HomeMy WebLinkAbout40132069 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
lnspection Requests: (714], 667-2738 lnspector Section: (714) 647-5853
Mecha n ica I Permit #: 40{ 32069
Pin #: 4714
Proiect Address: 3904 S Flower St
Assessor'sParcel: 410-291-02 Lot: NA
Unit: H
Block: NA
Bldg:
Tract NA
Suite Range:
Zoning: R4
E
Contractor
Address:
Prime & South Coast L P
50 California St 920
San Francisco, CA 941114606
Western Plumbing Services
1810 N. Linwood Ave.
Santa Ana, CA 92705
(714) 492-5490
Fse Type Amount
01116002 51604 Clothes Dryer - Residen 38.83
01116002 5160C General Plan Update 21.25
0'1116002 5'1604 lssuance 52.98
Qty
'1 .00
1 .00
1 .00
Fee
$38.83
$21.25
$52.98Phone
Tenant Name:
Phone
State Lic #: 1021101
Lic Type: C-36
Bus. Lic #: 364095
Workers' Compensation lnsurance:
Carrier: State Farm Fire and Casualty Company
Policy #: 90C6X6879
Expires: OBl24l2OlA
Botch3:43635 - 1/7 /2A18
oft ice: CTYH Tronsi: 22
Acct+: Refi l
Rcpti:02258743 - 5/7/20t9
frcnsact ion Totol
I0: ccuEl
1l !
4013206r
1l:42 An
tl'29t'l.gl
l,lestern Flurb ins Serv ices
Gmenol Plon Updote Fee
01116002- 51600000-
llechon i co I
01116002- 5160{000-
llos[er Cord
CC+:*r**r**r**i*{823
trL rl'l
Auth+:02669i
Building Use:
Job Type:
Nature of Work:
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Multi-Family (5 or more uni Occupancy:
Alteration Constr TyPe:
washer/dryer Code:
Daie:
Date:
Date:
R-2
VB
cMc 2016 Notes: lnstall a washer & dryer in an existing closet.
Zuniga, Allissa
Every pemit issued shall become invalid unless the wo* o, the sile
authoized by such permit is commenced within 1 80 days aftor its
issuance, ot it the work authodzed on the sito by such permit is suspended
ot abandoned for a period of 1 80 days aftet the time the wotk is
commoncecl-
o5lo7 t2ua
Account#
$21 .2s
$91.81
$1 13.06
$0.00
$113.06
lnspector MID#: 2018-143173
01 1 16002 51600
0'1 1 'l 6002 51 604
Fee Total
Paid lo Date:
Balance Oue:
AddressRange: 3800-3928
Historic: No
Owner:
Address:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE COMMENTS
Appliances
Metal Fire Place
Evap Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents /n\
Toilet Room / Clothes Dryer 5.v-t*vll4l)
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
Rough Mech.
Final Test
FINAL /nb/tk ('trzt>rt+-/62-,-/u
Owrd-B!ildr D.cldtion
I h6.byrmrm under pd hy ol p.rjury lh.t l.md.mF lomtn Co.l6.ro Lic.n* ttw aor $. lollovins r.&n (s4 7031,5 BcinBs
&d Proa6rio. Cod.): Aly Ciry or Coorr, *hich r.quir6 ! pcml ro 66riu.r. !lrd. inpolt. d.mlish or Eplt rny srDclu.. Fior ro il!
i$u!n.c. lLo rcquiG lh. .prlio'n for 3uch p.mn b fiI. t riSncn lt.r@nt thrl n or sh. is lic.Gd p@@t lo 0E povisios of thc
Conkdoli LieB.d L.w(ChlFo9, Coftn.rci(g wnh Setion 7000 of DivB'o. I o t tn. Bue'n.!! lnd Prot63ioN Cod.) or thtt h. or.
3hc n .x.Dfl rn*n'on .nd rl* bei! for rlrc lllq.d .&dprion .Any viollrion of Setion 7011.5 by ,ny lppliclnr lor ! pmil lubjcft $c
+plicanl lo. civil p.dry ofmr mrc lhm nv. hu.dr.d.lolLa (1500).
__l, 6 ownn 01lh. pFpcny. or m, cnployB *hh wrga a rh.t el. coBp.tuarion. will do lh. work dd lt. nrudw i3 .ol inrddd
or oreEd for s l. ( s.c 7044, Bulm.rs lnd P,oL$ion! Cod. Th. Conlncro* Lic.ns. Llw do6 not .pDly ro !n oMd ol rh. pop.ny
*ho buil.Lr or imDo\s rha6n, dd *h. dod such sork hituclaor hdlfor rtmush his or h6 ow. Gmploy6. provid.d rh.r euch
improv.r.nt e. mt ht.nd.d or offd.d lor sl.. I I how.na. lh. buildin! o. ifpbv.ncnt ie sold wnhin bnc ycar orcodplaion, $c
(rncFBuild.r will tuv. th. burdci olprovi.B th.r hc or ih. ,ol build or nrpDv. for lh. plrpo* of r!h).
_1. a ownnolrh. popcny. @.rclori!.1, conmdins whh lic.acd contr..roa ro $Nlrucl rh. pruj*r ( Sft. ?04{, Bain6i.nd
tuoaesion cod.: Th. contr<ioa! L.c6. Lrw do6 nor .pply lo & o*B of propsry wto builds or iDpov6 rtqotr . and who
comrcrs for such p@j.cls wilh a Co !cro(, lrc.ns.d puBunt ro th. Contmdo.3 LEn!. kw )
I @ cx.mpt n.d( s<rion ,8. & P C.forfib rcaoi
WORXERS COMPENSATION DECLARATION
I hq.by aflim und.r pcmhy ofpsjury orc oa thc lollowiry d(l*.lioN:
_l hw. .nd e ill oainl.h ! C!nif'@r. of CoB.rt ro S.lf.l Gur. for @r!.rc' cotrr.nsrion, a provd.d lor !y Sdion ITOO of $.
hbor Codc. fo. th. p.rfomm. of thc wdl for *hi.h thc p.dir i3 i$ucd.
I lnv. lnl snl ,ainlam wort.rs @mp.n$lEn rsoflne. c ..q!n.d by S.cIion lT0o ol th. ljbor Cod., lor th. p.rforronc. ofln
.omD.narirn inrumn@ ffin lnd policy nuhh.r ecfu r2"..._
r:C (oVlo t7a 8tz4 tt?6'i.*ai""*ffi[roq oircs; / rf ,-
I c.niaylh.l in lh. p.rformnc. oarh. wolk aor qhich lhk p.nnir is irsu.d.l shnll no'.nDloy ant p.Ron in.., ma.n.r so 6 ro
b.crmcslbJdl rornewoil.R omp.nslon L*iof Calilorn,,nd rsr.e r
compctulrion povisions of S*rioo l?00 of lhc t"::,ff
WARNINC Fail!6to !..ur. wo,[.6 @mp.n!.t,on cov.ris. rt uihwful. $d slEll subjd !n.mploy.r to criminalp.NltB and civil
fh6 up lo onc fiurt.d rhoMd dolls ( I100,000).i!.ddnio! to th. cGt of conp.Ntio,t dro!96 a prcvid.d for rhc Sdioo 10?6 of
lh. L,bor Cod., inleGl .nd.nom.r's fd
ueElsE!-qoxlBAcroatulclA
I ho.by.mrd undq pcnthyofpdjury tn3l I am lic.nscd u.dd pmvkion ofChaprE 9lco,m.tr.inA with S.dion ?000) ofDivision I ol
Cod., rnd my lic.cc is in foll forc. ud.ltel
Ll z-
ca!s!B!rcr!9!_t!i!!!rc_acExtri
I hcrebr.flnm ondd pcn.kyof!. urr lhar th.Bk acoBrtucrion lcndins lgcn.y aorrhc polomanc.otrhr*or[ fffsh'chrht podil is
nsucd (Scc. 11097, Civ C.).
AEEIC6IIIL-SEOJA I!q{
D.molnion Pmtu'A.h6lor Norificlion F.<tc6l R.aularionr (Tnk 40. Pm 6)
R.quircd lrtd oaNori,icirion
--l ccnify rhd rhl lidml r*ul.l ion! r.B-di.e ab6roi roolal !r. no! appliclbLlo thii proj.cl
l..nio rhat I hrv.,eadlnisapplicarion6ndstare lhattheahovc inlonmrion iscor.d I asrec lo comply wnh all Cny ond Colnly
ordinaeG rnd Sraie lrls rclal in8 lo bu ilding Epc.nl.iivB of this Cny a.d Comiy ro .nt.r lpon fi.
S,I,
M \W P5i \Permil,lnspeclion F r06
tD/srG.
Meter Release
D.r.: ____ _,olxnd.
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