HomeMy WebLinkAbout40134164 - Permita
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:40134164
Pin #: 31981 .1
Project Address: 1308 S Shelley St
Assessor's Parcel: 109-521-15 Lot: 14
Unit:
Block: NA
Bldg:
Tract 3355
Address Range:
Historic: No
Suite Range:
Zoning: R1
Owner.
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Aburto, Rafael
1308 S Shelley St
Santa Ana, CA 92704
(7141 425-1996
Specialty AC Heat
1289 E 7th Street
Upland, CA 91786
(eos) s82-799s
01 1 16002 51604
01 1 16002 5160C
01 1 16002 51604
01 1 16002 s777C
Fee Type Amount
Wall Heater/Floor Furna 68.14
General Plan Update 22.95
lssuance 57.20
Microfilm Records 3.91
Qty
1.00
1.00
1.00
1.00
Fee
$68.1 4
$22.95
$57.20
$3.91
State Lic #: 784495
Lic Type: C-36, C-20
Bus. Lic #: 349795
Workers' Compensation lnsurance:Carrier: Norguard lnsurance Gompany
Policy #: SPWC01S42T
Expires: 1112712019
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Mechanical
web user
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Mechanical
Fee Total
Paid to Date:
Balance Due:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cMc 2016
1111412019
Account#
N/A - No Balance
N/A - No Balance
$152.20
$1 52 20
$0.00
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 site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2019-155884
M ECHANICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
t h6eby aftum uod6 pcruty of pGjury that I m cxmpt from thc Contr.ctoB' Lictrsc law for thc following rmn (56.7031.5
Bwins and Prcf*ion Code): Any City or County rvhich requirB 8 Fmil to sGtruct. altc, imprcve &mlish or rpair ay
structuc. Fior to its ismc. also requirB thc applicmt for such pcrdt to frlc I signcd stalmat thrr hc or slE b licqE€d pmart
to thc fovisioru of thc Contractor's Liccnscd Law (Chapts 9, Commcncing with Sstion 7000 of Division 3 of thc Buine md
Prcfsions Codc) or that hc or she is dempt thq.ftom ud thc besis for thc allcgcd cxmptiotr. Atry violation of S6{bn 7031.5 by my
applicant for a pmit subjets thc applicant to a civil penalty of not morc thm fivc hundrcd dollm ($500).
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0s owner of the property. or my employees with wages as their sole compensation. willdo the work and the structure is not
intendod or offered for sale (Sa.7M4. Business and hofessions Code: The Contractor's License Law does not apply to an owner of
the property who hrilds or imp,rov€s ther@n. and who does such work himself or herself or through his or her own employec.
provided that such impovanrents arc not intended orofferod for sale. lf. horvwer. the building or impnovement is sold within one ]rar
of completion" the Orvner Builder will have the burden of proving tha he or she did not buiH or improve the propaty for ttrc purposcof
sale).
-1.
as o\rner of the property. am exclusively contracting with licensed contraclors lo conslruct the project (Sec. 7044. Business
and Profession Code: l'he Contractor's License Larv does not apply to an owncr of properly rvho builds or improves thereon.
and who contracts for such projects with a Contracto(s) licensed pursuant to the ('ontractor's License Larv).
-Iarne.\emptunderSection-.B.&P'C.forthisreason.l)irte
WORKERS' COMPENSATION
DECLARATION
I hereby affirm under penalty of perjury one ofthe follorving declarations:
-l
have and will maintain a Certificate of Consent to Self-lnsure for workers' conrpensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which the pcrmit is issued.
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have and will maintain workers' compercation insurance. as required by Section 3700 of the Labor Code, for the performance of
the work for which this permit is issued. My workers' compensation insurance carrier and policy number are:
Policy Number: Expires:
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certify that in the performance of the rvork for which this permit is issued. I shall not onploy any person in any manner
so as to become subjert to the workers' compensation laws of California. and ag,ree that if I should become subjcct to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall, forthwilh cornply with those provisions..
WARNING: Failure to secure workers' compensation coverage is unlawful. and shall subject an anployer to criminal pemlties and
civil fines up to onc hundred thousand dollan ($100.000). in addition to the cost of compensation, damages as provided for the
Section 3076 of the l-abor Code. interest and attorney's fees.
Date: Applicant:
I ICFNSEN CONTRAC'TOR
DECI..ARATION
I hereby aflinn under penalty of perjury that I arn licensc<l under provision ofChapter 9 (contmencing with Soction 7000) of Division 3
of the Business and Professions Code, and rny license is in fiull force and elfect.
License Class: License Number:
l)atc: ('orttrrclor;
W
I hady alfm udq p@rlty of pqjury that th@ i! . onstructbtr knding agacy fur thc pqfomcc of thc mrk 6r which this p6mit b
issucd (Se. 3097, Civ. C.).
Lender's Name:
APPI ICANT DF'CI ARATION
I herdD/ affirm under pcrialty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Required
Later of Notification
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c6ti& thd thc fcd6d rcgulatiou rcgading cbatos moval de not applicsblc to this prcjet.
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stiry tha I havc rcsd this spplic*ion {d statc that thc sbovc infomstiotr i! cotrEl. I rgc to @mply with all City ud Couty
odirc md Statc Lrw rclatilg to building coEtructioc atd h6rby uthorirc reFMtdiG of this City md Couty to atq upol thc
abovc mtionod pmpqty for irepction purpos
Applicant or Agent Signaturq f\atc.
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
!nsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
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.
Final Test
Meter Release ., I ,A ,1 {A
F!NAL tll'Mpltl fillrurc|,4v
Notes, Remarks, Etc.I r /?^WerVd ca -n) /rjtffiw
Lender's Address:
Pennitee narne (print):