HomeMy WebLinkAbout40134458 - Permita
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Proiect Address: 2001 S Main Sta
Mechanical
Address Range: 2001
Historic: No
Permit #: 40134458
Pin #: 63E53
Assessor's Parcel: 403-164-01 Lot: '1, 17, POR 2
Unit:
Block. B
Bldg:
Tract: 284
Suite Range:
Zoning: G1
Owner.
Address:
Phone:
Tenant Name:
Contractor:
Address:
BANK OF AMERICA NT & SA ASSESSTI
NC1-001-03-81
Charlotte, NC 282550000
(980) 335-3561
Deb Construction
2230 E Winston Road
Anaheim, CA 92806
(7141 632-6680
01 1 16002 51604
01 1 16002 51604
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
Fee Type
Air Handling
Bathroom Fan
Genera! Plan Update
I ssuance
Microfilm Records
Amount
46.25
31 .72
22.95
57.20
3.91
Qty
1 .00
1 .00
1 .00
100
1 .00
Fee
$46.2s
$31 .72
$22.e5
$57.20
$3.91
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Trsns*:23
Ref *
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318.44
AFI
Phone:
State Lic #: 372419
Lic Type: B
Bus. Lic #: 159001
Workers' Compensation I nsurance:Carrier: OLD REPUBLIC INSURANCE COMPANY
Policy #: MWC31521819
Expires: 05/31 12020
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'$
Building Use:
Job Type:
Nature of Work
Commercial
Tenant lmprovement
T.l.
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
B
VB
cMc 2019
':
,. i
.
Mechanical for interior tenant improvements related to
accessibility.
$162.03
$0 00
$162.03
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Chavez, Dave
Subject to Field:
Buildins Permit #: 1 01971 98
v?'02t06t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
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 permitis 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
$22.es
$1 3s.1 7
$3 91
lnspector MID#: 201 8-145049
MECHANICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNEN BT'ILDER DELCARATION
I hcrcby afnrm urdq lEmliy of pcrjury thst I m crcmpl ftom lhe ContrrctoB' Licens lrw for rhc following mmn (Sc.7031.5
Business 8nd Prcfession Codc): Any City or County which requircs a pcmit to mnstruct, alls. imprcw. dcmlish or rcpair any
structurc, prior lo its issumce. slso rcquircs thc spplicsd for such pemil lo frlc a signcd statemnt that he or shc h liccnrd pumant
to the provisions of the Contrctor's Licnsd hw (Ch8ptcr 9. Colrrerciog with Section 7000 of Division 3 of tlE Busine$ snd
PrcfessionsCode)orthallEorsheiscxemptthscfromardrhebosisforthcsllegederemption. AnyviolationofSctkln703l.5bysny
applicrnl for a lrmit subjcrls thc applicant to a civil pemlty of rct mrc thm Iive hundrc{ dollus ($500).
-1.
as owncr of thc property. or my employees wilh wagcs as their sole compensation. will do the work and the structurc is not
intendcd or offercd for sale (Scc.7044. Busincss and hofcssions Codc: The Contractor's License l-aw does not apply lo an owncr of
thc propcrry who builds or improves thcrcon. and who docs such work hirnself or herself or lhrough his or hcr own employees.
provided lhat such improvenrnts are not intended or offcred for sale. lf. howerrcr. lhe building or inqrroverrnt is sold within one )r&r
of complction. thc Owncr Builder will have the burdcn of proving that hc or shc did not build or inprorre tlrc propcrty for the purpsc of
sah).
-1.
as owncr of the propcrty. am exclusively contracting with licensed contractors to construct thc project (Sec. 7044. Business
and Prrofcssion Code: Thc Contractor's Liccnse Law does not apply lo an owner of property who builds or improvcs thcrcon.
and who contracls for such projects with a Contractor(s) licensed pursuanl to the Conlractor's Liccnse t aw).
-IamexemptunderSection-.B.&P.C.forthisreason.Date:( )u ner
WORKERS' COMPENSATION
DECLARATION
I hcrcby atTirnr undcr penalty of perjury one of thc following declarations:
-l
havc and will maintain a Certifrcate of Consent to Self-lnsure for workcrs' comSrensalion, as provided for by Section 3700 of the
I-abor Code. for the grrformance of the work for which thc permit is issucd.
Qf"tmr*rvill 37fi) of the Labor Code. for thc Jrcrfbrmancc of
grlicy numbcr are:
a h
O
Policy o
-l
ccrtify that in the performance of the work for which this pcrmit is issucd. I shall nol cmploy any person in any manner
so as lo bccomc subjcct to thc workcrs'compcnsation laws of California. and agrcc that if I should hccome subjcct to thc
workcrs' compcnsation provisions of Section 37fi) of thc l.irtnr Codc. I shall.comply with those provisions..
WARNING: Failure to sccurc workcrs' comlrcnsation covcragie subjcct an employcr to criminal penaltics and
civil fincs up thousand dollars (Slfi).000), in of compensation. damages as providcd for the
Scction 3076 of Code. intcrcsl and atlonry's fces.
I hereby affrm under penalty of perjury that I am liccn:rcd under provision of Chapter 9 (comnrcncing with Section 70m) of Division !
of thc Busincss and Profcssions Codc. and my liccnsc is in full force and cffcct.
t
Licensc
a
a
I hcrcby alllrm under penalty of pcrjury that thcrc ilgcncy pcrfonnancc of thc work for which this Jrcrmil is
issued (Scc. 3097. Civ. C.).
Lcndcr's Namc:
Lrndcr's Addrcss:
pp, tcANT DECL RA'IN
I hcrcby aflinn undcr penalty of pcrjury one of thc following declarations:
Dcrnolition Permits-Asbcstos Notification Fedcral Rcgulations (Title 40. Part6)
-Rcquircd
[-cttcr of Notification
rcgarding asbcstos urc nol applicablc to this projcct.
is correct. I agrcrc to cornply with all City and County
rcprcscntativcs of this City and County lo cnter u;ron lhc
atlove menlioncd propcrty for
lhal
f\nra. J
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
Insulation
Smoke Detectors lnstalled
Rough Ductwork
Vents Ir I
Toilet Room I Clothes Dryer dtlt%^rW>7Residential Ranoe (Il-
Other
Hood
Type I Hood
Type !l Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech
Final Test
Meter Release t\h
FINAL bv\10 D {f\rd 4\p"\
Notes, Remarks, Etc.\\
-.>
Drtl^,r1)tnsurancc. as
pcrrnit is u'orkcrs'conrpcnsation
Exoircs:
w contracror:Date:-
rcad this
Applicant or Agent Signature, X
Pcrmitcc namc ( printl:r\(,l-"llur