HomeMy WebLinkAbout40132520 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Cavic Center Plaza (M-19), Santa Ana, CA 92702
lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Mec han ical Permit #: 4ll13252IJ
Pin #: 23t9O
Project Address:2424NT stin Ave
Assessor'sParcel: 396-261-55 Lot: 8
Unit:
Block:A
Bldg: 24-K Address Range:
Tract: A.B. CHAPMAN Historic: No
Suite Range: Unit K-02
Zoning: R4
q
Owner:
Address:
The Bascom Group, LLc
26 Corporate Park Drive, Suite 200
lrYine, CA 92606
(949) 955-0888
Qty
1 .00
1 .00
1 .00
Fee
$40.34
$22 08
$55 04Phone
Phone
State Lac #: 1017936
Lic Type: B
Bus. Lic #: 356738
Workers' Compensalion lnsuranceCarrier: State Fund
Policy #: 9211358
Expires: 05/26/2019
Building Use:
Job Type:
Nature of Work
R-2
VB
cMc 2016
Multi-Family (5 or more uni Occupancy:
Alteration Constr Type
w/D Partition Wall (unit K-02code:
Date:
Date:
Date:
Notes
Planning Conditions
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Every pormil issued shall becgme invalid unless the evor* o, lhe site
authorized by such pormit is commenced within 180 days after its
issuance, or il the wotk authodzed on the site by such pemit is suspended
or abandoned for a period of 180 days aftet the time the work is
"g
Expand coat closet opening for w/D in units with 2
bathrooms, No bedroom addition, exterior alteration
and/or addition of square footage proposed at this
time. Original P/C performed under#10193842.
Chavez, Da
10197487
oal29t201a
Account#
lnspector MID#: 2018-145630
01 1 16002 51600
0'1 1 16002 51504
$22.08
$95.38
Fee Total:
Paid to Datel
Balance Due:
Tenant Name:
Contractor:
Address:
Arias General Construction
170'15 Casimir Ave
Torrance, CA 90504
(310) 3s0-8198
Fee Type Amount
01116002 51604 Clothes Dryer - Residen 40.34
01116002 51600 General Plan Update 22.O8
01 'l 16002 5'1604 lssuance 55.04
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
$1 17.46
$0.00
$117.46
MECHANICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.OWNER BUTLDEX DELCAIATION
I hcEby lmrn und$ penslry of Friury ln l mcEnpt frtrn lt. ConlracloE Li.ens La{ for lhe followin8 rc!re! (S6.70:ll.t
Busiress lnd Pofcssion Code): A.y Ciry or County ehi.h r.qllEs a pcmh ro @trnrucl. !116, impmB. &rulih or Eprt Dr'
srMnr, priM io ils iaM., d$ rquiB thc .rpltrnt for *h Fmit ro frt r siSE{ sraLrnr rhlr tE or rhc i! li@E d puN.,!l
|o $e lrDvisio.i of rlE Coniretdk Lkcncd kw (Ctapr.r 9. ConmNiir wilt S.ction ?000 of Divisiof, 3 of lhe Busincs nd
Pmlcasion. Codc) or rhat hc or rlE h cicmDl lhcrcfom and lhc bcrir fo! lhe alLgcd cictrrpliotr. Any viol,lion ofSrlbn 7031.5 by any
affllicafl lo! a lEmi slbhcr! the sprli.air m acivilpcnaltyoflor lmE lhm,ive lundEd dollffs ($500).
-1,
as owft. of rh. FoFny. or my cnphyes wirh E.Ecs !s lh.n $t @n!rcn$rior will do rhc rcrt lrd {r dlfu is ml
inrdd or o,fcEd ror nk 1Sd.7044. AGirca{ lld Pmlc*ions Codc Tnc C.nrmlols Lien* tjw do.s ml al,I)ly lo d o$n( of
lhc popcny who builds or in{,mws lhemr ud *to dms smh mi( himslf or hcB.lf or rhoueh hi. 6t hd own.lployes,
previd.d rh!! su.h Fpmrlrnh m mr inrcnd.d o.o,IcEd lo. sL. U. hosw, llE hoildi,3 or inpmwEnl ii sld wirhu o* )@
of coq,lcrior rlE Ovrcr BuiE€r *ill haw dE tirfrkn of povin8 rh.r hc o. ilE dil mr boild or inpmw lh. r,DIETy for llE I,EID9 of
-1.
asoqtur olrhc pmn ny. !ncxclusivcly...ruding wirh lien*d.onra.bN ro consrucr lh. pmjcd (Se. 1044, B6in$s
ond Pnircsbn Codc: ThcConkocrols Lic.nscLawdocs notapplylo onowncroaF opcnrwto builds.rinptuvcsrh.r.on.
and who conrEcts lor su.h Imjccls warh r Co.u!.ro(s) liensd pu^u ro th. Coni@tocs Lienr tjw).
-l
am€xcmfl undf Sedon- B. & P,C. for rhLi !e&n.
]T!]Af,ETS:IOAIEEMAIAN
PECId8AIIQN
I h€rcby amrh under pemlty of lcrjury orc of lhc follo*ins deladrioB:
l]htr(ixlc. lnrrhcl{rnn rrn.colrhcrork lnrs[i.hrltr'lf,nnl n N{ul
,l hav. und will nEinrain workcr' co'nEnsal ion iNurlmc. as rcquircd ty Sdion:1700 ofthe Libo, Codc, fo. $. pnfornuncc of
lhc 'ork for phicn lhistcrnril is hsucd. MyworkeN ompcnsol ion insumncc .dicr ml rolicy numbcr m:
_l.cnify lh!' in rhe Frlomncc oilh. work lor shkh rhir p.nnir k hsucd.l slEll nol employ any pcr$n i, an, turn(
$ a\ ro b.com subj({r to rhc Edkcm'compcnsrion la*s of Califonr[ ud asEC rhar it I sh.uld t&om subiGt to llE
wolkns.onu.nsrionpmvisionsofsErion1700ofrhcLaiDrCodc,Ishall,aonhwirhsm ywnh.ho*!m sions
WARNIN(;: Frailurc ro scurc "o crs compcns.tion covcr08c h unlo*tul. and shlll suhjccr an cDtl.rtt b ri,niMl p.trihis md
cMt linc. r! lo onc hundEd lhous.nd dollaB (ll in (idition ro $€.o\r of con Enrnrion. d@8.s !s pmvid.n aor lhc
L
DECIIIXAIION
I h.Ehy ofli.m undc. pcMlly of pcrjury lhd I nfl lien$d uodcr lbvi\nnr of Chaprcr 9 (N6ftn ing wirh s..rkln 70(10) oi Divisn'n l
of rhc BusiBsand Pr'a.ssions Cod., rnd nrt li.cnsc k in tullior.c dcfte!
CllSI8lJqIlllIiU'lDIN AENqI
I h.rcbt alfinn und.r Fn0hyofp.lury rhd thcrc h a conslE.tion Lnditrs lscnc, to, rhc t.rfolfuc. orrh. work lor whi.n thk Fi rir is
i\sucd(s( :llr7. civ c )
APPI ICANT DIICLARATION
I treby Jninn und.r Fnnlly of pcrjury oflc olth.lbllowirS dc.lidbns
Dcmhion P.irnils'Ashcsros Notilicarion ltdcrul Rcsul!rions l'lirlc.l0. Pan6)
-Rcqut
rl t lrer.f Noriar.rrion
-l
ccnilirhar rhc fc.lcful rosuldrio.i egrding ash.sr.s to rvalar. horamlicahlc k' lhh lnjsr.
-{, .*,r, ,nu, , *," ,"oU ,nn arulicarn,n !d darc rtnr rhe atnvc inlonori,n is c.n cr I rCN t, comply * irh all c y and (-otnry
odinrncN nnd Sra'. tiws
$ovc mtrlioncd pmlcny
hcrcby luhorne rcprc\c ariv6 drlhh Cily tr.d Counlyto cnls uFn th.
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
l\.4isc. 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
Openinos
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.?/tt /iv tbfrn
Final Test
Meter Release
FINAL 7n(n*nArc
Notes, Remarks, Etc
COMMENTS
\l"0ro..r
kndc.s Nsmc:
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