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""i?f i. santa Fe virrage Drive <br />Sunflower Associates <br />OWNER PHONE <br />3315 Eairview Road <br />MAILING ADORESS <br />Costa Mesa <br />CITY STATE/ZIP <br />cA 92626 <br />Olnr-lulld.r Dodrnbn <br />I hereby allirm that I am oxempt trom the &ntreclo/s Lrconse Law for the lollowing raaon (S6c. <br />7031 5. Businds and Prolessrons Code. Af,y clly or counly which raquires a permit lo conslrucl. <br />altsr. improve, damoli3h, or repair any structure, prior to its issuance, 8ls rsquiro3 the applicsnt <br />lor sch permrl to lile I srgned statement thet he B licens€d puBuant lo tha provisions ot lhe <br />Conlractor's Lrconsa Law (Chapter 9 (commncrnO with Scciion 7qD) ol OivEim 3 ol lh€ <br />Busrness and Piol6sron3 Co{re) or that he is exempl th6r6lrom and the ba3B lq lh€ allogod <br />eremplDn. Any violstion o, Soclaon 7031.5 by any applacant lor a peimil subi6E the applicanl to <br />a civrl penalty ol not mora than tiv6 hund.6d dollsrs ($500): <br />E Sction 7044A l. as owner ot the properly. ormyemploysswilh wags as lhearsolecompen- <br />salion, will do lhe woit. end lh6 structuro is not lnl€ndod or olttrod lor sala <br />E S*tion 70448 l. es owner o, the prcpeny. am exclusively conlracting with licenssd <br />contracttrs to conslruct the prcliet. <br />Oale - Owner (Sig ) <br />Conlrrlon lrt. Only <br />EaqLe Pacific Ventures <br />CONTNACTOR PHONE <br />751-32?? <br />ff Residential E lndustrial E Commercial <br />5.00 <br />10.00 <br />NO.EACH TOTAL <br />each plumbing fixture/trap <br />Dental Unit or Medical Gases <br />15.00 <br />30.00 <br />5.00 <br />5.00 <br />5.00 <br />100.00 <br />1.00 <br />5.00 <br />5.00 <br />8.00 <br />10.00 <br />FIXTURES <br />SEWER <br />Rain Water Piping (buried) Ea. 100' <br />1st 100'+Conn. <br />Water Piping Ea. 100' <br />Ea. Add'l Conn. <br />Waler Heater - Electric or Gas <br />Ea. Add'l 100' or Fraclion <br />MISCELLANEOUS <br />Private Sewage Disp. System <br />Temporary Gas Service <br />Repair or Replace Gas Piping <br />Ea. Add'l Outlet <br />GAS SERVICE 1 to 4 Outlets <br />PIPING <br />Water Softner 4.00ADDRESS <br />P^O^ Rnx 'l'l?gA <br />Alt. or Repair of Drainage - Vent Piplng 10.00 <br />Costa lvlesa <br />CITY <br />cA 92627 <br />STATE/ZIP <br />La\ivn Sprinkler I 6.00 <br />Rain System - Per Drain 10.00 <br />lnd. Waste lnterceptor 8.00 <br />Pool Traps 5.00 <br />I hereby aflirm Ihst I am licens€d und€r th6 provisions ol Chspter 9. Oivision 3ot lho Business 8nd <br />Prol6sions Code. 8nd my license is io lull lorce and etlsct. <br />Date 9-26-89 conrracto.(Sis) # <br />Lrcense No.420651 0149109ct^r" C27 ---- crty Lrcense <br />3.00 <br />'10.00 <br />5.00 <br />Deck Drain System - Fer Drain <br />Repair/Alt. Drainage or Vent <br />Vacuum <br />1.00 <br />So.Lil ConDmdbn Dclrdlon <br />I h€reby alrirm lhst I hava a caniliete ol conseni to slt-rnsuro. or a @nili€la ol Worl(er's Com- <br />pemation lnsurance C8rtilied copy is liled with th€ City building inspection d6panmenl. <br />I cstrty that an the porrormanceollhe wo.k lorwhich this permil is issued, lshall mtomployany <br />person rn any manner s as lo bsome subiocl lo the worker's comp€n3eton Les ot <br />Calilornra <br />No0c. fo APPllcsl: <br />ll aher makrng thrs Cedrlrcale ol Exemptron. you should become sublml lo lhe Worker's Compen- <br />satron provrsrons ol lhe Labor Code. you musl lorlhwrlh comply wrlh such provrsrons or lhrs <br />permrl shall be demed revoked <br />CW <br />Oale 9-26-89 Applrcant (Sr9 )see <br />Oale <br />- <br />Applicsnr (Sig.) <br />Sli,", 4l lgO veriried By (sis ) <br />(minimum $35.00) <br />5.00 <br />10.00 <br />10.00 <br />Backflow Device 2" or Less <br />Over 2" <br />Subtotal <br />TOTAL PERMIT FEE <br />Fenalty Fee (when applicable) <br />lssuance Fee <br />Violation Fee <br />Plan Check (Adjustment) <br />Plan Check 65% ol subtotal <br />(50.00) <br />Date <br />(minimum 20.00) <br />Receipt No.Pc# <br />PERMIT NO.DATE 9-26-89 5 511 <br />6.O0 <br />25 - Cto <br />35.00r-10.00 <br />Erplra0o.! <br />Thit pormil shall erpire by limitation and beoms null and void it the work suthorizod by this <br />pe.mil is nol commsncod within 180 days lrom lh6 drlo ot this p€rmit or il work authorizsd by this <br />parmil is suspendod or obandoned at any tim allor lha wort is cmrnonced tor a period ol t80 <br />day3. A nry psmit shsll bo oblained firsl b€tore 3uch wort can be racommancod. <br />Aopfcrnl N.rdo.r <br />I cerlity that I hrva rsd thB appliotion snd slate lhet th€ ab@e inrormltim i! cffrsd. I egre lo <br />comply wilh all city ordimnB end stela |rws rolaling to building cmsluction, and horoby <br />aulhorized repraontrtion ol lhis cily to stff upon lh€ aboFmenlion€d propcrty tor inspoclion <br />purpos <br />Date 9-26=89 Applicanl or Agent (Sig.)see attached <br />BUILOING <br />P€RMIT No nC vEnlFrEo BY (sig )PERMIT ISSUEO 8Y (Sig )J /rtv5(ACCOUNT <br />'11-41 <br />oa' APPLICATTON AND <br />PLUMBING PERMIT <br />(TYPEWBITE OR PRINT IN INK) <br />CITY OF SANTA ANA <br />206 W. 4th Street <br />667-2738 NAPPLICANT FILL IN AREA BELOW <br />(Dg-Izo <br />oo <br />f, <br />m <br />U)a <br />(,{ <br />8 <br />CN <br />U)g, <br />5ct <br />0, <br />rEo <br />P. <br />Hts <br />a, <br />rJoo <br />onP. <br />o <br />_l <br />Orstflbulron 1 lnspeclor Copy 2 Fne Copy 3 Frnance Copy 4. Applrcaol Copy <br />CS-61 I <br />) <br />ffi <br />-\- <br />\ <br />.{ater Service Ea. 100' -/ <br />M