HomeMy WebLinkAbout40132199 - PermitProject Address: 2520 W Seqerstrom Ave
Assessor'sParcel: 933-071-59 Lol: 2,611,2,4,5
Unit: A
Block: NA
Bldg:
Tracl: 8236/8868
AddressRange: 2600-2830
Historic: No
Suite Range:
Zoning: R4
q
City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702
lnspectlon Requests: (714) 667-?738 lnspector Section: (714) 647-5853
Mecha n ical Permit #: 4O132199
Pin #: 54247
Contractor:
Address:
Phone
Tenant Name:
Lori Truman
2620 w. Sege6trom Ave, #A
Santa Ana, CA 92704
(714) 913-2663
Slater General lnc
8502 East Chapman Ave# 31
Orange, CA 92869
(714) 653-5030
01116002 51604
01116002 51604
01116002 51600
01116002 51604
Amount
29.38
31.10
21 .25
52.98
Fee Typ€
Bathroom Fan
Range Fan
General Plan Update
lssuance
Qty
1.00
'1.00
1.00
1.00
Fee
$29.38
$31.10
$21.25
$52.98
Phone
State Lic #: 946654
Lic Type: B
Bus. Lic #: 353370
Workers' Compensation lnsurance:Carrier: Benchmark lnsurance Company
Policy #: CST5011908
Expires: O1lO1l2O'19
Bstchi:4{232 - 6/ lt/?018
0ff icet CTYH Tronsi: l{lAccti! Refi3
Rcpti:0?2?2770 - 6.;1l./lul s
Troosdct ion lotal
lofI
{ t"r 13? 199
3r {4 Pn
913+,71
Slsten 6enpr(r1 Inr
R-2
VB
cMc 2016
t?l . ?t
$l1t.4s
i134.71
Generol Plon Updnte Fee
0l I 161102- 5l60t0rlr1-
llechon i coI
0l I l6t-10?- 51684000-I(L Check 003514Building Usei
Job Type:
Nature of Work:
Planning Conditions
Planning Approval By
Plan Checked 8y:
Permit lssued By:
Subject to Field:
Building Permit #:
{,t\xernanoez, ratny
Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes
10196345
Every pefinit issued shall becoma invalid unless the wotu on the site
authorized by such pennit is commenced within 180 days after its
issuance, or it the wotu authorized on tho site by such pefinit is suspended
ot abandonad fot a peiod of 1 80 days after the timo the work is
commenced-
lnspector MID#: 2018-143185
0611'll201a
Account#
01116002 51600
01 1 16002 51604
Fee Total:
Paid to Date:
Balance Due:
$21.25
$113.46
$ 1 34.71
$0.00
$'t34.7',l
Owner:
Address:
Multi-Family (5 or more uni Occupancy:
Miscellaneous Constr TYPe:
Remodel Code:
MECHANICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.OWNER SI,ILDER DELCARATION
I hcrcby arfo und.r p.n.lly of pcrjury lh.l I m crcmpl ftlm lhc C.nlrnctoN LiNn.c L.w for lhc aolheing rca$n (Sd.70]1.5
Blrincss and Profcssi,i Cod.)r Any Ciry or Cou y lhich tcquircs , rEmi ro hnsrd.t. rlrd. inprcw. .kmliih or o,Eir ary
rmc,@. iirtu lo irr issuet, als rcquiB lhc rppli.{it for $h |l.mir ro nb a s'gNd stalcmnl lhal hc or shc L liccn*d llrunl
l. lhc l,Evisions of tlE ConlE lor's Licn*d La* (Chlplcr 9, ComnEnciry ,ith S*lion 7000 of Dirisioi 3 oi lhc BNincs ond
Pblcsions Codc) or rh n orinc iscx.mfl rlEEfromand rhc b8h for rlE alhgcd qcnip'ion. Any vblliio. ofS!.lhn'r0l1.5 by any
aptlimnt f6r , Fmir sbjsk lhc applic&l lo a civil pcn.lr, of rol rcG ihan fiv. hundrcd doll&s (Ssm).
-L
as owkr olrh. Eopcny. om crctusiv.ly co"lraclirg wnh lienrd conlr(loF lo onslrucl rtr pmirl (S.c. 7014, Buii*$
ad Protsshn Codc: Thc ConrErofr Liccnlc Lrs dfts nor alply to an own$ of llro!€ny sho blild1 or imlmvcs thcaon.
lnd who 6nr..ts f .ucnF.j.(s with ! Co.rfttorl9 lk.nsd prsunr lolh. Conrraclols Ltcne L.w).
lmct.mrr uiddsGlon , B. & P.C. for rhn B$n.
lhla Or...
-l
cc(ifyrhar i. thc pciforrotuc otrlE *olk ror whkh this rrnir h is\ucd. I shrll n6r rmplo, ny persn in ony mnncr
$ as b hccoft suhje' to rh. worlc* comp.nsol ion laws of Cllifornia. ond o8e lh.l il I shorld becom subjcd l.r rlr
*ork6 comp.nqlionrmvkionsofSdion 3?00 ofthc t{bor Codc.l sh.ll. fonh*ilt comply *ilhlln$ pmviFio.r,,
WARNINO: Failurc to surc worlc^ c.'npenuion crlcmsc n unhufll md \hull *uhjcc' an cnploycr to aiminal lEmhics ind
civil fincs !p t0 orc h!lhousa.d dollaG (!100.0m)iriotr n' rhc cod ofcoilFn\arion. d,tuB.r 0s lrolidcd lnr rhc
inrcrc( and lnorrcy\ ltcs
ucf,NsrlleQNr&tqra.8
DtillA[.IllQN
ol rhc RusincsnDd Pn)L$i,,n\ Codc. tul nry l'.c sr n r fullfrcc rn .ft.r
N
t codmro+(
AIPIICANLD!:CIAf,AIION
I lErcb) llim oD.tcr IEmh y nf pcrjory o d ofrhc fd!,si"g dcclarrrn,n(:
Dcinrition P.irni'sAs nus Norificrrnr ltdcrulRcAuldnff ('Iirh a0. &d6)
-Rrqtt{d
Urlcr ol Norili.nrn,n
_l rd ily OJr rhr rc .El Ee! l,r id$ reBdrding r\b.(os rc hul irc n.r trlplicdlc io rhn [ojccr
-lcenilyrh
l nivc rcrdrhisrndicrrion!fr1srtrrcrhr rlEnh,r inlnrmlri0r n.nft..r !rFLrro.oflplywirhallCiryatrdCounry
((
oullrtrizc rctrcscnloliles o
*"61 a
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
tOfagnrr'Clothes Dryer ?- t7.18 I t4oo et)
Flesidential Ranqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release tl
FINAL l0 ,ty IY l r/t^Dt({7/
Notes, Remarks, Etc.
COMMENTS
lnstallation
L as ow.o of rhc p.rEny. or ny cnploFcs wirh wagcs &s rhcn sb ..mp.m.rion. sill do rh. wort alt rlrc *rructlE is ht
intcnd.d or o,fcrcd for $h (Se.?044. Busincs and Pmfcssions Codc Thc Conlrucrois Lic.nE li* dms mr apply lo an owm. 6f
rh. potxfly lho blilts or iqmrs Urmn etd eho des sch hd( hituclf or hchcll or rhrough hh or hf own .np!oyc.s.
pbvidcd rhrr suct iq,ll)l€fuds d @r i.r.rd.d or o,Icrn for sh.li hoqMi rhc trilding or iqlorftn h $ld whhinom re
ol o,{lcrio( rhc Owmr Buildcr will hlE rhc hds of povin3 rhal h. o shc dA mr build or itrprorc fi€ pmrElly n,r rtr puqbrc ot
W{IRKTRSI C(ln'PFNSAIION
IIECIJIAIII,X
I hcrchy itm undcr Fnnllyofr.rjuryorc olthc following ddlrmrions
-l
h!!c ard willminllin ! Ccniararc nl C.nr to S€lHnsu.c for workcB .dn .nsario.. rs povidcd r.r hy Selion l?u) of rhc
Labor Codc, r'o! thc pcrloiourcc otlhc qork lor rfith lh.,rcmil is issued
_l hnvc nnd *ill nuink workcB .onpcnsalion insuBn.c, as rcquncd hy Sccrion :l?(D ol'lne Laboi Cdc. for rtc Frlotmne o,
lhc rort lor * hi.h lhh ,xrmil is hned. My workcN omlens.l ion insuroncc cMicr dd plicy nlmber e:
CrE*r
C!]ISIBIJCIIONIDIDINO.&OIIII
I hcrb! aflln undcr lErohy of pcrjury lhll lhcrc is a onsrrucl.n lcnding o8ency tor lne l)crfolr1@e o{ rhc wo.k for whi'n lhh Fmil ie
issuc{ ts* :1097. civ c.).
L.ftlc.\ Narm:
-
ordinrmcs dftl sral. Lrws elaring lo
nt.vc nrnli.n d pmFnt for
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