HomeMy WebLinkAbout30140858 - PermitProject Address: 123 N Jackson St
Assessor's Parcel: 198-25242 Lot: 147
Unit:
Block: NA
Bldg:
Tract: 540
Address Range:
Historic: No
Suite Range:
Zoning: R2
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA g27O2 Plumbing
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 3O{4O858
Pin #:
"r7fr7
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
Phone:
Alexander Dantes LLC
17300 Redhill
lryine, CA 92614
(949) 383-8309
Cirus Development
17300 Red Hill Ave. #280
lrvine, CA 92614
(el6) 852-ss75
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Fee Type Amount
Water Closet 14.22
Shower/Bathtub 22.25
Sink 12.70
Clothes Washer 13.97
Dishwasher 11 .97
Garbage Disp 10.66
New Sewer (First 100') 64.60
Gas System 14 44.51
Wtr Htr (Res up to 50 gr 22.25
Water Piping (Each 100 44.5'l
Rainwtr Pip'g (Each 101 21.66
Genera! Plan Update 22.08
lssuance 55.04
Qty
2.00
2.00
3.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
2.00
1.00
1.00
Fee
$28.44
$44.50
$38.1 0
$13.97
$1 1.97
$10.66
$64.60
$44.s1
$22.2s
$44.s1
$43.32
$22.08
$ss.04
State Lic #: 523605
Lic Type: B
Bus. Lic #: 346797
Workers' Compensation I nsurance:
Carrier: Hartford Underwriters lns Co
Policy #: 72WE2O3188
Expires: 06/30/2019
Building Use:
Job Type:
Nature of Work:
Single FamilY Dwelling OccuPancy:
New Constr Type:
Single Family Dwelling/OpglCode:
R-3
SPK
cPc 2016
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Batance Due:
New pre-fabricated/manufactured sfd with (3)
bedrooffis, (2) bathrooms, laundry room, dining,
kitchen, living room, & open patio in front. GGUSD
#51 50Planning Conditions:
Planning Approval By: Date:
Plan Checked By: Date:
Permit lssued By: Chavez, Dave Date: 0412512019
subject to Field: >- €-'. Account#
Buildins Permit #: 10197831
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 the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51602
lnspector MID#: 2017-136574
4951 r
r'TYlt
$443 95
$0 00
$443 95
stS
$22.08
$421 .87
AI
19.l
PLUMBING-INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrcby alfim urdcr pcmlty of pcdury ihat I m cxcmpt fmm th€ ContrlcloE' Licemc Lsw for rhc following @$n (5&.7031.5 .
Bugines and Pmfcasion Codc): Any City or County which rcquircs a pcrmit to mNtnrct, altc, impmvq &mlish or rgrair Cn1
structurq prior lo its imare, alrc rcquircs thc applicant for ruh t,mit to lilc 8 signc{ statclmt that h or chc k liccnrd purguanr
to lhc ltrovlrhN of thc Contnctq's Liccnsed Lsw (Chaptcr 9, Commcrcing with Sation 7fi)o of Division 3 of thc Businesr and
Pmfcssions Codc) or thrt h€ or shc fu excmpt thcG&om and the b&!is for thc allcgcd cxcmption. Any violation ofsction 703 1.5 by any
applicant for a pcmil sbjcts th. alrplicant to 8 civil pcmltyof mt mrc than fivc hundrcd dollm (15fi)).
-1,
as owner of the proF,erty, or my employees with wages as their sole compensation, will do the work and the structure is not
interded or ofFered for sale (Sec.7044, Busirrcss and Professions Code: 'l'he Contraclor's License l-aw does not apply to an ou'ner of
the proyrcrty wtn builds or impmves thermn, and wlrl does such work himself or herself or through his or her own employees,
provided that such improvernenls are not intended or offered for sale. l[, lrcwever. the building or improvement is sold within one ]€ar
ofcompletionr the Owner Builder will have the burden of proving that he or she did rnt huild or inpmve the progrerty for the purJnseof
sale).
-1,
asownerof the property, amexclusivelyconlracting u'ith licensed contraclorsto construct the pnrject (Sec. 7M4, Business
and Pnrfesskrn Code: 'l'he Contractor's License Law does not apply lo an owner of property who builds or improves lhereon,
and who conlracts for such projects with a Contractor(s) licensed pursuant lo the ('ontractor's License Law).
_l am exempt under Section_, U. & P.C. lirr this reason.
l)alc ( )u rrer'
IVORKERS' CONI PENSATION
DECLARATION
I hereby alTirm under penalty of perjury one of the following declarations:
-l
have and will maintain a Certificate of Consent to Self-lnsure for workers' conlpensation, as pnrvided for by Section 3700 of the
Labor Code, for the performance of the work for which the permit ls issued.
-l
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perftlrmance of
the work for which this permit is issued. My workers' comp€nsation insurance carrier and plicy number are:
,t-l A 0s tr. rsat\e)P>F (tr)Lfi L-\ \ rrd co
j u>t st L k +o-Zol1Policy
-l
certify that in the performance of the work for which this permit is i.ssued, I shall not employ any person in any manncr
so as lo become subject to the workers'compensation laws of California, and agree lhat if I stnuld trcorne subject to the
workers' compensation provisions of Section 3700 of the Lahor Code, I shall, forthwith comply with those provisions..
WARNING: l;ailure lo secure workers'compensation coverage is unlawful, and an employer to penalties and
civil fines up to one hundred thousand dollars (S100,000). in addition to the cost provided for tlre
Section 3076 of the Labor Code, interest and attorney's fees.
o^tu, ' 1'? 5-2 olert
UUCLAn {.rrON
I herc'by alfirrn under penaltyof perjury that I arn licensed under pmvision of Chapter 9 (commencing with Section 7000) of Division 3
of the Busincss and Pnrfessions Code, axl my license is in full force and eflect.
a z3U 6
License
n",.,' Lt-25-24?
W
I hercby aflirm undcr [tmlty of Frjury thst thft is 8 @ritruction lcnding agcrcy for the pcfomrce of thc m* ft,r which this lEmit ig
isrucd (S@. 3097. Civ. C.).
Lender's Name:
Lender's Adclress:
APPLICANT DECLARA'I'TON
I hereby aflimr under penalty of perjury one of the ftrllowing cleclarations:
Denxrlition Pernrits-Asbestos Notification l;ederal Regulations ('l'itle 40, Pnrt6)
_Required [.ctter of Notification
removalare nol applicable to this project.
with all City and County
and County to enter uynn the
above nrentioned prnperty for
Applicant or Agent Date: I L4 - LS_ 7 Qt1
l'ertnilee n:rrtr0
is
UNDER GROUND
Waste & Vent ql,a /r t hilrbt
Water-Under floor .lit lt4 il,*lzrri
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ Clarifier
TOP OUT
Waste & Vent
Water Piping
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Piping
Fill Line/Back FIow
Pool Heaterlcas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back Flow Device
Rough Plumbins
Final Gas Test /b - l/-t g DC}r!? lo)
Meter Release 7€8 zt ?L2r t l41A M_/
FINAL l'Z-?oU tLcte,)e,,n*Lt7
RemaNotes rks, Etc.
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