HomeMy WebLinkAbout30143104 - PermitProject Address: 3901 S Main St
Assessor's Parcel: 411-121-08 Lot: NA
Unit:
Block: NA
Bldg:
Tract NA
Address Range:
Historic: No
Suite Range:
Zoning: Ml
j
City of Santa Ana 20CivicCenterPlaza(M-19), SantaAna, CA92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 30143104
Pin #: 48,OO4
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Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Phone
Sacher Main and Stevens LLC
301 Forest Avenue
Laguna Beach, CA 92651
(949) 497 -3371
D L Hann Painting, lnc.
8625 Central Ave. #D
Stanton, CA 90680
(7141 724-2390
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 51602
01 1 16002 s1602
01 1 16002 51602
01 1 16002 51602
01 1 16002 53602
01 1 16002 s160C
01 1 16002 51602
01 1 16002 5777C
Fee Type Amount
Water Closet 15.32
Sink 13.68
Garbage Disp 11 .49
Floor Drain 11 .39
Wtr Htr (Comm up to 50 23.91
Water Service (Each 10 4l .gs
Backflow > 2" 47.95
Alter DrainA/ent 47 .gs
PIC - 650/o 0.65
General Plan Update 23.T9
lssuance 59.30
Microfilm Records 4.05
Qty
3.00
s.00
1.00
1.00
1.00
1.00
1.00
1.00
31 1.06
1.00
1.00
1.00
Fee
$45.96
$68.40
$11 49
$17.39
$23.97
$47.95
$47.95
$47.95
$202.1 I
$23.79
$5e.30
$4.05
t
State Lic #: 600226
Lic Type: B
Bus. Lic #: 189444
Workers' Compensation I nsurance:Carrier: California lnsurance Company
Policy #: 4000790101
Expires: 06101 12022
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. Hann F'ninbiBerBuilding Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By.
Subject to Field:
Commercial
Tenant lmprovement
TI
CSG Consultants
Hernandez, Kathy
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B, S-1
III B
cPc 2019 Notes. Plumbing for tenant
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P/C Plumt
06t28t2021
06t30t2021
Account#
Misc. Receipt: 75472
Misc. Receipt:
Misc. Receipt.
Total
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Buildins Permit #: I 01 1 06 147
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 sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MtD#. 2021-164912
01 1 16002 51600
01 1 16002 51602
01 1 16002 s3602
01 1 16002 57770
$23.7e
$370 36
$1 7.1 0
$4.05
Fee Total
Paid to Date:
Balance Due:
$600.39
$18s.09
$et 5.30
t4
$37u
;t-P.-l ,
7
PLUMBI NG.INSPECTOR RECORD a
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER I'EI,CARATION
I h6cby a,fm udq padty of pCjury thd I m q@F &om rhc CrtdractoE' Licm ls for thc followiog @tr (sc.7031.5
Buins aod Profcssion Codc): Any City or Couty wtich EquiE 8 Fmn to @flrruct, ahs, improvc doolish or npeh my
structw, prior ro its iswc, also rcquirc thc appliat for such pcrmit to file a signcd starmot thd hr or slE b licosod F$mstt
to thc pmvisioB of thc Contrrctor'B Licmscd Law (Chrptq 9, Comming with Sction 7000 of Division 3 of thc Buine ud
ProfcsiomCo&)orthathcorslrciJqarptfiqc&omDdrhcbosbforthcallcgcdqmpriou AnyviolatboofsccrboT03l.5byay
applicut for 8 p6nit subjcrs thc applicut to a civil pcnalty of rot rcrc the fivc hundrcd dollan (5500).
_1. s oma of thc prcpqty, or my cmployc wirh wage r rhcir $lc omps[diorl. will do thc wqk ad ttE ltructw b rct
intodcd or ofrqcd for slc (Sc.7M4, &sins od Pmft*sioB Codc Thc Crdra.lor's Li@ lrw doc lot 4ply to m offi6 of
$c proFty who builds or improu tlson, ud who &c sh wrt himclf or hqslf or thrcugh hir or ho om oploycca,
providcd that such imlmvqndts rc mt intadEd or off$d for slc. t[, howrc, thc huilditrg or imprcvqqft is old within orc ]6
of orrpleba thc Ovma Buil,:lq wil haw thc htrd6 of proving tlra hc or rhc dll mt tuild u im!rcw 0E Fopaty fur thr Frpos of
sh).
-1,
r omq of thc p(opsty, m qcluivcly contreting with licqEcd contractoB to oNtruct thc Fojd (Se. 7(x4. B{sinB
sd Proftsbn Co&: Thc Conraclor's Lic6$ lrw doB not spply to e oma of propcty who builds or imprcvB tha6G
ud who @ntsrcB hr such pojcrs with a Contracro(3) licsEcd prrBua[ ro th€ Cootrctor'! Li(re kw),
-l
am exempt undcr B. & P.C. for this reason.
WORKERS' COMPENSATION
DECLI\IIATION
I hereby affrm under penalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Conscnt to Self-lnsure for workers' comp€nsdion, ar providcd for by Secrion 3700 of the
Labor Code, for the perfonnance of the work for which the pernrit is issued.
_l have and will maintain workcrs' compcnsation insurance, as roquired by Section 3700 of thc l-abor Code, for the pcrformance of
the work for which this pennit is issued" My workcrs' compensation insurancc carric and policy numh are:
.r,ri-. QtLr.C g^r, n \v g u r.rt^rc- 4o
Policy c 90t A ' l'?oLL t
_l cer:ti& that in the pcrformance of thc work for which this pcrmit is issucd, I shall not ernploy any pcrson in any manner
so as to become subject to the workers' compcasation laws of California, and agrec that if I should bocome subject to thc
workers' compensation provisions of Sedion 3700 of the l-abor Codq I shall. forthwith comply with those provisions..
a
WARNING: Failure to secure workers'
civil fines up to one hundred thousand
comperuation coverage
dollars ($100,000), in
is unlawful. and subject an employer to crimind pauhies and
addition the of compensatioru damages as provided for the
Section 3076 of the tabor Code, intqest and attorney's
oeetL' J O' .2oJ-,1
I hereby affrrm undcr penalty of perjury that I am licensod 9 (commarcing with Section 7000) of Division 3
of the Business and Professions Code, and my liccnse is in full force and effect.
License Class: Liccnse
D$e: L' ,10' ,2d Ll
I hereby affrm under penalty of perjury that thcre
issued (Sec. 3097, Civ. C.).
agency for the pcrformance of the work for which this perrnil is
knder's Name:
I-endcr's Address:
APPLICANT DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Dernolition Permits-Asbestos Notif-rcation Fcderal Regulations (Title 40, Part6)
_Required Lrttcr of Notification
_l certi& that the federal rcgulations regarding asbestos rernoval are not applicable to this projcct.
_l certi& that I have read this application and state that the abovc with all City and County
and County to entcr upon theordinances and State laws rclating to building
above mentioned property for
Permitce name
and
o*e, L. 70 ' 2a >.)
UNDER GROUND -4 ;)
Waste & Vent tlNuTIl -nfoetD --
Water-Under floor ttt U\
Gas-Underfloor
Building Sewer
Area/Storm Drain
I nterceptor/ Cla rifier
TOP OUT
Waste & Vent I I, I ,a
Water Piping dl'iltlht aurh{gl 7V
Gas Pipinq 1-I
Roof Drain
Tub/Shower Test
Rouqh Water Heater
POOL/SPA
P-trap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool Heater/Gas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary SewerlCap
Back Flow Device
I I lt I ^{)
Rough Plumbing ill3ltAt b
Final Gas Test tl
Meter Release n It I .a
FINAL bltr ltt AWilh ruK
Notes, Remarks, Etc.tl
Applicant or Agent Signature:.
is correct. I