HomeMy WebLinkAbout40130644 - PermitCity of Santa Ana 20 Civic Cente r Plaza (M-19), Sa nta Ana, {:,A 9-279 2 Mechanical Permit#: 40130644
Permit Counter: (7 14) 647-5800 Inspection Requests: (7 14) 667-2 738 inspecto r Section: (714) 647-5853 Pin#: 96891
Project Address: 1715 W McEvoy Ln Unit: Bldg : Address Range: Su it e Range:
Assessor's Parcel: 101-531-04 Lot: 97 Block: NA Tract: 2887 Historic: No Zoning : R1
Owner: Thanh Vu
Add ress: 1715 McEvoy Ln
Santa Ana, CA 927061332
Phone: (714) 425-0852
Tenant Name:
Contractor : Owner-Builder
Address:
Phone:
State Lie#:
Li e Typ e:
Bus. Lie#:
Workers' Compensation In surance:
Carrier:
Policy#:
Expires:
Building Use:
Job Type :
Occupancy:
Constr Type:
R-3, U
VB
0 1116002 51604
0 111 6002 51604
01 116002 51604
0 111 6002 51604
01116002 51600
0 111 6002 51604
Fee Type Amount Qty Fee
Furnace/Comp Combo 11 8.1 9 1.00 $1 18.19
Clothes Dryer -Residen 37.57 1.00 $37.57
Type II Hood 6 1.07 1.00 $61 .07
Bathroom Fan 28.42 3 .00 $85.26
General Plan Updat e 20.56 1.00 $20.56
Issuance 5 1.26 1.00 $51.26
Batcht:36469 -12/1/2016 [D: LROSALES
Office: CTYH Transl: 103 2 of 4
Acct.;:: Ref~: 40130644
RcPti~0168200! -12/1/2016 3:48 FM
Transaction Total $1,306.70
Tho.rih Vu
General Plan Update Fee
01116002-51600000-
tlechan i cal
01116002-51604000-
Vi SC\
l,~·t: ~'Ill' *c: --·
$20.56
$353.35
~1,306. 0
Nature of Work:
Single Family Dwelling
Addition
Remodel/Addition Code: CMC 2013 Notes: Relocate kitchen & laundry room. Install bathroom fan
in (e) bathroom.
Planning Conditions: A/C unit in rear yard. All materials to match existing.
Planning App roval By: Mar, Escarlet Date:
Plan Checked By: Date:
Permit Issued By: Brodowski, Teri Date:
Subject to Field: ;::::,~
Building Permit#: 10189377
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
11 /30/2016
12/01/2016
Account#
01116002 51600
0 1116002 51604
issuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of180 days after the time the work is
commenced.
Inspector MID#: 2016-126212
Misc. Rece ipt:
Misc. Rece ipt:
Misc. Receipt:
Total
$20.56
$353.35
Fee T otal:
Pa id to Date:
Balance Due:
$373.91
$0.00
$373.91
MECHANICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG. COMMENTS Owncr•Buildcr Declarat ion .
( hereby nffirm under pe na lly of perjury that I am exempl form the Contractors' License Law for the fo llowing reason (~ec.703 1.5 Business
Appl i ances and Profession Code): Any City or Count y which requires a permi1 to cons truct alter. improve. demolish or repair any ~•~·w .. ;ure, pn• r tn its
issuance. also req uires the applicant for such permit to fi le a s ign ed statement that he o r she is licensed pursuant to the provis ions o,"!ht:
Meta l Fi re Place Contractor's L icensed Law (Cha pter 9. Commencing w ith Section 7000 of Divis io n 3 of th e Business a nd Professions Code} o r 1h::i t •he or
she is exempt therefrom and the basis for the a lleged cxemp1io11 .Any violation of Section 7031 .5 by any applicant for a pcnnit subject!.· the
Evap Cooler applic ant to a c ivil penalty of no t m o re than five hund red dollars {$500).
Furna ce ~ as owner of the property. or my employees with wages as the ir sole compensation. will d o the work and the structure is 001 intended
or offered fo r sa le ( Sec. 7044. Bl1siness a nd Professions Code : The Contractor 's License Law d oes not apply to an owner of the property
Compresso r who builds or improves the reon. and who docs s uch work himself or herself o r through h is or he r own e mployees. provided that such
improvements are not intended or offered for sale. If. however. the build ing or improve ment is sold with in o ne year o f com plet ion. th e
Misc. Equipm ent Owner-Builder will have the burden o f pl'oving that he o r she not b u ild or improve for the p urpose o f sale).
_I. as owner of t he property. am exclusively contracting with li censed contmctors to construct the project ( Sec. 7044 . Business and
Professio n Code: The Contractor"s License Law does not apply to an owner of property who builds o r im p roves !hereon . a nd who
Duct Work contracts for such proj ects w it h a Contractor(s) licensed pursuant to the Contractor's License Law.).
Pre -In s ula ti on _I mn exempt under Secti o n .B .&P C.~ l ... -!-\(.:, Date: . In s ulati o n Owner:)(._
S m oke D etectors In stalle d WORKERS C OMPENSATION D ECLARAT I ON
I hereby affirm under penalty o f perjury o ne o f the fo llowing declarat ions:
Ro ugh Ductwo rk I hav e and will mainta in a Cert ificate of Consent 10 Self-I nsure for workers· compensation, as pro vided for by Sectio n 3700 of the
L1bor Code. for the performance oft he work for which the permit is iss ued.
_I have and will ma intain workers· compensation in surance. as required by Secl ion 3700 oft he Labor Code. for the performance o fthc
work for wh ich this pern1it is issued. M y workers· compensat io n insura nce carr ier and policy number are:
Vents ,I Carrier:
T o il e t Room I Cl oth es Dryer lp/ tf 171 ~ Pol icy Number : Expires:
Res identi a l Range -(This section need not be completed if the permit is for One hundred d ollars {$100; or less)
Oth er -r:/J certify tha: in the perfonnance o f the work for which this pe rmit is issftd. I shall not em ploy any person in any manner so as to
became su bject to the workers · com pensa tion laws ofCaliforma. and agre t al ifl s hould beccme subject to the worke rs· -compensa1 ir.n previsions o f Section 3700 of the Labor Cnde. I shall.1J comply w ith those provisions ..
·----
Date:• \"")---! -lb Applicant : 'K 'J A----Hood -
Type I Hoo d WARNI NG: Failure to secure workers' compensation c overage is unlawful. a nd shall subject an employer to criminal penalties and civ il
lines up 10 one h undred tho usand dolla rs {$100.000).in additio n 10 the cost of compensation. damages as provided for the Section 3076 of
Type II Hood the Labor Code. interest and attorney"s foes.
Grease Du ct Ll!:;ENSED C ONT RACTORS DE CLARATIO N
I hereby affin11 u n der pena lty of perjury that I am licensed under provisio n of Chapter 9 (commencing w i1h Seclion 7000 ) of Divisio n 3 of
the Business and Prorcssions Co de. and my license is in full fo rce an d effect.
Fire Damper License C lass: L icense Number
O peni ngs Date: Contractor:
In sta llati o n CONSTRUCTION LENDING AGENCY
1 hereby affirm under penalty o f perjury that !here is a construction lending agency for th e perfonnance o f the work for which this perm it is
F .D. Drop Test issued (Sec. 3097. Civ. CJ.
Lender"s Name:
Lende r·s Address:
Above Hard Lid APPLICANT'S DECLARATION
Above T-Bar Demolition Permits-Asbestos Notification Federal Rcgtlialions (Tit le 4 0 . Pan 6)
_ Required Letter of Notification
I I _I certify that the federa l regula tions regarding asbes1os removal are nol applicable lo this project.
Rough Mech. <,?/I 'J )11 ;{).a 5 (i 9,1 ➔ -d, ,~; ,, "" , •• '"" ,.;, oe•:~ ""' '"" "" ••• "'"""'"" ;, oo-, , '""' ,o ""''' ,.;," '" c;., •• ~,m, Fi nal Test ordinances a nd S tate Laws re la ting to build. 1g pnstruction. and he re by a uthorize representatives of this City and County to enter upon the
above m ent io n ed property for inspection r-j-
Meter Release .,,,..., Ap plicant or agent sig.: ~ ~ Date: • l t.--( -( C,.
FINAL l!i~I ~!'6 t ~~;;z.r; Pennittee name (print): l(.._ :!wtt v~
M:\WP51 \Perm,t-lnspect,on Forms\Mechan,cal-lnspector Record.doc 03.31.06