HomeMy WebLinkAbout40134384 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Mechanical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:40134384
Pin #: S4275al
Project Address: 2141 S Maple St
Assessor's Parcel: 403-154-1 1 Lot: 3
Unit:
Block: G
Bldg:
Tract: 538
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Phone
Maria Figueroa
2141 S MAPLE ST
Santa Ana, CA 927073221
(7141920-9403
lnter-City Energy Systems, I
I,I75 N DEL RIO PLACE
Ontario, CA 91764
15621 777-1142
01 1 1 6002 51 604
01116002 5160C
01 1 't 6002 51604
01116002 5777C
Fee Type Amount
Wall Heater/Floor Furna 68.14
General Plan Update 22.95
lssuance 57.20
Microfilm Records 3.91
Qty
1.00
1.00
1.00
'1.00
Fee
$68.14
$22.95
$57.20
$3.91
State Lic #: 587709
Lic Type: C-36, B, C-10, C-20, HIC
Bus. Lic #: 199981
Workers' Compensation lnsurance:Carrier: Zurich American lns Co
Policy #: WC03816460
Expires: 0710112020
Botch+:5394i - t/t6/?a20 ID: CCUELLAR0f f .ice: CTYH Trans*: 76 -- "i -#'zAr:ct*: Rei+: +nfS+;l"S+Rcpt*:tt2866826 - t/t6/2a20 i;i; 'Cli'
tnsnsoction Total tJU4.4?
Inter-Citc Energy Scsterisr Inc
R-3
VB
cMc 2019 Change out.
- i22.?3
_ $t25.34
_ t3.?1
$3A+. +2
Auth*: r.r25910
$152.20
$0.00
$152.20
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Wall Heater
Zuniga, Allissa
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
0111612020
Account#
Every permit issued shall become invalid unless fhe work on the site
authorized by such permit is commenced within 360 days after its
,ssuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 I 16002 51600
01 1 16002 51604
01116002 57770
$22.95
$12s.34
$3.91
lnspector MID#: 2020-157168
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE !D/S!G.COMMENTS oWNF]R BUII,I'T]R DI:I,CARA'IION
I hcrchy ill'firnr undcr pcnrlly ofpcrjury that I am cxcnrpt lionr thc (i)nlracktrs' Liccnsc Law li)r lhc Ii)lk)wing rcilson (Scc.7031.5
llu\inc'ss rM Prolcssiur (ixlc)r Any City (,r (:ouilly shich rcquircs a pcrnril lo con\ltucl. ahcr. impr{rvc. dcnt)li\h or rcpnir {Dy
stntcturc. pri()r to it\ is\uancc. also rcquircs thc xpplicilnt for such Jtrilril lo lilc a signcd \lrlcnrcnl lhil hc rrr shc is liccnscd pursurnl
lo thc provisions ol'lhc Coiltraclor'\ Liccnsctl Law (Chaplcr 9. Conuncncing wilh Scclion 7U)O of Divisir)tr 3 (,[ lhc Busincss ald
rpflicilntlirrapcrtrritsubjcclslhc apflicanlklrcivilpcnaltyoliloliltr)rclhanfivchundrcddollars(S5(X)1.
_1. as owrcr of thc prcpcny. or my cmplo)cs with wagcs as thcir slc comlrcnsalion. will do thc wott ard the snEtw is ml
intcnd€d oroffcrcdforsle(Se.?044.BusinessandProfcssionsCodc:ThcContractor'sLiccnkLxwdoesnotspplytoanowrcrof
thc prclrcrty who builds or impmres themn, md who dfts such work himsclf or hersclf or through his or hcr own employees.
provided thst such imprcwmnts rc rct intendci o offcrcd for gh. lf. howew. lhc tiliHing or ir{rrcrcEnt is mH within orc ltr
of @nphtion, thc Owner BuiHs will havc the budm of prcvin8 that he or she did ml buiH or itrq,revc thc pnlf,rty for thc purynrc of
slc).
_1. as owncr of thc prcpcny. am exclusivcly contractirg wilh liccnsed contructos to construcl the projctt (Scc. 7044, Business
ard PrcfssionCode:TheContrsctor'sLicenscLawdocsnotapplytoanowncrofpropcrtywhobuildsorimproveslhereon,
snd who @nlncls for such prcjcts with I Conmclo(s) liccn*d pursuani to lhc Conlraclor's Liccnse kw).
I am cxcnrnt unJcr Scctir)n-. B. & P.C. for lhis rcason.
l)illr ()litrcr
WORKERS' COMPT'NSATTON
DECLARATION
I hcrcby ulfirm undcr pcn{ll y of pcrjury onc of thc folhwing dcchralions:
_lhavcamlwill nuintainaCc(illcatcofConsnttoSclf-lnsurcfor*orkcrs'contlxnsnlk)n.as prolidcdtorbySeclknr3?00oflhc
Luhor Codc. tor thr' pcrforiluncc o f thc sork lor which lhc pcrmil is issucd./
\.havc anrJ will nHintain workcrs compcnsation insutuncc. as rcquircd by Scclion J?U) otthc tibor Codc. for lhc pcrformmc of
thc work for which this pcrmil is issucd. My workcrs'compcnsalion insurance cilricr and Jnlicy numbcr uc:
Policy
_l ceflify that in lhc performnce o[thc work for which (his pcrmit is issued. I shall not employ nny pcrson in any manmr
s as lo hccom subjcct to thc workcF' @mpensstion laws of Califomia. and agrcc thd if I should bccore subjcct to thc
workers' comlEnsation pmvisions of Scction 3700 of the tntnr Codc. I shdll. fonhwith comply with thos provisions..
WARNING: Failurc to sre workcrs'comFEnsation mvcmgc is unlawful. and shall subjet m cmJ,loycr to qiminrl pemltbs and
civil fines up to om hundrcd thousnd dollrxs ($100.000). in addition to thc cost of compcnsalion. damges as provided for thc
Section 3076 of thc Libor Codc. inlcresl and altorey's fccs.
LICFNSED CON'T'RACTOR
DICI4IBAII0N
I hcrcby allirm undcr pcnalty of pcrjury thal I an liccnscd undcr provision ofChnplcr 9 (connrrcncinS wilh Scclion 7(il)) of Division 3
ol thc lJuriocss and Pmfcssions Codc. and nry liceil\c is in lull lorcc ild ctfcct.
1 0LiccnscNunrxLr:
CONS'I'RT]C'tIoN LIJNl)INC ACT.JNCI'
I hcrcby tlfirm undcr lEnalty ol pcrjury that thcrc is s con$lruction lcnding ogcncy li)r lhe pcrfoilMncc of lhc pork lirr which this prnrit is
issucd {Scc. 3097. Civ. C.).
l-cndcr's Nurnc:
bndcr's Addrcss:
APPLTCANT ITECLARATION
I lrrchy rllirD undcr |x[!lly of pcrjury onc ol lhc folk)wing declilrations:
Dctrnliti()il Pcrmits-A\bcslos Nolilicalion Fcdcral Rcgulrtions ('l-illc 40. l'an6)
-Rcquircd
lxllcr of N(nilicali(nr
-l
cerlily that lhc fcderalrcgulations rcguding astEslos rcn$vtrlare not applicublc to this Projcct.
is cor(t. I agre lo comply with all City and Counly
atnvc mnlioncd pmlEny
Applicanl or Agcnt
Permitee nilm
lo
nill slalc lhill lhc
aulhoria reprcscnlutivcs ofthis City and lo utEn thc
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Ranqe
Other
Hood
Type I Hood
Tvpe ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
n
Rouqh Mech.,nWh)
FinalTest
Meter Release ln
FINAL 1/h/z | .-z zu r'-cn
Notes,Remarks,{C -(-"I .il/
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