HomeMy WebLinkAbout40131762 - PermitCity of Santa Ana
Permit Counter: 1714) 647-5800
20 Civic Center Plaza (M- 19), Santa Ana, CA92702
lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Mec han ical Permit #: 40131762
Pin #: E5753
Unit:
Block: NA
Bldg:
Tract 43
Address Range:
Historic: No
q
Contractor:
Address:
Phone
MDO PARTNERS
17111 RED HILL AVE
lrvine, CA 926145607
Oltmans Construction Co
10005 Mission Mill Rd
Whittier, CA 906080985
(56219484242
01116002 5'1604
01'116002 51604
01116002 53603
01116002 51600
011't6002 51604
Fee Type
Alter Vent Sys
Bathroom Fan
PIC - 650/o
General Plan Update
lssuance
Amount
41.99
29.38
0.65
2't.25
52.98
Qty
9.00
1 .00
407.29
1 .00
1 .00
Fee
$377.91
$29.38
$264.74
$2',1.2s
$s2.98
State Lic #: 85393
Lic Type: B, A
Bus. Lic #: 175797
Workers' Compensation lnsurance:Carrier: Travelers Property Casualty Co
Policy #: VTC2JUB2789L89717
Expires: 0710112014
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:',
Subject to Field:
Building Permit #:
Commercial
Tenant lmprovement
T.t.
West, Glen
Amsden, Julie
'r0195329
Date
Date
Date
Misc. Receipt: 70548
Misc. Receipt:
Misc. Receipt:
Total
B
V B, SPK
cMc 2016
Every permit issuad shall become invalid unless the wotu on lhe site
authorized by such permil is commenced within 1 80 ddys after its
issuance, ot if the work authorized on the site by such peftnit is suspended
or abandgned fot a period of180 days after the time the wotu is
commenced.
$746.26
$245.64
$500.62
lnspector
01116002 51600
o1115002 51604
01116002 53603
$21.25
$460.27
$19.10
Project Address: 515 E Dyer Rd
Assessor'sParcel: 411-052-26 Lot: NA
Suite Range:
Zoning: M1
Owner:
Address:
Tenant Name:
tttt
TTY
Phone:
Occupancy:
Constr Type:
Code:
02106t2018
02t12t20'18
Account#
Notes:
Fee Total:
Paid to Date:
Balance Due:
MID#: 2018-140837
MECHANICAL.INSPECTOR RECOHD
DATE ID/SIG.COMMENTS oWNI]R I]IJII-DI]R DI]LCARA'I'IoN
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Btr\incs id It lcssi( Codc) Atry Cily or Counly shi.h requircs r Fnnir kr ..nsnrcr. rllcr. imi'ovc. dcNni\h ,r lqln . iy
ttolisri,nr(Codc)orrhir hco.shc ir crcmfr rhcrclrn'nlnd rhc hrsi\ nrrhcnlLlcdcxctrrpli r Aryvnnnrionofsi.rit T{rrl5hi.tr'r
rpplicrnr litr x r.rnir \uhircrs rlr rptli..nrri r.rviltrmlr!.lmr nnnc rhrf lir. hutrJdlnolhrs (.$5{x)).
l.rs oBncr ol'rhc p0|rnr.or i,y. otcc\*irherS.srsrhcnqnc.{nrNfsarnnr.rilld.rhc*orkddrlr{nrrurci\ n
rhctr'l{'ry sho btrrl(h or irn,'.ovc\ rhcren. anJ qla, dms s'.h work hnn\clfor hc'rcll.r rInnrgh hi\ or hcr owt cnrrL,,ycc\.
l. ,s owmr ol thc ,mF.ny. !m crclusivcly entrrcrin-q eirh licend *,nrt!.ros ro o6lrud ttr pmiEl I S€c 7044. Businc$
lnd h!ftsion CDdc: The Conrn ror's Li.c.sc L!* docs nol .pply to an owrcr of tmr. ysho buildsor imrrovcs rhcrcon.
rnd who .onrBrs for sch pmlccrs wirh a contracro(s) lirnscd nr6u,nr ro lh. contraclois Liccn€ Lns).
I amcrc,npr utulcr Scct
woRl(lrls' coMmNsaTlolt
DECLAf,A]JA!
I h.rcby lffirm lnds !€nahy ot !..jury 6nc ol $. lolkrwiog d(lmrions:
-l
h!v. ud will minrain . Ccnitr.re ot Cons.nl ro S.lf-InsuE lor vortss omp€nstion, &r t)n)!il.d for by Selion l?m o, rhc
tihor C!dc. for rh. Frlormtu of rlE w6r* for *hth rhe p€mil i! hsucd.
I hrw a.d willmainlain wortcls compcns0rhn insunrcc- as rcquiEn by Sd io. l70o of llrc L.hor C.dc. aor rh€ lcrronMmc ol
whkh rhis l.mir is istu n. My woik* @mrcnlarirn arsu@. .nt .id poliy nu
OozrlQ*,A o
4.*'y tur 'nr* r*,rn *m nt ,rr wo,k ro, *hkt rhF rc,m tr
; s ro l[com 'ubiNr rn
'hc
wdkn. .oml.nrd on b* \ or C.hfomi..
eo*c6 .omn osrion DovasioB of serk f, 37m of fi. lahor Cod.. I
hsued.l snallml cmploya.yDcr$n ina.y manncr
mn !-!E rhor iII qhould lxcunE subFcl to lnc
shlll, aonhwirh.on ly wi$ lln* ,mvhion\
WAnNNG: Frilurc lo surc mrkcr' ompcnraln,n cokEsc n uohwtul. and snall subj6t an cmPloFr lo diminal lEmhts lnd
civil 6nca up ro onc hrndrcd thousod doll6 ($t0o,m0). in addnion to rh. co( of ompcnsarion, dlnBgcs es [ovidcd aor lhe
seriotr 10?6 of$c t hor Codc. irrcrc(,od ontysrc6
,",", o?lZ:?.911) n,0,.,,,Fa,L
I !(:FNSFT) (]oNTRACToR
I'ECI.d.BAIIQN
I hrrbya1ft u d.r lcnnlr! ol Nrjmy rh lamliccnEdu.dcrprovisionotch,lrcr9(c.nnN,cins*nnS$ri,n7Ox,ofDivhion3
of rhc llr\incss rnd Pn,lts\bns Codc. d ,nyIiccns is in aull iore d clfccr
aGql3
o
IANEIBIJ1;.II!)]IIINDINGIIiENCI
I hcrchy affiflnntulcr pcndryofpcrjuryihtr rhcr. is i cotr{ru.rion kl\4rS !8crcy tu lhe 0.rfornrkc orrhc qort lot s'hin ihi\ Fr.'ir i\
i$tr.d (Sc..1097. aiv C r.
ATTLTANIDICI.Af,AIIOIS
I hmby anim u.dcr Fnally of Frjury om of rhc followins dftl&rrions:
Dcmlirion Psmirs Asbci rol Nori fi.ar ion Fcd.rol R.rularions (Tnb 40, Pan6)
Rcquncdblrcrof Norific ion
6=.",,,',,n,""
i'is asbcdos rcnFvrl aE d.'.rplicahlc ro lhh pn,iccl
and st0rcrllal dr atnE ir,orm ion n cod..' I trSreloc.mtlysilhall Cirr3id Counry
rnd hc.ct y lulhon* rcparcnr.rivci orrhis Cny!.d County'o ctrrd ufi,n rh.
,,,,,. OZ-Rr?9tb
Appliances
l\4etal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipmenl
Duct Work
Pre-lnsulation <4-(aJ )ze"h 7
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer
Residentral Ranqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
lt-1-vb T$J
Rough Mech.
Meter Belease
FINAL lo-l-/y
Notes, Remarks, Etc.
\/,U 044'<,rt lr$htltg (-v,kacuwl
APPROVALS
Above T-Bar lbee.*t
Final Test
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