HomeMy WebLinkAbout40132203 - PermitCity of Santa Ana
Permil Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical Permit #: 4O13.22Ot
Pin #: 9539Elnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
ProjectAddress: 2902 W Borchard Ave Unit:
Block: NA
Bldg:
Tract: 3627
Address Range:
Historic: No
Suile Range:
Zoning: R'l
E
Assessor's Parce| 4O7 -O41-2A Lot: 2
Owner:
Address
Thuc Nguyen
2902 W Borchard Ave
Santa Ana, CA 927043005
(714) 67s-8606
Fea Type
01116002 51604 Repair Vent Sys
01116002 51600 General Plan Update
01116002 51604 lssuance
Amount
41 .99
21.25
52.98
Qty
1.00
1.00
1.00
Fee
$41.99
$21.2s
$s2.98Phone:
Tenant Name:
Contractor
Address:
Owner-Builder
Bot,:hi:44251 - 6/
ofl iEei CTYH Tr
Acr:t+l
Rcptl:0??9318? -
Tn(tnsoct ion Toto I
t::
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Thuc Nsusen
Building Use:
Job Type:
Nature of Work
Single Family Dwelling
Addition
Addition
R-3, U
VB
cMc 2016
Generol Plon Updot€ f
01116002- 51600000-
llechon icol
01116002- 516040t1rJ-
V isn
CCi: r*r*Ir*rr*r*3:1 I
Notes:
Planning Conditions:
Planning Approval By: Date:
Plan Checked Bv: . Date:.\\
Permit lssued By: \LFHernandez, Kathy Date: 061A2018
Subject to Field: \
Accornt#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Buildins Permit #: 101 95340
Every pennit issued shall become invalid unless lhe wo* on the site
authoized by such permit is commenced within 180 days aftet its
issuance, or if the wo* eulhoized on the site by such pennit is suspended
ot abandoned lor a period ol 1 80 days aftet the time the worl< is
commanced.
01'1'16002 51600 $21.25
$94.97
$116.22
$0.00
$'t16.22
lnspector MID#: 2017-138714
01 1 16002 51604
Fee Total:
Paid to Date:
Balance Due:
Phone:
Occupancy:
Constr Type:
Code:
MECHANICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
Smoke Detectors lnstalled
Flou gh Ductwork
Vents
Toilet Room / Clothes D ryer
Residential Ranoe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.-t lts ,Ir(1ttfur)
Final Test I
Meler Release
FINAL E t(-r l^lClrMrr,l'2.1)
Notes, Remarks, Etc.II UY
OWNER DUILDER DELO{RATION
I hcrchy lmrn lnder pcMlry 6f perjury lhr I d cxenDr n$m rhc Cono&ror' Liccns. hw for E lolloviig Easn ($c.7031.,
Businss .nd Prof.ssion Cod.) tuy Cily or Courly which rcq rcs 3 Fmn to on(ml.,lI(. inporc, {hmlish or ELir dy
slrucrurc. prior lo its issuatrN, rho rcquncs $c arplic l for scn lcmir ro fic a siBmd stlrem rhar hc or shc ir liccosr! nuFunr
lo ilE p,bririo.s of tlE CoorB.loas Liftlsd tis (Ch,pt.r 9. Conmming wnh sNlioo 70m of Division 3 of llE Blsincss a.d
Pmf.ssions Conc) or lhat lf, or sh. h .xcmnl lhcr.frcm.nd llF hask for tlE allcScd cx.mplion. Any viobfion otS6lhn 7011.5 by uny
spt icrnr for a l,.mil subrc.k lhc rpplicanl lo a.ivil lcMlly of nol mE lh filc hundEd dollm (5500),
-1.
as owncr of lh. pmFny. r my cnrplolNs wnh r.8cs {. th.t sl. .onpMs0tion. wiI do lhc wk !M tlE slrud@ h mr
inrddcd oroflcr{ f6! sk (Sd.7044. Blsimss and PrDfcssk.sCodc: TIE Co ntoasL@reLlwilocseral,plylosowmrof
$o tmFny who hilds tr impmws tlEmn, lrd wh. do6slch wo hinsclforhcr*lforlnmuShnisorhcroencmrloy.es.
pmvid.d rhar suci inpovmft m rcl hrdd.n 6.6!Icrn for el,lt hows. r,r hiiBing6r arSMtu Lieuwilninom){,
olon$lcrbn. dc Owmr Buildcr {ill hlr rhc hdd ofr,oin3 thar lr or shc dit m! t iU or in9n w Ur lopcty for 0E putbs or
-1.
as o,ner ol lnc pmpcrlr. sr exclusilel, contretinS wilh liccnsd .onrrrcros ro @isrrucr ttrc Proirt (Scc. 7014, Butincic
anl Prorcs*ih Cod.: Thc C6nt,.rol s Lien* L,w .locr mr lllply ro e oen6 of rop.ny sho bDil& o. iq,mws lh.Nn,
a.d who conlncls for sNh l,oj(ls with a C,fltr.cto(, li.cns.d !u6Ml ro rhc Contacror's Lie.rc Lis).
I hcrcby amrm und$ ncMl'y of nsjury om of thc lbllouitrs dcchmtions
-l
hlvc sn eill minrain s Ccdifrorc oaconsnr ro S.lf-lnsuE aor mrkc6 coq*nslrbn. ,s Forii.d for b, S6rioo l70O ol rh.
r,bor Codc lor llrc p€nMmmc of tlE tud( ror wnth lhc Frmii h issuen
-l
hrvc rnd *ill @inroin *o,kctr .on{xnsarion insuhnc., f,i ftqut d hy Secrion 3?UO of th. t bor Codc. for th. pcrfomkc 6f
lhc work for *hkh rhh Frn is issucd. My wortca compcnsdion insurancc .mkr ond lblicy nuftbcr Nl
I.caity rh,l in rhc p.rao.mm. ollth vo.k 46, vhich rhi! F mar Ls is$.d.I rh.ll Nl dl oy any p.Mn inlry nMmr
s as lo b.!rm subjd to thc $orkcB comp.nsalion L$ of Californio. ord 088 lhal if I sholld b€toft sbj(r lo dt
*ork6' mmp.B.lion lovhhns ol Sdlhn l?00 of lh. t$or C.d.. I slEll, lbrlt*ilh 6q,ly enh lho* Povhions.
WARNINC: Flihr ro rcue qorl((..rlltn$rnr c-lctusc i\ unlxwful, an{ lhall \ubjer &. cmplor.r lo aimiMl IEMhics oM
civil nnc\ u! ro onc tlodEn thoNr.d doll&s (5100,()l)0), in lddinrn h lh. cosr .l .ofrFnerion, domgs as prcvidcd for ll*
I 1076 of rhc kbor Codc. inldcsl !M ahrrcy s tes
Dl;llnLBAlltul
Ihcrchtrlllrmukl.r pc hr_ot Nrjuy rhar I rm li!.n{n uMcr pr.\r{ion olChtlprcr g (.on,mncinE *irh Scclirn 7(Xi,) of Divi\ion l
of lhc llu\inc\\ rni Pn,fc\\i,n,! Codc. md niyli.c.\r i\ in tull,'nt aNlclLcr
Licc$c Clo$:-Liccnsc Numher:
D.te conlrrclor:
g}IIIAII:IIONIENDINCAGEICI
I hcmby rrtrnurdcr lEorlryolFrjury th3l lhdc is r cotrnMrnrn hnninS orcmy li,r rh. pcrlotrumc olrhc wo* ror whkh rhil Frmir is
i\s!.d (Sc...10)7, Civ. C.)
ATTLIIANLDESdAAIIAN
l,xnb, fiimundcr pctrrhy oipcrjury orc oflhc followirS d(lan(ions:
Ocmolirioo Pcrnrils'Ast{slos Norifi.arion rtdcral Rc8ulat ions (Iirlc tlo. PM6)
R.quncdbrrcrorNodli. tun
-l
.cdify lnfi rhc fcdcml reSukrions ESsdinS $bcsos Enotd m nor npplkobh lo thn poirt.
_l Luify rh, I hdr @d rhi* eplic{rion r.d iarc rhd thc uhovc iotomdion ie.o,d.l a8G ro co.ply with oU Ciry.nd Colnr,
orditutu$ lrd Shre Liwi rbrinS ro blilding 6 dtuciion. !d hcdby aurhori4 rpr.rnr.liws
rh)rc mnrioncd prcpcny n, ir\
At'plicafl or Ase Sisnaurc:-
cny ard Counrr ro cntcr ulntr rhc
tSEt
COMMENTS
lnsulation
lnstallation
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