HomeMy WebLinkAbout40134569 - PermitPermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Proiect Address: 5 E Hutton Center Dr
Assessor'sParcel: 411-102-06 Lot: NA
unit: 1000 Blds:
Block: NA Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning:SD76
city of santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Mechanical Permit #:4lJ134569
Pin #: 83963
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
BRE - OC Griffin LLC, Equity Office Prr
3100 Bristo!, Suite 200
Costa Mesa, CA 92626
(714) 9s1-2689
Cal Atlantic
HVACMechanical lnc
440 W Crowther Avenue
Placentia, CA 92870
(714) 937-530s
01116002 51604
01 1 't 6002 51604
01 1 16002 51600
01116002 51604
01116002 57770
Fee Type
VAV Box
Alter Vent Sys
General Plan Update
lssuance
Microfilm Records
Amount
46.25
45.33
22.95
57.20
3.91
Qty
1.00
1.00
1.00
1.00
1.00
Fee
$46.25
$45.33
$22.95
$s7.20
$3.91
Botchi:S{8gL - 3/17/2828 ID: omt rqle t5
*2?..91
13. ?1
$149.78
$351 .28
Phone
State Lic #: 682002
Lic Type: C-20
Bus. Lic #: 172783
Workers' Compensation lnsurance:Carrier: California lnsurance Company
Policy #: 82405528
Expires: 05lO1l2O2O
tlffice: CIYH lransi! 15Accti: Ref*: 4013
Rcpti:02916632 - 3/17/2020 9:45
Tronssct ion Totol t351.
HVACI'lechanicnl Inc
Generol Plon Updote Fee
(r1 I 16002- 516(r0(rtr0-Ilicrofih & 0ocurents
rr1 I 16002- 577700[t(t-
llechon icol
01116002- 51604000-
ICL Check 073170Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Commercial
Tenant lmprovement
T.l./Demising Wall
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B
I A, SPK
cMc 2019
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Mechanical for T.l
Fee Total:
Paid to Date:
Balance Due:
Chavez,
Buirding Permit#: 101102945
Every permit issued shall become invalid unless lhe work on the site
authorized by such permit is commenced within 360 days after its
,ssuance, or il 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.
lnspector MID#: 2020-158394
oav\tL'o3t17t2020
Account#
01 I 16002 51600
01116002 51604
o1116002 57770
$22.95
$148.78
$3.91
$175.64
$0.00
$175.64
O'-
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hseby affmn undq paalty of ptrjury thal I m excmp from the Contraclors' License l*w for the following r.@o (Se.7031.5
Bwines ud Profesion Code): Any City or County which require a permit to corutruct. slts, improvc, dmolish or repoir uy
structuq prior to its issumcc, also requirc the applicmt for such pennit to filc a signed statmf,t that he or she b licscd pusuilt
to thc provisioB of thc Contractor's Licensed Law (Chapts 9, Commmcing lvith Sfftion 7000 of Division I of lhc Buins ud
Prcfe$ions Code) or that he or shc is exempt thEefrom ild thc b6is for the allcgcd exmption. Any violation of S€tion 7031.5 by uy
applicilt for a pmit subjcts thc applicet to a civil penalty of not more thm tlvc hundrcd dollEs ($500).
-1.
6 oMtr of the propcdy, or my cmployB with wags 6 their sole compf,sation, will do thc work ud the struciqc b not
intodcd or offscd for sale (Se.7O44. Busines ad Prefasiom Code: Thc Contractor's Licme Law doa not apply to e omq of
the prcpcrty who builds or improvq th@n, ed who do6 such uo* himself or hmelf or thrcugh his or ho o*n mploym.
provided that such improvffits @ not itrtadcd or ofiqed for sle. lf, hows'q. the building or improvclmr is sH within onc )q
ofcompleion, the Owntr Buikls will have the hrd6 ofproving thd he or she did rct huild or imp(olr the propqty for thc purpos of
qle).
-1.
Bowns of the p(op6ty, m excluivcly contrscting with licrued contractoEto co$truct the prcjcct (56. 7044. BBins
md PpfesionCodc:TheContractor'sLiccnseLawdo6notapplytoeown6ofpropcnywhobuildsorimprovcslhcrcon.
and who contracts for such Fojects with a Conlmcto(s) licrucd puBuut to the Contractor's Licruc l2w).
_l u cxmpt unds Setion_. B. & P.C. forthis recon.
Date:_Owner:
IUQEKE8g,SAAIPINIAIIAT
DECLARA'TION
one of the follou ing delarations:I hueby aflim unda penalty ofpojury
-l
have and will mintah a Cstilicate of CoMt to Sclf-Ircure for workqc' @nrpens6lion, u providcd for by S{tioo ]700 of the
Iabor Codc for the po'fommce of the wort for which thc pqmit is isucd.
f havc md will maintain worlcrs' compcrualioo i6uancc. arcquird by S€tion 3700 of thc Labor Code. for thc psfomcc of
the work for which this po'mit is isucd My workers' compquation iroumcc cmia md policy numbr se:
CA DDSoR-e.tse0 Co
o 99 2-( ot oq ' s7 t7 z-oPolicy2
-l
ccnify that in thc psfomance of thc work for which this pmnit is issued, I shall not mploy any pamn in any mano
so 6 to bccome subjtrt to thc wo*ffi' compcosation laws of Califomia. md agE lhat if I should bccome subjct to the
workm' compcnsation prcvisioro ofScctioo 3700 ofthe Labor Code I shall, forthwith comply with thos prcrisioro..
WARNINC: Failure to scurc workm'compmalion covqage is unlarvful, md shall subj(t m mploya to qiminal pcnahiq md
civil fines up to one hundred thousand dollm ($100.000), in addilion to thc cosl of compereation, dmags o providcd for thc
S(tion 3076 of thc Labor Code, intdd od attomey's fe6.
DIJ('I,AR{I ION
I heby affm unda poalty of pajury thal I m licosed udc provision of Chaptq 9 (commcing whh Sccrbn 7000) of Division
of the B6ins ed Prcfessiom Codc, md my licw is in full forcc md effet.
Li"*ectas' ' 42o u".*rNu to. - ($?ryL
3 /t z12o 6on1.".1or.b{ HvAc- lrrf<.ff#tclr-
-\r
CONSTRUCTION LENUNG ACENCY
I brcby affrm udo poalty of perjury thar thse is a construclioo lqding ag6cy for the pGfomecc of thc work for which this p6mit is
issued (Sc. 3097, Civ. C.).
Lender's Name:
Lender's Addrw:_
I ho@ alfinn unda penalty ofpqjury one ofthe following dalaatiom:
Demoliion Psmits-Asbestos Notification Fcdqal Rcgutations (Tillc 40, Pan6)
_Requf ed LellE of Nolifi cation
-l
cEtiry thal lhe fedoal regulatiore regrding mtstos rmoval re not applicable to this prcject.
$rtify ml have red this application ed state thal the above infomation l
ordimcB ed Slate lxs relating lo builditrg coNtruction. ud h6cby authoria
is cor6t. I agrc to comply with all and Counly
ml6 ulrn lhe
above motioned propeny for inspetion
Applicilt or Agmt
Pmilc.me
reprdolativ6 of this
t/ D tzo
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled /^
Rouqh Ductwork Mt$n
UI\J
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
/,n\
Rough Mech.4-t,u,ilLtA
Final Test u Il I
Meter Release I I le-
FINAL r.t L(t 7o aro"l
Notes, Remarks, Etc.\\I
->
+'lLl-2,
)ltrn0 tn-
orr., ' thlb
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