HomeMy WebLinkAbout30143143 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Plumbing
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 30143143
Project Address: 2033 N Mantle St
Assessor's Parcel: 396-01 1-20 Lot: 1 15
Unit:
Block: NA
Bldg:
Tract: 3902
Address Range:
Historic: No
Pin #:
Suite Range:
Zoning: Ri
Owner:
Address.
Phone
Tenant Name:
Contractor:
Address:
Phone
Mary Espinosa
2033 N Mantle Ln
Santa Ana, CA 927057614
(7141 450-0499
Alan Smith Pools
227 West Carlton Ave
Orange, CA 92867
(208) 353-1 082
01 1 16002 51602
01 1 16002 51602
01 1 16002 51600
01 1 16002 51602
01 1 16002 57770
Fee Type
Pool Heater
Pool Piping
General Plan Update
lssuance
Microfilm Records
Amount
78.27
47.95
23.79
s9.30
4.05
Qty
100
1 .00
100
1.00
100
Fee
$78.27
$47.95
$23 79
$s9 30
$4.05
I
State Lic #: 571196
Lic Type: C-53, C-27, C-51
Bus. Lic #: 107
Workers' Compensation I nsurance:Carrier: Arch lns Co
Policy #: ZAWC 1254540
Expires: 0410112022
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Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Alteration
Pool repair
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3, U
VB
cPc 2019
reroJ
I l6t-tt.
05/1 212021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:Replace existing after pool replaster
Fee Total:
Paid to Date:
Balance Due:
Amsden, Julie
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 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
$1 8s 52
$4.05
$2 1 3.36
$0.00
$213.36
Inspector MtD#' 2021-166109
PLUM B! NG.I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEI'ARATION
I h6cby rffm und6 pcn8hy of pqjury thd I m qcmpt from thc Contractos' Licw L:w for thc fullowiq mn (Se.7031.5
Buines and Prcfeion Codc): Atry City or Courily which rcquic a ponit to oostrucl, altq, imgrcvc doolish or cpair ay
structurcpriortoirs issuacc.alsorcquisthceplimtforsuchpcmittofilcasigncdstalmt thrrhcorCEblicoscd plmal
to fic prcvisioN of thc Coohrctor's Licoscd Lrw (Chspt6 9, Commhg with Sction 7000 of Division 3 of thc BuitB md
Prcf*iom Codc) or that hc tr slrc is qmpt thc&om 8nd tlrc bsis for thc dlcgcd aopion. Atry violatioo of Sction 7031.5 by ey
applicut for a pannit subjets thc appti@t to 8 civil pculty of not morc tlur fivc hurdrcd dollm ($500).
-[.
as owner of thc propcrty, or my emplo]ces with wages as their sole compcnsation, will do tttc work and thc stnrcturc is not
intendcd or offcrd for sale (Se.7044, Business and Profesions Code: Thc Contractor's Liccnsc l-aw does not apply to an owner of
the propcrty who btrilds or improve thcron, and who does such work himself or hersclf or through his or her own employeca,
providcd that such improvcrnents are not intcnded oroffercd for sale. I[ howwer, the building or improvement is rcld within one ],Ear
of completion, the Orvner Buildcr will have the hrden of pnoving tha he or shc did not build or improvc ttrc propcrty for the purposc of
sale).
-1,
as owncr of the propcrty, arn cxclusively contracting with licarsed contracton to construct thc projocr (Soc. 7044, Brsiness
and hof€ssion Code: Thc Contraclor's License Law docs not apply to an owncr of property who builds or improve thcreon"
and who contracr for such trojec'ts with a Contracto(s) licerccd punruant to the Contractor's Licensc law).
-I
am cxempt under Section-, B. & P.C. for this reason.
Owner:
WORIGRS' COM'ENSAT'ON
DT'.cllUIATION
I hacby allim undo pcnaltyof po'juryonc ofthc following delmtioro:
-l
havc ild will msintah I Cqtificatc of ColMt to Sclf-lNurc for wrko' ompcruation, I providcd for by Setion 3700 of thc
bbor Codc, for thc psfomcc of thc rcrk for vtich thc ponit is issucd,
{ffh"u" "nd
*ilt ,aintain workm' compcruation ircurecc, I rcquircd by Sction 3700 of thc Libor Codc, for thc pqfomecc of
tlic work for which this pemit is isucd. My workc' compcnsaion imurucc cui6 ed lDlicy numbs sc:u.
Policy ,.
fr"*i$ that in the performance of the work for which this permit is issued. I shall not ernploy any pemon in any manner
so as to become subject to the worters' comp€osation laws of California, and agree that if I strould become subject to the
workcrs' compauation provisions of Section 3700 of the l-abor Codq I shall, forthwith comply with thosc provisions..
I-
I
WARNING: Failurc to sccure workers'compensation covcragc is unlawful, and shall subject an cmploycr to criminal penaltic and
civil fines up to onc hundrcd thousand dollars ($100,000), in addition to the cost of compcnsation, damagcs as provided for the
Section 3076 of the Labor Code, interest and attorn€y's fc6.
Dx", tlPlTFlA App*cenr: &*r* kurr*n
-t
1 I LICENSED CONTRACTOR
DTfIARATION
I hereby affirm under pcnalty of perjury that I am liccnsod undcr provision of Chapto 9 (commcncing with Sectbn 7000) of Division 3
of thc Busincss and Profssioru Codc, and my liccnse is in fuU force and effcct.
License cbt Numbcr:
Dare: 6ln lUlA ll
rl
W
I hwby affm undo p68lty of pgjury that thcc is a @Btruclion lcnditrg rSacy for th€ pqfomce of thc work for which thb pqmit is
isucd (Se. 3097, Civ. C.).
Lender's Narne:
l,cndcr's Ad&ess:
APPLICANT DECTI\RATION
I hct*Draffirnr undcr pcnalty of ffiury one of the following doclarations:
Dernolition Pcrmits-Asbestos Notification Foderal Regulations (Title 40, Part6)
-Requirod
lcttcr of Notification
-l
certi& that the fedcral regulations regarding asbestos removal are not applicable to this projed.
and state that the above infonnation is correct. I agree to comply with all City and County
and hereby authorize rcpresantatives of this City and County to enter upon the
above mentioned property for inspection
Applicant or Agent
Permitee name
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ CIa rifier
TOP OUT
Waste & Vent
Water Pipinq
Gas Piping
Roof Drain
Tub/Shower Test
Rough Water Heater
POOL/SPA n
P-trap/Drain Line 1-t,l-v.\,a-€
Main Drain/Pool Pipinq 'l- 14- lt ,/) trt\Y
Fill Line/Back Flow
Pool Heater/Gas Line
tr*)tu-lrr.tlN0 ?-t{-Ll D^J442
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewerl0ap
Back Flow Device
L1 Baq -zt t F -ri" 4t
Rough Plumbing 1-l4.lt b?o {r.
Final Gas Test
Meter Release
FINAL Q-19.?t E2-t {r-
Notes, Remarks, Etc.
Dete:_
Exoires:4l ie)2?
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