HomeMy WebLinkAbout40132086 - Permit (2)City of Santa Ana
Permit Counter: O14) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702
l nspection Requests: (7 1 41 667 -27 38 l n spector Section: (7 1 4\ 647 -5853
Mecha n ica I Permit #: 4Ol32OEG
Pin #: 18929
Proiect Address: 1116 S Mantle Ln
AssessodsParcel: 932-630-14 Lotr NA
Unit: B
Block: NA
Bldg:
Trcct:7492
AddressRange: 1102-1122
Historic: No
Suite Range:
Zoning: Al
?
Owner:
Address:
Conlraclor
Address:
Tenant Name:
Norma Gonzalez
'1116 S Mantle Ln
Santa Ana, CA 927032543
Reliable Energy Managemel
7201 Rosecrans Blvd
Paramount, CA 90723
(800) 6924011
Amount
63.14
7.50
2't .25
52.98
Fee Type
Furnace
Min Fee Adj
General Plan Update
lssuance
Notes: c/o
Qty
1.00
1.00
1.00
1.00
Fee
$63.14
$7.50
$21.25
$52.98
Phone
State Lic #: 704414
Lic Type: C-36, B, C-20
Bus. Lic #: 189601
Workers' Compensation I nsuranca:Carrier: American Home Aaaumncg
Policy #: WC026.!63(N0
Expires: 0710112018
Botch+:43669 - 1/9 /?t-tlg
off ice: CTYH Tpnnsi: IAcct+: Fef+:
Rcpt?:02?60286 - 'r.tq t?ltl!
TtonEoct ion TBtol
1O: (;f,UELLAT
3of3
4 irl.J?1186It[:6 All
t,i 19.61
Relioble Enerss Honq-.:M,: t I
Generol Plon Updote Fee
0tl1600?- 516000(rtr-
llechan i col
01116002- 51601(r(10 -
ICL Check 00SS57
t 12,:-. 3?
t4l9.gl
Building Use:
Job Type:
Nature of Work
Fourplex
Miscellaneous
FAU
Occupancy:
Constr Type
Code:
R-t
VB
cMc 2016
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Every pernit issued shall become invalid unless lhe wo* on lhe site
authoized by such pemit is commenced within 180 days after its
Bsuance, or il the wo* authodzed on the site by such permil is suspended
or abandoned tor a peiod ol 1 80 days aftor the time the wo* is
commenced.
(l5rernanoez, rauv
Date
Date
Date
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
lnspector MID#: 2O18-143248
01 't 't 6002 51600
0'1 116002 51604
$21.25
$123.62
Fee Total;
Paid to Date:
Balance Oue:
Phone:
01116002 51604
01116002 51604
01116002 51600
01 1 16002 51604
05,09/2018
Account#
$144.87
$0.00
$144.87
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE COMMENTS OWNER BUILDER DELCARATION
I hcrcby alli.n undcr p.mhy oi psiury thal I d cx€mfl fom lhe Conuscrou Licetr* L.* ibr lhc folhwing rct$n (Sq.ml l.5
Busin.ss ord Prof..sion Codc): An, Cny or Cou.ry whi.t requi8 ! pqmn lo onsltul. all(. imphl.. d.mu6h or eplir dy
smkllE. ritr ro iG issuaBc. rtlo cquiEs llE +plkui for srch Fmil lo lik ! sigr.i slaLftnl lhsl lE or shc is liensd N6@l
lo rlE pmvilioirs of tlE Co,rrrror\ Li..n*d Ltw (Ch{nl.r 9. ComcrcinS *ith S.ction 7000 of Divirion 3 of thc Slsin.ss lnd
Prcf.ssi.ns Codc) or rh lE or .rE k crcq,l ih.Eiiom rnd th. halis for lh. llhg.d .xor0ri.n. Ary viol4ion of Salbn ?011 5 by ey
optlka.r for a Fmit .ub.ialr llE atplics lo ! cilil !,cmlly of ml mr. tho !'iv. nundrEn dolds ($500)
-1.
!s o*M ot rhc pmpcnr. d my.mplorsr wilh we8.s 0! OEt $h ompenerior. eill d. th wk .,i ltE stnd@ i\ mr
inhnd.d or orccd for eb (Se.7o44. Busircss d Pmfcssions codc: The contdcior's Licns Lnw dms ml arulyro om.rof
rh. p'oFny who hoilds ot iryrcEs dtotr drd *hr dB sh ,qi hirclf or ncrclf or lhmush his or hc, ow. cmrlolt.s.
pmvidcd ih,r sch inlpmrm s B mr idcDdcd tr ofioEd for srlc. It hok@. rh. t{ din8 or ihpmEmnt is sld wilhin onc )t{
of.on!)Llhr. rlE Oqn6 Build6 will h{w lh. budcn of pmvin8 thrl lE or stc dit Dr boild or inlmw rh. pmtdy aor lh. pu{D$ of
_1. or osrcr of lhc INFay. m crctusirly .onrr.crins *irh tiaisrd .onreb6 lo consdd ltE prciEl (Sd, 7044, BNim$
a P,trf.{sno Codc:'rhc Conlrocror's Liccns. kw dBs nol opPlylo onowncr ofp,op.nysho buil& or impows lhcNn.
,nd who omacls Lr sEh prcirls qnh r Conrtulo(t lk€n{d puBunl lo $. Conlr.clols Lirn* ll*).
I lncx.mDt undcr SKtion .B & P,C, rotrhs rcason
D . ()*n..
!I}Xf,EBa.I;!DII!NTAII!A
DECI,AMI&!
I heEb, a,hrm undfi pclrlry of psjury om of thc followins dehnlionsl
lhrvc dwillrrirrifr(.nill.nc.lCo\ciruSrlfln\urclitr{orkcr!c.nrPcn\xri,n,.r\pn)rnlcdturbyScc!onlTlX)olrh!
l-rtxtrCixic, f(tr rhc lcrlnnru,rc ol !hc tr.rk l;rrhicI rhc ncrn,ir i! i\{.d
-l
h{vc ,nd will m.ibl0in *otkcts' compensarion ins!6ftc, as Equircd hy Sel ion 3700 of lhc Lslrt Codc. lot lhc p..fommc of
llE work for ehich rhis !.rnil is Gs€d My sorkcs .omFnelior inrnmc cMit &d Policy numbcr 6c:
-l
eniiyrh0r inrhcpcrformorccofrhcwor* ror whichrhh p.rmn n Gsucd.l shollnol c,rlPloy loy p.^o. i.a.rnurcr
$ N Io tl.and slbrir ro rh. wor*.B mq,.nsotion h*s ofcolifomi!. snd DgEc thd il I should be.om slbjcd ro r,t
workqf ohpcnsorion lr.lhions of Scclion 1700 of lhe Lltnr Codc. I slall. fonhwid .omtly wnh lho$ PDvBidni
WARNINGT Flilurc to rcurc wortcrs 6np.nsri.i ..vcrrt.
.i!il fincs ur ro onc hundrcd rholslid dolhh {$10o,0(D), in
Ser io. 10?6 of fi. tihn Cc{c- inrftnand$omy\ r*s
",,,, al3)ttr n,,,-,, \(
h unlawful. ond ihlll subjccr d y.r b nimintrl p.nrhic\ rnd
I hcrchy lr'lirm undcr lcoolrrorr.rjury rhat I nli.cnrMutrdc!tnovisionoiCtulprct9(comnf,rnr8wirhSR.-lion7((())nrt)ivhi,.]
of rhc Busirc*iftl Pmfcsrion\Coic. and nyliccn{ is in lull fttr.r, clfL{r
!)
IhcrctyrnnnrlndcrpcnahyurFrjuryrh rlrc is!connrucli(tn lcndin-!uscn.yrorrhcrdfonMNcolrhcsork for ahich rhrs Fnil i\
issucd (Scc. 30r)?. Civ C )
AI[U(^.NfD}:CLA.BATA
I lub]_Jlltrtrtrtl.r Jrnnlryol tf,ijrloncol rh.l()ll rn,g,lccrrrri,nx
I)c tr,hri,tr l'd r$ \h.{o\ N.rlicrlion I cturrl RrgulJrnn,s II irlc Jl,.I'an6)
Rrqun lirrcrol Norili.ari(rr
-l.drify
(ha! rlE fcd.ml Egulilions EEudins lstrslor omvddr nor anpli.,bL h lhis ItmJc.l
-l
cenify lhrr t have rc.d lhis lmlicnr
ordironccs dt Slarc LiqsElarinE ro hli
ahov. nrnriotrcd prcFnyfor i.spdrion
I lgra rocomtl, {irh rll Cirylnd Counry
ircs ollni!Cny d Counry ro cntcrllx n lnc
Applicd o.AgcnrSiCnolurc *", I lclrr
a {-,
Itt
fr
Appliances
Metal Fire Place
Evaporalive Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough 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
Rouqh Mech.
Final Test
Meter Release
FINAL 0/ill{,AI rffil t)
Notes, Remarks, Etc.
ID/SIG.
rl
txrdcr . Nirr
-
Psnril.c m'm (prinl):
=
=
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