HomeMy WebLinkAbout40113465 - Permit (3)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738
Mechanical Permit#:4O1{3465
lnspector's Section: (714) 647-5853 ks
Project Address: 4 E Hutton Center Dr
Assessor's Parcel: 41 1-092-30 Lot:NA
suite: 1000
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning:C2
Owner:
Address:
Contractor:
Address:
Phone:
Phone:
Tenant Name: The Credit Exchange
Triple Net Properties, LLC
1551 N Tustin Ave, Ste 200
Santa Ana, CA 92705
Gene Tribolet
25801 Obrero #5
Mission Viejo, CA 92691
(s49) s83-9300
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Commercial
Tenant lmprovement
TI
Serna, Janet
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Fee Type
Vav Box
Air Handling
lssuance
Notes
Fee Total:
Paid to Date:
Balance Due:
Amount
16.00
16.00
32.50
Qty
3.00
1.00
1.00
Fee
$48.00
$16.00
$32.50
$96.50
$0.00
$96.50
State Lic #: 480519
Lic Type: B, A
Bus. Lic #: 0169201
Workers' Compensation lnsurance:Carrier: State Fund
Policy #: 1381 026
Expires: 1210112005
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B
I-F.R. SPK
cMc 2001
11t02t2005
\ct 0tba5Building Permit
This permit shall expire by limitation and become null and void if the wotu authoized by this permit
is not commenced within 180 days from the date of this permit, or if the wofu authoized by this
permit is suspended or abandoned at any time after the woft 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 #: 01 1 -01 -591 5 lnspector MID#: 2005-65410
.ffi
EE.ti1tr\1/ \r
I hmby affim uda parlty of pcjury $11 rm ampt fm thc Conr8ctoB' Licmsc Law for thc following rcoon (scc.703l.5 Bain6s
od Prcfdsim Codr): Any City 6 Coutrty *hloh r€quiG 8 pqmil to cmtsucq dtcr, improvc, dmolish or rcpair my sEuctrc, prior ro ia
issMcc, dlo rcquis thc applimt fc ruch pa'mit to filc a sigrcd ltatmmi thct hc or lhc is licoscd pursumt to thc provirim of thc
Cmtreltr's Licmcd Lsw (Chapta 9, Concaciry widr Scstim 7000 of Dvision 3 of thc Buines md Profesioro Codc) or that hc or
shc k cxmpt $mfrm md thc bsic for thc rlc8cd cxmptim .Any violation of Scction 703 L 5 by my applicmt fo a pmit subjccts thc
applicmt to a civil pcrdty of nd mqr rhd fivc hu&cd clollm (3500).
_I,u omoofthcpropcrty,smyaryloyawithwagcurhcirsolccompcasuion,will dothcworkudthcsmctucirnotintodcd
o offocd fr salc ( Scc,7044, Buin* ud Profsiom Codc: Ihc Contaclor's Limc Lsw d€ not apply to a omcr of thc propcrty
who buildr orimpove thm, mdwho docr such wok hiruclf orhmclf o through his c hcr own cmployco, povidcd that such
improvmar e not intadcd o offacd fc ralc. If, hovcva, thc building or imprcvmmt is sold within onc ycu of completion, rhc
Ownu-Builda will havc thc buda ofproving $8t hc tr shc not build orimprovc for thc purposc of selc).
_I, u oma of thc prcpcrty, m acluivcly mtrrcting with licrucd mtrrctm to consmct thc prcjcct ( Scc. 7044, B6in6s ud
Prcfssion Codc: Thc Confasttr'! Licdc Liw dc trot spply to & M6 of propqty who builds o improvs thcrcon , md who
contreB for such projccB with I C6rerd(!) li@cd pmumt to thc ConErctor's Licmc Law.).
_lmqmpudaS6tim & P.C. for thh rcEon.
WORKERS COMPENSATION DECLARATTON
I hacby affim uda pcnalty of pcrjury onc of thc followinS dcclmtions:
_l hsvc ud will maintain 8 Ccatifics& of Cmot to SclfJnsuc for workm' compcosation, 6 providcd for by Scction 3700 of the
Labor Codc, for thc pcrfmme of thc work for which thc pmit is issucd
Z:[havc md will maintain wqkm' rcmpcasatior idsufficc, c rcquircd by Scctiof, 37Oo of the Labor Codc, for thc pcrfommcc of thc
work for which this pamit is issucd. My wortm' compcnsation insuocc cmic md policy numbcr ac:
Policy
(This sccti@ nccd not bc complacd if thc pcmit fu for Onc hudrcd dollm ($ 100) or las)
_l ccniry $at in thc pqfmcc of thc wd* for vhich this pcmit
bcmc subjcct to thc wortm ' compcnsatim lcws of Califmiq ud
is isud I chall not cmploy in my mmna so u to
agrcc that ifl should the worken
comPquation of Setion 3700 ofthc Labq Codc, I futhwith comply witlr
WARITIING: Failuc to sccuc workm'
finc up to onc hundrcd thowd dollm
mpcnsation
($loo,0oo),in
thc Lsbo Codc, iotqcat ud anmcy's fcs.
LICENSED CONTRACTORS DECLARATION
I hmby affim uda pcoslty of pqjury that I m limcd unda prcvision of Chrptq 9 (comcncing witl Scction 7000) of Division 3 of
thc Buines md Prcfesim Codc, ad my licanc is in firll fqcc md cffct.
Ddc: Omd: _
Licosc Clus:_ Licmsc
I hocby affim uda pcnalty ofpqjury &at thft
issucd (Scc. 3097, Civ. C.).
Lodq's Nmc:
aSocy pafmocc of thc work for which thir pcmit is
Lmds's Addr6sl
APPLICANT'S DECLARATION
Dmolition Pmia-Asbcsts Notificstiq Fcdcral Rcgulations (Titlc 40, Pd 6)
_ Rcquircd Lcncr ofNotification
_l ccrtifr that thc fcdcral rcgularions rcguding ubetos rmoval ac not applicablc to this projcct.
-_ I cmiry that I havc rcad this applicatim md strE lhat thc abovc infom8tion is corcct. I agrcc to comply
ordinilcs od Stal. Laws rcluing to building construction, md ha€by authorizc rcprcsotativs of this City
with all City ud Counry
sbovc matimcd propcrty for
md County to 6id upon tlc
purpGcs.
Applicet tr
Pmincc nmc
APPROVALS DATE !D/StG.COMMENTS
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.h, [).t't-
FinalTest
Meter Release
htrFINALQ-/?a//rAr,
MEGHANICAL.I NSPECTOR RECORD
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