HomeMy WebLinkAbout40134655 - Permit (2)I
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:AOi34655
Pin #: 762EG
Proiect Address: 1918 112 S Svcamore Sta
Unit:
Block: B
Bldg:
Tract: 289
Address Range:
Historic: No
Suite Range:
Zoning: R2Assessor's Parcel: 015-063-1 1 Lot: 5
Owner:
Address:
Ana Castillo
1918 S Sycamore St
Santa Ana, CA 92707
(7141 317-s681
01 1 16002 51604
01 1 16002 s1604
01 1 16002 51604
01 1 16002 51604
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
Fee Type Amount
Wall Heater/Floor Furna 68.14
Bathroom Fan 31 .72
Laundry Fan Envir. Air 36.21
Range Fan 33.57
General Plan Update 22.95
lssuance 57.20
Microfilm Records 3.91
Qty
1.00
1.00
1.00
1.00
1.00
1.00
1.00
Fee
$68.1 4
$31 .72
$36.21
$33.57
$22.es
$57.20
$3.91
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Mechanical
Occupancy:
Constr Type:
Code:
R-3
VB
cMc 2019 Notes: Mechanical
Planning Conditions:
Planning Approva! By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
web_user
Date:
Date:
Date:06/01 t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit rssued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
N/A
N/A
No Balance
No Balance
Fee Total:
Paid to Date:
Balance Due:
$253 70
$2s3 70
$0.00
lnspector MID#:2020-1 59 17 1
M ECHANICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER AUILDER DELCARATION
I haeby affurn unda poalty of perjury thal I m cxempt from thc Conlractors' License Law for thc following te@n (54,7031.5
Busins md Prcfsion Code): Any Ciry or County which rcquire a pcmit lo srulruct. Eltq. improve. dc'iholish or rqtir oy
structuc. prior to its i$uece. slso requirs the applicant for such pemit to filc a signed statmmt that hc or shc b licms€d psuilt
to the provisiom of thc Contractor's Licened [:w (Chapter 9. Commcncing sith Sation 7000 of Division 3 of thc Busins md
Prefsions Code) or that hc or she is cxempt thqcftom md the basis for the alleged excmpion. Any violation of Scction 7031 .5 by any
applicantforapomitsubjslsthe applicanttoacivilpcnaltyofnolmorelhelivehundreddollus($500).
-1.
r o*nc of the Fopcny, or my employm with wagc r their mlc comprmtion. willdo thc \rcrk md rhc stnrc{w is nol
intqrded or offscd for sle (Sa,7044, Businas od Profesiom Codc: The Contractor's LiceN law do6 nol apply to il orvner of
lhc prcperty who builds or improv€ th@tr drd who do6 such rvork himself or heelf or through his or her own cmployG.
provided rhat such imprcv@mts sc not intoded or ofrs€d for slc. I[, howqq. thc building or improveml is sld *'ithin onc ]q
ofcompletion. the Olws Buildq will hare thc burdan ofprcring tha hc or shc did not build or improvc thc prepoty for thc prrpose of
ele).
-1.
r owna of thc propcty, an cxclusivcly contr8cling with liceBcd contractoE lo costruct the projcct (Ss. 7044. Buins
ud Profissbn Codc: The Contrsctor's Licose L8w do6 not apply to il own6 ofproperly rvho builds or inprovG th6@n.
md who conlnc-ts for such Fojcts with a ContEcto(s) licqscd purswt to thc Contractor's Licffi Law).
-l
m cxctnpt unds Setion-. B. & P.C. for this re6on.
f\^. ^.
WORKERS' COMPENSATION
DECLARATION
I hereby affrnn under penalty of perjury one of the following declarations:
-l
have and will maintain a Certilicate of Consent to Sclf-lrsure for workers' conlpensation, as providcd for by Scction 3700 of the
L,abor Code, for the performance of the work for which the permit b issued.
-I
have and will maintain workers' comperration insurancc, ost required by Section 3700 of the l-abor Code, for the pcrformance of
the work for which this permit is issuod Myworkers' compcnsation insurance carrier and policy numk are:
Policy Numbcr: ExPires:
_l certi& that in the performance of the work for which this permit is issued. I shall not cmploy any person in any manner
so as to bec'ome subject to the workcrs' compensation laws of California and agree that if I should become subject to the
work€rs' compensation provisions of Sedion 3700 of the Labor Code I shall. forthwith comply with those provisions..
WARNING: Failure to sccure work6s' compensation coverage is unlawful. and shall subject an anployer to ciminal pcnalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to thc cost of compensation. damagcs as provided for the
Section 3076 of the labor Codc interest and attorney's fecs.
LICT'NSED CONTRACTOR
nF.T.LARAT|ON
t hoeby aflirm und6 peoalty of pcrjury th* I am licenscd under provision of Chapter 9 (commencing with Seaion 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effcct.
License Class: License Numbcr:
ll^ . ^.ftnnlrontlar.
W
I hrcby affm undu pculty of pqjury th8t thm is I ortslruction lctrding agmcy for thc pcfomcc of thc work for which this porit b
Civ. C.).
l'ender's Address:
^ rr, ,c N, "rc, RAT,
I herdry affrrn under penalty of perjury one of the following declarations:
Dernolition Permits-Asbestos Notification Fcderal Regulations (Title 40. Part6)
-Required
Letter of Notification
-l
cEtiry thd rlE fcd6.l rcgulatiou rcgrdiog ubctos moval e lot pplicsblc to thb ptoj61.
-l
6tiry thst I havc ud this application [d statc thrt thc abovc infomdion is cotrE{. I agrc to 6mply with Ell City 8td Couoly
ordimce ed Statc Lam rchtiry to building constnctioq ad hqcty autlbriE rcpr$mrive of thir City ud Couty to 6ta upon rhc
abovc Mtiotrcd popaly for iBpoctioo purpca
Applicant or Agent Signature:
l'r'r nrilct' r)iunc (pr irrl)
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Ranqe
Other
Hood
Type I Hood
Type Mood
Grease Duct
Fire Damper
Openings
Installation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release l .A
FINAL ll la{l 2d Dkr ry
Notes, Remarks, Etc.
Carricr: