HomeMy WebLinkAbout30143591 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
PermitCounter: (714) 647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: 3O143591
Pin #: 93376
llnr
Project Address: 1024 N Olive Sta
Assessor's Parcel: 405-283-20 Lot: 34
Unit:
Block: NA
Bldg:
Tract 354
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Tenant Name:
Contractor.
Address:
Phone:
Sal Ramirez
1024 N Olive Street
Santa Ana, CA 92703
(7141 884-2545
Empire Plumbing Heating &
8349 Katella Avenue
Stanton, CA 90680
(714l- 816-s12e
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01 1 16002 5777C
Fee Type Amount
Tankless Water Heater 70.64
Repipe Res (Each 100' 47 .95
Water Service (Each 10 47 .95
General Plan Update 23.79
lssuance 59.30
Microfilm Records 4.05
Qty
1 .00
200
100
100
100
100
Fee
$70 64
$e5 e0
$47 95
$23 79
$se 30
$4 0s
State Lic #: 794154
Lic Type: C-36, C-l O, C42, C-20
Bus. Lic #: 163353
Workers' Compensation I nsurance:Carrier: lnsurance of the West
Policy #: WSDS0 S13TT01
Expires: 1011512021
Botch *36$+97 - g/26/2tt21 I0: av icton ic
0f f ice: CTYH Tr'onsi: 16 I of 2Accti: ftef *: 3tll4359t
Rcpti: (t3397269 - 8/26i?021 9:45 AH
Tronsoct i on Totol t4+g ' g7
npire Plunbins Heo[ins & Au
Building Use:
Job Type:
Nature of Work:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling OccuPancy:
Alteration Constr Type.
Tankless Water Heater/Re-piCode'
R-3
VB
cPc 2019 water heater to be located in the attic/handouts given
$301 63
$0 00
$301.63
Planning Conditions:
Verduzco, Violet
Date:
Date:
Date.
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 site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
08t26t2021
Account#
Misc. Receipt:
Misc. Receipt:
Mrsc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23 7e
$273.7e
$4 0s
t
lnspector MtD#' 2021-168452
N\
PLUMBI NG.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATION
I heby affm undc psalty of pgjury thd I u q@pt from thc CotrtretoB' Lic@ kw for the followirg !us! (Se.7031.5
Buine aod Prcfcsion Codc); Any City or Cou!try which rcquiB I pqEil to @!slsct. alta. imprcvc damlbh or rq"r'uy,
structurc Fbr to itc isstmq slso rcquirB &c applicmt for such pmh to 6lc s sigrtd 3ldaErt thd hc or shc b licccd pwan
to thc provbioN of the Contsutor's Liccnscd law (Chaptq 9, Comming with S61ion 7000 of Division 3 of thc Bwinagmd
Prcf*ioro Co&) or that hr or sbc b qcmpt th@Eom md thc basis for thc dlcgcd umption. Any violrtioo of Scrion 7031.5 [v uy
rpplimt for 8 p6mit subjcts thc applimt to 8 civil pcmlty of rct rcrc thm fivc hudrcd dolla (3500). J
-1.
r omq of the propqty, or my mplole with wagc s thcir slc mmpcrualiorr will do thc work ard tlE sfildw is mt
inqdcd or offcrcd for slc (Se.7044. BuiB ed Prof*ioB Codc: Thc Codrsclor's Licw Law doc not pply to m om6 of
thc prcpsty who hril(b or irprorc tlpon ard who doa sh mtt hiNclf or hqElf or thrcugh his or ho om oploye,
providcd rhar such imFowrErl! rc mt htqdrd or offucd fur sh. Ii howffi. tlE ttriHiDg or irprwrra is pld withio m )a
of ompldion, thc Own6 BuiEc will harc thc burdgr of proving the hc or slrc dil mt buiH or impmrc tE Eopqty 6r thc Brpos of
slc).
-1,
re omc of thc pmpcty, u ocluivcly cornracling wilh licaBod cootretoB to @oilruci tlE Fojcl (Se. 7044. BEin6
ard Pro&sion Codc: Ttc Contrator's Lic@c Law do€ ma apply to e om6 of prcpcrty who builds or impmv6 th6@D.
md who mntncts for such pmjct8 with I Codacto(s) licord punuarl to thc ConEstor's Liw Lrw).
-l
am exempt under Section-, B. & P.C. for this rcason.
WoRKERS, COMPENSATTON
DECI.ARATION
I hoeby afnrm under penalty of perjury one of the following declarations:
-l
have and will maintain a Ccrtificatc of Consent to Self-lnsure for work€rs' compensationt as providd for by Section 3700 of the
I-abor Codc, for the performance of the wort for which thc pcrmit is issued.
-l
have and will maintain workers' compcnsation insurance, as rcquired by Section
the work for which this permil is issued. My workers' compensation insurance carrier
3700 of the l-abor Codc.
are:
for the performance of
and policy
*,-rl-r,$r1-,c-uuL)
Policy
'l
(/ r.-z(
_l certiff that in the performance of thc work for which this permit is issucd, I shall not employ any person in any manner
so as to become subject to the workers' compersation laws of California, and agrec that if I should become subject to the
workers' compensation provisions of Seclion 3700 of the labor Code I shall, forthwith comply wilh those provisions..
WARNING: I;ailure lo sccure workers'and
civil fines up to one hundred thousand the
attorney's fe6.
DECI.,ARATION
I hercby affrrm undcr penalty of perjury that I arn liccnsed under provision of Chaptcr 9 (comrncncing with Section 7000) of Division 3
of thc Busincss and Professions Code. and my license is in full forcc and effect.
License
CONSTRUCTION LENDINC ACENCY
I hwby affirm und6 pcnalty of psjury that th6c is a @Btruction landiag agacy for the pqfomcc of thc rcrk for which this pqmit is
isuod (Se. 3097. Civ. C.).
kndq's Nmq
Lendcr's Address:
APPLICANT DECLARATION
I herclry aftinn undcr penalty of perjury one of the following declarations:
Dernolition Perrnits-Asbestos Notification Federal Regulations (Title 40. Part6)
-Rcquired
Ldter of Notification
--l certi$, that the fideral regulations regarding asbestos removal are not applicable to this project.
-l
certi& that I have read this and state that the above County
ordinances and State l-aws relating construclion.upon the
abovc mentioned
Applicant or Agent
Permitcrc
Z
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ CIa rifier
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 Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service q-g-?A Dz-n* {.t
Lawn Sprinkler
Sanitarv SewerlCao
Back FIow Device
Rough Plumbing
Final Gas Test
Meter Release IL
FINAL Ple4lu tl {n
Notes Etc.
Ltgr? tr2l, /4icenseNumbcr: . )qVr V
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