HomeMy WebLinkAbout30243317 - Permita City 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 #i 30.243317
Pin #: 5OO98
Proiect Address: 1012 W Richland Ave-a-
Assessor's Parcel: 010-1 91-21 Lot: POR 12
Unit:
Block: 1
Bldg: Address Range.
Tract: HILLYARD ADD Historic: No
Suite Range:
Zoning: R3
Owner:
Address.
Phone
lgnacio Rodarte
1012 Richland
Santa Ana, CA 927034811
(7141 795-8219
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01 1 16002 5777C
Fee Type
Cap Fixtures
General Plan Update
lssuance
Microfilm Records
Amount
7.48
23.79
s9.30
4.05
Qty
200
1 .00
1.00
1 .00
Fee
$14 96
$23.7e
$59.30
$4.05Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Batch*:5?776 7/2/2ir2I I0: IlFIHEOA
0ff ice: t]'YH Tr.nrrs*:27 2 of'2Acctir $ief*: 311243317
tlcpLir03342365 7/2/ ?021 11:17 An
Trnnsocbion Io[ctl 172?.ltt
[9noc I o f{000r'cE
6ener01 F lnn UpdnLe F ee
u l I l6ttt"t2 - 51ot tt ttttttt-
F'lumb ins
Lrl I 16tru2- 51o02(t(t0-
11 icrof i ltr & Dscurrterrts
rrl I l6uU2- 377 7[t[t[t[t-
(:ash
i:honge
$23 .7y
$74. i6
$4 - r'i3i
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Alteration
Nru Demo
Occupancy:
Constr Type:
Code:
Date.
Date:
Date:
R-3, U
VB
cPc 2019
S Hernan dez,Kathy 07t02t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date.
Balance Due:
($
Remove unpermitted patio attached to garage, remove
unpermitted window and mandoor in garage, remove
unpermitted bathroom and return the garage to
intended use
$102 10
$0 00
$102.10
Buirdins Permit #: 1 0 2107 137
Every permit rssued 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 site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23 79
$74.26
$4 0s
lnspector MID#: 2021-167249
/
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PLUM BI NG.I NSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS OWNER BUILDER I'EI,CARATION
I h@by affum und6 pfialry of pcjury that I m q@pt from thc CoesdoB' Lic@ Law for thc followiag rcn (Sc.70J\5
Bwins and Prcfeion Codc): Any City or County which rcquira a pcmt ao orulrucl, altc, imprcvc, darclish or rpair my
strucluq prior to its isumcc also rcquirc thc spplicet for such pcnnit to 6lc a signcd statmal thal hc or shc b licGcd pwanl
to ahc provisioE of thc Contractor's Liccnscd Law (Chapt6 9, Comacing with Sction 7000 of Divisior 3 of thc Buire md
PmfBsioN Codc) or that hc or shc is qcmpt th@&om ed th€ b8sis for thc atlcScd smFion. Any violation of sEtbo 7031.5 by my
applient for a pcrmit subjcts thc applicmt to a civil pcrulty of not rcE the five hudrcd dollm ($500).
-1,
as owncr of the propcrty, or my employees with wages as their sole compensation" will do th€ work and the stnnure is not
intcndod or offcred for sale (Sec.7044. Busincss and hofcssions Code: The Contraclor's Licensc [^aw does not apply to an owner of
the propcrty who builds or improve thcron and who docs such work himself or hersclf or through his or hcr own employec,
providd that such imp,rovanrcnts rc not intended oroffirod for sale. I[, howerrer. thc hrilding or improvenrcnt is soH within one ],tar
of complaio& thc Ov.,ner Builder will have thc hrden of proving thd he or she did not build or irnpnovc the propoty for thc purposc of
sale).
_1, os owner of thc propcrty, am exclusively contracting with liccnsed contftrcton to conffuct thc project (Sec. 7044. Btsiness
and kofcssbn Code: The Contractor's Licelse Law does not applyto an owncr of propcrty who builds or improvc thereon,
and who contracls for such projds with a Contracto(s) licenscd puniuant to the Contractor's Licensc t aw).
_l am under 8.,&P.C.rforthis.69
Owner: Kf'trtumOirpf,snr
DECLARATION
I hercby affrrm undcr poralty of pcrjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
labor Code. for thc perfonnance of the work for which the permit is issued.
_l havc and will maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. for the perfonnance of
the work for which this pennit is issued. My workers' compensation insurance carrier and policy number are:
Policy Number: Expires:
_l cerri& that in the perforrnance of the work for which this permit is issued. I shall not ernploy any person in any manner
so as to become subject to the workers'compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code. I shall, forrhwilh comply with those provisions..
WARNING: Frailure to sccure workers' compensation coverage is unlawful, and shall subject an cmployer to oiminal pcnalties and
civil fines up to one hundred thousand dollars ($100.000), in addition to the cost of compensation, damages as provided for the
Scction 3076 of the Labor Code, interest and attorney's
DECI"ARATION
I hcreby affrm under penalty of pcrjury that I am licensod undcr provision of Chapter 9 (commancing with Section 7000) of Division 3
of the Busincss and Profcssions Code, and my licersc is in full force and effect.
Liccruc Class: Liccnsc Number:
('ontl':rclor'
W
I hwby aflm unda poulty of psjury thd th4 is a on*rucrion lading agcy for tbc pafow of thc mrt 6r wtfoh thL Fmn is
iscd (Sc. 3097, Civ. C.).
Lender's Name:
[.cndcr's Ad&ess:
APPLICAIT{T DECLARATION
I her*y affirm under pendty of pcrjury one of thc following declarations:
Demolition Permils-Asbcstos Notifrcation Federal Regulations (Title 40, Part6)
-Roqu
ired [rttcr o f l,lotificabn
_l cotiS that the lederal rcgulations regarding asbestos rernoval are not applicable to this project.
-l
ccrri$r that I have read this application and state that the above information is conect. I with all City and County
and County to mter upon theordinances and Statc Laws relating to building construclion, and
above mentioned property for
Applicant or Agent
I'crnrilce nRnre
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
! nterceptor/ Clarifier
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 Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler tl
Sanitary SewerlCao Qlnb,
Back Flow Device I IU
Rouqh Plumbinq
Final Gas Test
Meter Release ,IA
FINAL td"h,tl INotes, Remarks, Etc.
I
Carricr:-
orru, V ^?^7/
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