HomeMy WebLinkAbout30143006 - PermitCity 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 #: 3O143OOG
Pin #: 392574rn
Project Address: 2800 N Main St
Assessor's Parce!: 111-111-11 Lot: 1
Unit: 2825
Block: NA
Bldg: Address Range:
Tract RESUB OF SHAFEFI-,Iistoric: No
Suite Range:
Zoning: C2
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
State Lic #: 435582
Lic Type: B
Bus. Lic #: 378785
Workers' Compensation lnsurance:Carrier: Berkley Nat'l lns
Policy #: BNUWC01S4643
Expires: 0711312022
PERilTTCANCELLEDb;5 co..-.5socjrcr
DATE:q-\{-}\
Htfl+.
?,*
Fee Type Amount
Sink 13.68
Floor Sink 17.39
Cap Fixtures 7.48
Wtr Htr (Comm up to 50 23.97
Water Piping (Each 100 47 .95
Wtr Conditioner 47.95
Backflow > 2" 47.95
Appl Not Listed 70.64
PIC-65o/o --\ 0.65
General Plan tJpdate 23.T9
lssuance r: * 59.30
Microfilm Recoids 4.05
Centennial Real Estate Company
8750 N Central Expressway #1740
Dallas, TX 75231
(s721 888-8044
Spike Construction lnc
7915 Harper Ave
Downey, CA 90241
(562) 454-7673
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01116002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
51 602
51 602
51 602
51 602
51 602
51 602
51 602
51 602
53602
51 60C
51 602
5777C
Qty
4.00
3.00
7.00
1 .00
100
1 .00
1.00
1 .00
484.85
1.00
1.00
1.Qq
Fee
$54 72
$52.17
$s2 36
$23 e7
$47 9s
$47.95
$47 95
$70 64
$31 s.1 s
$23.7e
$se 30
$4 05
Building Use:
Job Type:
Nature of Work:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial
Tenant lmprovement
TI
Julie
07t14t2021
09/01 t2021
Account#
Misc. Receipt: 75372
Misc. Receipt:
Misc. Receipt:
Total
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
M, S-1
II A, SPK
cPc 2019
.tl t I 6LtLtz
Pluilb r ns
1l l16rru2
Notes: Tl-linstall paftltlon walls and hard lid ceiling to create a
service corridor,install t-bar ceiling, add pre-fab
walk-in cooler, frame in (1) interior door, relocate (2)
doors, add (1) new door
APPLIANCE NOT LISTED = PRV
Planning Conditions:
Planning Approval By:
Plan Checked By: CSG Consultants
01 1 06290
Every permitissued 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 permit rs 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 53602
01 1 16002 57770
$23.79
$457.01
$136.56
$4.05
Fee Total
Paid to Date:
Balance Due:
$800.00
$178.59
$621 .41
lnspector MID#: 2021-1 65209
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,
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PLU M BI NG-I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNEN BUILDER DELCARATTON
I hreby affm undtr poalty of pqjury that I m qmpt &om thc ConbactoB' Licm Lrw for thc fotlowingwn (Sc.7031.5
Buiaes urd Prcf6sion Code): Any City or County which rcquiro a pomit to @nstruc:t. altc. improvq danolish or npair uy
struct@. prbr to its isumcc, also rcquirc thc epticmt for such p6mit to filc a signcd stdclmt that hc or drc b licoscd pwant
to thc provisioE of the Cotrtrrclor's Liccnscd lrw (Chspt6 9. Comcncing whh Setion 7000 of Division 3 of thc Bsins md .
Profsions Codc) or that hc or shc is cxcnpt th@from ud thc basb for thc alkgcd cxdption. Any violation of Setiotr 7031.5 b my
applicmtforap6Eit3ubj6lsthc rpplicanttoacivilpmltyofnotmorcrhmfivchundrcddollu($500).
_1. as ownef, ofthe property. or my employees with wages as their sole compensation. will do the work and the stnrcture is not
intended or offered for sale (Sec.7044, Busincss and Professions Code: The Contraclor's License Law does not apply to an owner of
the property who hlilds or improvcs theron" and who docs such work himself or hersclf or through his or her own employec.
provided that such improvanants are not intendod oroffcrod for sale. If, howevcr. the building or improvement is sold within one )ear
of complaion, tlrc Orvner Buildcr will have the hrdcn of proving ttra he or she did not build or improve the propoty for the purposcof
sale).
-1,
as own€r of the propcrty, am exclusively contracting with licerucd contractom to construci ttrc projecr (Soc. 7044. Buiness
and hofessbn Code: The Contractor's Liccnse Law does not spply to an owncr of property who builds or improves thereon,
and who contracts for such projecis with a Contracto(s) liccnsod pursuant to the Contractor's Licensc law).
-I
am exempt under Section-. B. & P.C. for this reason.
I)oto.
WORKERS' COMPENSATION
DECT.ARATION
I hereby affirm under pcnalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsurc for workers'compensation. as pnrvidcd for by Section .1700 of the
I-abor Code, for the performance of the work for which the pcrrnit is issued.
IV I have and will maintain workers' compcnsation insurance. as rcquired by Scction 3700 of the Labor Codc. for the po'formancc of
G work for which this p,ermit is issued. My workers' compeosation irsurancc carricr and policy number arc:
-l
certi$, that in thc performance of the work for which this pcrmit is issued, I shall not cmploy any pemon in any manncr
so as to become subject to the worters' compensation laws of Californiq and agrec that if I should bocomc subject to the
workers' compensation provisions of Section 3700 of the Labor Code. I shall, forthwith comply with thosc provisions..
WARNING: Failure to secure workers'compensation coverage is unlawful, and shall subject an anploycr to criminal ponhies and
dollars ($100.000). in addition to the cost of compensation. damages as provided for thecivil fines to one hundred thousand
Section Labor Code. interest and attornery's
0c1 L
DECI ^R/ATIONI hereby alnrrn under peoalty of perjury that I am liccnsod under povision of Chaptc 9 (commcncing with Section 7000) of Division 3
of the Buiness and Professions Code, and my licensc is in full force and cffect.
Nurnber:t4 5 5 (?,1-,
,",., OQlnl/ 2l contrrctor: SO t,('.l - [on(k u..Kan f-nC,I
W
I hercby affrnn undr pcratty of pojury that th6e is a coctruction lcnding agmcy for thc pofonnilcc of the work for which this p6mit is
issued (Se. 3097, Civ. C.).
Lender's Name:
I.crrtlcr''s Arkh css:
APII.ICANLDECI.ABAUAN
I hq*y aftrn undq pcnalty of pqjury orc of thc following dclrations:
Demolition PmiteAsbctos Notification Fcdqal Rcgulatios (Tillc 40, PEr6)
-Required
Lrtta of Notificdiotr
-t
cqtiry that the fedsal regulatiom rcgading rbstos moval rc not applicsblc to this pDjE1.
f,Eh cqriry thar I havc red this application and statc thrt thc sbovc infomation is corct. I agrE io comply with all Cfty md County
ordimcs 6d Statc lr$ rchtiry to building condructioG ad hqcby authoriE rc?r€altstiva of this City md Couty to 6lq upon thc
above mentioned property for
Applicant or Agent
Permitee nrme
q c 'l-l
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Piping
Fill Line/Back FIow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbins
Final Gas Test
Meter Release
FINAL
Notes, Remarks, Etc.
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