HomeMy WebLinkAbout40131675 - Permit (2)City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
lnspection Requests: (714\ 667-2738 lnspector Section: (714\ 647-5853
Mechanical Permit #: 40{3{675
Pin #: 30292
AddressRange: 100-230.
Historic: No
Suite Range:
Zoning: SP2
srProject Address: 100 N Harbor BIvd
Assessor'sParcel: 198-061-17 Lot: NA
Unit: C-1
Block: NA
Bldg:
Tractr NA
Owner:
Address:
Conlraclor
Address:
Phone
Tenant Name
GARFIELD BEACH CVS LLC
1545 W 17TH ST
Santa Ana, CA 927063300
Federal Building
'15870 Curlis Ave
Fontana, CA 92336
(909) 428-8007
Fee Type
01116002 51604 Alter Vent Sys
01116002 51604 Min Fee Adj
01116002 51600 General Plan Update
01116002 516M lssuance
Amount
41.99
28.65
21.25
52.98
Fee
$41 .99
$28.65
$21.25
$52.98
Qty
1 .00
1 .00
1 .00
1 .00
State Lic #: 374153
Lic Type: B, C-39
Bus. Lic #: 366882
Workers' Compensation lnsuranceCarrier: State Fund
Policy #: 9038073
Expires: 0110112019
Eqtch?:43901 - tr/22/2019 ID: osoffice: ITYH TrmE+: 113 3A,:ct+: Refi: 40131
Rcpti:022691,t3 - 5/221201S 5301
Tnonsoct ior Totol 111640
Federol Bu i Ld ins
6enerol. Plon Updote Fee
01116002- 51600000-
llechon icsl
r.u116002- 51604000-
ICL Check 0(13281Building Use:
Job Type:
Nature of Work:
B
VA
cMc 2016
Commercial
Tenant lmprovement
TI
Notes:
Planning Approval By: Date:
Plan Checked By: Date:
Permit lssued By: Chavez, Daven / . Oate: 0512212018
Subject lo Field: "/ - Account#
Planning Conditions
Buildins Permit #: 101 95042
Every permil issued shall become invalid unless the wor* o,l fhe site
authodzed by such permit is commenced within 1 80 days aftet its
issuance, ot it the wot* authotized on the sile by such permit is suspended
or abandoned fot a period of 1 80 days aftet the time lhe wo* is
commenccd.
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600 $144.87
$0.00
$144.87
lnspector MID#: 2017-140384
01 1 16002 51604
$21.25
$123.62
Fee Total:
Paid to Oate:
Balance Due:
Phone:
Occupancy:
Constr Type:
Code:
MECHANICAL.INSPECTOR RECOHD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I ficrcby ltfrm !nd( pcn,lly .f F jury lhd I M cicnq t.m thc ContrsctoB Lienc Llw to. rh. folouins r6sn (Se.7oll5
Busiicss rrd PreL$ion Codc)r Ary Ciry or Couniy which rcquircs s ltmir lo m.nru€1. dls. im0ovq &mlhh or rcrEn 8nv
suucturc. prior ro ns issuec, aho rcquircs $c appliclil for slch fmir to lil.. siencn slalcft.l rhd lt or slE n fiened lllN t
ro thc Eovliionx oftr Conlrslols Licencd L{s (ClEflcr 9. Commrcing wth Scciion ?000 of Division I of$. Buiincrs 'id
P$fessionr Codc) or thai i. or shc ir.rcnfl thmfiomsnd thc bsis for lhc !l hg.d .rcmpt ior ' Any liolalion ofs..l6n ?031 5 byanv
spplicant for a p.mir Ntjsrs rhc lpplica to ! civil p..!hy of ml turc lhu alvc hundrcd dolldrs ($5OO)
-1.
!r oercr of rhc poFny. or my cmrlhrt\ wnh w,8.s ts rh.n $t omp.rstbn. vill .lo dF worl on llE srnxlr h mr
intnd.d d o6.En for sE (56,7014, EusiBss tnd Pmfcssions Codc Thc ConlBlor's Ltc c Ll* docs mi orPly lo 3n owr of
rh.ImFrry al$ hrihts o, irymrs lh.mr ud who dG *h *o* hiB€lf or hcBlaor lhDlgh hb ot hcr o*n enplovccl.
flrvid.d rh.r skh impm@ds e mt inte'id oroff4n t for sL.li howsi lhc hr ding6r atpmwm hsEqnhinoncF(
of 6n0hii,tr lh. OwNr Buildn vill hlE llt htdcn of proving 0ur hc or shc did ml ttuih or inqhe 0E tmFny for llE I'uqDs of
l. rs owncr of rhc t'rcpcl|y- m crchsnrly mnttrtin-r wilh licensd conudo6 ro onnel li. pn,iEl (SB. ?O4a- Bu\incs
ard Enltirbn Corhi Thc Conlmlols Liccn$ Lle do*.or irplyto eowncr ofrmFdy sho huilds or iml,rcves lh*.on.
snd vfio s.trrcrsfor such rftjek siihr C.nhclo(, liccnscn lusudt ro rhc C.ntractols Lic.n* tiw).
_l m er.mfl lndf Seri,n-.B. & P.C for thlr F.r.n
woRI(arui' coMPFIlsATroN
DECIdSAII9N
I hcrby amrm und.r pctully ot pcrjry om of lh. followin8 dc.hntionil
lrhtr (ixic. ln, rh. ,[rlori n.roirhcwork lnr\hichrh.Itrn,ir n n{tr',t
-I
h.v. lnd willmrinhin sorlor' co,t{,.6alhn insu6r.., as rcqlircd b, selion 3?00 of llE L!bo. C.dc. ror lh. PcrlbrMc 6r
the wo,k lor which thn pemil h icsen. My work6 .oqEnslion i.i!6n c cMtt lld policy ntmh( &
-,
anify rhll in rhc lx.formN. of lh. work forwhihrhkl.rflr is issu.d.l shlll nor cmploy rny per$n i. lnv m ncr
e $ ro tE@@ subj.cr lo lhc uorkc*'fl'nrcnuion ltrws of Clliioni!, ud osc lh,l if I should bccont suh.i.ci lo rh.
so*os.oopcnsdn,n,mvisk,nsofSari,n:1700olih.tiborCodc.Ishdln,nhsnhcoftPlywilhrl$sPovnions,
WARNINC: Frilurc ro soe rorkcG omFnsalion oleBsc is unliwirt. rnd sholl subj.( 3n cmploytr lo aininal FMlrid and
.ivil fines W lo om hlndEd lhoui&d dollrs ($100,U ). in oddilioo lo lnc cosl of coh!..srrion. dtmg.s as Prcriddd ror rh.
snrkrn 3076 of thc Lrtnr Codc. inr.rcst 0nd atlnrcy s fes.
d
LllliNsEllcorgllcraB
DES,AI{II!]N
IhcEUrflinnxdorlrnrlyolncrjurythatIurlilr{dund$lnovisionolChaprdr9(onnncnciD!*ilhs.di{)n7(xn).fl)ivirion:1
of rh, ausirEsrand Pn) fclrn, ns codc. uxl nry liccn* h in full ntrr tuxl.lL!l
3
CONS-TNUC](}N ! FNDIN(; ACFNCY
I hcrch, rtfirn trndrl,rMlIyollE juylhar lh.rc is d.onnfldion lcndi,S ascn., rd rhc t binutrcc.lrhc work ror {hich this lErnrir is
isrucd (SLr.:109r. Civ C )
APPI,ICANT DI'CI AII,{'TIoN
I lfr*ryrrli ! cr F.trklryolfcrjxry otrc ol lhc (nk,wirs dcclJrrn,n\:
l).nmlirn,tr Pc nir*A\hc{o\ Norifi.nri{,n l:cdchl Rcguhrn s IIitLc to- li'n6)
Required l.ctrcr ol Norifi cdi,)n
l..nifyth,t rhc icdcrnl rcPrhrn,n\ rcsddins nst{nor rcm,vrl rrc nor.Illicnhlc ro lhl pDjc.i
4it..r, ,n, , ,,.. .uo ,nr rnrlNr ii'n JJil {rtc rh r}t abovc irloirBrid t..ftc.r t usre lo curply wirh .ll Cir v rtrd Counrv
.,rdrnr'ncc\intlSrrrclr{\rI'r'n3r.hu'lLln!conn.,n,n.rdhcr.byonrioriTcrcI'escn'divus()llhkCily0ndCounryk'cnrsuFnlhc
Applic r orAgcnl siBnrr ,,. t(
Appliances
It/etal 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
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 l'1
FINAL 2-n-n **.w
Notes, Remarks, Etc.
Drr. -. Orn.r.
- l'r'1" q
*,, s+)- ll
L.nd.r'r N.m:
-
ahnc nEnriord ptulrdy ror ins!.crion _*.,.s-il-t'
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