HomeMy WebLinkAbout40332890 - 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
Mechanical Permit #: 40332890
Pin #: 6{30il
Project Address: 1920 E Seventeenth St
Assessor'sParcel: 400-011-03 Lot: 3
Bldg:
Tract 6313
Address Range:
Historic: No
Suite Range:
Zoning: C5
Owner:
Address:
Contractor
Address:
Alex G Gladkov Dental Corp
6818 S La Cienega Blvd #203
lnglewood, CA 90302
Fee Type
01116002 5160{ Bathroom Fan
0'l'116002 51604 Min Fee Adj
01116002 5160C General Plan Update
01 1 16002 51604 lssuance
Amount
30.52
12.34
22.O8
55.04
- rl/19/2tl9, IDz
FronB+:106
Ref+: 4tJ,' - l1lr9l?01s itrtol li- tt
Qty
2.00
'1.00
1.00
1.00
Fee
$61.04
$ 12.34
$22.08
$s5.04
Phone:
Tenant Name: Orthodontic Center of Orange County
VCD&SONSINC
526 S Ross Street
Santa Ana, CA 9270'l
(714) 80r-7604Phone
State Lic #: 596135
Lic Type: B
Bus. Lic #: 3442
Workers' Compensation lnsurance:Cafiier State Compensation lnsurance Fund
Policy #: 1877843
Expires: 1110112019
pdate Fee
,00l]O-
04rr00-
r*rx6939
Occupancy:
Constr Type:
Code:
Commercial
Tenant lmprovement
TI
Notes
Plannang Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buildins Permit #: 10396696
1111912018
Account#
Legalize unpermitted work - new partition walls to
creale dental rooms, xray, office; (2) new restrooms;
new exterior door; demo patio cover.
$150.50
$0.00
$1s0.50
Oate:
Mr late:
l\ Dale:l\
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
$22.08
$128.42Every pemit issued shall become invalid unless the wg* on the site
authoized by such permit is commenced within 180 days dfter its
issuance, or if the wod< authotized on the site by such permit is suspended
or abandoned tot a peiod ot 1 80 days aftet the timo the wotk is
commenced.
lnspector MID#: 2018-143892
01116002 51600
01116002 51604
Fee Total
Paid to Date:
Balance Due:
unt: 120
Block: NA
Building Use:
Job Type:
Nature of Work:
B
VB
cMc 2016
Planning Conditions:
rD/srG.COMMENTS OWNER AUILDER DEI]CAILAIION
I nftB arrm uida paElty of pdjury ltd I d .r@pl 6@ thc Conrt.r6 Uc.ns.lnw for lh. followi.S ta$n (S4.r0ll.t
Buin4s sd Piof*ion Cod.)r Any Cny or Counl, which rcquir6 . pdf,il lo condrucl, alt, inFov.. danoli.h or rP.n &v
3r&cruc. ,.b. ro irs iBuecc al$ requiB $. ,ppli.d fo, locn Fnril lo fi1. . sisn.d sla@@l thar h. or C'. b lic@.d p@el
lo rh. proBioB oa $. c.nE.d6! Li@n .! t w (chapro 9. connacirB wilh setio. I)00 oa Divilion 3 of thc BBi&s ed
PbfBsions Cod.) or $ hc or sh. i5 qdpl lt@noE ed lhc besis for thc dlcgcd .r.m!rion. Any violado. of S.cliotr ?01I 5 bv aot
rpplicaor for a pdnil lobjcB ln .pplicEr ro a civil p.Bhy ofnor noc rt.n nv. hu.&.d dolles (1500).
-1,
s oMq of lh. popdiy, or my mllor6 wilh wa86 s lh.ir sL odPdsdon. wi! & rh. wut dd rhc ffd@ i noi
ir od.d or ofi6.d for saL (Sc.7044. BBins ud Pr.fdiotu Code Thc Conlrrclols Licals kw &6 tot .pply lo & oMa of
t6.FDFly wlb t!il& or iry.!6 thao,! .rd *ho dod $ch w* tirelf or h@lf or rlmueh hB or hd om drllovc
providcd rhrt such imFovoMli @ lol lnad orolt,ld lor $L. ll hoxtE. dt luildi.g or iDF!6EI is eld withii on. va
olconDldio!. dE Olle BliuE will hd. th. hrdd otprcviig thd tt or !h. dil ml bui6 ot i.prow $. FoPatv lor tlE FnF* of
-1.
sowofln popdty. m qclusi!.ly cobuacling wiln lic@d conl@clou lo coclncl lh. prcjd {Sft. 7044. BLsinar
dd Proiisih Cod.: TtE Conlrr<loar Lic.e hw dod rcl .pply lo u ow.q of propdly sho blilds ot inprovBlha@n
ed who @ ncls ror such pojcls *nh a c!!tnclo(9lhosd pmuir ro th. Conl6cror3 Lic6. Lsw).
-l
m .idpr u!&r S!.lion . B. & P C. for lliu !con.
1DORKERS' COMPEIISAITON
BECI,AMIIOX
I hd.byailmn und.r F.ahyolpdjuryon ofttc tollowi.g d<laatioN:
-t
hrve dd *ill @inrlin 3 Ccnificalc olcooFr lo s.la-lNrr. for mlkdt .onrpcnstion, s Flvided fo. by serion 1700 of th.
Labor Cod€, lor lhc pqlommc€ olthc worl fo, ich thc p@il i3 issred.
-I hav. ed will main8in wo*.c .om!..!tlion iGuranc.. N r€qut d try s<tio. 1700 of th€ tlbor Cod. fDr th. pqfom c.ol
is isu.d, My wo,kdi comp.Mtion insuec. cmid md policy numb6 aciF^.
.l(I 22/?
-I
c.niry lnal io th. psfoll@c. of rhc sotk fo. which thtu p.mn is i$ued. I sh.ll nor dnploy .ny pdsn i, oy mmd
$ s ro b{omc subjer b $c ed(6' compostion laws ot Calilodk, dd t€te lhd if I should bdooc aubjdl to thc
worl6' omPs$rion ptuvisioB ols..lion l?Qo oalhc tjbor Co&, t sirll. fonhwith onPly wilh lho* pr.vtioN..
WARNINGT l_.ilure to slE *ork6' comFnerio. co!da3.e ddoyq to 6nnin.l FBlli6 dd
to orc hundEd lho@d dolls ($100.U10), in drD.gd B provid.d for lh.
Se(io. 3076 .f th. bhor Cod€. inrdd od
,*", )l - 14 -)p l{ ooo A4
LlcEllE-cotrrBAcrof,
DECllSAnO!
I t d'y .ffd uid,r Dallry of pcjlry lhs! I 0n li6s.d &da Fovlion of Ch.pl6 9 {omtuitc wnh Seliot ?000) of Divilio! l
of rhc Buir* dd PtufBioN Codc Dd Dy [q@ is i. tull forc dd.IL.l.
bi s-
I hmty amrm lidd pomllyotFrjuryrhar lhse is a coNlnrclion lodin8 aSocy forlhe pGlof,nancc olthc\ork lor which lltu ptrnil ie
issucn (Se.:1097. Civ C.).
AELICAILD&CIA8ADqts
I hddr, .&m ud6 p.rally ofFjuT onc ofth. followin8 d..ltarioG:
Damltion P@ieA!b61o. Norificdioa F.d@l R.rublioB (TnL 40. Pal6)
-Rcquircd
L. d of Notifi..do!
-l
carily rhar th. Ld@l rcslLrioB ESdding 6b6los rdoval dc noi tpplttblc lo lhis pojdt
-l
cdit ttol I havc rqd lhis ion ,nd slri. rhd thc .bor c md'on i(cond I0Uero (omp\ tr hallCirvsndC"unry
ordna.c6 ed star. llws rFetaril6 otlhi! cny dd couly lo .nlc woo lh.
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
Other
Hood
Tvpe I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.4/ttlo z fus-rk /il
Final Test {--
,lI
FINAL 1Vl4il,t ,t"lgtL wr E*?N
Notes, Remarks, Etc I I
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE
L.dn'! Nu.
-
ah,r n6r ion.{ popcny lor *-bzq
Meter Release