HomeMy WebLinkAbout40132309 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Mechanical Permit #: 40{ 323Oo
Pin #: 96666
Owner:
Address
Burtin Manufacturing
420 W Central Ave
Sanla Ana, CA 92707
(7',|41270-',t390
Therapeutic Hemp lnc
RJSJCorporationdbaRJ
6102 E Paseo Rio Verde
Anaheim, CA 92807
(7r4) 981-6s89
Feo Type
01116002 51604 Add'l Vent Sys
01116002 51604 Min Fee Adj
01116002 51600 General Plan Update
01116002 51604 lssuance
Amount
43.62
29.76
22.O8
55.04
Qty
1.00
1.00
'1.00
1.00
Phone
State Lic #: 928192
Lic Type: B
Bus. Lic #: 369993
Workers' Compensation lnsurance:Carrier: California ln3 Co
Policy #: 468534001
Expires: 0/.10112019
e
7/lL/2818
[ronsi3 32
Refi:- 7/rt/zgt[
Amsden, Julie
Subject to Field:
Building Permit #:10195741
Every pemit issued shal become invalid unless the wo* on the site
authorized by such permit is commenced i'tithin 180 days after its
issuance, ot if the work authoized on lhe site by such perfiit is suspended
or abandoned for a pedod of 180 days after the tine lhe wo* is
commenced.
M
III B, SPK
cMc 2016
07t11t20't8
Account#
I tonsoct
RJSJ
Generol
(r1116002
ilechon i (
(r1 116002
V iso
Notes: lnstall door in existing demising wall to a new access
hallway and a new exterior doorway opening servin9
the hallway.
$150.50
$0.00
$150.50
ion Totol
)rnt ion dbo I
sn lJpdote Fe€
:16(r(rtr0(r-
Building Use:
Job Type:
Nature of Work
Planning conditions:
Planning Approval By
lndustrial
Tenant lmprovement
lnterior door
Occupancy:
Constr Type
Code:
Plan Checked
Permil lssued
Dale:
Date:
Dale:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
MID#: 2018-144303
01 1 16002 51600
01'116002 51604
$22.08
$128.42
Assessor's Parcel: 410-022-26 Lot: NA Block: NA Tract NA Historic: No Zoning: Ml
Phone:
Tenant Name:
Conlractori
Address:
Fee
$43.62
$29.76
$22.08
$55.04
t7)t.
Fee Total:
Paid to Date:
Balance Due:
lnspector
MECHANICAL.INSPECTOR RECORD
APPHOVALS DATE ID/SIG.COMMENTS
Appliances
It/etal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Ranqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
TestF.D. D
Above Hard Lid
Above T-Bar
Rou gh Mech.?ytqnr b1/
Final Test
Meter Release
FINAL lt ttr),/
Notes, Remarks, Etc ,t rl'-
OWNER BUTLDER DELCARAIION
, hercby afliro und$ Fn.lly ol p.dury llEl I m cx.nfl nDm rh. Conr.dm' Lic.nrc trw for lh. followi4 msn (S€.1r11.5
Blsinc$ ad Profcision Codc): Any Ciry or Colily whi.h Eqlirs a ltmn lo.odru.r. rlrq, inprur, dcmlhh or mprn ery
stnrlue. !.br ro iri isMc. .to equircs lh. .ppli.or for $h p.m,r m lih r siFed 3rrl.Mr lhrl h. or dE is lie.*d puBu!
ro rhc !tuvisions of lnc Co atoas Lic.nrd L{q (Clqrer 9, Conmkins sirh S6don ?000 of Oivhhn I ol th. Eusincs lnd
Ptutcsions Cod.) or rhdt lE or shc is cxcdpr rh.Efiom and rlE basis lor thc lllce.rl .xcmplion. Any viol4tion olsetbo ?031.5 hy uy
appli.ant for ! ,cm flbixli rlE appli@nl ro ! .iail pcmtr, ot ior mE rh.n fiv. huided dou&s (t500).
-1.
$ owncr of lh. I,!,f,rly. or my cqrloyr{s *ilh pags rs th.n bk shpcns.thfl, *iI {h tlt *o* {d lhc $tur@ ir ml
inrcnd€n orofftrcd tor sh (56.7044, Blsimss end Prcfossions Codc: Thc Contrerols l,iene Laa do* nor ap yroM.wnqof
ihc pr{xny wlx, hlilds d in{tb$ dElra dd wt$ dds sh sd( hiniclt or hcmlf or thn,ueh his or lEr own.q,lotrcs,
flovidcd rhar such opmkftnk E ml idcndcd or o,twd lorsh.lt ho*.@, lnc hoihiru Dr impNsmnr is sld ]ihinoft rtu
ot..n?bIio.. rhc oB*i Blildd will hae tlt htdei ot Imviq rlul h. or lhc dii er boild or in!ftr lnc pbFry ror Oc p!rr* 6r
-1.
trs ownfolihc pmFny. rm.rclusivclymnrracline wirn licln*d contmron to coosrdct rlr lmiccl (S*. ?044. B!\inc$
arn hDfc$i.. Codc: Thc Conkmloli Liftn\c Lle dcs nor applyro.noancr oftroFnysho buildsor inpr.v.s lhd.on,
and who conrncls for slch pdcds wnh e CoilE.ro(d li*isd lusuMr b the Conhcbls Lt.tr* t w)
lr rcx. r|n uilc' Sr(li,u .ll &P('ntrrhnr..*[
glBf,E8S:gtMtlUSAIIq!
DEI]I.ASAIIIIN
I hcrcb, afim unrhrycmhy otF.iury o* ot llE following dcclddio.s:
1..'tir Qtrlc. ri)rrlrc pcr mnn.eolrhcrqk rartrhi(hrhc |Ennili\n{'.n
rh. {,rtl,'rhLhrhi.oa'nr'.N.u.d Vrr,'lfl. ., f .J, i1.u"r,r.rni JilF.'i,),,un'},,.u-
.,,.,,, CAl, (o.rtio., fr4; Co.
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ccrlify lhnl inrhc p.rformrcc of rhc work for vhich rhis p.rmil h is cd.l shallnol cmployanyrcson in aiym.nncr
e rs to h.$m subjd ro thc wrlcrs'smre.erion hws of Cllifohia. 8nd as@ thll it | \hould tt.om subidl !o ltE
porkc6' sn{f,nstion lmlisions of Sccrion 3700 of lh. L{tor Cdq I nElL fonhwnh .onl,ly wirh lhoe pevhions..
W RNINC: Faihrc lo s.uc wor*ns oft{rnslin,n cov.fl8c is unlnwful, lnd shau subj€ct cmrloyer ro oi6i.{l FMllil {nd
civil fincs up ro om hundEn rnouslrd dolhs (ll00.m). in addirion ro thc cost ofcoftpcidion, damger a. tovided for rhc
Sccrion 3016 ofrlE tzhor Cod.. inhsl dd anormy s tsl
o",",aj!!t! E +pa*,.
uc[N,sEDtllNrtdtraa
IECIIISd.IIQN
I herctt!{firm undcr I'cMlty of pcrjlry lhal I am li$flsd undcr pRvi\ion ol Chatrcr 9 (connEftin8 $irh S..rion 7fiD) orDivision l
of rhc Buslrcsslnn PRncssions Codc, urd 'ryliccn\c is i. tu ll tbr.$ ald cfi'.r1.
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ccnily thar rrr Ldrn Fgubtio.s Ng,di.8 sh.sos Enn%l m nol spr,ltlbh lo tnis lrmJccl
l&difyrhd I hlvc icad rhk lppl
.dinntuci,ndSllk hw\ruhrnEb
rhnr rhc abrc infnmr bn is.orel lr8te
x,vc trf,nri{m.d pn)p.n} r{n
Aprl'crnr or Agcor Signrru
h...hy rurhtrirc ruprc\ctrhrilcs o
lo.orply anh oll Citylnd Count,
lihh Cirymd Coutrry ro cntcr upon fi.
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rutffia
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t.trd.. \ d'lrcsq:
,rppr tc,rti orii an tittiF
I iqcby lllmn undcr pcnolry ot pcrju,, onc orrhc n,llosins dclnlarions:
Dcnnnirn Pcnni(iA\h.eos Norificdidtr Fcd.rnl Rotxhrnrs (]'nh 40. Pnri6)
RcqutcJ ldlcr of Nolili.uirn
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