fot which this p6mil b
issucd (Se. 3097, Civ. C.).
Lcnder's Namc:
[,cndcr's Addrcss:
APPI ICANT NTCLAITATION
I hereby affrnr under penalty of perjury one of the following dcclarations:
Dcrnolition Permits-Asbcstos Notification Federal Regulations (Title 40. Part6)
-Required
l-etter of Notification
-l
ccrtify that the fcderal regulations regarding asbcstos rcnroval arc not applicablc to this proict.
_l ccrtify that I have rcad this Application and state that the abovc information is corrcct. I agrcc to comply with all City and County
ordinanccs and Statc l.aws relating to authorizc rcprescntativcs of this City and County to entcr upon the
abovc rrcntioncd propcrty for
Applicant or Agenl
Permilee name
UNDER GROUND
Waste & Vent
Water-Under floor ll
Gas-Underf loor nl,s/t-b
Buildinq Sewer I I
ArealStorm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipincr
Fill Line/Back Flow
Pool Heaterlcas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCao
Back Flow Device
Rouqh Plumbinq
Final Gas Test
Meter Release tlt
FINAL rdBlzt
Notes, Remarks, Etc.I lrJ
I
Owner:-
Dete:_
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