HomeMy WebLinkAbout40132617 - PermitCity of Santa Ana
Permit Counter: (714], 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702
lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Mecha n ica I
Proiect Address: 2620 W Seoerstrom Ave
Assessor'sParcel: 933-071.59 Lot 2,611,2, 4, 5
Unit: A
Blockr NA
Bldg:
Tract: 8236/8868
AddressRange: 2600-2830
Historic: No
Suite Range:
Zoning: R4
ry
Owner:
Address
Contractor
Address:
Lori Tillman
2620 W. Segerstrom Ave, #A
Santa Ana, CA 92704
17141423-1062
Slater General lnc
8502 East Chapman Ave., #:
Orange, CA 92869
(714) 653-5030
Fee Type
01116002 51604 Bathroom Fan
01116002 51600 General Plan Update
01116002 51604 lssuance
Amount
30.52
22.O8
55.04
Generol Plsn Updste Fee
ull16002- 91600000-
il€chln icol
0r116002- 51604000-
ICL Cheik 003629
Fee
$30.52
$22.O8
$55.04
Tenant Name:
Bstchi:46067 - 9/24/2018 I0: JGULTIN
office: CTYH Tronsit 50 i :;'Acct+: Ref+: {0153r. ,',
RcDti:02390008 - j/21/2018 l2:Lrj i11
frqnsoct ion Totol t336. St
Slster 6enenol Inc
State Lic #: 946654
Lic Type: B
Bus. Lic #r 353370
Workers' Compensation lnsurance:
Carrier: Benchmark lnsurance Company
Policy #: CST501'1908
Expires: O1lO1l2O19
Building Use: Multi-Family (5 or more uni Occupancy:
Job Type: Miscellaneoua constr Type
Nature of Work: Remodel Bathroom code:
Planning Conditions: No change in floor plan
Planning Approval By
Every permit issued shall become invalid unless lh€ work on the site
authorized by such pemit is commenced within 1 80 days aftet its
issuance, ot if the wo* authorized on the site by such pomit is suspended
or abandoned fot a period of180 days aftet the time the work is
commenced.
ogt24t2018
Account#
Notes: Remove & replace fixtures in downstairs bathroom.
$107.64
$0.00
$'107.64
U, R.2
VB
cMc 2016
efi
Date:
Date:
Dale:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
196345 $22.08
$85.56
MID#: 2018-143185
01116002 5'1600
01116002 51604
Fee Total:
Paid to Date:
Balance Due:
Permit #: 4lJ13,2617
Pin #: 3o,437
Phone:
Qty
1.00
1.00
1.00
Phone:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
lnspector
MECHANICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.
Appliances
lvletal Fire Place
Evaporative Cooler
Compressor
Misc. Equipment
Duct Work
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer 1*274K w{utd
Residential Ranoe v
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Meter Release
FINAL 16ltulK AAhilfk K),,'
Notes, Remarks, Etc
OWNER BUILDER DELCAIATION
I hcrny rfim undei pcBlry of F jury lhxr I a! .xcmpr fDm lhc ConlrocloB Liccns t,w ror lhc fotloqing rci$n (Se.7011.5
Blsincss od PDfcssion Codc): Ary Cily or Counly wnkh BgliEs a Fmit lo oNttud. alt6. it{,rot. .IcnElilh or rcI,ln any
srtu.urc, prhr ro irs issum. !l$ rcqunca thc ipplicant fo. skh pcdir to 6lc a siBncd sllrm th8l lE or shc is lir(Ed puBanl
lo lhc pDvisions ol tlE Conlrmtoas Liccnsd l,w (Ch!pr.r 9. ComcminB wir[ S.cdon 7000 of Divition ] ofthc Businc$ and
Pmacssions Codc) or rhlr tc or ihc n c&qr rlErfroft sd rlE 6aris for rhc allcBcd .xc4)tion, Any viokionofSdlbn ?01,.5 by try
.pplicanr fo, a lclmil subrecrs th. lpplicet lo a .ivil Fn.lry ol .or DB tha 6v. hui&cd dollas (tr@).
-1.us
owncr oa thc prcFny. (tr my.n oy@s wnh qsscs es rhct sk ompcn$rhn. will do rhc work ald rslrB1w k mr
intenH 6r oncrcd Lr slc (Se.7044, ausi.css and Prolc$io.s Codc Th. C.nlEclor'r Ltcns tis &Es ml awly to d ownd of
lhe pFlf,.iy *ho hilds or in{,mts thcmtr et pllo dxs sun mrt himsclf o! h€sclf or tholsh hii d hct owo coplo}tcs.
providcd rhr' slch ihpm\\iMls @ mr i cfth oroficEd ,or {b, li hosc$ rtc }ailjhS or nr{mwd Lc $ld wnnin onc Fr
oa.orDlcrb rlr Ovmr Buildcr $ill h8k lhe buds! of pmvinA rhd hc o. shc dil mr huitl or intmw ,rc pmtEiy for tL purFE ot
-1.
a\ owmr oflfie pmpcnr. ancxcl$ircly conr&rins qirh liccn*d conrrcbs
'o
consldcr llE pmic.l (56.7044, Businsr
and Pnf6sbn Codc: Thc Comracror'r Lic.nsc bw des nol{pnlyro u ownq of prop.n, who builds or imtmlei ftercon,
aod sho odncG fo. such rmjcri *irh ! Oonhcro(9 licc.sd purunr ro rhe Gnl..crols Liccn* t w),
_l urcicmlr undcrs.dion_, B &PC n,rhisrN)n.
loxrE8{routENla.rloN
PECI.AAAIIAN
I hceiy a0irm udcr p€tulry of rdjuty om or rhc fotueing d*ladrionrl
-l
hlvc &d eill tuinrain ! Ccrlifrarcolcons ro S.laitr$rc for qorLcB coq,cn$lion.,s prcvidcd Lr hySc.lion 3?00 ofthc
tlbor dc. for lh. pcnormmc of tnc work for wfii.h lhc lEmit iq ksucd.
*l hlve lnd will tuinhin {orkcn .onFnqario. inrutur.. as rquind by sNrion l70o ol ltu tibor Codc. for lhc ,cdormncc ot
rhc mrt f.r *hi.h rhir Frnrir ir L*kd My wor*c6 mm,rnsa(ion insuraftc cmicr rnd Ibliy nunbcr ec:
-l.cnity
Uar in rhc lerfomre ol t sork for whi.h rhis,,$mI Li i*ued.I shall nol mrploy any pcisor in.nytun*r
$ as lo h.mnr subjd to lh. wortcB compcnsalion laws otcllifomin. do8Nlhul if I sk,lld lf,{oft $bjccl 16rlE
*ortss' ompcNllion tovicions ol Setion l?0o of lh. t$or Cod.. I shdl. fonh*i'h comply *iln lho* provisio.s..
WI|RNINC: Failurc ro scurc mrtcn compctrsotinn .o!cr08c is unlawful. and shlll \lhjccr an cmplortr h diftinal pcMhks tnd
lo onc hundrcd lhousond dolltrfi It 000). h addniofl ro In€ cosr ofconFnsarion. ddmlcs ,. ,,rovid.n lor th.
7 z,(tv
I hctobl alfiirn uidcr !. rlrtof!c!ury r
DECI.ABAIIJN
undo lmtisio. of Ch.pt.r 9 (ommtuins wnh Serio. TOo0) orDivnion l
or th. Aueinc$ lod Pof*sions Coda. .,i 6y |tcn* k h tull f.rc. {n cfic.r
c
i\lidJ lsc. .lrrr?. (-iv C )
[trn'nr rcsunnr8 sbcst,s rcnD!!| 0rc nor lppli.ihlc h rhi\ tmjc.r.
ion ltn sr.lcrhrt lh. ahor informtiotr n codd.I aBe ro@6t1, wirhlllCiry.nd C.unry
buidnr! conno.riotr and h.rcby aurlEriz rcprc*nra'ivcs ol lhh Cny rnd Counryb cnrcr lx,n r,E
7 z.q /8
COMMENTS
Furnace
Pre-lnsulation
Final Test lrodca\ Addre\s:
-
,rl)g x:,rllr or.r't anlrrtx
I lm$y dtn nr urdcr pctrrlry oipcrjury otrc.flhc lnll.wirE dcchririons
,)cnnnirn[ fcmirwAslt(os Norilicrrion F.dcal Rcguhrions ( tirl.40. Prn6)
Roquncd l-crror.f N.rilkdri(rr
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