HomeMy WebLinkAbout40133809 - Permit (3)Permit Counter: (7'14) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Project Address: 4926 W Kent Ave
Assessor's Parcel: 108-373-08 Lot: 76
Unit.
Block: NA
Bldg:
Tract: 3528
Address Range:
Historic: No
Suite Range:
Zoning: Rl
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Mechanical Permit #:40{33809
Pin #: 77455
Owner:
Address:
THAO NGO
4926 W KENT AVE
Santa Ana, CA 927041936
(7141 383-0002
Fee Type
01 1 16002 51604 Bathroom Fan
01 1 16002 5160C General Plan Update
01 1 16002 51604 lssuance
Amount
31 .72
22.95
57 20
Qty
100
1 .00
100
Fee
$31 .72
$22.95
$s7 20Phone:
Tenant Name:
Contractor:
Address.
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier.
Poircy #:
Expires:
Bobchi:51291 - g/1/2r19
Off ice: CTYH Trnns*: 5?Acct*: Ref*
Rcpt*: tr2711253 S/1/2ttI
Tronsoct i on Totnl
THAO H6O
Genergl PInn Updnte Fee
Ltl I t60tt2- Fl6luJr_rr-r[r-
l'lechan i c01
t:rl I 16002- 5161t401r0-
Viso
C:C+ : *rrrrrr**x *x5927
4 of 5
4tr133Str9
tr:50 Al1
I r 013. 4/r
{i?? .q:i
$gg .v').
$1 r 01 3.tr4
Auth+ :463350
ID: NGAR(:IA
:
91
$
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Addition
Addn & patio cover
Occupancy:
Constr Type.
Code:
Date:
Date:
R-3, U
VB
cMc 2016
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buildins Permit #: 101 100080
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Inspector MID#'. 201 9-151 159
08t0st2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Auth on file.
Fee Total
Paid to Date:
Balance Due:
01 1 16002 51600
01 1 16002 51604
$22 9s
$88 92
$111 87
$0 00
$t t 1.87
o
M ECHANICAL.! NSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUTLDER DELCARATION
I hrcby amm unds poalty of pcrjury that t m qmfl fiom the Contmclon' Licffi lrw for thc following rmn (Sc.7011.5 .
Buine ard hofcssioo Codc): Any City or County which rcquirc a pomit to conslrucl. aho, improvq dcrnolish or rpair uy
structuc. prior to its isumca also rcquirs thc applicmt for such prmit to file a sigrcd slalmat that hc or shc b licmscd puBumt
to thc prcvisioE of thc Contnctor's Lisscd Law (Chapto 9. Commcing with SEtion 7000 of Division 3 of the Bsins md
Prcfeiom Codc) or that hc or shc is smpt thdefrom ed the bosis for thc alk8cd crmption. Any violation of S6rion 7031 .5 by 6ny
applicmt for a pmnit subjcts lhc applicut to a civil pmlty of not mrc thm fivc hundrtd dollm ($500).
_1. as owner of the property. or my employees with wages as their sole compensation. will do the work and the strucitre is not
intended or offered for sale (Sec.7044. Business and Profcssions Code: The Contraclor's License law does not ryply to an owll€f, of
the propcrty who builds or improve theron. and who does such rvork himself or herself or through his or her own employecs.
provided that such improvanrents are not intadcd or off€rcd for sale. I(, howerrer. the hilding or improvernent is sold within one )car
of compkrion the Orvner Buitder will have the burden of proving that he or she did not build or improve the propaty for the purposc of
sale).
-1,
BS owner ofthe prop€rty, am exclusively contracting rvith licensed contractom to construc't the project (Sec. 7O14. Business
and hoftssion Code: The Contractor's License Law docs not apply to an owncr of property who builds or improves thereon.
and rvho contracts for such p,rojects rvith a Contracto(s) licensed pursrnnt to the Contractor's License Larv).
_l am exempt B. & P.C. for thisr
DECLARATTON
I hereby affrm under penalty of perjury one of the follorving declarations:
-l
have and will maintain a Certificate of Conscnt to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
Iabor Code. for the performance of thc work for which the pcrmit is issued.
_l have and will maintain workers' compensation insurance. as roquired by Section 3700 of the l-abor Code. for the performance of
the work for which this permit is issued. My workcrs' compensation insurance carrier and policy number are:
Policy [lrpir es:
_l certifu that in the performance of the rvork for rvhich this perrnit is issued. I shall not employ any person in any manner
so as to become subject to the rvorkers'compensation laws of California. and agree that if I should become subject to the
u'orkers' compensation provisions of Section 3700 of the Labor Code. I shall. forthwith cornply r+'ith those provisions..
I
WARNING: Failure to secure rvorkers' compensation is unlarvful. and shall an onployer to criminal
civil fines up lo one hundred thousand dollars in addition to the of damages as for the
Section 3076 l,alxrr interest and a
8 f {
v
I hereby affirm under penalty of perjury that I am licenscd 9 (commencing rvith Scction 7000) of Division .3
of the Business and Professions Code. and my license is in full force and effect.
[,icense Number:
!)atr:: ('oltlritclor:
W
t hqrby affm unds pcnalty of pcrjury that th@ is a consruc{bn krding rgocy for thc pcrfomcc of thc work 6r *fiich this pamit b
issued (Sec. 3097. Civ. C.).
Lender's Name:
Lender's Address:
,\l'Pl.l(',\\ I l)li('1.,\ll.\'l'loN
I hereby affu:n under penalty of periury one of the follorving declarations:
I)emolition Perrnits-Asbestos Notification l;ederal Regulations ('l'itle 40. Part6)
_Required l.etter of Notification
_l certify that the federalregulations regarding asbestos rernovalare not applicable to this project.
-l
cerri$, that I have read this
ordinances and State [.as's
above mcntioned property for
Applicant or Agert
Permitee name
and state lhat
tu",0,5. 11
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
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
!nstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.q 2)a llH4t^^#'/4€D)
Final Test u
Meter Release ,\
F!NAL u l.t4T :lr-:rrr ^ (\lt ,vy
Notes, Remarks, Etc.U\
8
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