HomeMy WebLinkAbout40131980 - Permit (2)City of Santa Ana
Permit Counter: (714], 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702 Mechanical Permit #: 40{3{gEO
Pin #: 213.21lnspection Requests: (714) 667-2738 lnspector Section: (714\ 647-5853
Proiect Address: 1246W Third St U nit:
Block: B
Bldg: Address Range:
Tract: ROBINSON ADD Historic: No
Suite Range:
Zoning: SPI
ry
Assessor'sParcel: 008-092-02 Lot: 12
Owner:
Address:
Fee Type
01116002 51604 Furnace/Comp Combo
01116002 51600 General Plan Update
01116002 51604 lssuance
Amount
126.90
22.O8
55.04
Qty
1.00
1.00
1.00
Fee
$126.90
$22.08
$5s.04Phone:
Tenant Name:
Contractor
Address:
Owner-Builder
Phone
Botchi:4{621 - 7/5
Off ice: CIYH Tr'n
Rrpt+:0?318987 -'Irnnsoct ion '[otsl
I0r |-E0SALES4of4
+rrlf,199rlritlj Alltr.lr? q4State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
AlPiondro D J ifiene:
Single Family Dwelling
Addition
Addition
Occupancy:
Constr Type
Code:
R-3, U
VB
cMc 20r6
Genecsl Plsn tlpdgte F
01116002- 516ff(t001-
llpchan ical
0111600?- 516t400(-
Viso
c(+ l r******r**rI99q:
i2?. BS
*1s1.94
$1r193.36
: arAl gqfr
Building Use:
Job Type:
Nature of Work
Notes: 436 sq ft room addition add family room and office
Planning Approval By Date
Date
Oate
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Plan Checked By
Permit lssued By
Subject to Field:
Building Permit #
sden, Julie 07 t0512018
Account#
10196037 $22.08
$181.94
$204.O2
$0.00
9204.02
Every pennit issu9d shall become invalid unless the wo* on the site
authorized by such peftnit is commenced within 180 days after its
issuance, ot ifthe wor* authotized on the site by such pemit is suspended
or abandoned lor a peiod of 180 days afler the time the work is
commenced.
lnspector MID#: 2018-'141079
01 I 16002 51600
01 't '16002 51604
Fee Total:
Paid to Date;
Balance Due:
Alejandro D Jimenez and Mayra A Jime
1246 W Third Street
Santa Ana, CA 92703
(323) 809-0792
Planning conditions:
MECHANICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUIt-I)!]R DT]LCARA ION
I hcruhy rflirn u dcr rcnohy oa ncrjury rhar l dr cr. lt li.'n rl[ Cu rrron l.kcn\c L!tr nrrhc followi.S Bu$n lscc?o:ll5
Busnrs\ rtrd l'rot ssn,n C,rdc) Atr! airy or counry which ,cqutc\ r F-rinn b c.n{d.r. rl'cr, iurr^q {L'mli\h or rc,)an nny
(tucro'.. Ilritrn, ir\ nsudncc. al$ rcquncslhc |Pplicror li)r u.h pcfl irk,lilc r siAncd srarcnEnr rh"r h.or $c h liccnscd Pursulnl
ro rhc provi\n,ns ol rtr Conkr.rtr-r Li.etr{d tr* lChlltrcr 9. On.',r.i.i'rB wirh Sccri('n T(xXJ ol Di!isi{,n I of rh. Busirt.s ind
Phrcsn)n\ cld. r .r rhrr tE or shc is cxc rrr rh.rclro'rand rhc hr\il ntr rhc nlkS.d cxcmnriotr Anyvitrtrnf.l Sccri('nrl)]l5 hyrny
rfDli.dnr l(tr.p(irnil \uhjcrr!rhc rpPlicar n, !crvrlt,cnrhyolm! mrcrhrn r'ivc h!idred dollrn ($50Oi.
\-it* ^, ^, , '* ,""""!. ,tr my.nnhry(r. tr h tr rlcs,N ihcn olc c.'nN srrion. willdo Ihc Bolk Nr rhc {r-rm \ rn
.'\l,a "' ,, n-",1 r" 't r s,..?trr. tlu\i"c$ rd tt' 'li$nnr Co c Thc (1trlticrri l-iccn{ Iiw docs nor .pltly h rn o$ncr oI
th.pn,r y \ l.o h'ikl\ or nq,n)!ts rlf,dll and u'h. d.c\ \sh { od hnnsclf or lrrsll or rhrcugh his or h$ nwtr cnrpl(iycc\.
pm! id.!l ihd \urh inlnrvcNnr uc nor inrcndd or orlLr.n f(n !,lr tl tDwcwr. rlB hu itli4 or itrSnnM.nr t ekl wirhin o c yt,tr
oiconlPhrion. rhcOsN! Buildq tr,llh!\rrh. htrdcnorpmvirSrh r hcorthc did 't htrild or nnfmvc rhc rml{ny n rhcrury'tol
l.nsowmroirhcpopcnr. 'nci.lu\ivcly.onttrirrtsirhli...scdcoDlrr.thro.on{ntrrhcnr.jc.l(S*.' 70'l.l Bulirtcts
u'rd,bll\\i Codc: ThcCotrhct,tr\ Li.cnr l.asdo.\ nor rpflrk) .*ncrolpn,Ptnysh(,buildsoritrrhvc\llrcrcon.
.nd s,ho contra.rst, !u.h nn,F.rs sirh r co.rfl.tu(, lic.trscd pur\ud n,ihccuntricrDis l-iccnsc t!!r
-I s o,\
\
I hcrcby !finm undcr Fnalryotp.rjuryonc ofth.lollowu dcchBtn,ns:
-l
harc dd *ill minlrin ! Ccrtifrcatc ofconEfll k, SclHtrsurc lot workEC otrp.n$lk'n. &r povid.d lor by Sdlion l7O0 ot tlE
Lshar Code forlhc lEforllMe of lt *ml aor whicn E,*rmil b issucd.
-l
hlvc and will mainlain wdlcs cohp€nelaon i.wN, es '!q!iEn by Setion 3700 olrlE l4or Cod.. tor rhc IsfolMc of
lh. wt ,or whicfi lhis t mi ii i<,&d. My so.t 6 codlpc.sdbtr iN@c .,rhr $d Plty nuhbct el
Poli.l Nu nt.r:-t{ltc
(!T?!r,ry rhlr in
'hc
pc,rorMncc .r rh. work ror which rnis p6mir is i$o.d. I shelt nor eoploy any pcr$. iI any nq*r
s a\tglcom tuhj(t h rhc ao*d!'omFnsrion lo*s or cdiromh. md l8R thor irl shorB ha.@ subiNr ro rlE
worlci'onqEnsrio.I,hvilionsofSc.lior3T00oflheLltorCodc,lshtlLfodhwnhdnplywilhllsspm,bio.s..
WAf,NING: F.ilurc lo KW wo cn .onr.nrdion dtrcm8c is u.Lwtul. md slt.ll slbj<l an cnployer lo oimiMl pcMxi.s,trd
.ivil tlncs !p lo om hundEn lholsnd doll&r (Slm,(x)O), in oddition lo lhc corl of.omp€nstlion, dutrE8cs as Pmvid.d for lhc
il5ilEqtr,icT
IIDI;I.A8.AITO!
I hcEhy dllirnund.r pcixxyol p.rjury rh0t I an liccntn undcr pr)vi\ion ofCh:lPter 9 (conuEncins *nh sccri,'n Ttl(()) .i Dn i\irn' .l
ol rhc Busims{.nd Pmicssions Cod.. url mylicctrs is h fullnra.fricflNr
(onl.ncl.r
II)NSI&ICIIIINIENDINC.AIjEN1;I
I hcrcby omnn utrdcr pcnnllyofFrJUry rhnl !hc( n a consirucli(r lcndins as...y for lhe PcrtotnErcc ofrht *urk nr which lhn p.rmir i\
nsucd rSc..:1097. Civ C l.
AIELICANI.DISLAS{ITON
I lEtby oliim uftlcr !'(nalty ol ri.rjury oft of rhc iollowinS d.clurar ions:
l).n{nlion fcrnrir Asb.sr.i Norific.lion Fsdcral RcEularions (Tnb.lo. Pd6)
Rcquircrl Llrtcr ol Norific,ri.n
zl.cnilyrhat rhc fcdcra I csu lnl ions rcaardiq asbe(os rcnmvrlm ml smli4hlc to lhis !mj.{r.
is corcd I rlrm h cory,y *ilh o[ Cnylnd Couoty
r.rcscnrorires ofrhis Ciry dd Cou.tylo cnlcr ulx)n fic
AFlrlicnnl or A8.nl Signafurc:
Appliances
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Bouqh Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Ranqe
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release
FINAL /-3/-/? u tde/o{-a?/)
Notes, Remarks, Etc.
N4etal Fire Place
Other
Hood
Lcndq r N,mc
-
-"b\c*'Y's
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