HomeMy WebLinkAbout40130569 - Permit6|[ Ciff of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA s2702 Mechanical
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Permit #= 40130569
Pin #: 42402
Proiect Address i 2332 N Towner St
Assessor'sParcel: 001-213-02 Lot: 2
Unit:
Block: NA
Bldg:
Tract: 6540
Address Range:
Historic: No
Suite Range:
Zoning:R1
Owner:
Address:
Phone:
Jose Mata
2332 N. Towner St.
Santa Ana, CA 927061942
(714) 393-63s8
Fee Type
01116002 51604 Bathroom Fan
01116002 51600 General Plan Update
01116002 51604 lssuance
Amount
28.42
20.56
51.26
Qty
1.00
1.00
't.00
Fee
$28.42
$20.56
$51.26
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Bat
0fr
Act
Rcr
Trc
.ltefi:
/?016
Gen
r:rl 1
Ilec
011
ICL A1
Building Use: Single Family Dwelling
Job Type: Addition
Nature of Work: Addn/Remode!/Porch
Occupancy:
Constr Type:
Code:
Date:
Date:
R-3, U
VB
cMc 2013
Planning Conditions: New windows to match existing in operation & materials. New stucco
finish & stone to match existing in type/finish.
11103t2016
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
Convert front porch to new office. lnstall interior wall &
convert part of living room to new bedroom & gym.
Add 1-full bathroom & front porch (260 sf). Auth on file.
$100.24
$0.00
$100.24
Planning Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buildins Permit #: 1 01 89947
Every permit issued shall become invalid un,ess the work on the site
authorized by such permit is commenced within 180 days after its
lssaance, or if the work authorized on the site by such permit is suspended
or abandoned for a peiod of 1 80 days after the time the work is
commenced.
01116002 51600
01116002 51604
$20.56
$79.68
lnspector MID#: 2016-129977
L
M EGHANICAL.INSPECTOR RECORD
DATE ID/SIG.COMMENTSAPPROVALS
Appliances
Metal Fire Place
Evap Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
,
Rough Mech.9/E//t=AF[uo rr^h) /
Final Test t//
Meter Release , .lA\\\ttru ,l
FINAL 'rSil\tU \Mi$t0 t\h
Owncr-Builder Dcclaration
I heteby alTirm under penahy of perjury that I am excmpt form th. Contractors' Liccnse kw for thc following r6son (ss.7o3J .5 Bsi-Jss
aod Profesion Codc): Any City or Couty which rcquirc a pmit to co6truc1. altcr. improvc. dcmolish or rlpaFany stutui. prior to its
issuncc.alsorcquirethcapplicrnlforsuchpcmittofilcrligncdltatemcnt lhathcorshcisliccucd puBumttothcprcvbionrofthc
Conttactor's Licensed Law (Chaptet 9. Commencing wilh S.clion 7000 ofDivision 3 ofthe Burincs and Profagions Codc) or thst hc or
shc is cxcmpt thcrcftom and thc b8is for thc allcgcd cxcmption .Any riolation ofSction 70! 1.5 by uy rpplicant for a ponh subjccts thc
spplicant to 8 civil pcDshy ofnot morc th[ fivc hundrcd dollm ($500).
_1. u owno of thc propcny. or my cmployG with wag6 s thcir solc compcnsstion. will do thc work md lhc structuc is not intodcd
or offercd for sle ( Se 70,14, Busines snd Professions Code: Thc Contractor's Lic€me Law doe not apply lo an owner ofthc prcpcny
who builds or improvcs thcrcoo, and who do6 such work himsclfor hmclfor through his or her own cmploycB. providcd thrt such
improvcmcnts uc not htcndcd or offqcd for slc. lf. howcvq, thc builditrg or improvcmcnt is sold within onc ycr ofcomplclion, thc
Ornq-Buildcr will havc thc budcn ofproving thrt he or shc not build or improvc for thc purpose ofsElc).
_1. I owncr of thc propdy. am cxclwivcly contmcting with lic.D.d contrrctoB to coBtruct thc projcct ( Scc. 7044, Buincss md
Profesion Codc: Thc Contrrdor's Liccruc Lrw do6 not apply lo u owncr ofpropcny who builds or improvcs thcrcon . &nd who
contrrct! for such proj.cts with 8 Contractor(r) liccnled pursurnt to the Controdor's Lic.nsc Lrw.)
& P.C. for
Dste:
I hscby aflim unds pcn8lty ofpqjury onc ofthc follow
_l havc and will maint8in 8 Ccrtificatc of CoNcnt to SclfJnsure for workers' compensstion. ss provided for by S6tion l?OO of the
Labor Codc, for thc pqfomncc of the work for which thc pcmit is issucd.
_l have and will mainlain workers' @mpeMtion insumnce, as requircd by Seqtion 3700 of the kbor Code, for the pcrforroncc of thc
work for which this p€rmit is irsued. My workers' compenstion insurance orrier and policy numbs rc:
Policy Number:__-_ _Expircs:
-
(-l.llis sfttion need not be "o.pl"t.d if th. p*it i. fo, Onc hrrndrcd d<,ltaro-{$tOOl or lcss)
_l ccatify thsr
bccamc aub.jst l
in thc pcrforuncc of thc work for which this rs isucd, I shall not mploy any pcmn in any manner so s to
agree that ifl should become suhjet to the workers'Io the workers ' conlpengtion bws of and
compcnsation provisions ofScction 3700 oflhc t,abor sith those
WARNINC Farlure to secure workers'unlawful, and shall subj*l an employcr to criminal pemlria and civil
fitr6 up to onc hundrcd thouaod dollan ($l
the trbor Code. interest and atiorney's fees.
to lhe cost ofcompcnsation. damagcs s providcd for thc Scction 3076 of
LICENSED CONTRACTORS DECLARATION
I hercby 8ffm und4 penalty ofperjury that I m liccnsed undo provision ofChaptcr 9 (commcncing with Scction 7000) ofDivision 3 of
lhe Busincss and Profcssiou Codc. md my liccnsc is iD full forcc md cffcct.
l.icense Class: License Nurnbcr
CONSTRTICTION LENDING ACENCY
I hcrcby iflirm unds pcnally ofpcrjury thal lhcrc is a construclion lcnding agcncy for lhc perfonnance oflhc rvork for which this psmit is
issucd (Scc. .1097. Civ. C.).
l-ender's Name:
l*ndq'3 Add.s: _
APPLICANT'S DECLARATION
Dcmolition Pemhs-Asbcstos Notification Fcdqal Rcgulstions (Tillc 40. Pan 6)
_ Requircd kttcr of Notification
_l cdify thst thc fcd6.l regulstions rcgarding sbstos removal arc not applicable to this project.
_ I ccnit that I havc rcad this application md ststc th8t thc abovc infomation is concd. I 8grcc to comply with all City and County
abovc mcnlioned
Applicant or agcnt sig.:
Perrnitlee na!ne
to building and hqcby authorizc rcprcscntativcs ofthis City and County to enter upon the
MIWP5 1 \Permit-lnsp€ction Rocord.doc 03.31.05
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