HomeMy WebLinkAboutOC_378566 - PermitsREGIONALGFFICE APPLICATION FORrPLUMBIli.
t 26052 GETTY DRIVE y .a COUNTY CiFE
:®W4NP 0. BOX 4048 S ,� I;
L'AGUNA NIGUJEL CA 926?! +T' , x 400 CIVIC.CENTER DRIVE EST
714831-26101 EMA REGULATION (/S', v SANTA ANA,. CA 92702
- {% .714-834-2626 -
ADDR SS 2^891Y'0.�l 0?IMA-*tl7-.TRACT
G % >:.. • ,.LOT NO. —109
AREA IVQ.LlI VAr AT
CONTRACTOR
NEAREST
CROSS STREET Q O (J d'
If
ADDRESS 60 01116/101
' OWNER Tei hexwS7%�. GO �i
TEL 7•
CITY NO.
PROPOSED 'PRESS T
USE
CERTIFICATI FOR REGULATIONPERMIT-
`. Contraciorg/�7O.
I cendy that the following Conn. Uc No �� CL— and Classdmation.
is in full force and effect Workers Campenaef�
Certdmate on file nM1 by Expiration date
`� "� i is O a
-''b'p`fi-+"'--'R'—
PERMIT FEES
RES: $.75 per $7,000 of valuation
_,. or fraction thereof. - FEE
:other A pecan
h
I hereby certify I.am exempt from Sec 7031.5 of the Business and Professional Corte,.
Drv. 3, Chap. 9j Contractors License Lew and under the following section
Owner (Sect 7044) or
OMinor Work under $100 (Sect 7048) or
ElEmployee working for wages only (Sect 7053), or
00ther: r.
Vt F�=L"DATION: $ D/Q @
/ I
# _ -
NO - - TYPE OF FIXT' EOR ITEM FEE
-WATERCLOSET (TOILET)
' '�1
Certification of Exemption from Sect 3800 of the California Labor Code, Article 3, '
construction, Permit
L The permit is for One Hundred Dollars ($100) or less
❑ I certify that in the performance of the work far which the permit is issued l shall not
1 employ any person in any manner so as to became subject to the Workers
:Compensation laws of California. `
I(tafter making such certification the applicant for this permit should became subject to
the Worker's Compensation provisions of the Labor Code, the applicant shall forthwith
comply with the provisions of Sect 3700 or this permit shall be deemed revoked.
I hereby acknowledge and state that the intonation l have provided is:cprrectboth crime
permit and this certificate and agreeto complywrth all County Ordinances and State laws -
reqpkan building construction / l
BATHTUB -
,SHOWERSTALL
YLAVATORY. WASH BASIN )
KITCHEN SINK ARBAGE DISPOSAL Er""'-
LAUNDRY. TRAY [I AUTO WASH. MACHqRr
DISHWASHER I
'-Date.
SERVICE SINK
(Applicants Sign j
"FLOOR SINK
NSPECT N RECORD
., .FLOOR DRAIN
URINAL
DRINKING FOUNTAIN
APPROVALS `DATE Insgiectgr,'s Signature
' RAP ❑INTERCEPTOR ❑�.
GROUND WORK SOIL ONLY. p Si� ,,�
DRAIN
GROUND WORK WITH ,.
WATERPIPE❑ GASPIPE ❑
74EATER- .
.ROUGH PLUMBINGttAf bA,;!' .+� a+
SOFTENER
'GAS PIPING TO
PRINKLERS AES.❑.COMM:❑
WATER HEATER
TEM LPG ❑:
NAT.
M
SEPTIG TANKOUTLETS
FIRE SPFL SYSTEM -- -
SEEPAGE PIT
SEWER (VALUATION)
SEWER 7-9—gQ
TANK -
GAS T�STGE
PIT(S) '
SPRINKLERS SYSTEM
- LEACHING FIELD.- -
FINAL-
,- PERMIT ISSUANCE. 3 6W
UTILITY,LKO NOTIFIED
BUILDIN M$N Com..
J 49
TOTAL FEE ya
O
QED' PLANS
.CHECKED BY:
VERIFIED BY: VAWbATION p . , _ ';3 T �"F � ger I I "Y-
'Fye-tl .A ,��.k; `
` yp
th r' P•-! IX P -f
37 5 � L� s
CASHIER DATE PERMIT NO. _ _ PERMIT FEE CODE PLAN CHECK TOTAL r