HomeMy WebLinkAbout40130316 - PermitCity of Santa Ana
Permit Counter: (714], 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
l nspection Requests: (7 1 41 667 -27 38 l nspector Section: (7 1 4) 647 -5853
Mecha n ica I Permit #: 4Ol3O3{ 6
Pin #: 24936
EProject Address: 120 S Pacific Ave
Assessor'sParcel: 007-320-04 Lot: NA
BIdg:
Tract NA
Address Range:
Historic: No
Suite Range:
Zoning
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
01116002 51604
01'116002 51604
01'116002 51604
01'116002 51604
01116002 51604
01116002 53603
01 I 16002 51600
01 1 16002 51604
Qty
1.00
1.00
3.00
1.00
1.00
269.37
1.00
1.00
PAID
rlAy 0B 2018
Olson Company
120 S Pacific Ave Unit# 34
Seal Beach, CA 92703
(562) 596{770
Owner-Builder
Fee Type Amount
Heat Pump 86.82
Clothes Dryer - Residen 38.83
Bathroom Fan 29.38
Laundry Fan Envir. Air 33.54
Range Fan 31.10
Plc - 650/o 0.65
General Plan Update 21.25
lssuance 52.98
Fee
$86.82
$38.83
$88.14
$33.s4
$31.10
$175.09
$21.2s
$52.98
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work
Condominium
New
New Condo w,/garage
Occupancy:
Constr Type
Code:
R-2, S-2
V B, SPK
cMc 20r3 Notes: Plan 4Dffees pd on M-
Planning Conditions:
Planning Approval By:
Plan Checked By: West, Glen
Permit lssued By: zuniga, Allissa
Subject to Field:
Buildins Permit #: 1 0190459
Date:
Date: O3lO2,l2O17
Date: 05|OA2O1A
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01116002 51600 $s27 .7s
$242.16
$285.59
$21 .2s
$264.34Every pefinil issued shall become invalid unless the work on tho site
authotized by such pefinit is conmenced within180 days afler ils
issuance. or it the wotu authorized on tho site by such permil is susponded
ot abandoned fot a peiod of 1 80 days after the time the wo* is
commencec!.
lnspector MID#: 20'16-130947
01'1 16002 51604
Fee Total:
Paid to Date:
Balance Due:
Unit: 35
Block: NA
Phone:
t-,rr,=aaart-
DATE ID/SIG,COMMENTS OsG-B!ildr Dcclanrion
I fi.r.by .fiirm und.r p. lty ol pdjlry rhat I m .icnp fo.o U. Co.t6aotr Lieni. rl* fo, $. followins ,aon (!* ?03I.5 BGin6s
and Pm&.iion Cod.)r Any Chy or Comr, whi.h r.quiB . p.mir ro oBrtu r, .lln. 6prow. d.ooli3h or Ep.t ay llfucrurc, pdo! lo n3
brue.. ds rcqut6 lhc applic!,u foriucn pmnro 6lc ! ristudsrll.m thllhcorsn b li..tu.d p@61lo lh. povisioN of rlE
Conraclois L'c.nred LBw(Chapls9, Comn.nci.s wnh S@tio.7000 ofDivi3io.I offi.Bu'n6!md Profe$on. Cod.) or thal hc or
rh. ir dcnpl thmfrlm rrd rh. b&is for rh. !ll.s.d d.hprion .Ary violtion of Sdtion 701 L5 by my .lplicanr aor . pcmir rubj.$ th.
rpplicur lo , .ivil ,.uhy of rcl mo,c lha livc h(drcd dolla { $500).
La owncr of th. pmp.ny. or ny chploy.6 wirh was* tE lh.ir 3ol. comp.nsation. will do lh. woi( md rlr ruclurc i! nol imodcd
or ott r.d for slc ( Se 70{, Burin6t rnd Prof6tion! Cod. Th. Cont.do Li@nr Lr* dG rol .pply ro .n oM.! ol th. pFpcny
wto buildr or inpror6 rh.fttr d vho dq lct work niN.lfor h6.llor thoust hi! or hs own .nploy.6. povid.<l !h.r !!ch
impror.m.nlr t( Dol iDt.nd.d or otfd.d for {k. ll hos.vd. lh. buildiry or inpro!.n6t ir tou wnhin oo. y@ ot.onplaio.. thc
()lxGFBuildd will h!v. rhc burdcn ol prorir! th h.o, lhc nol boild o. ioprov. fo.lh. purpo!. of3!lc)
Yt6 oenr of rh. pbpdy. dn .tcl6iv.l, .onr6c B wnn licced cootocroB lo .osrtud rhc Foj*r ( S.c. ?O{.1, B6in6s a(l
P6a.sbn cod. Th. Conrmdor ! L E.N. L.w do6 nor lpply ro e owE of prcpqiy who buildi or inprold thq@n . ed {ho
6nrr.d.lor such proJell wnh. Conr!.ro(i) lic.ncd pu6ur.r ro rh.Coikidoar Lrc.n!. bw )
_l d .x.npt undd Sedon _.8. & P,C. for thi! tun.
!o!trE!sl9u!E!s !o.!rDEc!4a/!IIs!
I h.r.by omnnuod{p.mhy of ,.rjuryo.colrh. follo$ins d.clahrions:
lh.v€and will,hrinl.inoC.nific.l.olCoB.nl to S.lf-lNUielor wo.k.B comp.nst6n.!s prold.d lorbyserrcn 1700olrlr
L.bor Cod.. lor lh. Frfonunc. oflh. wor* fo. which th. ,qmil iJ i!ru.rt.
I hrv. .nd will m. rnrain *ork6r conp.Mrbn 'n.u6nc.. $ r.qutr.d hy Sccr
'on
3700 ol th. llhor Cod.. aor $. pcdortunc. ol lh.
wort fot whict thr p.rnit ir isuci. My work.6 .omp.nst'on insuonc. €nid rnd po li., numb.r uc:
PolicyNumber: Expn6:
(liissdionne.d nor t compl.rcd iath. p.rmit h aor Onc hundrcd dollau lll00lorlc$)
I c.nify lh3l in th. p.rforndnc. oalh. work forqhich this pcrmil is strll nol .mploy any p.6oi
b.c!m. subrel lo th. work.6 onD€nsrlion hwsolCaliaornir.
.onp.oer io. provaion! or S(rion 17@ of lhc hbor Cod., I
Yt"o
IVARNING: Frilur. lo sur. worl.u comp.Bdion cov.ng. 6 unLaaul, tnd rhlll su6j.cl .n .nploy.r ro crimim I p.Mhi6 rnd civil
fin6 up ro oG hundcd rhoNd dolla (1100.0@).in .ddnb, lo rh. .sr of.ohp.n$ ion. dlms.s a povilcd tu th. Sdion 10?6 of
rh. bbor Cod.. rnr.id.nd lnom.y r f€
LICENSED CONTRACTORS DECLARATION
I nftby afiim und.rp.naltyoapdjuryrh.t I m ric.N.d lndr pmrision ofCh.prc.9(comm.ncind qnh Sd io. 7fir0) oi Division I ol
lh. Busin.s.nd ProfqsioN Cod.. md ny lic.N. i! in lulllo,.. Md.Il{t
{-l-,s
I h.,.by.lfi,,n und.rpcnlhyofpc.juryrb rh6.kacocttulio.kndinaaacncyforrh.p.rrolmnc.ofrh.*orklorshi.hrhisp..mnG
irsu.d (Scc. -r097. Civ. C.)
Afrllcaxr.ti"u&clAaAllaN
Dcmolirion Pmit!.Arb.$6 Nolifiotion Fcdd.l Rcgul.rioB (Tirl. 40. Pan 6)
R.luircd t tt6olNotifi qtion
I ccnifylhll Ihc f.dcralr.gulalionr r.srdins 6b6los rcmoul.rc not 0Dplicabl. to lhis prcjKt
..- I c.niry rhal I h.\c Ead rnis ipplic.i ir .or.cl. I r8G ro .ospl, w iri .ll Cir, lnd Counr,
ordiunc6 a.d Sur. I iws ,.l.tin8 izcr.rr* lln.solthisCilyrtrdCounlyto.,lcruponth.
abovc mcntio.cd proDcn, for 9-g-,s
Appliances
Metal Fire Place
Evap Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork io.l(-18 r '6?4t,
Vents
Toilet Room / Clothes Dryer
Residential Range
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above T-Bar
Rough Mech.
Final Test
Meter Release
/2-f -/8 e
FINAL
MECHANICAL.INSPECTOR RECORD
M:\WPs1\Permii-lnspection Forms\M6chanical lnspeclo. R6cord doc 03 3l 06
APPROVALS
Other
Above Hard Lid
/2-3+R 7z'zl A/,v C,?/r.al
L€nnc i Addrdr
P6mirr.. ne. (pdi0:
I