HomeMy WebLinkAbout40134581 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 40{3458{
Pin #: 397OG
Proiect Address: 1021 112 W Chestnut Avea
Assessor's Parcel: 008-21 2-34 Lot: POR 11, POR 12
Bldg: Address Range:
Tract: BUCKINGHAM Historic: No
Unit:
Block: A
Suite Range:
Zoning: R2
Owner:
Address:
Phone
Mike Mattingley
1021 112W. Chestnut
Santa Ana, CA 92703
(7141 325-6230
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
01 1 1 6002
51 604
51 604
51 604
51 604
51 604
51 600
51 604
57770
Fee Type Amount
Furnace 70.66
Clothes Dryer - Residen 43.46
Bathroom Fan 32.88
Laundry Fan Envir. Air 37.54
Range Fan 34.80
General Plan Update 23.79
lssuance 59.30
Microfilm Records 4.05
Qty
1.00
1.00
2.00
1.00
1.00
1.00
1.00
1.00
Fee
$70.66
$43.46
$6s.76
$37.54
$34.80
$23.7e
$5e.30
$4.05
/
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier.
Policy #:
Expires:
Botch*:55956 7 /21/2tt2B ID
0f f i ce: CTYH Tr crns* : IAcct*: Ref*: 4
Rcpt+: Cr3[rtr9806 7 /21/2Cr2fi I
Tronsact i on Totol f6
J
5
lilre llottinslev
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:Verduzco, vio,.NtJ
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
0712112020
Account#
Accessory Dwelling Unit-D Occupancy:
New Constr Type:
New ADU Code:
R-3
VB
cMc 2019 Construction of a new detached accessory dwelling
unit consisting of 2 bedrooms and 2 bathrooms. ADU
unit is state standard.
$33e.36
$0.00
$339.36
Date:
Date:
Date:
Subject to Field:
Buildins Permit #: 101 103488
Every permitissued 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 permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 1 6002 51 600
01 1 1 6002 51 604
01116002 57770
$23.79
$31 1.52
$4.0s
lnspector lVlD#: 2020-1 58554
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNEN BUILDER DELCANATION
I hercby affum undcr peoalty of perjury that I m cxempt fiom th€ ContrrctoE' Lice[E Lrw for the following rcaSn (Se.703lS
Business and Profcssion Cldc): Any Cily or County which rcquircs a lmit to construct. 8lts. improw, demlish or rcJ[ir rny
structurc. Irir to its issumcc. ds rcluircs thc 4plicmt for such pcmil lo filc I sigrcd slalemnl that he or she is licensd pursrnt
to thc provisions of thc Contractor's Lkrnsd kw (Chapter 9, Comrcing wilh Seltion 7000 of Division 3 of the Busircss ud
Prcfessions Codc) or that he or shc is exempt thcrefrom snd the hrsis for the sllcged exemption. Any violslion of S6tiotr 703 1.5 by sny
appticant for a pemit subjrcts tk spplicsnl to 8 civil pcmlty of nol mre thil fivc hundred dollrs (5500).
_1. as owrcr of thc pmpcrty. or my enrploye€s with wsges &s thcir $lc comlEnsslion. wil do tlE wtr* std ttE $tune k rcl
intcrdcd or ofrcrcd for sh (58.7044. Busircss snd hofcssions Cods Thc ConlEctor's Liccns kw docs not spply to m owrer of
tlE pmpcny yho huiEs or inprcw ttEmtr dd uho dG sh mr* himsclf or hwlf or thrcugh his m hcr own cmploSces,
pmvided thrt such imp(owrcnts rc mt intclded or offered for sh. lf. horcq. thc huilding or itrprorcmnt is sld wilhin om ,sr
of sq)|€liorl the O{rcr BuiHcr will haw thc burdor of prcving tlut hc or shc did rct buiH or irpmre 0rc pmpcrty for the purpo$ of
slc).
_1. as owrcr of the prcpqty, m crclusirely contmcting with liccnsed contrrctoF to @nnruct thc Plojctr (Ss. 7044. Busircs
Urd Proftssim Code: Thc Contrutor's Liccnrc L8w d@s ml spply to m owns of prclEny wlo builds or imptores thcreon.
and who contmcts for suh prcFcts with 8 ConrEcto(s) lkTn*d puEunt lo tlrc Conlrctor'r LiEns hw).
[hrcxcmpt undcr B. & P.C. for this reason.
Urrra. 2-f
}V()RKERS' C(Ii\I PENSA'I'ION
DECLARA'I'ION
I hcrchy afllrrn under penillty of pcrjury onc of lhc followirrg dcclaralions:
_l havcan(lwill tnilintainaCcrtilicatcofConscnttoScll'-tnsurcl'orworkcrs'conrpcnsiltiotl.as providcdtbrby.Scction3T(XDot'thc
l;rtxrrCrilc. lirrthcpcrli)nnanccofthcworkli)rwhichthcpcrrnit isissucd.
_l havc alld will rnaintain workcrs'conlpcnsation insurilncc. as rcquircd hy Sccliott 37ffi of thc l-ahor Codc. for thc pcrlbrmattcc of'
tlrc work l'or which this pcrmit is issucd. My workcrs' conlpcnsation insurancc ctrricr lncl policy ltumbcr arc: \
Policy
(%lccrtify rhat in thc Jrerformance of thc work for which rhis permit is issucd. I shall nor employ any person in any manner
so as to bccomc subject to the workers' compensation laws of California. and agrcc that if I should trecome subjc'ct to the
workcrs' compcnsation provisions of Section 3700 of the l-abor Codc. I shall. forthwith comply with thosc provisions..
WARNING: Failurc lo sccure workcrs'compcnsation coverage is unlawful. and shall subjcct an employer to criminal frenaltics and
civil fincs up to one hundred thousand dollars ($l00.Un). in addition to the cosl of compensation. danragcs as provided for the
Scction 3076 of thc l-abor Codc. inlcrcsl und attorney's fecs.
Drt". 1(14(W
I ICENSED CONTRACI'OR
DECLARA'TION
I hercby all'irrn untlcr pcrralty of pcrjury lhat t arn liccnscct ulrdcr ;lrovision of Chaplcr 9 (contttrcncing with Scctittn 7(Xn) of Division 3
ol' thc Busirrcss arrd l'rofcssions Codc. ancl rtty liccnsc is in tull fbrcc atd cll'cct.
l ):rlt
W
I tmby atfum unds pcnalty of pcrjury tlut tlse is a @nstretion lcnding agcmy for lhe perforc of thc mrk for which this pqmil is
issued (Se. 3097, Civ. C.).
APPLICANT DECLARATION
I hcEbyatlimundcr pcnalty of Frjury onc of thc following dcclarations:
Dcrmlition Permits-Asbcslos Notificulion Fcderal Rcgulalbns (Tillc 40, Pod6)
-Rcquired
krtcr of Notificalion
-l
ccnify lhd the fcderal rcgulations rcguding asbcslos rcmrval arc not applicrblc lo lhis preirl.
lofiirrity rttur t havc rcad this application and statc lhd the abovc infirnnation is comcl. I {8re to mmply wilh all City and County
ordimnccs and Statc [!ws rchting to huilding construction. ilxl hcrcby authorizc rqrcscntativcs ofthis Cily lnd Counly lo cnlcr ulnn thc
atxlvc nrcnlioned propcrty for inspcction purposcs.
Applicant or Agcnt
Pcrnritcc nanrc
I
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
[\Iisc. Equipment
Duct Work
Pre- lnsulation
lnsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room I Clothes Dryer
Residential Ranqe
Other
Hood
Tvpe I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rouqh Mech.
Final Test
Meter Release tl ,ll t ^ -^ny'
FINAL llWPo UP3lroL vdo
Notes, Remarks, Etc.I
Date:._1t-$l l-l.
Contrnckrr:
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