HomeMy WebLinkAbout40132241 - PermitCity of Santa Ana
Permil Counler: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702 Mecha n ica I Permit #: 4lJ132241
Pin #: 6841{lnspection Requests: (714\ 667-2738 lnspector Section: (7'14) 647-5853
Proiect Address: 1221W Carlton Pl U nit:
Block: NA
Bldg:
Tract: 1378
Address Range:
Historic: No
Suite Range:
Zoning: Rl
E
Assesso/sParcel: 015-232-16 Lot: 25
Victoria Lee
1221 Carlton Place
Santa Ana, CA 92707
(7141482-7772
Amount
30.52
22.08
s5.04
Qty
1.00
1.00
1.00
Fee
$30.52
$22.08
$55.04Phone
Tenant Name:
Conlractor
Address;
TSL
510 Catalina Road
Fullerton, CA 92835
(625) 52s-3000Phone:
State Lic #: 520303
Lic Type: B
Bus. Lic #: 370540
Workers' Compensation lnsurance:Carrier: Midwest
Policy #: BNUWC0i39i40
Expires: O1lO1l2O19
Botchi:{5887 - ? /12/2019 I0: ccuEl-l-AR
OfficP: CIYH Tronsi: 36 6 of 6Ac€ti: Refi: {0132211
Rcpti:02382845 - 1/12/2018 1?:39 Pl',
Tronsoct ion Totsl t843,12
TSL
Building Use:
Job Type:
Nature of Work;
Single Family Dwelling OccuPancY:
Alteration Constr TyPe
New Bedroom/Bathroom/wircode:
R-3, U
VB
cMc 2016
6eneral Plon tlrdote Fee
0111600?- s1600000-
llechsn icol
01u600?- 5160{000-
V iEo
cc+: *rr*ri***Itr5{0{
_ 92?.08
_ tss.56
,843. +2
Authi:04327GNotes
Planning Conditions:
Planning Approval
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permil #:
By Date:
Date:
Date: 0911212018
Account#
Teri
96810 01116002 51600 $ 107.64
$0.00
$107.64
Evory permit issued shall become invalid unloss the woak o, fhe slte
authotized by such permil is comnenced wthin 1 80 days after its
issuance, or il the wotu authoized on the sita by such pefinit is suspended
or abandoned fot a period of180 days after the time the work is
commenced.
MID#: 2018-144168
01116002 51604
$22.08
$85.56
Fee Total:
Paid to Date:
Balance Due:
Owneri
Address:
Fee Type
01116002 51604 Bathroom Fan
01'116002 5'1600 General Plan Update
01116002 5'1604 lssuance
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
lnspector
MECHANICAL-INSPECTOR RECORD
OWNER BTJILDER DELCARAIION
I hcrchy a,firm unds Foalry of rcrjury rhal I d cxcdpr liom rh. C.flractos Liensc lle lor fic following rcMn (S@.?031.t
BGi.c$ ald Poacsiion Codc)r Any Ciry or Counr, whi.h Eqlics . tEnn lo co.sh.r. !ltd, iq,ow. d.mlish or qtrn .ny
srrud@. prkr lo irs isu.@, ab. equircs rh. +plkoi lor rNh Fmir ro fik r si8md rrll.m $!r lE or shc k lk.n*d pueal
ro lh. pidvkbns or tlE Cootracior. Lienscd hw (Ch4rcr 9, Comncing wirh Seclio. ?000 of Divhion 3 ofthc Bosincss and
Ptufcssions Cod.) or rhlt n or shc is cr.mpr thcrfrcn.nd thc ha\is for rlE allc8cd cxcrrrio.. An, viobrio. of Serion 70J 1.5 by rny
,!tli.! for ! Dermit iubjets rlE arl,lkanl ro a.iril rcn.lr,o[nor mEtho,iv. hundrcd doll"rs (S50o).
-1.!s
owncr ofltf, prlpcny. or y emrlorRs wilh wtr8cs at fi.n slc ompcnslion. *ill&'llEwort dd llE srttN ir Nr
inrcd.d o, oficed for ek (S€.7O14. BuriN$ md Eofc$io.s Codc TIE C.nna.rol. Licc.sc L* .Lcs nol a$ly to on owrcr of
lhc ImIEny *hot lds or inpmB llEmn, !d wts d(Bsuchwlt hinsclfor hcmlfor lhml8h hn or hcro*ncmphyt*.
prcvidd 6d $ch i,'provw.tss mr iilcB,.t notu for elc. !r. noeM. tE t{ildingo. irFoEm G$ld*LhiroRFe
of @rqrhioo. tlt Owncr BuiEo will hav. th hrdcn ol tmving thll hc or rhc dd mr build o inpmve rhe I'mFny lor rh. |)urlns of
_1, !s.wncr of rhc topenr. .m.x.lNircly conr&ring wirh liccnrd .onrkro6 ro consDcl rh. lmj(l (se. 7044, BNincs
ad EofRsih Cod.: Thc Conhcrols Liccnsc Lr* dcs mr rmly to.nown.r ofImF.ny*ho huilds or iot'oKs rh.ro..
rnd *ho cobrBck for ruch Fmi*h with ! C.n'rdcbrl9 lkcnsd ln6unl ro rhu ConlB ols Lkcnsc L,w).
I urcrcnrpr uMcr Sccr
}OBtrEB{..CI}!4IENIAIIAN
DECLTSAIIIA
I lEeby afirn ond6 D.ndy of Frjury oe of rn€ follovine &ilarathtrl
Ihavcrdsilli!i' r$nCcniil.JrcolCo srirbSrllli\ur.nr$orkr^'.on!f,n\rri()n,i. {rov edlorhrSccrt,n.l?(x}ofrhc
trhor C{nid. l,n rh( r^-rlan u{cofrh.work lnr *hich rhc |xnnir i\ isucrt
-l hsvc !tui will 'n.intri. workcB coryEnsark n insura'Ec. as rEqui,rd by Sslion 3700 of lhc knor Codc. for rh. Ffo'rMc of
lh. work for which lhh pcmil is iss.d. My *ortqs' c.mrcnsatio. insurancc cutrtr 8rn Plicy nunh.r rcl
_l.cniryrhar an rhc pcf.mftc olrh. w6rk a.. *hth ihii p.rnir i\ isso.n.I *hall mt.mDloy.ny pcMn in lny mMrc.
s ns lo lx{om subid lo ihc workcis onFnsalio. hss of C.titb.nio. and lgN lhal if I 3hrld tEtoe suhirr to rlE
woltcs orrp.Nolio. pmvisions ofSetion 3700 of lhc tibo. Codc.I nEll. aontwi$ otr'ply *ith rho*l)mvhio.s..
WARNINC flilurc lo slE oorkcn .onrr.n\alion colcmAc n lnh*lal on<l \h,ll \ubj.{r an cmployci lo ciminal lrmllis and
cilil fincs ur lo onc hundrcd lhousand dollan loo,ftX)), itr 0ddiioi to rhc cosr ol.odD.nidio.. datugc! us l,rovid.d for rh.
Seclion 30?6 of lhc Lrbor Codc. inl.rcsl $d
DrlLllttra\
ol rlr h^inr\\ ud ltolts\i,r^ Cotlc. r d trrr liron\. n i', lull nm. klofic.r
E -C>Jc 3
I h.rchy affi flnundcr lcMltyof !.rjurytis cd (sa 1097, Civ. C.).
n(rucrion kndinsarc*yforrhcpdtortuo.corthcw rkntrehi.hrhisllrmit i(
I ediryrhd rh. fcd.rnlr.eularions nearding,strros rcmldlarc M {plictrblcro lhhlmjNr
ilv I Mlc rcad rhh omlicar ion arxl srutc rha, rhc ahovc infomrnnr i\ concr I asre h .omply sirh rll Cny rtrd Counry
Sr0r.t $ rcbti'r8 to buihinS conslrucrio..ond hcEbyaurhnze rc,rc*nuilcs ofr Cny and Counry lo enrr upon $c
APPROVALS DATE ID/SIG.COMMENTS
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
Other
Hood
Type I Hood
Type ll Hood
Fire Damper
Openings
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.4l?2ltSfi 6)
Final Test ul
Meter Release tl
FINAL hlnilk A/hrrk kr'
Notes, Remarks, Etc.I
/^, tfi=/tt'
Grease Duct
lnstallation
?..-,"".i/tt-r/ rt'
l-cnd.rr Addrcs\
,tPU r.rr rVr rXr:t ,l n,rrrrW
I ka$y,itnnr u.dm pcn,lly ofp.rjuryotrc olrhc tullowinS dcclanrions:
Drmolil n PcrnrillAsbcnos Notiri(.rion FcdcrrlRcEularions(l'itlc J0. Pani)
_Rcquircd L.rrcrolNorifr t,n