HomeMy WebLinkAbout30143590 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAS27O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (7'14) 647-5853
Permit #: 30143590
Pin #: 72375
Proiect Address: 1024 N Olive Sta
Assessor's Parcel: 405-283-20 Lot: 34
Unit:
Block: NA
Bldg:
Tract. 354
Address Range:
Historrc: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Salvador Ramirez
1024 N OLIVE ST
Santa Ana, CA 927032334
(7141 884-2454
01 1 16002 51602
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
Water Closet 15.32
Shower 23.91
Sink 13.68
Add'l Sewer Connection 23.91
General Plan Update 23.19
lssuance Sg.3O
Microfilm Records 4.05
Qty
100
100
1.00
1.00
100
1.00
100
Fee
$1s 32
$23 e7
$13 68
$23 97
$23 79
$5e.30
$4.05
!
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
'Expires:
Botchi :60(67 8/25/2021 ID: LR0SA[-EOffice: CTYH Trgns*: 6 2 of 5Acct*: Ref*: 301 43590
Rcpti: tr3386994 8/21/2021 I :58 PH
Tronsqct ion Totol t817.39
Solvndor Ron i rer
Genernl Flnn Updote Fee
0l I l6tr02- 516rJl:r0l:ltt-Building Use:
Job Type:
Nature of Work
Single Family Dwelling
Alteration
New Bathroom
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cPc 2019 P I u m *{ $ |$t,fihsEf h,+f9rnnm conversion
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By.Zuniga,
Subject to Field:
Buildins Permit #: 1 01107772
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.
Notes:
Fee Total
Paid to Date:
Balance Due:
ll icrof iIr & Docunents[l I l6fitj2- 1777fi0rr0-
ViEn
(:C+ : **trr*r*r ***88 t I Ar.rth*:tL
Ailrrv 08t25t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 51602
01 1 16002 s7770
$23 7e
$136.24
$4.0s
$164.08
$0 00
$164.08
lnspector MID#: 2021-168434
PLU M B! NG.I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEI.,CARATION
I hoeby alfm undo Fmlty of pcrjury that I m qmpt from thc Cortractots' Licw taw for thc following.ren (Sc.703lJ
Buincs srd Prof*ion Codc): Any City or Courty which rcquirc a pcrnh to @fl*ruc( ahq, irnprovc danolish or npajr uy
struclurq Fbr to its ismcc. slso rcquiB thc applimt for such pqmit to filc a signcd $armat thd hc or slE b licqEcd pl|Mt
to thc provisioN of 0rc Contretor's Licascd Law (Chapt6 9, Comcncing with Setion 7000 of Divisioa 3 of thc BcitK md
Prcfsioro Code) or rhat h€ or shc b qcmpt th@from ud thc basis for thc allcgcd qmption. Any violation of Sction 7031.5 by uy
applicutforEp6mitsubjctsthc rmlimttoscivilpcn8ltyofootmorcthelivchundrcddollm($500).
-1,
os owner ofthe propertyt or my employees with wages as their sole compensation.
intended or ofFoed for sale (Sec.7044. Business and hofcsions Code: The Contraclor's License law does not apply to an owner of
the propcrty who builds or imFovc tlreroru and wlrc docs such wort himsclf or hcrsclf or through his or her own employee.
providd that such improvonents arc not intendod oroflAcd for sale. I[, howwer, thc building or improvcfiicnt is rcld within one ]rcar
of complaion, the Ourncr Builder will have the hrden of proving tha he or she did not btrild or improve the popory for the purposc of
sale).
-I,
8s owner of the property, arn exclusively contracting with liccrsed contracton to construct the projct (Scc. 7044, Buiness
and Pnoftssion Code: The Contractor's License Law docs not apply to an owner of property who builds or improvcs thereon,
and who contracts for such projects with a Contractor(s) liccnsed pursuant to the Contractor's License law).
_l am exempt B. & P.C.
L
I hereby alTirm undcr pcnalty of po'jury one of the following declarations:
_l have and will maintain a Certilicate of Conscnt to Self-lnsure for workers'compcnsatioq as provided for by Soction 3700 of the
l-abor Codc for the performance of the work for which the permit b issued.
-l
have and will maintain workers' compensation insurance, as required by Section 3700 of the l,abor Code, for the performance of
the work for which this perrrit is issuod My workers' comporsation insurance carricr and policy numk are:
Policy Number: Expires:
_l certi& that in the pcrformance of the work for which this permit is issued, I shall not employ any person in any manner
so uts to become subject to the workers'compensation laws of California, and agrec that if I should become subject to the
workers' compensation provisions of Seoion 3700 of the Labor Code. I shall. forthwith comply with those provisions..J
WARNING: Failure to secure workers' compensstion coverage is unlawful, and shall subjcct an and
civil fines to one hundred thousand dollars ($100.000), in addition the
Section I-abor Code,and attorney's \
Z L
DECI,ARATTON
I hereby affrm under penalty of pcrjury that I am licenscd under provision of Chaptcr 9
of the Business and Professions Code, and my license is in full force and effect.
Soction 7000) of Division 3
Liceruc Class: License Numbcr:
l)atc
W
I hacby afEm udq pauhy of pajury tba Um is a @nsrudbn loditrg !g@y for th. pafomc of thc rcrk br which thb pauil b
issucd (Sc. 3097, Civ. C.).
l.crttlcr's N;rtttc.
Lendcr's Address:
APPLICANT DECLARATION
I hoebyaffirm undcr penalty of perjury one of the following declarations:
Dcmolition Pcrmits-Ashcstos Notification Fedcral Regulations (Tille 40. Part6)
-
Requ ired Lettcr o f Notifi cltcn
_l cotify that the federal regulations regarding asbcstos removal are not applicable to this projed.
-l
certi$, that I have read this application and state that the above information is correct. I all City and County
ordinances and Statc laws relating to to cntcr
above mcntioned propcrty for
Applicant or Agent
Pernritee nome
\
Z Z
thc
UNDER GROUND
Waste & Vent 1-Q,-21 **<olt-
Water-Under floor
Gas-Underfloor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ Cla rifier
TOP OUT
Waste & Vent ?4-ot .8, {Z
Water Pipinq n-2-a w4 (t
Gas Pipins
Roof Drain t ^l tn t A
Tub/Shower Test 4t t+tLl wMtxM.,ftb
Rough 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
Sanitary Sewer/Cap
Back Flow Device
Rouqh Plumbins
Final Gas Test
Meter Release
FINAL t^ln.r l'r..bn
Rema Etc.
+
Carrier:
Date:_
17
Contractor:_
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