HomeMy WebLinkAbout40134929 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: Q1$ 667-2738 lnspector Section: (714) 647-5853
Permit #: 4Oi34929
Pin #: 1018'2
Proiect Address: 291 3 W Yuma Gira
Unit.
Block: NA
Bldg:
Tract: 3915
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 109-825-14 Lot: 8
Owner:
Address:
LUIS ZELAYA
2913 W YUMA CIR
Santa Ana, CA 927041568
(7141 s67-1 381
01 1 16002 51604
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
Fee Type
Furnace
General Plan Update
lssuance
Microfilm Records
Amount
70.66
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
Fee
$70.66
$23.7e
$s9.30
$4.0s
Phone:
Tenant Name:
Contractor:
Address.
Reliable Energy Managemel
7201 Rosecrans Blvd
Paramount, CA 90723
(800) 6924011Phone:
State Lic #: 704414
Lic Type: C-36, B, C-20
Bus. Lic #: 189601
Workers' Compensation I nsurance:Carrier: Travelerc Property lnsurance
Policy #: U89K07110A202G6
Expires: 0412912021
Building Use.
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Furnace c/o
Occupancy:
Constr Type:
Code:
R-3, U
VB
cMc 2019 Notes: Furnace change out. lnterior only.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By.
Subject to Field:
Building Permit #:
Chavez, Dave
Date:
Date:
Date:09t24t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
TotalY(7o
Every permitissued 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 permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
$23.79
$129.96
$4.0s
Fee Total:
Paid to Date:
Balance Due:
$157.80
$0.00
$157.80
lnspector MID#: 2O2O-1 61723
M ECHANICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrcby allirm undcr pemlty of Friury that I m cxcmpt from the ContncloF Lkrns Lrw for the following rcs$n (S1c.7031.5
Business ard Prcfcssion Codc): Any City or County whbh rcquircs a prmit to onstruct. altcn imprcve. demlish or rcp8ir rny
structre. Fior lo its issure. als rcquires thc applicant for such pcrmit to file I signed staleGnl that he or shc is lien$d ptmrnt
to thc prcvishns of the ContEctor's Lien*d kw (Chaptcr 9. Commrcing wilh Sation 7fi)0 of Division 3 of thc Busircss rnd
PrcfcssionsCode)orthathcorshcisexcmptthwfrcmandthe brsisforthcallcgcdexemption. AnyvklstionofsclionT03l.5byany
applicanl for 8 ]Emit subjets the spPlicant to 8 civil pemhy of not mrc lhu fivc hu.drcd dollars ($50O).
_1. as owner of thc property. or my employc.es with wages as thcir sole compensslion. will do the work Bnd the structure is not
intcnded or offered for sale (Scc.7044. Busincss and Profcssions Code: The Contractor's License l-aw docs not apply to an owner of
thc pmJrcrty wlrl builds or inprorrcs thcreon. and wtn docs such work himself or herself or through his or her own employces.
provided that such improverncnls arc not intcndcd or offcrcd for sah. If. however. thc building or improvenrnt is sold within one )rcar
of complction the Orrner Builder will have the burden of proving thal hc or shc did rnt bnrild or improrrc the propcrly for the purposc of
salc).
_1. as owner of the propcrty. am exclusivcly contracting with liccnscd conlractors lo construct thc pro.icct (Sec. 7W. Business
and Prrofcsskrn Code: Thc Contractor's Liccnsc Law docs not apply lo an owner of pro;rcrty who huilds or improvcs thercon.
and who contracts for such projects with a Contracto(s) licenscd pursuant to the Contractor's Licensc taw).
-l
am cxempt undcr B. & P.C. for this reason.
( )rr nrr
WORKERS' COMPENSATION
DFCI ARATION
I hcreby affirm undcr penalty of pcrjury onc of the following declarations:
_lhavcantlwill rruintainaCcrtilrcitte<ll'ConsclrtloScll'-lrrsurcfrrrworkcrs'cornpcttsution.as providcdforhyScclionSTfi)ofthc
Lahrr C}xlc. for thc pcrfornnncc of lhc u'rlrk for which thc pcrrnit is issucd.
-l
havc and will rnaintain workers'Section 3700 of the [-abor Codc. for thc performance of
thc work for issucd.carricr an<l number arc:
a 11,
IPolicy
_l certify that in thc perforrnancc of the work for which this pcrrrrit is issued. I shall not ernploy any pcrson in any manncr
so ns to bcconrc subjcct to the workcrs'contJrcnsalion laws of California. and agrcc lhal if I should bccomc subict to lhe
workcrs' cornpensation provisions of Scction 37fi) of thc Lahor Code. I shall. l'orthwith cornply with thosc provisions..
WARNING: Failurc to liccurc workers'compensation covcrage
dollars ($1ffi.000). in
and attorncy's fc.es.
is unlawful. and shall subject an employer lo crirninal Jrcnalties and
civil fincs up t<r hurrdrcd addition lo thc cost of damages as provided for thc
Section -i076 inlcrcst
o 0
l)l'lCL,\Rr\'l'l()N
I hercby aftirm under pnalty of perjury that I anr liccnscd under provision of Chaptcr 9 (contmcncing with Section 7Un) of Division 3
of the Business and Profcssions Codc. and rny liccnsc is in full frrrcc and cll'cct.
Liccnsc -
t Contracto.'(
W
I hcrcby !flirfl undcr ]Enulty of pcrjury that therc is a construction lcnding agcmy for lhc performncc ofthc work for which lhis lsmil is
issucd (Sc. 3097. Civ. C.).
kndcr's Namc:
lrndcr's Addrcss:
. prl ,c . NT I'EC, .
I lrcrcby allirm under penalty of pcrjury onc of the following dcclarations:
Denrolition Pcrmits-Asbestos Notification Fcdcral Regulations (Title 40. Purt6)
-Rcquircd
lrttcr of Notificalion
with lll arxlCourrly
and
atrovc nrcntioncd propcrly for inspcction
Applicant or Agent
Pernritcc narrrc (print
\,q to
Appliances
Metal Fire Place
Evaporative Cooler tl
Furnace u lalh a kkN
Compressor I I t
Misc. Equipment
Duct Work
Pre- lnsu !ation
!nsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
Other
Hood
Type I Hood
Type !l Hood
Grease Duct
Fire Damper
Openinqs
Installation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech
Final Test
Meter Release ,
FINAL lt l/ula ;9
Notes, Remarks, Etc.I
+
Date:_
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