HomeMy WebLinkAbout40133607 - PermitProiect Address: 2611 S Harbor Blvda
Assessor's Parcel: 414-231-10 Lot: POR I/POR 1
Unit:
Block: N
Bldg:
Tract: 509/101 3
Address Range:
Historic: No
Suite Range:
Zoning: Ml
City 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 #: 4o^{3360T
Pin #: 92E55
Owner.
Address:
Phone:
Tenant Name: Krayden, lnc.
LGHAlliance, lnc
3755 Avocado Blvd, Suite 443
La Mesa, CA 91941
Foxx Building Services
P O Box 5747
Fullerton, CA 92838
(7141 630-ss5s
Fee Type
01 1 16002 51604 Compressor
01 1 16002 51604 Fan Coil
01 1 16002 51600 General Plan Update
01 1 16002 51604 lssuance
Amount
93.73
59.03
22.95
57.20
Qty
2.00
2.00
1.00
1.00
Fee
$187.46
$1 18.06
$22.95
$57.20
Contractor:
Address:
Phone:
Botchi:52617 - l|,:t/2I/2ttl9 ID: onoroleslS
0ffice: CTYH Tronsi: 182 2 of +Acct*: Ref*: {0133607
Rcpt*: fr27823+2 - fi/21/2$19 2 ! 39 PH
Tronsoct i on Totol lt 1083.84
Foxx Bu i ld i ng Serv i ces
State Lic #: 701251
Lic Type: B
Bus. Lic #: 374149
Workers' Compensation I nsurance:Carrier: State Fund
Policy #: 9029433
Expires: 1111612019
Generol Plon Updote Fee
Ctl I 16[102- 516t10000-
llechon icql
ttl116002- 51604000-
Uiso
CC;: rrrrrrrrrtr* I 933
Notes: Leaglize Walk-ln Cooler & Freezer
Fee Total:
Paid to Date.
Balance Due:
t22.9:;
t362 .72
t1r0S3.S+
Auth*:086805
Building Use:
Job Type:
Nature of Work:
lndustrial
Alteration
Walk-ln Cooler & Freezer
Amsden, Julie
Jose DeSoto
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
B
V B, SPK
cMc 2016
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Buildins Permit #: 101 100309
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 the sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2019-149765
10t21t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 51604
$22.es
$362.72
$385.67
$0.00
$385.67
M ECHANICAL-I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER I'ELCARATION
I hwby affm undo poralty of pajury that I m qmpt ftom thc Conlractors' Liccnsc Law for thc following @tr (Se.7031.5
Buins urd Prcfsion Codc): Any Chy or County which rcquirc a po'rnit to @nstruct. altc. improvc dcmolish or rpair uy
shuctuc Fior to its iswcc. also requic thc applicmt for such pcf,nit to 6le a signcd statmot thd hc or'shc b licmscd pu$ad
to thc provisioN of lhc Contrsctor's Licenscd [:w (ChEpt6 9. Comcncing with Setioo 7000 of Division 3 of thc BNincs ild
Prcfsions Code) or that hc or shc is qmpt thqeftom ud thc b8is for thc allegcd cxmption. Any violation of Sction 7d-l1.5 by any
applicmt for a pomit subjcts thc applicmt to 8 civil pcmlty of not morc thil fivc hundrcd dotlars ($500).
-1.
as owner ofthe prop€rty. or my employees with wages as their sole compensalion. will do the work and the structure is not
intended or offered for sale (Soc.7044. Business and Professions Code: The Contrac{or's License Law does not apply to an owner of
the propcrty who builds or improve thereon" and who does such wort himself or hcrself or through his or her own employees.
provided that such improvanents are not intcnded or offered for sah. t[, howel'er. tlrc building or improvement is sotd wilhin one ]car
of complaiorL the Ourner Builder will have the hrden of proving tlrd he or she did not build or improve the property for the purposc of
sale).
-1.
as owner of the property. am exclusively contracting with licensod contractors to construct the project (Sec. 7044. Business
and ProfEssion Code: Thc Contractor's License Law does not apply to an owner of property who builds or improves thereon.
and who contracts for such projeds with a Contracto(s) licersed pursuant to the Contractor's Liccnse l-aw).
-l
am exempt undcr Section-. B. & P.C. for this reason.
Owner:_
WORKERS' COMPENSATION
DECLARATTON
I hereby affrrm undcr penalty of perjury one of the following declarations:
-l
have urd will maintain a Ccrrificate of Conscnt to SelFlnsure for workers' conlpensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which the pcrmit is issued.
-l
have and 3700 of the Labor Code. for the po'formance of
the rvork for and policy number are:
-bl a)
Policy
-l
certify that in the perforrnance of the rvork for which this permit is issued, I shall not employ any person in any manner
so .ur to become subject to the work6s' compensation laws of California. and agree that if I should become subject to the
workers' compcnsation p,rovisions of Section .1700 of the labor Code, I slull. forthwith comply with thosc provisions..
WARNTNG: Failure to secure workers' compensation coverage is unlawful. and shall subject an onployer to crirninal penalties and
addition to the cost of compensation. damages as provided for thecivil fines up to one hundred thousand dollars ($in
Section 3076 of the Labor Code.and so-v
I ICI'NSED CONTITACTOR
DECLARA"I'ION
I hereby aflirrn under penalty of perjury that I arn licensed under provision of Chaptrr 9 (cornmencing rvith Section 7000) of Division -3
of the Business and Professions Code. and rrry license is in full force and effect.
K,."*.z.El
/\
CONSTRI.JCTION LENDINC AGT'NCY
I hereby affinn unda pcnalty of ptrjury that thqe is a comtruction lflding agency for thc pafomoce of the work for which this 1mmit is
issued (56. 3097. Civ. C.).
Lender's Name:
Lender's Address:
' ,rt tcANr ""('I hereb,y affrnn under penalty of perjury one of lhe follorving declarations:
Denrolition Pernrits-Asbestos Notification Federal Regulations (Title 40. Par16)
-Required
Letter of Notification
-l
cdiry thd thc fodoal rqulaios rcgadiog asbetos mv.l m not applioblc to this prcirl.
-l
cgliry that t hflc ud this applicarion ad statc thst th€ sbovc infomdioD is con6t. I agrc to omply with all Chy md Couty
ordiwB md Ststc L8w rclaing to building connrdioll ad hqcby suthoriE rcprsrt8tivB of this City ed Couty lo 6tE upoo thc
'' Pennitee name
l0-
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-!nsulation
Insulation
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
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release
FINAL /r{o-a (-ct5r '*l4r-)/7
Notes, Remarks, Etc.
YI
t
Ereiro' ll
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