HomeMy WebLinkAbout40132441 - Permit (2)City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Mec han ical Permit #: 4f)132441
Pin #: 94949
Proiect Address: 4018 W Lehnhardt Ave
Assessor'sParcel: 108-722-25 Lot: 25
Bldg:
Tract 8924
Address Range:
Historic: No
Suite Range:
Zoning: Rl
E
Owner:
Address:
Contractor
Address:
Fee
$126.90
$91.s6
$32.30
$22.08
$55.04
Mimosa Diep & Tien Nguyen
4018 W Lehnhardt Ave
Santa Ana, CA 927042219
(7'r4) 785-8301
Owner"Builder
Fee Type Amount
Furnace/CompCombo'126.90
Bathroom Fan 30.52
Range Fan 32.30
General Plan Update 22.08
lssuance 55.04
Qty
1 .00
3.00
'1 .00
1 .00
1 .00
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Planning Conditions: A,/C in rear yard.
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Fregoso, Vince
Brodowski, Teri
10196323
Occupancy:
Constr Type:
Code:
R-3, U
VB
cMc 2016
Date:
Date:
Date:
08/08/2018 Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
08/08/2018
Account#
Every permit issued sha become invalid unless the wo* on the site
authoized by such pemit is commenced within180 days aftot its
issuance, or il tha wotk authoized on the site by such pemit is suspended
or abandoned for a peiod o1180 days aftet the time the wotu is
MID#: 2018-143123
01 I 16002 51600
01 1 '16002 51604
$22.O8
$305.80
Fee Total
Paid to Date:
Balance Due:
Unit:
Block: NA
Phone;
Tenant Name:
01 1 16002 51604
0'1 1 16002 51604
01 1 16002 51604
01 1 '16002 5160C
01 1 16002 51604
COPY
Building Use: Single Family Dr,velling
Job Type: Addition
Nature of Work: AdditionrRemodel
Notes: Add 'l12 bathroom. Remodel (2) existing bathrooms &
kitchen.
$327.88
$0.00
$327.88
Temporary
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE COMMENTS
Appliances
Evaporalrve Cooler
Furnace
Compressor
Ivlisc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Boom / Clothes Dryer
Residential Range
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinos
lnstallation
F.D. Drop Test
Above T-Bar
?n)Bough Mech.I I
Final Test .I r
I ,{Vr}rrlFINALIr/r( {6 *r)
Notes, Remarks, Etc U\
OWNER BUILDER DELCARATION
I hcEby slfirm udcr pcflllty of pcrrur, rhd I m crchpr fmm rne Conrldo6 Lhm{ Liw ao, rlF lollowin8 EasD lse.7ol Lt
B!\inc$s anij lrofe$tun Codc): An, Cny or Counry shth dluiB a lfmh lo .onslrucl. alle, improvc, d.mlnh or EItrn u,
s1ru.rurc. p.br ro irs isuMcc. oho rcquircs lhc q,plicer for rucn Frmit 'o
fik a si8ncd rrarcmnr rh.l lr o, shc G li.c!$d puBuMr
ro rtc pmvi{ons oarE Coirador's Lk..ed Llw (Ch.rtd 9. Co.mmine wnh Scclion ?m0 of Divisiofl I oflhc Blxin.ss lnd
Prof.isions Codc) or $ll h. or sht is cx.mpr rhcEfmn and ihc basis for rhc !ll.C.d crcmprnrn. Any riolrrion ofsc.lion ?0:11.5 by an,
applicMl for ! IRrn l suhjccls thc llllicantloacivilpcnalryofnolmrrhlnfivchundr.ddolldG(S500).
_l, asoencrollnc tmFny. an.r.lxsiv.lycont..rine wnh ljcnscd co racloF lo con(tucl lhc pmjccl 15* 7044. Bu\incs
and Pttrf6sionCo.lc: Thc Conrrkbls Liccnle Liw d@. nor aptlyro u oqnooapropc y who builds or improvcs lhcoon.
a.d who 6 .a.k aor ru.h pmicls virn ! ConrE io(9 licnkd puswr ro thc Conlr*roi. L&ne llw).
I m cx.md und€r S<rDn . B. & P.c for rhis EMn,
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hrle &d sill minlsin . C.nifrc.lc ol C6n$fl ro Sclf-!B@ for mrk6 .omFNarion. ss p6vid.d tor by Selhn 37@ of dc
a,tor tu . aor rlE p.rfnn1am of dE s.r fo which rlE ,€nir h i$Ed.
_l hdvc and willminnin sork ^'conpcnrorio. insuBF.. !s rcquircd by Selion 1700 ot rhc L,lxtr Code, forlhc p$formncc of
fi. $brk for whth rhh lErnit ir ir$cd. My wor*6 .ompen ion insurmc ori.r d lolicy nlnbo e:
Folicy N{r!b.i &piE3:
I.cniay rhd i. ihc p.noi,umc ofth. *ork for whi.h rht rcnni h niucd. I \h!ll nor .nDkry,ny p.mn in ony mo"ncr
s as b hc$nE subjcr k' rhc *o*si cotrqEnsar tun hws or Califomin. und aem rhd if I should tEom $hi€rr ro rhc
*ortcrs onpcNalion Doviion\ ofSeri.n 17fi) or rhc tilrtr Qd., I shdl. ronhwilh coqrly tith rhos [ovisions,,
u(ENsgllorrnA(r()B
D&CIASAIION
Ihcrct'yrin unncr pcmlly ol Frjur, rhai I rn licc krl !trdrr provisionofChnflcr9(comnEncins wilhSccrion 70i10)ol Diri\ion I
oi rhc ausircs\..d Pmlis\ior{(o e.and myliccn\c i\ in rull li,rce anl.lrlrr
CANSIAIJqUONIEBDIICICIiNCI
issucd lsrc 10q7, Ci! C )
AIIIJCANfDECIABAIAN
I lmtry dlnD u ndq p.nalty olpcrjury onc olrhc nnk,win8 dcclururion\:
Dcnolirioi Pcdic A\tr{os Notia. k,n Fcd$al RcSUhrn,nsOnlc 4tr, Pd6r
RcquncdIr crof Norifi.llion
-l
..nify lhd $. lcdcBl ESnlitioN rc8arding aslrslos Emval !rc tul apglicabk ro lhh psld
-l
ccnify r&t I hqk @d rnn appliculio, ,rd rrare rnd dE atnvc inrormiion is .orot. I 388 lo comDly with s[ Cny and Coonly
ordiMrcs snd Slarc ti$s Ehri,B to blildi.g con.m.rio.. ad hcoby erthrift rclr*nllliws of lhis Cily 3rn C,!tr|, lo cnrs !po. 0t
lbovc mnthrEd polcny fd i.sp..rioi puqhci
Arpl i.in r or 8.nr siSMru
iffII,g.dlwi
I
ID/SIG.
Metal Fire Place
Above Hard Lid
Meter Release
-l-
as owncr of rhc prcFny, or my cmployc.r wirh wagcs $ rhet sh .onwnsd ion. will do Fwmk3dtlE sEur6 ir mr
inrcnd.d or oficrcd lor ek (Sc.7044. Busircss af,d Pref.$ions Codc: Tho Conlrocrols Li.strs La* d@s not aoply !o e ow,n of
rh. rrcFny who tnikLs o iqmqs thcdn. dnd sho d.a uh kni him{lf or h.r*lf or rkouSh his or rEr o*n mployccs.
lmvidcd rhar ru.h inlpro\mnk m mr intcd.n ororlsld lor$h.l( hwE.llE buildiE or irymEmnt ir sB wnhi.. )d
of corphtion. th€ Ownc, Buildd will htrv. dE bu&! of toving $d tp or .h. dt ml build ot nrylm* lhc l,bndiy to, lhc Flpoe or
WORKFILS' COMPENSATION
DECI,/$AIIQ!
I h.rchy um.m undcr p.nalry of pGrury oa of rhe follo*ing debr.rions
WAXNINGj Fsi[rc ro sw lort 6'€mp.N.lion oEmSc is unh*tul. and sh{ll subicl M cn{'loy.r lo dninal FEhis lnd
.ivil frn s up lo one h!.drcd lhousand doll&! ($100,000), in lddnioi to lhc.ost of comrcnerio.. da@8q as Fovijcd for lt.
Sccrhn.1076 ofrhc trbor Cod.. irlcE{ &d {lorry \ fes.
Lad.l3 AddB!
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