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Home My WebLink About40134832 - PermitCity of Santa Ana 20 Civrc Center Plaza (M-19), Santa Ana, CA 92702 Mechanical PermitCounter. (714)647-5800 lnspection Requests. (714)667-2738 lnspectorSection: (714)647-5853 Permit #:4O134432 Pin #: 66019 Proj ect Address: 1217 N Cabrillo Park Dr Assessor's Parcel: 400-172-35 Lot: 35 Unit: Block: NA Btdg: Tract: 9207 Address Range: Historic: No Suite Range: Zoning: R4 ? Owner: Address: Phone: Tenant Name: Contractor: Address: Phone: HENRY H WILSON 1217 CABRILLO PARK DR Santa Ana, CA 927013180 (714!.9s3-1942 Greenstar Home Services ln 1951 N Main Street Orange, CA 92865 (949) 885-0102 01 1 16002 51604 011'16002 51600 01 I 16002 51604 01116002 57770 Fee Type Amount Furnace/CompCombo 136.71 General Plan Update 23.79 lssuance 59.30 Nlicrofilm Records 4.05 Qty 1.00 1.00 1.00 1.00 Fee $136.71 $23.79 $s9.30 $4.05 t23.'79 9195,111 t1 . rl: t635. g6 g6gE6i:56194 - g/L4/2n2A I0: ccuELLAt oriiii: c:rYH Transir 7 L o-t- 4 Acctli Ref*: 4t'134832 Rcpt,i:03029255 - g/l+/2tt?tr 9:39 AH Tronsoct ion Totol $635,S6 Greenston Home Senvices Inc .l State Lic #: 795556 Lic Type: C-36, C-20 Bus. Lic #: 344246 Workers' Compensation lnsurance:Carrier: Liberty lnsurance Corp Policy #: WA763D508631019 Expires: 'l0l01l2020 Building Use: Job Type: Nature of Work Single Family Dwelling Alteration HVAC Notes:Direct change out of furnace & a/c Planning Conditions: Planning Approval By: Arias, Fernanda Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Occupancy: Constr Type Code: Date: Date: Date: R.3, U VB cMc 20't9 08t14t2020 08t14t2020 Account# lVisc. Receipt: Misc. Receipt: Misc. Receipt: Total Amsden, Julie Every permit issued shall become invalid unless the wo* on the site authorized by such permit is commenced within 360 days after its lssuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 360 days after the time the work is commenced. 01 1 16002 51600 01 1 16002 51604 01116002 57770 $23.79 $196.01 $4.05 Fee Total: Paid to Date: Balance Due: $223.85 $0.00 $223.8s lnspector MID#: 2020-160760 + MECHANICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG COMMENTS OWNER BUtt,DER DELCARATION I hcrcby afftrm undcr penalty of perjury lhal I m cxcmpl fmm thc ContracloF' Liccnsc kw for the following rcssn (Se.7031.5 Busincss ard Profcssion Code): Any Chy or County whbh rcquires a ;rcrmit lo construcl. altca improve. dcmlish or rcIEir sny strucnrrc. prkr to its issuance. also rcquircs lhc spplicant for such fErmit to filc a sigred statemnl that he or shc ir liccnscd purruant lo the pmvisions of thc Contractor's Liccnscd ljw (Chaptcr 9. Commcncing with Setion 7000 of Division 3 of thc Business and PmfcssionsCodc)orthatheorsheisexcmpttherefromsndlhcbasisforthcellcgcdcxcmplion. AnyviolationofsectionT03l.5byany spplicant for a pcmit subjects lhe applicant lo a civil pcn{lty of nol more th0n fivc hundred dolltrs ($500). _1. as owrer of thc pmlErty. or my employcs with wagcs as their elc compcnsalion. wiu do the wok ord the stnrtw Ls mt intcrf,lcd oroffcrcdforsle(Se.T044,BusinessmdPmfcssionsCode:ThcConlractor'sLiccnrcljwdocsnotapplytoanowncrof lhe pmFny who builds or inprows *E@n. ard who des such work himself or herself or thrcu8h his or hcr own employces. providcd that such impmrcrents rc not intcndcd or offcrcd for salc. If. howcvcr, lhc buiuing or improvcmnt is sold within onc )re ofcomphtion. thc Owncr Builler will havc thc buden ofpmving thal h€ or shc did not build or itnpmvc lhe prcFrty for thc purtns of slc). _1. as owrer of lhc prcpcrty. am cxclusivcly contracling wilh liccnsd contracbrs to construct lhc pmjcct (Ss. 7(}14. Busircss and hollssbnCodc:ThcContractor'sLiccnscLawdocsmlapplyloanowncrofprofErlywhobuildsorimfrovcslhcrcon. und who conlncts for such projects wilh a Contmcto(s) liccnscd pursuanl to lhc Contractor's Liccnsc [jw). _l om cxcmpt undcr lr. & t'.C. lbr this rcr\on. ()ri ncr: ]UQSSEBLCQIIPJNIiAIIAN DECI.ABAIIAN I hcrcby iltfirm undcr frcnalty ofperjury one ofthe following dccluralions: _lhqveardwill rointainaCenifkstcofconsnttoSclf-lnsurcforworkcm'comlEnstion.ss prcvidedforbySetion3T0Ooflhc Labor Code. for the perfomrce of thc work for which thc pemit is issucd. ,H havc {nd will maintoin workcrs' conrpcnsation insurancc. as rcquircd by Seclion 3700 olthc lnbor Codc, for thc psformncc of work for which lhis pcrmil is issucd. My workers' compcnsotion insurancc canicr and ;nlicy numbcr uc: Policy _l ccrtify that in lhc pcrfornrance of lhc work for which lhis pcrmil is issucd. I shall not cmploy any person in any manncr so 0s lo bccome subjsl to lhc workers' compcnsalion luws of California. and &Brcc that if I should hccom subjcct to thc workcrs'comlrcnsarionprovisionsofSction]T00ofthctihorCodc.lshrll.fonhwithcomplywithlhosprevisions.. WARNING: Failure lo scurc workers'smpensation covcrogc is unlawful. and shall suhjel !n cmployer to oiminal Jrcmlties and civil fincs up lo onc hundrcd thousand dollars (Sl00.U)()). in addition lo lhc cosl of compcnsation, damges as provided for thc Scclion 3076 ol Codc- intcrcsl tqtVt,|$tn(? LICENSI.]D CON'tRAC'TOR DFCI,ARAl'ION ol thc l]usincss illd Prolcs\ions Codc. ilnd my liccnsc is in Iull lirrcc and clli'ct. Liccosc Nunrbcr: Contractor: W I hcroby aflirm undcr rcnrlly ofpcrjury lhal lhcrc is a conslruclinr hndinS agcncy tbr thc lcrformancc ofthc work for which this lEnnil is issucd (Scc. -1097. Civ. C. ). [*ndcr's Name: Lcndcr's Addrcss: APPLICANT DECLARATION I hcarhy {fliml undcr lcnalty of perjury onc of tlrc follo*ing dccluations: l)cnxrlition Pcrmils-n shcst)s Nolillcaltrn Fcdcral Rcgulntions (Titlc.l0. Pda6) -Rcquircd Lcllcr of Nolificalion _l certify thst the fcdcral rcSulations rcgarding asbcstos rcmoval m nor lpplicablc to this prejct. lfilpmlfy tnur I hBrc rcad this applicalion 8nd state lhlr rhe abovc infomtion is corst. t agrc to comply with all City and County tHinihKcs snd Srate bws rchting lo building constructio[ tud hcrcby authorizc rcIrEsentatives ofthis City ed Countyto ents upon tlE abovc [rcntioncd propcrly for Applicilill or AEcnt Pcrmile narrc lprinl): ,^,", oglloll\ dt Appliances Metal Fire Place Evaporative Cooler Furnace Compressor Misc. Equipment Duct Work Pre-lnsulation lnsulation Smoke Detectors lnstalled Rouqh Ductwork Vents Toilet Room / Clothes Dryer Residential Ranqe Other Hood Type I Hood Type ll Hood Grease Duct Fire Damper Openinqs lnstallation F.D. Drop Test Above Hard Lid Above T-Bar Rough Mech Fina! Test Meter Release ./ /I FINAL ?/,t7 /zno -M)r> Notes, Remarks,Etc./-vtl