HomeMy WebLinkAbout30114133 - Permit{City of Santa Ana
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Plumbing Permit #: 3O'114133
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Permit Counter: (714) 647-5800 Inspection Requests. (714) 667-2738
Project Address: 2017 N Williams St Suite:
Block: NA
Bldg:
Tract: 6501
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 396-105-21 Lot: 33
Owner:
Address:
Debbie Thompson
2017 N Williams St
Santa Ana, GA 927057842
(7141 647-01 18
Fee Type Amount
Wtr Htr (Gas) Res/Com 7.S0lssuance 30.00
Qty
1.00
1.00
Fee
$7.s0
$30.00
Phone:
Tenant Name:
Contractor:
Address:
Nock Plumbing, lnc
11612 Knott Av #17
Garden Grove, GA 92841
(7141 895-1 246
C i bs of Sonto Ann
PD: 7 /23/A3IO:RJINEHEZLOC : C i Y!
CUST: IHV:301 141330137 Cr003 00051109 7 /?ii/tt t, 'Phone
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TRA},ISACTION TOTAL:Buildins
CK
CHANGE
State Lic #: 707775
Lic Type: C-36, HIC
Bus. Lic #: 0151 428
Workers' Compensation lnsurance:Carrier: INSUR CORP OF NY
Policy #: !C7000029200
Expires: 09/01 12003
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Building Use:
Type of Work:
Nature of Work:
Single Family Dwelling - Dc Constr Type:
Miscellaneous Occupancy:
Water Heater Code:
VN
R3
cPc 2001 Notes: Mail-in permit. Handout given.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Brodowski, Teri
Date:
Date:
Date:0712s12003
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Building Permit Fee Total:
Paid to Date:
Balance Due:
$37.50
$0.00
$37.50
This permit shall expire by limitation and become null and void if the work authorized by this permit
is not commenced within 180 days from the date of this permit, or if the work authoized by this
permitis suspended or abandoned at any time after the work is commenced for a period of 180 days.
Before such work can be recommenced, a new permit shall be first obtained to do so.
Account #: 01 1-01-5912 lnspector
PLU M BI NG-I NSPECTOR RECORD
COMMENTSAPPROVALSDATEID/SIG.
UNDER GROUND
Waste & Vent
Water-Underfloor
Gas-Underfloor
Building Sewer
ArealStorm Drain
lnterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Pipeing
Roof Drain
Tub/Shower Test
Rough Water Heater
POOUSPA
P-trap/Drain Line
Main Drain/Pool Piping
Fill Line/Back Flow
Pool Heater/Gas Line
Misc
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back FIow Device
Rough Plumbing
Final Gas Test
Meter Release
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Notes, Remarks, Etc.7
Owna-Builda Dclmtio
I hmby aIfim undr padty of pcrjury that I m qmF fdm thc CotnEtors' Lica5c llw ftr $c following ltas (s.7031.5 BsiDe'
md Prcfsiq Codc): Any City u Cunty which rcquiro a pcmit to mstuct, altcr, improvc, dmlish u rcpair 4y tfuctutr, pris !o it!
isme, also rcquirc thc appliilt ftr sch p6mit to filc I si8trcd stdmat thrt hc s shc is liqscd pmumt o thc prcvisims of dtc
Cqtrrcror'r Limrd hw (Chagt6 9. Cmrmcing with Sccrion 70(X) of Divisim 3 of thc Buine md Prcfcim Codc) c that hc u
shc ir cxmpr rhcfrm sd rhc boris fa olc allcgcd amptio .Any violrtim of S6tim 7031.5 by uy rpplimt fa I pcmir subjcB rhc.
spplimt !o a civil pctrdty of not mm thu fivc hudrcd dollm (t500).
_t, u oma of thc propaty, c my mploys with wrg6 6 thcir solc mpqtsatim, will do thc wo* md thc structw i! nd intcndcd
u offacd fa salc ( Se.7044, Bcins sd Prcfeiru Co&: Thc C6tr&1q'i Liere lrw dc not rpply to u w of thc prcpqty
who builds s imFove thm, md who dod swh wq* hiroclf c hmdf c thrcugh his c ha om mployce, Ircvidcd thal such
imprcvmmts e not inhdcd tr oflsrd fc salc. I( howcvr, thc building u imprcvmmt is sold within mc y6 of mplaim, thc
Omr-Builrtcr *ill havc thc burdcn of proving thst hc s rhc trot build tr imprcvc for thc purpoec of salc).
_t, a om6 of $c popcrty, m uclwivcly mtracting with limlcd mtrrcts! to ffisrrud thc prci61 ( 56. 7(N4, Buin6 od
Profsim Codc, Thc Cstretor's Liffic Lsw dc not spply !o m owna of propcaty who builds q improv6 thmn , md who
mtret ffi $ch prcjElr wi$ a Cmt".tc(s) licEcd ptlB@t to thc Cmt rctd's Lims Law.).
_l arn exempt under Section B. & P.C. for this reason'
Date:f)wnar'
WORXIERII COMPENSATTON IIECIJIRATION
f ha*y efiim udaFndty of FjEy oc of thc follwing delmtiou:
_thrvcedwiltminuinaCqtificrrcofCmtosclf-lromfawqlcrr'cmpaErtio,a poviddfcbyScrim3700ofthc
LrborfuG, forthc prfrmue of thc wct fqvhici thc pqmit is irrucd.
I harc od will minttin ws*c(N' onpaufim iBmcc. a r€quircd by Scdim 3?00 of thc kba Coda fq 6c Pcrfme of thc
ilqh fs which thir psmit i! isucd My ;oi*at' conparsrtim ircumcc mic md policy nmba ut:
Policy
(This wtim ncad not bc mplacd if thc pamit is fo Onc hundrcd dollffi {t100} q ls)
_l erriry that in thc pafomcc of thc wod( fq which this pdmit is isucd. t shsll not mploy uy pamn in uy mund so & to
bamc subjcr to thc wokcr ' mpauation lsws of Califmi4 ud agr that if I should bccom subjet to rhc wukm'
compcnstim prcvisions of Scctim 3700 of thc kbor Codc, I shall, f6rhwith comply wirh rhec provisions. .
Darc' Applicet
WARNING: F8ilurc to scurc wor*6' @mpcnsatio ovcragc is unlawful, md shall subjcct m cmploycr to oiminal pcnoltia ud civil
fins up ro oc hundrcd thmd dollm (1100,000),in sdditim to thc ct of mparsation, damags u grcvidcd f6 6c Setion 3076 of
thc Lrbq Codc, intmt ild 8ttomcy's f6.
LICENSED CONTRACToRS I'ECLARATION
t h@by 8ffim undcr pastty of pcrjury thd I m liqrcd ud6 prcvisio of Chapta 9 (macing with Setim 7000) of Divisio 3 of
fic Buin* ud Pmfcrios Codc, md my limsc is in full fmc ud cffca.
License Class: Liccnse Numbcr
Date:
CONSTRUCTION LENDTNG AGENCY
! hmby aflim uda pcnalty of pcrjury thst thqc is a onsEuctio lcnding agocy fu thc pcrfomucc of thc work fq which thir pcmit is
isucd (Se. 3097, Civ. C.).
I Lender's Name:
APPLTCANT'S DECLARATION
Dcmolition Pcmits-Asb6tc Notification Fcdoal Rctulstions (Titlc 40, Pan 6)
_ Rcquircd t:ncr ofNotificatim
_l crrrify that thc fcdcral rcgulatios rcguding 6bqtG rmoval rc not aPPlicablc to this projct.
_ I ccnify thd I havc rcad Ois applietim ud ststc thar thc abovc infomstioo is corcct. I agre ro comply with all City ud County
trdineB ud Strtc LaB Elating ro buildiog mtruction, ud h@by ethqia rcpGcnrariv6 of this Ciry ud County to qtcr upon thc
sbovc modocd prcpcdy for inspoction purpose
Applist or8g6t !ig.: Da&:-
Pmittcrm(FinQi
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