HomeMy WebLinkAbout40134202 - PermitProject Address: 2422 N Larchmont Ave
Assessor's Parcel: 003-100-30 Lot. 15
Unit:
Block: NA
Bldg:
Tract: 1562
Address Range:
Historic: No
Suite Range:
Zoning: Rl
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Permit Counter: (7'14) 647-5800 lnspection Requests: (7141667-2738 lnspector Section: (714) 647-5853
Mechanical Permit #: 4o^1342o.2
Pin #: 29{691{
Owner:
Address.
Phone:
Tenant Name:
Contractor
Address:
Phone.
KAREN L YEAW
2422 N LARCHMONT AVE
Santa Ana, GA 927062017
(7141 541-2s68
Service Champions
3150 E Birch Street
Brea, CA 92821
(7141 777 -7777
01 1 16002 51604
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
Fee Type Amount Qty
Furnace/Comp Combo 131 .87 1.00
General Plan Update 22.95 1.00
lssuance 57.20 1 .00
Microfilm Records 3.91 1.00
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Fee
$1 31 .87
$22.e5
$57.20
$3.e1
ierv i ce Chonp i on s
State Lic #. 799170
Lic Type: C-36, B, C-2, C-20
Bus. Lic #: 196430
Workers' Compensation lnsurance:Carrier: EVEREST NATIONAL INSURANCE COMPANY
Policy #. RM8WC00044191
Expires: 0512912020
Generol Flnn Updgte Fr
0u 16002- 516000(10-
ilechon icol
01116002- 51604000-
ll icrof i lm & Docunents
0l I16002- 5777ttr100-
ICL Check A21426
Notes: Change out FAU in attic, change out compressor in
rear yard.
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
HVAC
Amsden. Julie
Planning Conditions:
Planning Approval By:Soto, Ricardo
Plan Checked By
Permit lssued By:
Subject to Field:
Building Permit #:
Occupancy.
Constr Type
Code:
Date:
Date:
Date:
R-3
VB
cMc 2016
11127 t2019
11t2712019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit issued 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 sife by such permit rs suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 201 9-156183
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
$22 e5
$1 89 07
$3 91
Fee Total:
Paid to Date:
Balance Due:
$2t s.93
$0.00
$215.93
\
M ECHANICAL.! NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hmby afiim unda pcrulty of pcrjury thal I m cxmpt ftom thc CootractoE' Licffi trw for thc following wn (Sc.?0315
Busince and Prcfeion Codc): Any City or County which rcquirc a pan'nit to snstrud, 8ltq, imprcve. dmolbh or (Dair oy
structre, pdor to its isuucc. also rcquire thc applicut for such pcmit to 6lc a signcd sldmqt thd hc or shc b licoscd Plmmr
to thc provisioru of rhc Conttrtor's Licascd t:w (Chaptq 9. Comocing with Sction 7000 of Division 3 of thc Busirc md
Prefasiom Codc) or that lE or shc is qmpt th@from md thc bosis for the allc1cd qmpion. Any violstion of Sctbn 70i 1.5 by trI
applicantforapcmitsubjEBthc applicanttoacivilpcmltyofnotmorcthmfivchun&cddollm($500).
_- 1. as o\\,ner of the proFtrty. or my employees \r'ith \\'ages as lheir sole cornpensation. s'illdo the s'ork and the slructure is not
intcnded or offered for sale (Sec'.7O{4. Business and Professions Code: 'I'he Contractor's License [as'does not apply to an os'ner of
the properly u,ho builds or irn5noves thermn. and rvho does such $'ort himself or herself or thnrugh his or her os'n employees.
provided that such improvanents are not intcrrded oroffered frrr sale. ll. hou'ever. the building or improvetnent is sold rvithin one year
of cornptetion. the (hvner Buildcr rvill have the burden of proving that he or she did not build or irnprove the propory for the puqnsc of
sale).
- _t. .ts owncr of the property. arn exclusively contracting rvith licensed contraclots to construct the proiect (Sec. 7044. Business
and hofession Code: The Contractor's License l.arv does not apply to an ou'ner of property u'ho builds or improves thereon.
and rvho contracts for such pt'ojects rvith a Contractor(s) licensed pursuant to the Contractor's l.icense [-aw).
I zun exempt under Section- B. & P.C. for thi.s reason.
I )ir I t':Onner:
WORKERS' CONI PENSATION
DECLARATION
of the follorving declarations:I hereby affrrm under penalty of perjury one
-t
harc ard will minrain ! Ccrtificatc of ColMt to SdflBurc for rcrtc' omparatiou'u povidcd for by Setion 3700 of th€
Lrbor Codc fur thc psfoMc of thc mr& for which thc pmit b isucd.
.Xhavc and will maintaitr work6' compffition insurmcc, r rcquircd by Serioo 3?00 of thc Lsbor Codc for thc pqfom of
thi rcrk for which this pcrnit is iscd. My wottc' smposdioo imc mir ad policy numbc rc:
l'olicy l:xpircs:
I
_l certi$, that in the performance of the work for s'hich this permit is issued. I shall not employ any person in any manner
so as to become subject to the work€rs'compensation laws of California. and agree that if I should bccome subject to the
workers' compensation provisions of Section 3700 of the Labor Code. I shall. forthwilh comply rvith thosc provisions..
WARNING: Failure to secure rvorkers' compersation coverage is unlawful. and shall subject an €tnploy€r to crirninal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for the
attorney's fees.
DECLARATION
t hereby alTirrn under penalty of perjury that I arn licensed under provision of ('hapter 9 (conrtnencing s'ith Section 7000) of Division -1
of the Busincss and Professi<lns Code. and rny license is in full florce ancl ef flcct.
c fl?/7dLicenseNumber:
('ontrRctor: /e/
('oNS'l'RU(' I ION LItNI)lN(;,\(;r.N('\',
I hmby affim unds pcnalty of pcrjury that th@ is 8 @nstruction hnding agmcy for the pqfollmcc of thc wort for *'hich this pcmh is
issued (Sec. -3097. Civ. C.).
Lender's Name:
Lender's Address:
APPLTCANT DECLARATION
I her€by aflirm under penalty of perjury one of the follorving declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40. Par16)
-Required
Letter of Notilication
--l
certify that the federal regulations regarding asbestos removal are not applicable to this proJect.
___l cotify that I have read this application and state that the atnve information is correct. I agree to comply with all City and County
ordinances and State Larvs relating to building construction. and hereby authorize representatives of this City and
above mentioned property for
Applicant or Agent
I'ennitee nauxe
?
ru1xrn the
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 Range
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release I
FINAL /t4*,4[,t*'v1,
Notes, Remarks, Etc..4V I'