HomeMy WebLinkAbout40132327 - PermitProject Address :1921E Alton Ave
Assessor'sParcel: 430-191-17 Lot: POR 115
Bldg: Address Range: 1901-1921
Tract: IRVINE SUB Historic: No
Suite Range
Zoning: P
q
unn: 200
Block: 9
City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
lnspection Requests: (7 1 41 667-27 38 lnspector Section: (714) 647-5853
Mecha n ica I Permit #: 40132327
Pin #: 13769
Owner:
Address
Phone:
Tenant Name:
Contractor:
Address:
Amount
43.62
29.76
22.O8
55.04
Edwards Lifesciences
I Edwards Way
lrvine, CA 92614
(949) s2s-6579
Edwards Lifesciences
CDG Builders, lnc
24 Execulive Park, #150
lrvine, CA 92514
(949) 892-3510
Fee Type
01116002 51604 Alter Vent Sys
01116002 51604 Min Fee Adj
01116002 5160C General Plan Update
01116002 51604 lssuance
Qty
1.00
1.00
1.00
1.00
Fee
$43.62
$29.76
$22.08
$55.04
State Lic #: 921615
Lic Type: B
Bus. Lic #: 3/,278A
Workers' Compensation lnsurance:Carrier: Evorest Nat'l lns Co
Policy #: 7600012738181
Expires: 0112012019
gotchi:{48{3 - 7/17/20tg I0: CCUELLAR
office: CTYH Tr6nsi! I I of IAccti: Refi: 10132327
ftcpti:02326?37 - 7/f7/2018 g?31 An
TFonsoct ion Totol t 150.50
CD6 BuilderE' Inc
$150.50
$0.00
$150.50
Generol Flan updote Fee
01116802- 516000u0-
lle.hsn icol
01116002- 51604000-
ICL Check 018721
t3?.0s
tl?8.42
t150.50Building Use: Commerclal
Job Typs Tenant lmprovemont
Nature of Work: Tl
Occupancy:
Constr Type:
Code:
B
III B, SPK
cMc 2016 Notes:
Planning Conditions: lnterior work only. No exterior alterations or modifications.
Planning Approval By:
Plan Checked By:
Permil lssued By: Zuniga, Allissa
Subject to Field:
Buildins Permit #: 1 0195954
Every permit issued shall become invalid unless the wo* on the site
aulhorized by such pernit is commenced v,tithin 180 days after its
issuance, ot if the work authorized on tha site by such perrnit is suspended
or abendoned fot a peiod ol 1 80 days aftet the time the work is
commenced.
o7117 t2018
Account#
01 1 16002 51600
011'16002 5'1604
$22.08
$128.42
Date
Date
Date
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Phone:
Fee Total
Paid to Date:
Balance Due:
lnspector MtD#. 2018-142278
MECHANICAL-INSPECTOR HECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER OT]II,DF:R DEI-CARATION
I hcrchy rliirm undcr ncnnlry ()I l^-rJury rlrr I r.r.nltlr rron rlE Cod,!.tri Li.ctr{ litr n, !h. bll vin8rcrw,nlsc.70ll5
Br\i'r.$ r Pn,ts\i(,n Cod.) An! Cily o! Qtnrry *hi.h rcqrm\ r Fnnil r .on\lnrcr- ulrc!. impn,vc. dcnrnish or rqlir rny
{fl.ruro. pri(r b irs i$uiflcc, (l() rclut \ ihc lIlpliunr litr {rcl |f,nnit ir ilc r silned \lrrttnr rhrr h.or shc i\ licco{d nunustr
h rhc ,l isi{rx ol ttu C. ta.ttr\ l-i.cnscd L,* lchintr 0. Cf'n rc .in8 *irh Scdit)n ?0(x) o, Dilnn,n .r .l rhc Bu\tu$ lnd
P'of.\\n \ Codc)orrhd Mor shc iscxcrrpl lhc.elio'.lnd rhch\n ntr rhcallclcd cx.nrPrion A tviolnrnofs(rion7(,ll5trrny
imli.nDrtusF..mnsu$jcchih.3lplicn.[.r$ilpctrdryoln.rnrtrclhanlirrhunJfud olld\ 155fi,
-1.
er oqkr of rhe prorf,dy. q my employss *ilh s!8es &s then sk ..mpc6llion, *iI do l,E qstr and llr 3rffiw n ml
i.nd.d o.ofcmd for $lc (56 ?O14. Buri.*s dd Profcssioosqlde: Thc Co r&ror's Uccne Lje do.s nol !Ppl,lo u owrct of
rlE pFlery *tF hl,Uq 6 inpmEc tlE6n..tn who dG st s* hinclf ot h.r*lf or fircugh fiit or htr o*n cnplores.
tmti&d rnor such irymEftms e Dl hlcM.d or off.Ed for eh.ll h.wvcr. rlE ttilding or hp(ft8nr is$ld wnhin orc Fa
ofconl)kxin. rh. Ovnc. Builhr wil naE lhe hrdca of I,D$nB thd lE or sh. did ml tiih or itfmt di. PoFfly lor th. puFos of
-1.
a. oeft, of rhc ImFny. !m crcltsivcly anltul hB $nh [ccncd contrdos lo onsrwt llE Euc<,r (Ss. 704a. Busims
lnd h!6:ssion Codc: Thc C.htrdctor's Licensc Luw dms nol lpFly lo.n ownct ofpoFny who builds or iry,.oer $.@n
lnd who oirtsds aor ruch Eorc.rs wirh a Conn do(i) lieosql puffldl lo llE Coirtulol s Lkxtre trw).
lancx.nDr u.dcrseron .a &PC forlhbElsr.
IIIBtrESS:.COMPjUSAIION
D&CI.Af,AIION
I h.rcby arfirm undcrycnllty of ldjury o.. of rhc following dNlnBtiom:
I h \. rkls,ll,tuirl inrC.nillclrcoiCon\ctrrloSrlrl'trurclitrs.rkcrrconrt4-n\xrion.a\li{JV.dfulbyS.crionlT(Xrollhc
lrh, (i c. i,ih.IBrlnnurcol rhc sork n)rw[i.hrhc p.nniri\ n\hd
J have a.d witl diot!.. eorkcrs coq,cisalion insuraflft, &s rcquiEd by Setion l?00 of ltc kbor Cd.. for tlE I'ctfomftc of
rhc *ork ao, whkh rhis pcmil is isssd My sort6 onF.erion insurMcc caEtr ud ,olic, nunbo 4l
svo{esf Nahonat ln(rV?mn (, t
-+lo0oOtLaaB [at t
-l
c.nify ltul in rhc pcrformrc offic work for whkh lnh pcrmil is Gs!c( I shallno' cmtloy lny l,cBon in a.y nunmr
e &\ to hecom rubjccl lo rhe wortcm compcnsllion hws o{ C.lifomi!. s.d aBrcc lhlr if I should lE o@ snbiEl b llE
sortql conF.erbn t ovisions of Sdion 1700 of lnc Lahor Codc, I rhrll. fonh*ilh .o"{iy wnh rhdr tE rions
WARNING: Failurc ro scuE *r*cR' ompenslion covmse is uila$tuI, ind shx! subjc.l e €ry,loytr ro dininal Fmlli\ lnd
civil liflcs up ro om hundrd rh.!s!nd doll6 (3100.000), in addnion lo th. .o{ of conPcnslio.. dtmlca d ptovidcd for lh.
o*", alr rhc Irhrci)dc. i' crcn ind
^/.^olddFd,g
Dt rt a-B^uoN
Inuruhyrfli' rndcr p.tr.lryotlujuryrhar t !m li..nsd u tr Pn,visidloiChrprcr9l..nuf,n.irg sirhSccrion?of,orDiui\i'n l
o, rh.Ilusinc\\ 3nd PR,fu\\i()is (-odc, itrd trryliccnsc i\ in lirlllar.rarl.fla.r.
l Ll tplS
s _c
coNsrRncrloN I FrtDll!(: acFNc'v
I hcrcby afii n undc, Fmhy of pcdlry lhd rhce is t oiqrBrioi hndilS !8cfty tor lh. lcrfomm or llE hrk lot *hhh lhn llmn t
isued (sd 3097. civ. c.)
AIILICANLDEEUf,ATTON
I lmi6y Jtn'n undcr pttrrlry ofpcrFry.nc orrhc lollowinS dNlnrarions:
Dcnnlirion Pcrnrih'Artf,\ro\ Norinc ion ftdclo| Rcsul ions(Tnt 40, Pd6)
-R.quiEd
lf,trcr of Nolili..thn
I cdify rhlr rhc acdcml rcslLridnr Egd.linB NtEi6 r.nrvrl !rc nor sp0lkabL ro lhn pmj.tl
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room / Clolhes 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
Rouqh Mech.
Final Test
Meter Release
FINAL l.l5 -la Jdc2JtQ 'q9
Notes, Remarks, Etc
Drt., Orftr:
B
c!q er\dsdJs6=-
L.nd.a3 Addc*r
-
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c.niryrh l htv. rcod lhs aptltdt,n rflj rurc rhd th. ahoE inromrlion is.oret.I08re!o cory)ly snh !U Cirya.d Counly
nrJinan.c\snJ Srrr. Lrw(,$]l|'ry rn bu 'ld rnE con{rucri, L srd h.'.by.ulbnr rcPrcscnldilci ofihis Cilysod Couil, t{r c.lcr uFn tlE
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