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Home My WebLink About40134897 - PermitU Permit #: 4O134E97 Pin #: 66317 City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853 Proiect Address: 400 N Tustin Avea Assessor's Parcel: 400-043-09 Lot: POR 6 Unit: 240 Block: NA Bldg: Tract: 678 Address Range: Historic: No Suite Range: Zoning: P Owner: Address. Phone: Tenant Name: Contractor: Address: Phone: Park Center 400 400 N Tusitn #260 Santa Ana, CA 92705 (7141 550450e NUMA Network Service First Contractors Ne 2510 N Grand, #1 10 Santa Ana, CA 92705 (7141 573-2200 01 1 16002 51604 01 1 16002 51600 01 1 16002 51604 01 1 16002 57770 Fee Type VAV Box General Plan Update lssuance Microfilm Records Amount 70.64 23.79 59.30 4.05 Qty 4.00 1 .00 1 .00 1 .00 Fee $282.s6 $23.7e $5e.30 $4.05 BsUch+ : 16{ 0f r ice: (.7 Acct*: Rcpt*:03t16 State Lic #: 556812 Lic Type: C-36, B, ASBS, C-61, C-2, C-1O, C-21, C-53, C-20, C-33, D-35 Bus. Lic #: 141280 Workers' Compensation lnsurance: Carrier: State National lns Co Policy #: AMx082002i001 Expires: 0211212021 'lech ct ,Jtso [:(:*: *r 516tt40ttlr rr*r****6 Building Use: Job Type: Nature of Work: Planning Conditions: Planning Approva! By: Plan Checked By: Permit lssued By: Subject to Field: Commercial Tenant lmprovement TI Occupancy: Constr Type: Code: Date: Date: Date: B II A, SPK cMc 2019 09t09t2020 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Notes: Mechanical for Tl Fee Total: Paid to Date: Balance Due: Amsden, Julie Buildins Permit #: 101 103668 Every permitissued shall become invalid unless the work on the site authorized by such permit is commenced within 360 days after its rssuance , or if the work authorized on fhe site by such permit is suspe nded or abandoned for a period of 360 days after the time the work is commenced. 01 1 16002 51600 01 1 16002 51604 01 1 16002 57770 $23.79 $3+1.86 $4.05 $369.70 $0.00 $369.70 lnspector MID#: 2020-1 58657 a ? a MECHANICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNERBUILDERDELCARATION . f I hercby 8fftrm uriler pcnslty of pcrjury that I m exempt fiom thc ContrctoE' Lkens law for the fotlowing rca6n (Scc.7031.5 Business atd Prcfession Codc): Any City or County which reluircs 8 pcmit lo onstret, dls. imprcrc, demlirh or rcpoir my struclurc. Fior to ils issuare. also rcluircs thc applicst for such Fmit to fih q sigred ststemnt thst he or slrc ir liensi p|msil to thc prcvisions of thc Contrsctor's Lkrtrsed llw (Chapter 9. Comercing with Sstion 7000 of Division 3 of thâ‚¬ Busircss and PmfcssionsCode)orthathcorshcisexemptthrefromandthebssirforthesllegcderemption. AnyviolationofSectbnT03l.5byany rlrplicant for a pcrmit subjccts lhc spplic8nt to 8 civil penalty of not mrc than five hundrcd dollss ($500). -1. as owner of the profrcrty. or my employecs with wagcs as thcir solc compcnsation. will do the work and thc structure ls not intended or oftbred for salc (Scc.7044. Business and Professions Codc: Thc Contractor's Licensc l-aw docs not apply to an owncr of the propcrty who builds or improvcs thcrcon. and who does such wo* hirnsclf or herself or through his or her own employecs. providcd that such improvcnrnts are not intcndcd or offercd for sah. ll. howevcr. the building or impmvenrnt is sold wilhin one )rar of completion, the Owncr Buildcr will havc thc burden of proving that hc or she dkl not build or irnpmve thc proSroty for thc purynse of sBle). -1. as owner of thc property. am cxclusivcly contracting with liccnsed contractors to construct the project (Scc. 7W. Business and Profssion Code: Thc Contraclor's License Law does not apply to an owner of properly who builds or improves thereon, and who contracts for such projccts with a Contractor(s) licenscd pursuBnl to the Contractor's Liccnsc Law). -l arn cxenlpt under B. & P.Cl. lirr this rcason. Owner:_ WORKERS' COMPENSATION DF'CI-ARATION I hcrcby affrm under pnalty of perjury onc of thc following declarations: -l have and will maintain a Ccrtificate of Consent to Self-lnsurc for workers' compensation. as provided for by Section 3700 of the l^abor Code. for the performance of the work for which the lrcrmit is issucd. -l havc and will maintain workers' compensation insurancc. as requircd by Scction 3700 of the Labor Code. for the performancc of lhe work this pcrmit is issucd.ronllcnsaliorr irrsurarrcc carricr and policy rnrnrbcr ilrc: Policy -l certify that in the lrcrforrnancc of lhe work for which this Jrcrmit is issucd. I shall not employ Bny person in any manncr so as lo becomc subjcct to thc workcrs'compcnsation laws of California. and agrcc lhat if I should bccornc subjcct to lhc workcrs' compcnsation provisions of Section .i700 of the [:tnr Codc. I shall. forthwith comply with thosc provisions.. WARNING: Failurc to sccure workcrs'compcnsation coverage is unlawful. and shall subject an cmploycr to criminal penalths and civil fines up to onc hundrcd thousand dollars ($1O0,ffDt. in additicln to the cost of compcnsation. damagcs as provided for thc .Scction 3076 of thc Code. inlcrcst und altorncy's fccs. LICENSED COT{TRACTOIT DT'CLI\RATION I hcrcby aflirm under pcnalty of perjury that I am licenscd under provlsion of Chapter 9 (comnrcrrcing with Section 7m0) of Division 3 of the Business and Professions Code. and my license is in full forcc and effect. G LLicenseNurnhcr: W I hcrcby 8ffrm under pcBlty of Fdury thst thcrc is a @nstruction bndiog rgsrcy for thc pqfm of tlE work for whhh thii p6mn is issucd (Sc. 3097. Civ. C.). [.rdtr's N8m: lrnder's Addrcss: APPLICAN'I' DTCI,TRA'TION I hcr""by allirrrt undcr pcnllty of'pcrjury onc of thc following dcchral iorrs: l)cnxrlition Pcrmits-Asbcstos Notil'icalion Fcdcral Rcgulations ('l'itlc 40. Part6) _Rcquircd Lctlcr of Notitication -l ccrtify that the fcdcralrcgulations rcgarding asbcstos rcnmvalare not applicable to this proict. -l ccdify lhat I havc rcad this applicalion ard strte that thc aborc informtion is corccl. I agrc lo @mply with all City rnd County ordinarccs and Stale kws rclsling lo building construction. ard hcrcby ruthorire rcprcscntatives oflhis City ud County to entcr ulrcn thc atxrvc menlioncd propcrty l'or Applicarrl or Agcnt l)crrrtitc'c narrrc ,,$4f 1,)2a Appliances lVletal Fire Place Evaporative Cooler Furnace Compressor Misc. Equipment Duct Work Pre-lnsulation lnsulation Smoke Detectors Installed Rough Ductwork Vents Toilet Room / Clothes Dryer Residential Range Other Hood Type I Hood Type ll Hood Grease Duct Fire Damper Openings lnstallation F.D. Drop Test Above Hard Lid At rTt Above T-Bar ll'Y''40 lJ kz/&t bq00 Rough Mech. Final Test Meter Release lA,/ FINAL /1.29 'L0,I//5?Q Frt> Notes, Remarks, Etc l)nlc: t l)nlc: 1l)ale: