HomeMy WebLinkAbout30142865 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Plumbing
PermitCounter: (714)647-5800 lnspection Requests: (7'14)667-2738 lnspectorSection: (714)647-5853
Permit #: 3O142865
Pin #: 57946
Proiect Address: 2225 112 W Downie Pla,
Assessor's Parcel: 399-153-09 Lot: 108
Unit:
Block: NA
Bldg:
Tract 2419
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone
Hai Nguyen
2225 W Downie Place
Santa Ana, CA 92706
(7141 258-6943
NT&M
23526 Cavanaugh Rd
Lake Forest, CA 92630
(7141 706-2824
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
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
Fee
$30 64
$47.94
$41.04
$15.05
$1 1 .49
$6e.5e
$47.95
$23 e7
$47.9s
$50 01
$23.79
$59.30
$4.05
51 602
51 602
51602
51 602
s1 602
51 602
51 602
51 602
51 602
51 602
51 60C
51 602
5777C
Fee Type Amount
Water Closet 15.32
Shower/Bathtub 23.92
Sink 13.68
Clothes Washer 15.05
Garbage Disp 11 .49
New Sewer (First 100') Og.59
Gas System 1-4 47 .95
Wtr Htr (Res up to 50 gr Z3.gZ
Water Service (Each 10 4T .gs
Hose Bibb 10.67
General PIan Update 23.79
lssuance 59.30
Microfilm Recordr 4 05
Qty
2.00
2.00
3.00
1.00
1.00
1.00
1.00
1.00
1.00
3.00
1.00
1.00
1.00
State Lic #: 1030481
Lic Type: C-10
Bus. Lic #: 36742
Workers' Compensation lnsurance:Carrier: State Fund
Policy #: 9231643
Expires: 0511712021
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Building Use: Accessory Dwelling Unit-D Occupancy:
Job Type: New Constr TYPe:
Nature of Work: ADU Code:
Planning Conditions: All materials to match existing.
R-3
VB
cPc 2019
HT&]1
Planning Approval By:
Plan Checked By:
Permit lssued By: Hernandez, Kathy
Subject to Field:
Buirdins Permit #: 1 011051 69
Date:
Date:
Date:02t25t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Fee Total
Paid to Date:
Balance Due:
Construct detached,ADu to include (2) bedrooms, (21
bathroorns; kitchen, living room, taundry area and
':
'
$472.77
$0.00
$472.77
IJ
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 the 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 51602
01 1 16002 57770
$23.79
$444.93
$4.05
Inspector MID#: 2020-162347
Notes:
PLUMBI NG.INSPECTOR REGORD
APPROVALS DATE ID/SIG GOMMENTS OWNER BUILDER DETrcARATION
I hmby affrm undr penalty of pajury thar I m qmpt ftom the ContracloB' LiceN Law for the followiog ren (Sc.7031.5
Bwincs md Prof*ion Codc): Any City or County which requirc a pamit to @Etruct, altq, improvg danolish or npair ay
. structure prior to its isuucq also rcquirc thc applicut for such pcnnit to filc a signcd stamot thal hc or slE b lic@s€d pwuet
llSdOe2yt@rntractor's Licqscd l.lw (Chapt6 9, Comocing with Setion 7000 of Division 3 of thc BNitrN ad- PrcfcsbreCo&)oithaTlErsheisqmptth@fromudthcbasisforthcallcgedumEion. AnyviolrtionofS*rion703l.5byuy
spplimtfo.apcntritsubjetsthc applicettoacivilp€naltyofnotmorcthefrvchundrcdclollm($500).
-1,
as owner of the property, or my employees with wages as their sole compensation, will do thework and the structure is not
intended or offered for sale (Sec.7044, Business and Professions Code: The Contractor's Licerne Law does not apply to an owner of
the property who builds or improves ther@n, and who does such work himself or herself or through his or her own employees.
provided that such improvanants are not intended orofferod for sale. I(, howwer. the tnrilding or improvement is sold within one )rcar
of complaion, the Ourner Builder will have the hrden ofp,roving ttra he or she did not build or improve the property for the purpose of
sale).
_1, as owner of the propoty, arn exclusively contracting with licensed contractors to construct the project (Sec. 7U4, Business
and Profession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a Contracto(s) licorsed pursuant to the Contractor's License Law).
-l
am exempt under Section-, B. & P.C. for this reason.
Owner:
WORIGRS' COMPENSATION
DECLARATION
I hereby affrrm under penalty of perjury one of the following declarations:
-l
have and will maintain a Certificate of Consent to Self-Insure for work€rs' compcnsation, as provided for by Section 3700 of the
Labor Code, for the pcrfonnance of the work for which the pennit is issued.
_l have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of
the work for which this permil is issued. My workers' compensation insurance carrier and policy number are:
Carrier:
l
Policy
_l certi$, that in the performance of the work for which this permit is issued. I shall not employ any person in any manner
so as to become subject to the workers'compensation laws of California, and agree that if t should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall, forthwith comply with those provisions..
WARNING: Failurc to sue wolkm' compemation ovmge is unlawful, md shall subjet m mplolu to qiminal poultic md
civil fmcs up to onc hmdrcd thomd dollm ($100,000), in additiotr to the cost of compereation, damaga c providcd for the
Section 3076 of the Labor Code, interest and attorney's
I hereby affrm under penalty of perjury that I am liccns€d under provision of Chapter 9 (commcncing with Section 7000) of Division 3
of the Business and hofcssions Code, and my license is in fuU force and effect.
License tDJ oq 3 I
ox",?-& f - [Lo*,)
W
I hwby affm uda pemlty of pdjury that th6e is a @ns(ruction lmding sgocy for thc psfomce of thc work for which this pqnit is
issued (Sc. 3097, Civ. C.).
tcnds's Nme:
-
Lender's Address:
APPLICANT DECLARATION
I herdry affirm under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Required
Letter of Notification
-l
cqtiry that thc federal regulatioro rcgading 6b6tos rmoval de not applicable to this prcject.
_l cgtiry that I have red this application od statc that thc above infomtion is cored. I agr@ to comply wilh all City ud County
ordinancB ild State laws relating to building coNtructiorl 8nd hqcby authorize reprMtative of this City od Counly to @t6 upon thc
above mentioned property for inspection
Applicant or Agent
Permitee nRme
,,,., &&f -80&/
UNDER GROUND I / ,-r
Waste & Vent 7-?zz(((-u*
Water-Under floor y'ze -:
Gas-Underfloor ,te+/(&-z 7
Building Sewer
Area/Storm Drain
I nterceptor/ Cla rifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back FIow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back FIow Device
Rough Plumbing I ;,L5/4 {Lr))
Final Gas Test
Meter Release
FINAL c -?p:-,Ll ItlJ-t 9 d e 0a7 -1'l
Notes, Remarks, Etc.
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