HomeMy WebLinkAbout40132335 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Mechanical d,,Permit #: 4Oi
Pin #:44454
Proiect Address: 3401 S Harbor Blvd
Assessor'sParcel: 414-262-08 Lot: POR 3
Unit:
Block: NA
Bldg:
TTact WLLIAMS
Address Range;
Historic: No
Suite Range:
Zoning: P
Owner:
Address:
Contractor
Address:
P hone
Tenant Name:
Kaiser Permanente
1707 Barcelona Circle
Placentia, CA 92870
(714]- 572-5811
Kaiser Foundation Health Pl
1707 Barcelona Circle
Placentia, cA 92870
(909) 4274700
01116002 51604
01116002 51604
01116002 51604
01'116002 53603
01'116002 5160C
01116002 51604
Amount
90.19
44.51
65.57
0.65
22.O8
55.04
Fee Type
Compressor
VAV Box
VAV Box
PIQ - 65Yo
General Plan Update
lssuance
Qty
3.00
1.00
1.00
381.30
1 .00
1.00
Fee
$270.57
$44.5't
$65.s7
$247.85
$22.08
$55.04
Phone
State Lic #; 370871
Lic Type: B
Bus. Lic #: 2108
Workers' Compensalion lnsurance:Carrier: Dept of lndustrial Relations
Policy #: 1053
Expires: 0110112019
BOtChi:{5512 - S/2,.i2QI8 IO! HGARCIAoffice: CTYH Trons+: 29 3 of 3Accti! Ref+! 10132335
Rcpt+:0?3s9733 - S/2t/2018 11:52 AH
Tronsoct ion Totol 12t411.29
Ktr ispn Foundotion He(Ith Plnn
Geflerol Ploo Updote Fee
01t 16S02- 516110000-
ltechon icql
0r116002- s160{000-
]loster Cord
CC+ !r**r*rli**r*3031
r:r
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permil #:
Commercial
Tenant lmprovement
TURool Mtd Equipt
CSG Consultants
Zunaga, Allissa
10197038
Occupancy:
Constr Type
Code:
N/A
N/A
cMc 20't6
g4ls.69
011 16002 51600
92 r 411
Auth+ ! 01284.q
$705.62
$247 .85
$457 .77
Notes:
Date:
Date:
0712412014
48t21t2018
Account#
Misc. Receipt: 71253
Misc. Receipt:
Misc. Receipt:
Total
Every permit issued shall become invalid unless the wo* on the site
authoized by such peftnit is commenced within180 days after its
issuance, ot it the wo* authoized on the site by such pemit is suspended
ot abandoned fot a period oi,180 days aftet the time the wo* is
commenced.
lnspector MID#: 2018-144710
01 '1 16002 51604
$22.08
$435.69
Fee Total
Paid to Date:
Balance Due:
Building Use:
Job Type:
Nature of Work:
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE tD/stG.COMMENTS
Appliances
Evaporative Cooler
Furnace
Compressor
Misc. Equipment .:\
?f ? 1,., (, *lrJ,Cr_r, PJC.1
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled z1
Rough Ductwork u \*./
Toilet Room / Clothes Dryer 1-?r-lv gUbJeql>
Residential Ranoe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
,,A
Rough Mech.t5-
Final Test
Meter Release
FINAL ?-lu.t Y,
Notes, Remarks, Etc.
OWNER BUN,DER DEI,CARATIoN
I hcEhy rfrrm undn petulry of pqiury $a, I m qen{)l non fic Coillreror' Lietre Lrw for dE louowing F&sn (Se.7031.5
Bositus3 .id Pmf.sion Cod.): Any Cny or Cd.ly wttn EquiEs . Imi lo omrMl, .lld, inprclc &tulhh .r E?.it ey
sEEt@, pri6. ro irs h rN, !b. Equies rhc applicer tor ilch Fnd lo 6b a sigo.d lratcmr rh.r lr o. rlE i! liftN.d IrUNrr
lo rhc rmlisiod of rlE Coix4rols LienFd Lle (Ch!/cr 9. Conwring rnh Sedion 7000 ot Division I of rlE Busim$ .nd
Prfcrsiors Codc) or lhar lE or shc ii cxenpl fiecfron rnd rhc b8i\ fo, rhc ollcgcd crcmriioo. Ary violaio. ol Selion 7O.l1.5 by lni
applicail for r n @il subi4ls ll'rc appli$nl ro . .ivil pcmly of nol noe d& five hlndrcd dolles ($r00).
_L &s owncr of lhc !m!crry. or my cmployes wirt wnScs 0, rhcn sb conrFnsd ion. will do tlr {dk dd rh€ sn&r@ h mr
inrcndcd or o{ter.d ir qlc (Se.7ol4. Businc$ and Professions Codc Thc ColllBroas l-i*n* Llw docs nor apply b an owmr of
rh(,mpcny $ho hoilds.. ir{'ms rlayoo. un wno da sKh w* hiosclf o. hcrclf or llmugh hh or hcr o*n cnpluttcs.
Jt.ovilcd rh.r such inqmrcmnts m ml inl.nd.d o. oIftEn for sb. If. howi rh. h{ildin8 or tr{,owr h$ldpilhinoft}ce
of@npbi6n. llt O*er Blildfi will hlr r,E hden .f lrotn8 rlEr ,r o, sh. dii mr tuild or in!@e the poFny fo. tlE pUIDF of
-1,
as o$ncr of rhc ,,!rcny, im cicloiirl, .ont8riis qith licensd contftcloB ro @Nrud rh. tftid (Sec, 7044. BNim$
snd hDfssiofl Codc: Thc Conkacrol s Licn* L,e des rcr .pply ro d owncr of,rnp.ny vho builds or inpovcs lhcmn.
and wlD enrracrs for such loich wt! u Contmcrorl$) ltcnrcd p!6uor ro rhc C.nracroas l,i.cnc tlw),
_l dmcxcnrrr uftl.r S.crnln .B &PC lorrhhron$n
SO8trE8S:I:OMEEII,:AIIAN
D'CI AIIATION
I hcrcby nfllrn undc. !.ndry of Fiury oft of lh. folkrwing d&l.r.rir1
IhNcd \illnair[drrCc ili. cofQ r*nr t) Srlr-lNurc lin workcri .onllcrrrri( ,rs pn)lidcd id bySc.rie]7(x).lrh.
t-rtrtr Gxl., fd ih. t rln'nxtncc orrhc *ork fttr \rhih rhr lrnlir is i\\ucd
zflilc rnJ { ill nri rin wo*ch c.nD.r\rri(in i'surrncc. r\ r.quir.d hy S&rnr .l7U) ot rhc ttrhor Codc. ii,r r lt Nlid nhn.c ol
co,nFisarn,n nBurocc cudid rkl pli.y nu'nb.r dc:
/
a 1^t-/ I
-l.cftirylnol
in thc pcrfoflMn.collhc work for which lhk pcrmil is hsucd. , shall nor cmploy ony F6on in any tu.m,
$ a to bcam subjcc o rlr wod.c6 odpcnrlrion la$s olcslilomi!. and lsrcc thlr ill should trrom suhirr io rh.
wodcm comrEnslionB)visions olSccrior l?m oflh€ Lnhn (-odc.I sh!U. lonhwiih.$drly wnh th,e povhiong..
WARNINC: Frilurc lo scurc workcs' o'npcn$tion $v.aqc is utrhwtuL md sholl subF-l an cmpk,rrr lo oimiloj pctulrics rd
civil lincs up k, o.c hundrcd thousand dollrs ($100,(ion ro th. .orr of compcn\orion, domEcs ar pturidcd f{r rh.
Selion 1076 ofrhc L2trtr Codc. irrcrcsr
D,<-&2t:1-L-
LII;IISEITJONIIACIUB
DESJBA.IION
I h.sby aflinrundcr l]cnlltyofpcrjury thit I li.cna{ lndcr pmviio. olch{plcr 9(commmins eiiir Sdi,n ?fin) ofDivision l
ol rh. Businossond Pmfcsrl{nx L:odc. and mylicctrs ir ir tullloNmCcflicr
o*,, 8^n /- / E
CAX$XUCIII) IEIDING.AGENCI
I hcrcb, affim undcr pcnulty of Frjury rh, thdc ir r co.ntudion knding as.tr, ror rh. Frro@ncc ollnc work for whkh Ihis lrmn is
nsucd (Scc.309r. Civ C.r
APILICAII,DEC!8AIIII!
I hcrchy,rmr u.d.r pcn,lry or p.rrury o.c ofth.lollownrg dc.lr.rions:
D.mlirion Pcrn h'Asbc(os Norincarhn Fcdcrll Rceul0riotrs (lirlc40. Pan6)
_R.qun d kncr o, Nori,Lari,n
I c.dify lh rhc fcd.rdl rctlla'n,r Eg,rdih8 rsh.{os Em)hl nft n.r amli.6lc k, lhn ,fl,irt.
-l
ceaityrhar I hlvc rcad rhir upllicaraon lnd nllcrhor lhc !bo!c irlorrorion n cotucr I aBre !o.onnly *nh 0I cirytrndC'.unty
ordinln.cs lnd Sr,r. Lrws nldin! to consrucrn'n. ui h.r.b$ulhorizc rcprcscnrstiv.s otlhi! City tr.d Colnlylo cnr$ q!.n rhc
.hovc m.liomd ,mp.ny lor
trh.xnr .r Ag.nr Sig rr0
:<a a/^.1
I
lltll,l
,dW
Metal Fire Place
*a ,r440)
K
Vents Avwu
kJ4tlA,l
- \ \/
knd.is Add(.s
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