HomeMy WebLinkAbout30143666 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927o2
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Plumbing Permit #: rot4rG66
Pin #: GiGOaC
Project Address: 2726 W Camden PI Unit:
Block: NA
Bldg:
Tract: 4022
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel 408-212-11 Lot: 65
Owner:
Address:
Pedro Santana
2726 Camden Pl
Santa Ana, CA 92701
(7141557-2836
01116002 51602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type
Wtr Htr (Res up to 50 gal)
General Plan Update
lssuance
Microfilm Records
Amount
23 97
23.79
59.30
4.05
Qty
1 .00
100
100
100
Fee
$23.97
$23.79
$59.30
$4.05
Phone:
Tenant Name:
Contractor:
Address:
Specialty AC Heat
4650 Arrow Highway, Suite CG
Montclair, CA 91763
(eoe) s82-7eeePhone:
State Lic #: 784495
Lic Tvpe: C-36, C-20
Bus. Lic #: 349795
Workers' Compensation lnsurance:
Canier: Security National lns Co
Policy #: SWC1307380
Expires: 1012312021
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Plumbing
Occupancy:
Constr Type:
Code:
R-3
VB
cPc 2019 Notes:
I.
Plumbing
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field.
Building Permit #:
web_us"v
Date:
Date:
Date.09t2112021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
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 fhe sife by such prmit is
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:
$1 11.11
$111.11
$0.00
Inspector MID#: 2021-168904
INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS OWNER BU I LDT'R NELCAR.ATION
I hereby affinn under penalty of periury that I am exempt form the Contractors' License Lau' for the following reason (Sec.70l1.5 Business
and Profession Code): Any City or County rvhich requires a permit to construct. alter. improve. demolish or repair any structure. prior to its
issuance. also rcquires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the
Contractor's l-icensed Larv (Chapter g. Commencing with Section 70fi) of Division -1 of the Business and Professions Code) or that he or
she is exetnpt therefrom and the ba-sis for the alleged exemption. Any violation of Section 70-11 .5 by any applicant for a pernrit subjects the
applicant to a civil penalty of not more than five hundred dollarc 1$-s00).
Y f . .r owner of the properq,. or my employees rvith s'ages as rheir sole compcnsation. will do the rvort and the stnrcture is not inrended
or offered for sale (Sec.7044. Business and Professions Code: The Contractor's l.icense l-aw does not apply to an owner of the prop€rty
rvho builds or imp,roves thereon. and rvho does such rvort himself or herself or through his or her own employees. provided that such
imgnovements are not intended or offerod fcr sale. If. however. the building or imp,rovement is sold within one year of complaion, the
Orvner Builder rvill have the burden of proving that he or she did not build or improve tre properw for thc prpcs€ of sale).
YEi. a-. owner of rhe property. am exclusively contracting rvith licensed contractors to construct the project (Sec. 7044. Business and
Profession Code: The Contraclor's l-icense [.arv does not apply to an o$'ner of property who builds or improves thereon, and
who contracts for such proiects with a Contracto(s) licensed pursuant to the Contractor's License Law).
!! t a, exempt under Section . B. & P.C. for this reason.
woRKF RST COMPFNS^TION nFCl r RJ{TION
I hereby alTinn under penalty of perjury one of the following declarations:
f t n.". and u'ill mainrain a Certificate of Consent ro Self-lnsure for workers' compensation. as provided for by Section 3700 of the
Labor Code. for the performance of the work fcrr rvhich the permit is issued.
YES
_l have and will maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. for the performance of the
work for which this pennit is issued. My workers' comp€nsation insurance carrier and policy number are:
. Sccurfi Nrtlona!( arner:
J)olicv
swc1307380
Nunrber:_Expires:
1012312021
NO
_- l certi$'that in the performance of the rvork for rvhich this permit is issued. I shall not employ any person in any mann6 so
as to become suh.iect to the rvorkers' comp€nsation larvs of California. and agree that if I should become subject to the worten'
compensation pnrvisions of Section -1700 of the Labor Code. I shall. forthrvith cornply with those provisions..
WARNIN(i: Failure to secure rvor*,ers'compensation coverage is unlarvful. and shall subiect an employer to criminal pcnalties and civil
fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for the Section -1076
of the l-abor Code. interest and attomey's fecs.
LICENSF'N CONTRACTOR TIECI ^ RATION
I herehy alTirm under penalty of periury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code. and rny license is in full force and effect.
c20 c3E
l-icense ('lass:78.L05
License Number
CONSTRIICTION I FNUNG AGTNCY
I hereby affinn under penalty of perjury that there is a construction lending agercy for the per"formance of the work for which this permit is
issued (Sec. .1097. Civ. C.).
l.ender's Nante:
l-endc'r's Address:
APPLICANT NFCT AITATION
I herebv aflinrr under penalty of perjuw one of the followrng declarations
l)enrtllitron Pernrrts-Asbestos Notrficatron Federal Regulalrons (Title 40, Part6)
!a Required Letterof Notification
YEs I cer1ifu that the federal regulations regarding asbesros removal are not applicable to this project.
YES'-- I cerri& that I have read this application and state that the above infonnation is correct. I agree to comply with all City and Coutty
nrdinun.., and State Larvs relating to building construction. and hereby authorize representatives of rhis City and County to enler upon the
above mentioned property for inspection purposes.
Reroof
Roof (Diaphragm Sheathing/Frame)
Structural Final
Plumbing
Under Floor I Under Slab
Rough
Shower Pan / Tub Test
Water Service
Sewer / Sewer Cap
Gas Air Pressure Test /r />
Plumbing Final 'l Itsh,llri> W\I
Electrical I I \-/
Service (Meter / Panel)
Grounding / Bonding
Rough
Electrical Final
Mechanical
Gas Air Pressure Test
Rough
Piping (HW, CW, etc.)
Exhaust Ducts
Mechanical Final
Notes, Remarks, Etc