HomeMy WebLinkAbout30143631 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (7'14)647-5853
Permit #: 30143631
Pin #: 34024
Project Address: 1905 W Hall Avea
Assessor's Parcel: 412402-36 Lot: 80
Unit:
Block: NA
Bldg:
Tract 3679
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Tuan Anh Nguyen
1905 W Hall Ave
Santa Ana, CA 92704
(s09) 217 -8287
Protech Seal Construction lr
1932 S Janette Ln
Anaheim, CA 92802
17141 2s3-80s3
01 1 16002 51602
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01 1 16002 5777C
Fee Type
Cap Fixtures
Cap Gas Outlet
General Plan Update
lssuance
Microfilm Records
Amount
7.48
9.12
23.79
s9.30
4.05
Qty
1.00
1.00
1.00
1.00
1.00
Fee
$7.48
$9 12
$23 79
$se 30
$4 05
t
Phone
State Lic #: 1007054
Lic Type: B
Bus. Lic #: 378707
Workers' Compensation I nsurance:Carrier: Norguard lns Co
Policy #: PRWC202134
Expires: 0112012022
Botch*!60664 - ?/9/2fi21 ID: HCAZALES
Off i ce: CTYH Transis I 2 of 6Acct*: Ref*: 30143631
Rcpt+:03{(t635(t 9/9/2(r2l 9:59 Al1
Trnnsoction Totol 3lr247.lJg
Protech Senl Construction Inc,
Demolistt/infill swimming pool & remove associated
equipment.
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Alteration
Pool demo
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3, U
VB
cPc 2019
09/09/2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
Amsden, Julie
Buildins Permit #: 101107908
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 fhe site by such permit is suspe nded
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 s1602
01 1 16002 57770
$23.79
$7s.90
$4.05
$103.74
$0 00
$103 .74
lnspector MID#: 2021-1 68667
PLUMBING.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BTM.DER DELCARATION
I hercby 8fftrm undcr lEnalty of perjury that I m excrtpt tom ahe ContrrctoE Liccnse llw for lhe follovitrS rcawn (Scc.703l.l
Busincss and Profcssion Code): Any City or County which rcquircs s pemil to mnstruct, alts, imprcve, &mlish or rcpair my
structw, Firr to ils issure, rls rcquiEs the spplicsnt for such pcmit to fih s sigred slstcmnt thrt hc or dE h liccNd pursilt
to thc provisions of the Contr.ctor's Liccn$d hw (Chspter 9, Clmrcing wilh Setion 7000 of Division 3 of the Business md
PrcfcssionsCodc)orthathcorshcisexcmptth@fromsrdthebasisfortheslhgcdcxctrrplion. AnyviolationofsslbnT03l.5byany
spplic8nt for s frcrmil subiEts the applicant to & civil pcnalty of not mrc thm livc hundrtd dollus ($500).
_1. as owtrcr of thc prof,crty, or my cmployecs with wagcs as thcir solc compensation. will do the work ild thc stnrturc is not
intcndcd or offercd for sale (Sec.7044, Business and Profcssions Code: Thc Contraclor's License Law does not apply lo an owner of
thc propcrty who builds or improvcs thcreon, and who does such work hinrself or hcrsclf or through his or her own cmployccs.
providcd that such impmvcnrcnts arc not intcndcd or offercd for salc. If. lmwerrcr, the building or imprcvcnrnt is sold within one )c&r
of complction, the Owner Buildcr will have thc burden of proving that he or shc did not buiH or improvc the propctty for the purynse of
salc).
-1.
8s owner of the propcrty. am cxclusively contracting with licensed contraclom to construct thc project (Soc. 7W. Busirrcss
and Prrofessbn Code: The Contractor's Liccnse IJw does not apply to an owncr of property who builds or improrrcs thereon,
and who contracts for such projeas with a Contracto(s) licensed pursuant to the C,ontractor's License kw).
-l
am cxcmpt under Section-, B. & P.C. for this rcason.
I )irlt
TQSSEINTOMPINSIIDON
DECI.A8AtrON
I hcrcby rmrm undcr pcnalty of prjury ore of the following deleations:
-l
havc ad will mintsin I Cef,ificate of Consent to Sclf-lnsurc for workcrs' cotr{f,nstion, rs providcd for hy Scction 3700 of thc
hhor Codc. for thc pcrfomncc of lhc work for which thc pcrmit is issucd.
--.?
l-f havc und will maintain workcrs' compcns.tion insumncc, as rcquircd by Scction 37OO of thc kbor Codc, for thc JErformncc of
lhi work for which this lErmil is is$cd. My workm' @mpcnsslion insurrrcc cmicr and fnlicy numbcr trc:
iP Gu^AD I
Clrricr:
Policy 0r- oG*? L
_l ccrtify that in thc pcrformancc of thc work for which this prmit is issucd, I shall not cmploy any pcrson in any tnanncr
so as to bcconrc subjcct to thc workcrs' compcnsation laws of California, and agrec that if I should bccomc subject to lhe
workcrs' compcnsation provisions of Scction 3700 of thc l-abor Code, I shall, forthwith cornply with thone provisions..
WARNING: Failurc to sccurc workcrs'compcnsation coverage is unlawful. and shall subjccl an employer to crirninal pcnaltics and
civil fincs up to onc hundred thousand dollars ($100.000).
Scction 3076 of thc l-abor Code, interest and attorncy's fccs.
in addition to the cost of comJrcnsation, damagcs as providcd for thc
De.rat Oq-Oq-?-l
DE'Cr ATIATTON
I hereby affrm under ;rcnalty of perjury that I am licensed under provision of Chaptcr 9 (comnrcncing with Section 7000) of Division 3
of the Busincss and Professions Code, and my license is in full force and effect.
Liccnsc Nunrbcr:7 s-t
W
I hcEby rffrm under Fmlry of perjury rhrt tlm is 8 @nstructbn bndirg agemy for thc Frfotlrc of lhc work for whkh this pcrmil ir
issucd (Sc. 3097, Civ. C.).
l.ender's Name:
lrnder's Address:
APPI ICANT DECI ARATION
I hcrcby affirm under penalty of perjury one of the following declarations:
Dernolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Required
Letter of Notification
_l ccrtify that thc fcdcralrcgulations rcgarding asbcstos rcmoval arc not applicablc to this projcct.
I?".nify that I havc rcad this application and statc that the abovc informarion is corrcct. I agrce to comply with all Ciry ancl County
ordinanccs and Statc Laws rclating to and hcreby authorizc reprcscntatives of this City and Counly to cntcr uJron thc
above nrcnlioncd propcrty for inspcction
Applicant or Agent
IDernrilee nnnre AA
o*", D 0.- O4-24
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf loor
Building Sewer
ArealStorm Drain
I nterceptor/ CIarif ier
TOP OUT
Waste & Vent
Water Pipinq
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 Heaterlcas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler lt
Sanitary SewerlCao t"/z/?a frl"rrla
Back FIow Device tl v \-/
I
Rouqh Plumbinq
Final Gas Test
Meter Release tl Ir
FINAL lol ttla J6f4)
Etc.I
Date:_C4-ofl*'Lt contracto r, ?tOTB-tt tr*c rattetbion)