HomeMy WebLinkAbout40134521 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical Permit #z 4fl134521
-.Pin #: 6{46{Permit Counter: (714)647-5800 lnspection Requests. (714)667-2738 lnspector Section: (714)647-5853
Proiect Addressi '1231E Dver Rd unit:235 Bldg:
AssessolsParcel: 411-131-36 Lot: NA Block: NA Tract: NA
AddressRange: 1231-1241
Historic: No
Suite Range:
Zoning: SD63
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Building Use:
Job Type:
Nature of Work:
Greenlaw
1261 E Dyer #'100
lrvine, CA 92612
(949) 331-1316
Smiths lnterconnect
Crew Builders lnc
6191 Cornerstone #101
San Diego, CA92121
(858) 587-0900
Commercial
Tenant lmprovement
TI
01 1 16002 51604
01't16002 51604
01 1 16002 51600
01 I 16002 51604
01116002 57770
Fee Type
Compressor
Alter Vent Sys
General Plan Update
lssuance
Microfilm Records
Amount
93.73
45.33
22.95
57.20
3.91
Qty
1.00
1.00
1.00
1.00
1.00
Fee
$93.73
$4s.33
$22.95
$57.20
$3.91
State Lic #: 753428
Lic Type: B
Bus. Lic #: 332227
Workers' Compensation lnsurance:Carrier: Zurich American lns Co
Policy #: WtC55137310
Expires: 1010'112020
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B
V B, SPK
cMc 2019 Notes: Mechanical for-lnterior Tl to include creating (3) new
offices and one new conference room.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Chavez, Dave
Subject to Field:
Buirdins Permit #: 101103261
04t2712020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01'r16002 51604
01116002 57770
$22.9s
$196.26
$3.91
Fee Total:
Paid to Date:
Balance Due:
$223.12
$0.00
$223.12
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 3@ days after its
issuance, or if the work authorized on the site by such permit rs suspended
or abandoned for a period of 360 days after the time the work is
commenced.
np4f MID#: 2020-158006
IUItrUrlAIYILAL.INDl"trU I U}( KEUL|KU vt-2-
APPROVALS DATE ID/S!G.COMMENTS
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation 9 lat '7,/?-ff 5-.
Smoke Detectors lnstalled lv
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 tl
Above T-Bar 5 At 7L Dt.tflO t a+Xa
I v
Rough Mech.
FinalTest
Meter Release IZ-
FINAL *67
Notes, Remarks, Etc.U
()\\ \t R lll_rt.lrl.R t)t..1.(,\R..\ I l()N
I hcrcby atlurn unda luralty ofptrlury tha I an cxqnpt fiom thc ('onus(rors' Licmre La\y fbr lhc tolloving reurn (Srr 7011.5
llusind and Profcssion Codc): Any City or County uhich rcquirs a gnmit lo congrucl. rlt6. irnprovr. d(rJlBh oi Ei,ir m!
slrucluc. Fbt lo its issucc. also rcquir6 lho applicail lbr such pdrnit ro filc ! sitnsd slalqMt thu hc or shc s liccud prrsuau
to lhc proyisioN of thc Conlractd's Liccnsed LaN, (('hapler 9. (-ornmcncing wilh S6lDn 7000 of Division .l oftlrc Busios ud
PlofctioruCodclo.lhathcorstrciscxcmptlhscfronrmdthcllosisforrhcallcgqlcremgxion. AoyviolationofsedionT0.ll.Shynny
applicantforapennitsubJcrlsthe applicsnltoacivilpcMhyofnorrmElhmlivchundraldollars($500).
-1.
6 owrcr of thc prcpny. or my cnrploys wilh weg6 s lheir $lc omposstion, wi[ do thc wo* ed thc selur b mt
inlsdcd orofleredforsale(Sc.7044.Businwmdl'rofruionsCodc:Thc('ontractor'sLi{rreLarvdosmtarplytoilno\vnsof
thc p,apdly who builG or imfmvq thsqn. ud who doq srch rvork hinrclf or ho$ll or throu!,h his or hcr om enrplolcs,
ptovidcd that luch improvq&a(s N rol iilmdcd or ofibrd fq sle. lf, horqq, tlr hrikling or tnlnrvorcnt ir rcld within one ya.
trfcompktion. thc Owns Builds rvill have thc hrdor ofproving tha he or she did mt build or irqrove rhe popa.ry for lhc purlxrs of
slc)
-1.
6olvB ofthe lropqty. rn cxcluively contrrcting with licoscd codrxtots to coBnd rhc frojd (Ss. 7044. &dt6
md PtofeixCodc: IheContractor'sLiccnELarvd6notapplyloeownqofptopfiywhobuildsorimprovetheoo.
aod who sntrcrs fer Juch projcrs wirh a Contrero(s) ltwd puEuen to lhc ContEc.tq's LiccN Li* ).
_l ill e\qopt uodcr Sqtion_. ll. & P C. for lhis r6)n.
Date: Orns:
woRlil:Rs, coMPINSA iloN
DE(]l.lRATION
I hcrcby alfirrn untler pcnalty ofpcjurl onu ofthe following d$leationsl
-l
havc od will ruintEin o CalifNltc of Conscnl to Sclf-lNurc for *orkerr' conrpenstrtiou, rs ps\ idc,J for by Scction -l700 o f tlrc
Labor Code. for lhc pqftrnnmcc ofthc wo* for rvhich the pqrnii b ssued.
f,t havc and u ill mainlai[ workc,s' compeNdion iNrarEe. 6 requircd b] Setion -1700 of the Labor ('odc, for the pcrlbrnucc of
thc rcrk for which this Brintr G issl. My workas compcMion imurmc canio and policy nurnbct ac:
Zurich American
tblicy wcss1373106 10t01t2020
-l
sqlify lhal in the Jxrfornrance of thc work for rvhich lhis permit is srucd. I chall not cnrploy auy Jxrson in any rnanncr
so o to &roorc subjwl to lhc rvorkcs' cornlrcnqtion larvs of Calilomia, ud aUN lhar if | lhould bccotne subjst ro the
wortcrs'conr;reoutionptovisionsofSccliotrlT00oflhcLsbor(lodc. lshall.forthwithcornplywithtlro*provisiom..
WARNINGi Failurc to wuc workcrs'cornlsrstion cove&gc is unlawful. atrd shBll suhilrt an crnploycr to rirnin{l tmdlris imd
cNil liil6 up lo onc huodrcd thousdrd dolles ($1m.06r0). in ddition to thr co$ of cornpcnmtioo, donogcs as prrrvidcd lirr thc
S61Dn 1076 oflhe kbor Codd. itrtsBl aod snorruy's fues.t4t27t2020Christine Van
LI('ENSED CONTIIACTOR
DfI'IAILATION
I hauby alfirm unda pcnoltyof lujury tha I m licerccd unde polision of ChaFq 9 (comruncing wilh Sslion 7000) of l)ivision 3
of the Buruo ard Pmfsioru Codc. ed my licw is in full forcc and cffqt.
B 753428
r)rrr 4127 12020 (.(,ilrr:r(,or Crew Builders lnc
,,.,,. 412712020\-
CONSTRUCNON I ENDIN(:,{GEN(Y
I hocby affrm uodcr pu'ulty ol pqjury thal th6c s a co6ttuLlion Loding agmcy ftrr thc pafoll@cc of thc wrl for shich thi, fEnli b
iryed (Scc. -1097, Civ C.).
Lcrxirr's Nrnle
l-cnder's Adries:
,APPT.ICAN'T DI'CI-ARATION
I hotbyaffmuodo penalty of pcjury onc of thr following dcluaions:
Dstrolition Permit&Asb6tos Norificatiou l'edsal RqgulalioM (Tillc 40, Part6)
-Requircd
t.dts of Nolification
X I .otify,h", ,t
"
f",ltral r$guhltnts rcSaduu sb€slos rcmovsl&s fin opplicrblc ro this projd.
X t coriry rh8r I havc red thb appltarion ud statc that thc above informabn b cffi. I rgle ro comply wiih ,ll City snd Counry
ordwmG ud Statc tiws relding lo building condMtion. uxl lvcby autlrrrizc r.p.ffitdiv6 of this Chy ard County lo at6 trpon rh.
ahovc nmlioocd propcny for iroperion purF)s6.
Crr.rt4fir,\.(, Va*wAppliciltr or AgcnI Signaturci
p.*ire ildnc (lx.iil) _ehfisti nellan-
Jzl\nrn-
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('ris