HomeMy WebLinkAbout30343701 - PermitProject Address: 1607 E McFadden Avea
Assessor's Parcel: 402-322-17 Lot: NA
Unit: A
Block: NA
Bldg:
Tract NA
Address Range: 1S01-1609
Historic: No
Suite Range:
Zoning: Ml
City of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA927O2 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 303437o-1
Pin #: 258OGil
Owner:
Address:
Phone:
Tenant Name:
Reza Semsarieh
1607 E McFadden Ave, A
Santa Ana, CA 92705
(7141 352-6990
Daily Hug Coffee Roasters
Owner-Builder
01 1 16002 51602
01 1 16002 51602
01 1 16002 5160C
01 1 16002 51602
01 1 16002 5777C
Fee Type
Sink
Min Fee Adj
General Plan Update
lssuance
Microfilm Records
Amount
13.68
47.65
23.79
59.30
4.05
Qty
2.O0
1.00
100
1.00
1 .00
Fee
$27.36
$47.65
$23.79
$s9 30
$4 05
-a
Contractor:
Address:
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Botchi:60940 9/3fi/2tJ2l
Off ice: (:TYH Trsnsi: lSAccti: Ref*:
Rcp t* : 113429870 I /3$/2tr21
Trsnssct i on Totol
IO: HCAZALESlofs
303437A1
11313 An
1777 .66
$23 ,79
_ s134.31
$4.0:;
{777.66
Authi:tr7131+Notes:
Rein Semsar i eh
Sinks
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
rssuance, or if the work authorized on the site by such permitis suspended
or abandoned for a peiod of 360 days after the time the work is
commenced.
lnspector MID#: 2021-169 176
Building Use:
Job Type:
Nature of Work:
lndustrial
Alteration
Sinks
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B
!I! B
cPc 2019
Julie
03108117
09t30t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
$23.79
$134.31
$4 0s
Fee Total
Paid to Date:
Balance Due:
$1 62.1 s
$0 00
$162.15
i$
PLU M BING-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNEN EUILDER DELCARATION
I hcreby affum under FBIty of pcdury thrt I m excnpt fiom rhc Contr8cm' Lkcre Lrw for thc following mn (Ss.7031.5
Business od Profession Codc): Any City or County whbh rcquires s tEmir to onstrut. alt6, imprcve, dcmlish or rcp8ir uy
struchrc, prior to its issuore, slso requircs the applbut for srch pemit ao lih I si8rcd slrlcmnt lhat lE or slE b liccnsd plmstl
to thc prcvisbns of the Contnctor's Liccosed taw (Chsptcr 9, Colmming wilh Sction 7(m of Division 3 of ahc Busircss ud
Profe$ionsCodc)orthsthcorsheisererptthwfromardthcbasisforthcrlleScdexcmption. Anyviolationofs4lbnT03l,tbyuy
spplicmr for 8 pcmit subiEts thc spplicsrt to s civil pctrslty of mt mrc lhrn livc hundred do[rrs (S5m).
-1,
6 owncr of lhc prcpcny, or my cmplo)€s vith wrgcs s thcir slc ampensslion. will do lhe wut ard thc stnrhrc b ml
ircnded or ofrcrld for sle (Se.7044, Busircss ed Rofc$iotrs Codc: Thc Contactq's LLIE Lrw dcs ml ,pply lo m owffi of
thc FoIffiy who hrilds or inprcs tlEml and who dm sh wi* himslf or hcrclf or rhrcu8h his or her om erplolrccs,
prcvidcd that such imprcwrcnts m mt htcndcd or ofIeEd for sb. If, howffi. the buiEing or inprcrcmnt i! sH withh orc )sr
of orpletioo th OwH Buildcr will hsE tlE burdm of poving ths! hc q str di, mt hoild q inprcE ilE poFty fotr th ptleos of
sb).
D6 * o**, of U* prcpqty, m exclusircly @ntrrcting with lien$d @nlrrctos to @n*rucl llt ptoirr (56. IX4. BBircs
furd ProfcssimCldc:ThcContrctor'sLiccnst wdcsrctspplyiouowncrofprcpcrlywlrebuildsorimprcwslhcr@n,
and who @nlrrcts for such prcjctr with I Conts&to(s) li!rcn*d pursul to thc Contrctor's Licens [:v).
_l am B. & P.C. for this rcason.
11'( II{K IiRS' COII PITNS,\TI( )N
DECLARATION
I hcrcby alfirm undcr pcnalty of pcrjury one of thc following declarations:
-l
have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation, as provided for by Section 3700 of the
I-abor Code. for thc pcrformancc of thc work for which thc permit is issued.
-l
huvc and will maintain workcrs' compcnsation insurancc, &s rcquired by Scction 3700 of thc Labor Codc, for the pcrformance of
thc work for which this pcrmit is issucd. My workers' com;rcnsation insurancc carricr and policy numbcr erc:
Carrier:
Policv Number: Exoires:
l.
AS ccrtify that in the pcrformance of the work for which this permit is issued, I shall not employ any pcrson in any manncr
-so as to bcconr subjc"ct to the workcrs'compensation laws of California. and ngree thst if I should beconrc subject to thc
workers' compensation provisions of Section 370O of thc l-abor Code, I shall, forthwilh comply with those provisions..
WARNING: Failure lo sccurc workcrs' comlrcnsation covcragc is unlawful. and shall subict an cmployer to criminal pcnaltics and
civil fincs up to onc hundrcd thousand dollars ($100,00O), in addition to the cost of compcnsation, damagcs as providcd for thc
Scction 3076 of thc l-abor Codc, intcrcst and allorncy's
I hcrcby affirm undcr pcnalty of perjury that I am liccnscd 9 (commencing with Section 7000) of Division 3
of the Business and Professions Codc, and my licensc is in full forcc and effect.
Liccnse Class: License Number:
Conlractor:
W
I hcrcby aflirm undcr pnalty of pcrjury that thrc is a @nstruction knding rgcrcy lbr the pcrformncc of thc work for which this lEmit is
issucd (Ss. 1097, Civ. C.).
kndcr's Narrc:
Lcndcr's Addrcss:
APPLIC ANT DIICLARATION
I trcrcty aflirnr undcr pnalty of prjury onc of thc following dcclarutions:
Dcnrolition Pcrmits-Asbcstos Notification Fcdcral Rcgulations (Titlc 40, Parl6)
_Rcqu ircd lrtter of Notilication
-l
ccrtify that thc fcdcral rcgulations rcgarding asbestos rcmovalare nol applicablc to this project.
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underf loor
Buildinq Sewer
ArealStorm Drain
I nterceptor/ Clarif ier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
ltIain Drain/Pool Pipinq
Fill Line/Back Flow
Pool HeaterlGas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitarv SewerlCao
Back Flow Device
Rough Plumbing
Final Gas Test
Meter Release
FINAL /0{ge{LCrS/rg@ *;lry
Notes, Remarks, Etc
Date:_