HomeMy WebLinkAbout40132505 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702
lnspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853
Mechanical Permit #: 4O132505
Pin #: 73121
Assessor'sParcel: 002-261-30 Lot: POR 25
Unit: A-3
Block: NA
Bldg: Address Range:
Tract POTTS, BORDEN &lSistoric: No
Suite Range:
Zoning: Cl
T
Owner:
Address
Phone:
Tenant Name:
Contractor;
Address:
JLLC PALM TERRACE APARTMENTS
16456 BERNARDO CENTER DR
Anfi Diego, CA 9212a2582
Owner-Builder
Fee Type
01116002 5'160,4 Furnace
01116002 51604 Compressor
01 116002 5160C General Plan Update
01116002 51604 lssuance
Fee
$6s.s9
$90.19
$22.O8
$55.04
Phone
State Lic #:
Lic Type;
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
iilil!:'ffi - YR!,3!.'i, Io'i LRosALEs
ffftliorrrorr, - r,rlilii* i?liiFib
"
I ronsoEt ion Totol ti4.!.41i
JLLC PALII TERRACE AFAPI I,FHTS
t22.08
,?10.9?
Generol Plqn Updote Fpe
0r 116002- 51600000- --
Itechon i col
ott 16082- 51604000-
U iso
CCi! *rrrItrrr*tr405S i5{2.40
Aut h i:0l391GBuilding Use:
Job Type:
Naiure of Work
Planning conditions:
Planning Approval By;
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Multi-Family (5 or moro uni Occupancy:
Miscellaneous Constr Type
Comp Code:
Guevara, Jerry
R-1
VB
cMc 2016 Notes: c/o
$nernanoez, ratny
Date
Date
Date 08t22t2018
Account#
oBt22t2018 Misc. Receipl:
Misc. Receipt:
Misc. Receipt:
Total
Every pemit issued shall become invalid unless the work on the sile
authotized by such pernit is commenced within 1 80 days attet its
issuance, or if the work authoized on lhe site by such pemit is suspended
or abandoned fot a petiod of 1 80 days after the time the work is
commenced.
$22.08
$210.82
$232.90
$0.00
$232.90
lnspector MID#: 2018-145590
01 I 16002 51600
01 1 16002 5'1604
Project Address: 2724 N Bristol St
Amount
65.59
90.19
22.O8
55.04
Qty
'1 .00
1 .00
1 .00
1 .00
Fee Total
Paid to Date:
Balance Due:
MECHANICAL.INSPECTOR RECORD
ID/SIG.COMMENTS OWNER BUTLDER DELCARAI'ION
I hercby lrrn ond.r pc.dry of !.{!ry Ihd I m ei.hpt fron rhc Conr*ro6 Lier* Lrs for lk folloeiiS rc.h, (Se.7011 .5
Aurimrs lrd Prcfession Code)r Any Cny o. Counry whkh Equirs, Fmil r. oinrud. 3ir6, i,pmv., &mlhh or E sn lny
nrucrE. prior b n3 issuNc, so Equircs rhc .pplicer for such pemit ro file a siSn d sral.mfl $!r hc or rhc iq liend puMnl
ro rh. Fbvisions ot dE Co.rr&mf i Li.cned trw (Chlprcr 9. Conmrcing wnh S.clion 7000 of Divisio. 3 of dE AusiM3 rd
hlfe.sions Codc) or $d h. or shc b cxcn{'l ficrcfrcm $d rhc b8i! for rh. all.ged.renption. Any liolalhn of Sc.rion 7011.5 by any
applicr for { ncmit suhirls tha applic&r lo a .ivil ,enalry of rct rcrc oun fiv€ hundEd doum ($500).
-1.
as owmr or lllc pmtEny. or Dy cmploFcs wiih qlscs ss lhct sol. coor.hs ion.willdol,f,qo mdrhe indwicmr
iorerd.d or otrcrd fo. el. (sc 7044. Busincss snd Pmacssions Cadcr Thc C.htkrors Liens t w dms nol rytly h an owftr o,
thc r,!I,en, *hd blikrr or in{,66 ir*mn. a,n wtn dEs Mh pon himsclf or lrr*lt or rholgh ht or hc. own.nployc.s.
lrovidcd rhrr such nr{,mwnrsm mr inrodrn orollcnd for $t. lf, l5rc6, rlr hliuin-q or iiImEmfl ir $ld sirhin oE yr{
ofcotr{,lcrioG rlt Oqcr Blitld will lEw rh. bldcn of pmvinS $ar h. or sh. dil ml buiB .. arpiDw rh. p$Fdy for ltE puqDe or
_1. !i owtur of rhc proFny. am .r.lusiv.ly conr,k]lin8 wnn ficc.scd conrrocrm ro .onsre-l rlr pojcc, {Sec. 7014, BuilB
ond hoftsion Codc: Thc Contractoas Licen* Law des nor spply ro an 6wnc, ollorcny who huilds or improvca lhcron,
and who @nlBcr lor such Imixrs sirh a conado(s) Iiccnsd ,)x6unr ro rh. conrr&roas Li.!n* bq).
_l oncxcrrfl lndcr Sccriod ,B.&PC lM'htrc{son
l,rr( (rr.rr
IOAf,EII.: TMIAIAIION
DECI.ABAIII'N
I hcrcby amrn lodcr F.alry ol Fjrry on. or
'h.
followi.g drE&,.lions:
_l haw od will EElljn a C.nifi.[e of Consdr Io Sclf-lnslr for *ortcB enpe.srion. a. ,rcvidcd for by Selion 3700 of thc
kbor Cod.. fd rhc pcrfomcc ot rhe etk td shich thc p6nir is hsucd.
-l
har lnd will mlinlaan worlcR' conp.nsalion iNuErcc, s rcquiEd by Sdion 1700 oflnc Lrbor Co<lc. lo, lhc Frfordrcc of
lhc work fo, which rhis lEmir is tscd. My workc* s'nFnstrrion insuEd ffar !d poliy tumb.r el
PolicyNunbar Erp
-l
ccrrily rhal in ih. p.rformrcc of rhc wort for whichrhis Frmir h issucd.l {hru nol c.l9loy my FMn in lny ruftr
s m ro h.roft slbjc.r ro rhc wolkcJ comFnerion lrwr ot Cllitomir, .nd a8B rh&l if I shou[ ta.onE subirl lo rtE
workBl @ntcnsaliotr pDtisions of S*l ion l7O0 ol rh. Ltt{, Codr. I sh,l!. lonhwilh omply with ltr$ prcvisioB..
WARNING: F.ilurc lo KUrc qorkcG conD.n tun co snbjcl an cmplorr ro aiminal pcMlrics and
tcoEpcrsalion, danEges as p.ovilcd for thccivil fincs ut ro oN hundrcd lhousand dolli^ (SlOJ.llX)
Codc. intcrcsl and ulromy s li€1
DECLAtrAIlAd
Ilrcrchyilrtnru cr prnallyolpcrjuryihrr, a ritn*l undcr ttlisi,r ol chtj,s 9 (co.nmm ir8 silh Sc.rion 7lD0) orDivi\n -r
ol rhc Btrsi.cs 0nd Pror'cs\io.\ Codc- md N,liccn\. i\ h lullrbRudenit
CAIIIBIJqUONI.ENDIBIi.AGENCI
I h.Eby !flim u!d6 FBtly of p.dury lh.t llEE k ! orsltucli,n Lndn'8 a8sey for lh. pdfru of lhc mrt for *hkh lhk l8nn i!
irsed (S€c.1097. Civ C).
AIPLICANL])IjIIAA{UON
I lHr$y i0nD unn.r lttralry ol !.rjry onc oI rfu lollo*ire dc.lurri.rs:
l)cnmlirion l,cnnirs Ashc\ros Norincrrion l:rdcrrl Rc!ulxrnn\1lirfu J0. Pnn6)
R.qutcd larrc.ol Nor'fi.fton
I ..niry rhnr rh. lcd.ral rcglloions Egedine dshtslos r.nuvdl ar. nor ,tplic$k lo lhn pmjccr
l.cnift rhd I havc Md lhk aFtlicalion !d n.rc
'h,'
0hov. iniorMion h comr.l dlle roomply*nh r0 Cny ud Counl,
ordinu.cs and Srar.liwr rcllri.S t)aurhotu epEer lrivcsofthiscnyaldCon y to cnlE uFn llE
x,vc nrtrri{,mil ,,mP.ny hr in\F.tio
Amlnrnr or Alcnr Sigidrur.l (
Appliances
Metal Fire Place
Evaporative Cooler
Compressor
Ivlisc. Equipment
Duct Work
Pre-lnsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Ir
FINAL Ql2,o IK /,///Z 0)
Notes, Remarks, Etc.I I
APPROVALS DATE
Furnace
lnsulation
Meter Release
kndai3 AddEs:
-
sla lr \
T
--------r------
=
I
=
I
I
=