HomeMy WebLinkAbout40115532 - Permit (3)20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical Permit#:4O1{5532City of Santa Ana
Permit Counter: (714) 647-5800
Project Address: 4 E Hutton Center Dr
Assessor's Parcel: 41 1-092-30 Lot: NA
I nspection Requests: (7 1 4) 667 -27 38
suite: 1000 Bldg:
Block: NA Tract: NA
lnspector's Section: (7 1 4) 647 -5853
Suite Range:Address Range
Historic: No Zoning:SD76
Owner:
Address:
Phone:
Tenant Name
Contractor:
Address:
Phone:
Legacy Partners
4 E Hutton Center Dr
Santa Ana, CA 92707
(71415454976
The Credit Exchange
GTI Commercial Contract
25801 Obrero #5
Mission Viejo, CA 92691
(949) 583-9300
Fee Type
Alter Vent Sys
Repair Vent Sys
lssuance
Amount
16.85
16.85
34.00
Qty
1.00
1.00
1.00
Fee
$16.85
$16.85
$34.00
$67.70
$0.00
$67.70
State Lic #: 480519
Lic Type: B, A
Bus. Lic #: 0169201
Workers' Compensation lnsurance:Carrier: State Fund
Policy #: I 381076-2005
Expires: 1210112007
Botchi:2796 - 03/22/07 ID: I!60NZALEZ0ffice: (:TYH Transi! 31 3 of 6Accti: Refi: {0115532
Rcpt+:0(r1389113 - 3/22/2il07 1l:22 An
Tnsnsaction Totol 1Lt376.64PllB Controctor
GTI Conrerciol Controctors
Ilechnn icol
Check 51rJ6
t67,7Lt
tIr376.t54
Building Use:
Job Type:
Nature of Work:
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Commercial
Tenant lmprovement
T!
Verduzco , Viotet\N
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Notes
Fee Total:
Paid to Date:
Balance Due:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B
I-F.R. SPK
cMc 2001
05t22t2007
lc lsqrqbBuilding Permit #:
This permit shall expire by limitation and become null and void if the wo* authoized by this permit
is not commenced within 180 days from the date of this permi| or if the wotu authoized by this
permit is suspended or abandoned at any time after the wofu is commenced for a peiod of 180 days.
Before such work can be recommenced, a new permit shall be first obtained to do so.
Account#: 011-01-5915 lnspector MID#: 2007-75807
M ECHANICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OMs-Build.r D@lrrstion - i
I hcrcby rffm unda pmlty of psjury thlt I m acmpt form thc Coilntron'Liee lrw for tho following rootr (re.7031.5 Buinot
Ed Profsrion Codc): Any City or County which rcguils r pcrmit to oEtruct, rltcr, improvq dcmlirh or rcprir uy tlIuctuo, prior to itr
isrune, also rcquir* thc rpplient for ruch pmit to fila r ligncd s6tcmcnt thlt hc or rhc ir li€Ncd punwt to thc proviriou of the
Contnctor't Lieruad hw (Chapta 9, Comcncing wirh Swtion 7000 of Divirion 3 of thc Buinq ud Profariou Codc) or tlrt hc ot
rhc i! cxcmpt thoro&om rnd thc bs!i! for thc sllcgcd fiomption ,Any violation of Scction 703 1.5 by uy rppliunt for r pcmir tubj€cu tho
applioil b r civil pculty of not morc than fivc hudrod dollm (S500).
_I, N oucr of thc propcrty, or my omploye with ugo u thcir lolc @mpcMtioq will do thc work ud lhc rtruduc i! oot itrtodcd
or offcrcd for salc ( Se.7044, Buin63 [d Profqrioil Codcr Thc Contruclor'r Lieuc hw do6 not rpply to u ow of tho propdty
who builds or improvs thcr@r\ ud who do6 ruch work himrclf or hdlclf or through hir or hc om cmploya, providod thet ruch
improvcmcnts uc not inrandcd or ofrcrcd for slc. I{, howcvcr, thc building or improvcmcnt ii told within onc yd of@mplotior\ thc
Omcr-Builda will havc thc burdca ofproving tlut ha or shc not build or improvc for thc purporc of rrlc).
_I, u omor of thc proparty, Em qcluivcly @ntr8cting with liccrood ontrsctorr to srotruct thc proj*t ( Sw. 7044, Buinqr ud
Profsion Codq Thc Contrraor'r Liee bw doB not rpply to u oma of propaty who buildr or improva thq@n , ud who
@ntrsct! fo, lucfi projcd! with r Contrrclor(t) li@od puEBnt !o thc Conuactor't Li@Nc lrw.).
_l m acmp uda Sc.tion
-8.
& P.C. for thir ruon.
Datc:
WON,KERS COMPENSATION DECI.{R TION
I hocby rfrirm undcr pculty of pcrjury ono of tho following dchntiou:
_l hrvc ud will mitrtrin r Cclifiot of Corent to Sclf-Iuuc for mrksr' ompcBtio[ s providcd for by S.ctiqo 3700 of th6
l,bor Codo, for thc pcrforrucc of iho work for wtioh lha pcmit ir irrucd.
_I havo mrl will roitrtrh worktrr' smpcution iilurucc, u roquirod by Soction 3700 of th6 Lbor Codg for tho pcfot]ru* of thc
work for which thir pcmir ir iuucd. My workm'iruwcc wia and policy trumbd srcl
Policy €V lz- t-rfl
(This scaion nccd not bc if thc pamit is for Onc hun&cd dolbs (t100) or lu)
_l ccnify $st in thc pcrformne of thc work for which thir pcrmit ir issucd, I sh8ll not cmploy any pmon in rny mMcr so u !o
bcemc subjrct to thc rcrk6 ' @mp3nstion hwr of Crlifornirn rnd rgle thst if I should bc@mc rubjcct to tho worlcr'
compcnBtion provilionr ofS6'tion 3700 ofthc hbor Codg I shrll,provirions.
-1fl--01
WARNINGT Frilurc to rroc workan' ompcMtion ovcngc il ud rhall rubjet u mploys to riniul peuhis rnd civil
@mpcnutior\ dsrogs s providcd for lhc Setion 3076 ofIino up to onc hundrcd thowd dolbo (1100,000),in sddition to thc colr
thc hbor Codc, intsct Etrd rnomay't f6.
W
I hcreby rfrirm undcr poulty of psjuy t}l!t I m lierocd unda provirion of Chapta 9 (@mcnoing with S6tion 7000) of Division 3 of
thc Buinc$ rnd Profqrioro Codq ud my liccuc ir in full forc ud cfrct.
Liccroc Liccnrc Numbcr
q
W
I h6cby amrm und€r pcuhy of pcrjury tlil rhcrc is s @Ntruction lcnding rgcncy for thc pcrforunrc of thc work for which thit p6mil ir
iruod (Se. 3097, Civ. C.).
Lcndq'r Nrmc:
Lcndcr'r AC&sr:
APPLICANTIS DECLARATION
Demolirion Pcmit!-fubcltor Notifi{tion Fcdml Rcgulrtiou (Iitlc 40, Psfi 6)
_ Rcquircd lrn6 of Notifiotion
I @friry rhrt thc fcdml ragulrtiou rqgsdiag ubotos rcmnl uc not rppliqblc ro thit prcjet.
_ I eni& thlt I hrvc rqd thit rppliotion ed ttrE th8! thc lbovc informtion ir @rc(r I rgre to comply with rll City rtrd County
ordioncq rnd Stetc lrw rslrting to buildhg ouEucrior\ rnd
abovc mcntioncd
Appli6nt or rgcnt
Pcrmittcc mmo
ruthorizc rcprsctrtrtivo ofthL City rod County !o otq upotr thc
Appliances
Metal Fire Place
Evap Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar \
Rough Mech.L't?, I )/Y1/1,/
FinalTest
Meter Release
FINAL (,/?-l )W
Forms\Mechanic€l"lnspsctor R€cord.doc