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Home My WebLink About40130720 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, Cf ~27,__02 Mechanical Permit#: 40130720 ., Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853 Pin#: 34329 Project Address: 2042 W Eleventh St Assessor's Parcel: Owner: Address: Phone: Tenant Name: Contractor: Address : Phone: State Lie#: Lie Type: Bus. Lie#: 004-173-14 Lot: 77 ESCOLASTICA A ORATE 2042 W 11TH ST Santa Ana, CA 927031923 MOOR Inc Oba Econo Air 555 Van Guard Way Brea, CA 92821 (844) 693-2666 445220 C-36, C-10, C-20, C-46 179268 Workers' Compensation Insurance: Carrier: Security Nat'I Ins Policy #: WC9481984 7017 4 Expires: 11/02/2017 Building Use: Job Type: Nature of Work: Planning Conditions: Planning Approval By: Plan Checked By : Single Family Dwelling Miscellaneous Furnance c/o Occupancy: Constr Type: Code: Date: Date: Unit: Bldg: Address Range: Block: NA Tract: 1685 Historic: No Suite Range: ~ ~ Zoning : R/~ R-3, U VB CMC 2013 Misc. Receipt: Misc. Receipt: Fee Type 01116002 51604 Furnace 01116002 51600 General Plan Update 01116002 51604 Issuance Amount 61.07 20.56 51 .26 Qty 1.00 1.00 1.00 Fee $61 .07 $20.56 $51.26 Batch~:36734 -12/22/2016 IO: ELIZAE\ETH Office: CTYH 7rans~: 46 1 of Acct~: Rer~: 4013072( R~Pt~:01693991 -12/22/2016 12:39 Transaction Total $132.39 MOOR Inc .bn Econo Air eneral Plan Update Fee i2~.56 11111600?-51600000-· Me:hanica. $112.3~ 11 6 02 ;;,1604000- V, sa $132.8 \.•c::aHH**~****l046 Auth~:(11)3975 Notes: Furnace change out. Like for like. Permit Issued By: Chavez, Dave Date: 12/22/2016 Misc. Receipt: Subject to Field: Building Permit #: Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 180 days after its 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#: 2016-133637 Account# 01116002 51600 0111600_? 51604 Total $20.56 $112.33 Fee Total: Paid to Date: Balance Due: $132.89 $0.00 $132.89 APPROVALS DATE ID/SIG. Appliances Metal Fire Place Evap Cooler Furnace Compressor Mis c. Equipment Duct Work Pre-Insulation Insulation Smoke Detectors Installed Rough Ductwork Vents Toilet Room I Clothes Dryer Residential Range Other Hood Type I Hood Type II Hood Grease Duct Fire Damper Op e nin gs In stallation F.D. Drop Test Above Hard Lid Above T-Bar MECHANICAL-INSPECTOR RECORD COMMENTS Ow ner-Builder Declaration I hereby affirm under penalty of perjury that I a m exempt form the Contraclors' License Law for the fo llowing reason (sec.7031.5 Bus iness and Pro fession Code): Any C ity or County which requires a permit to construct, alter. improve, demolish o r repair any structure. prior to its issuance , also requires the applicant for such permit to file a signed s tatemenl that he o r she is licensed purs uant to the provisio ns of the Co ntractor's Licensed Law (Chapter 9. Commencing w ith Section 7000 of Division 3 of the Business and Professio ns Code) or th:u he or she is exempt lherefrom and t he basis for the alleged exemption .Any violat ion o r Section 7031.5 b y any applicant for a permit subjects the a pplicant to a civi l penalty of not more than fi ve hundred dollars ($500). _I. as owner or the p ro perty. or my employees with wages as their sole compensation. will do the work nnd t he structure is not intended or o ffered for sale ( Sec. 7044. Business and Professions Code: The Contractor's License Law does not apply to an owne r or t he propc1ty who buil ds or improves thereon. and who docs such wo rk himself or hersclror through his o r her own employees. provided that such improveme nts are not in tended or offered fo r sale. If. however. the build ing or improvement is sold within one year or c ompletion. the O wn er-Builder will have the burden or proving that he or s he not b uild or improve for the purpose or sale). _I. as owner of the propen y. am exclusively contracting with licensed contractors to co nstruct the project ( Sec, 7044. Business and Profession Cod e: T he Co ntractor's License Law d oes not apply to an owner of p roperty who builds or im prove s t hereon . and who contracts for such projects with a Contractor(s} li censed purs uant to the Contractor's License La w.). _I am exempt under Section ________ .B. & P.C. ror this reason. Oitt c: _____________ Owner: _________________ _ W ORKERS COMPENSA TION DECLARATION I hereby affirm under penalty or perjury o ne o f the fo llowing dec laratio ns: _I ha ve and will maintain a Certificate of Consent to Self-Insure for workers' compensation. as provided for b y Sect ion 3700 of the Labor Co de. fo r the performance or the wo rk for which the pcnnit is iss ued . _I ha ve and will maint.1in w orkers· compensa t ion ins urance. as require d by Section 370 0 or the Labor Code. for the performance or th e work for w hic h t his permit is issued. My workers' com pensat io n insurance carrier and policy numbe r arc : Carrier :_•..,_,_/},-=,.( <f=-. n_(1_Ll_t ___cfu=-.=s =u r=a _n c_;:e____;Cc_'D ____ t I Polic y Number: • \IV(, Y L{ '6 l q CoY 7 () \ 14 Expires: ' \'O l 2.fJ / 7 (This section need no t be completed if the pennit is for One hundred dollars {SI OO} or less)----+---1~'--.,_- _I cc1ti ry t ha t in t he performance or the work for which th is permit is issued. I shall not employ any person in any manner so as to became subject to the workers' com pensa tion laws of California . and agree that if I s ho uld become subject to the workers' compensation provisions of Sect ion 3700 of the Labor Code, I shall, forth with comply with those provis ions .. Oat e:_' ____________ .Applicant:_-L==::.._ __________________ _ WA RNING : Failure to secu re workers' compensation coverage is un lawful. and shall subj ect an e mp loyer to criminal pena lt ies and civil fines u p to one hu nd red thousand d o Uars {$100.000).in addition to the cost o f compensat ion. damages as provided forthe Section 3076 or the Labor Code. interest and attorney's fees. LICENSED CONTRACT ORS DECLARATION I hereby affinn under p enalty o f perjury that lam licensed under provision of Chapter 9 (commencing w ith Section 7000) of D ivision 3 or the Busine ss and Pro ressions Code. and my license is in fall force and e ffect. • vli..\1lC~O Licens e Class: • C 3\o Date '2.. \ u,\ 2, Ol \./ . I L icense Number _______________ _ CONSTRUCTION L ENDING AGENCY J hereby affirm under penalty o r perjury that there is a construction le nd ing agency for th e perfonnance or the work for which this permit is issued (Sec. 3097, Civ. C .). Lender's Na me : _________________________ _ Lender·s Address: _______________________ _ APPLICANT'S DECLARATI ON Demolition Pcnnits-Asbcstos Notifi ca tion Federa l Regulations (Title 40. Pan 6) _ Required Letter of Notification [ _---,~t ha t the foderal regulat ions regardin g as bestos removal arc not applicable to this project ,_R_o_u_g_h __ M_e_c_h_. __________ -+-------->------+------------------~ ...... t ~ertify that I have re ad this application and state that the above infonnat ion is correct. I agree to comply with all Cit y and County Final Test ordmanccs and State Laws re latmg to bu1ldmg construction. and he reby~uthonz cpres 1at1ves ofth1s C ity a nd County to e nter u pon the above mentioned property for mspect1on~es._/ ~ I ! Meter Release / / Apphc ant or agent Sig ~ ~ / ~ Date / z. _l.--Z.. [;!-di b I-F-IN_A_L-----~(R-/+..I"-6___...,..R_S_.~_I -.,,.+-1fl-_JL01-f-.--+-q,_-_<{ _______ _. l'ermi11ce name(print):_~~-----1/D-; ;~la~f'\~~-·'_ck~o._r_d_'1 ____ 1 __ • __ I 7 M:\WP51 \Permtt-lnspecUon Forms\Mechanical-lnspector Record.doc 03.31.06