HomeMy WebLinkAbout40132386 - PermitProject Address: 3779 S Plaza Dr
Assessor'sParcel 412-131-12 Lot
U nit:
Block: NA
Bldg:
Tract NA
Address Range:
Historic: No
Suile Range:
Zoning
E
@ City 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{32386
Pin #: 63700
Contractor:
Address;
Amount
30.52
42.86
22.08
55.04
Fee
$30.52
$42.86
$22.08
$55.04
Phone
Tenant Name:
BSG West Bristol LLC
5 Park Plaza
lrvine, CA 92614
Goldline Construction
3004 Gainsborough Dr
Pasadena, CA 91107
(6261222-6174
Commercial
Tenant lmprovement
T.t.
Fee Type
01116002 51604 Bathroom Fan
01116002 51604 Min Fee Adj
01116002 5160C General Plan Update
01116002 51604 lssuance
Qty
'l.00
1.00
1.00
1.00
Phone
State Lic #: 994034
Lic Type: B
Bus. Lic #: 37OO02
Workers' Compensation lnsurance:Carrier: State Compensation lnsurance Fund
Policy #: 9134311
Expires: 06/03/2019
FER&rCN
INITIAL:
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Illcq.I ED
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Botct?: {fr077 - 7lfi,lm18 ID: CCUEI-LAR
office: CT'ltll frohsi! {l I of IAact3: Rafi: t0132386
Rcpti3023{{5fl) - 7lfilml3 ll.15 All
Tnonsoction Totol ll r693.2t1
60ldl i ne Construct i on
Ctenerol Plon llpdote Fee
0l I l6&n- 5t6firno-
Fe<ton i col
olt16&?- 5t6{x000-
ICL Chec* 00202t
Notes: T.l. - Demo partition walls and install new walls to
create restroom.
$150.50
$0.00
s150.50
t22.08
t12S.42
tIr693.20
Building Use:
Job Type:
Nature of Work:
Occupancy:
Constr Type:
Code:
M
V B, SPK
cMc 20r5
Planning Approval By: Date:
Plan checked By: [l(\-zlOate:
Permit lssued By: zunlga, nttissa \\ Date: O7l3Ol2O18
Subject to Field: Account#
Planning Conditions:
Buildins Permit #: 101 96857
Every permit issued shall becgme invalid unless the wo* on the site
authodzed by such perfiit is commenced within 180 days after its
issuance, ot il the work authoized on the site by such pemit is suspended
o( abandoned br a pedod ol 1 80 days after lhe time the wo* is
commenaed.
lnspector MID#: 2018-144079
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Fee Total
Paid to Date:
Balance Due:
$22.08
$128.42
Owner:
Address:
'q
01116002 51600
01116002 51604
MECHANICAL.INSPECTOR BECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCAR TION
I h6by amrn hdcr I'cMlry ot nerjury rh.r I m ci.mtr fiom rhe Conmdm Licens. ttq for rlE followir8 E.sn (sa.701t.5
Busincss .nd Pri,lcssion Codc) Any Cily or Cou y which ,.quircs 3 Frni ro conddcr. 8lrs. impmrc. dcmlhh or Epat any
srtucruc. Itrior ro irs hsude. oho equiEs rhe srpliconr for such p.mir ro lilc a siSned slarcftnl rh,r lE or ihc is liccn*d pur$ r
ro tc provisioor ofrh. Conrractor's LiBnscd ljw (ChapH 9. ConieNilg wilh Setion ?00O.f Division'l otllE Bu.incs,nd
Pmf.sio$ Code) o. lnrt h tr shc t qempl rlrefrcm&d rlE hGi! lor rE illcS.d .xcq,lion. Any viohtioi of Selion ?0115 b, lny
applisl for . Fmir subj€.ls thr lpplkanl lo acivilFExyofnot mElno fivc hundr.d doll&s (1500).
-1,
as ownfi ol rh. ImFny. or my c.rrloles wilh wa8.s rs rh.n st omp.nslhn, will do rh. sort and lhc sm.lm ir rcr
inrcderl or olibEd lnr sL (s6 7014, Buri*ss and Pmfcssions codq Ttc Conracrofr Liccnsc Ltw .Lcs mr apply ro .n ovmr of
lhr pmpcny whr b{irds tr irqmrts tlrcMn. ard Bho d6 sct mlk him$lf or hcrelior lhmush his D, hcr ow. cnploy4s.
0rovidcd rhd skh im!remnts @ mr i cndcd oroltrcn fo. qL. li h.wB. fi. huildiq or nryoErnrn sB eithin oft ru,
ot smpLrion. rhe Owtur BuiBs vill hlE rlr hrdcn of Fovin8 fid hc or nr di, or hoiu or ir{ew lhe pol{n, ht llE pnpos of
-1,
!s own{ oa r hc nmFrrr. 0m crclusilelr conrrucr ins wirh ,ilrnsd conr.lcrod ro coosrrud rhe F)jc.r (Scc 7M, Bu\inc$
nd PrfdsiD cod.: Thc contrdols Liccnsc tjw dDr* nor q,tly ro on oqncr ofprcpcirywho build\ or imtrclcs rh.icon.
and who.onrB-tsnrsuctF.ixl$wirh!Coorffkn(9lilrn*dp!^unrrorh.ConkB.u\Liccn*trw,.
-l
rm cxcnrpl u.d.r Se on- B. & P.C. for Inh rcasn
UOBf,ES OMPIISAIION
oDctASArxld
I hcrcby amrm undcr pcMlly of lcrjury otu of rhc followin8 dccl,r.tiotrs:
-l
hrvc .rn *ill minkin ! CcnifEd. of Cone ro Sclf'ln$rc ftr qorten .ofirnsarion. ui prlvitn for by SEiio. 3?00 of $.
ljtE. Codc.lo.thc pcrformR ofth. srk for vnth tn Fnjr is icaud.
_l havc and *ill minlain qorke$ conn nsaion iBuhft.. ,s Eqltcd by Serion 3700 ot thc trb6r C.nc. fo. lhc psfolrMa of
th. M* fo' *hkhrhtDcmi i. irnr.d Mrwo,lrss Ommnrdiun incurmc Mi(r,n polFy numb.r m:
cet, .5/16 D-/
I ccniliihat in rhc n rlormmc ofrhc work for whi.h rhi p.rmn i. ksu.d. I shall nol cnlloy lny pcron in any ronner
$ os lo bcom subict to lh€ uorkcn'compcn$lion bws of Cllifomia. md lgrc thlt it I slhuld tEtom sxbi{ ro rlF
woltal comFnsati,tr ,,ovisions o{Sccrion 1700 ofrhc L3hx tue.l shau- fonh*irh coq)ly *nh$.s pmvbions
WARNINGT Fdilurc b $.urc wor*crs ompcN0lion ..vcn8c h xnlawful. !trd shall subict on crryloycr to dnind Fidhis !.d
.ivil rincr uti r, onc hundrcd lhousdnd dollaA ($addilion lo rhc cosr ofconrpcndion. drm8cs 3s lrovided tor rhc
Sr.ri(m 1076.lrhr l-rhn Cixl.. iIrrrr rtrd
"",,.
'7-7o-l I
uuilsDllc(JNl&tl:Iaa
IECLAEAUAN
I h.rby nflirmrnd$ pcidryoltrrjurt rh[ I m li.ci*d undcr pn,visn olChirlcr9(lannnrncir8silhSccli,)n7(xX)rofDivi\n,n]
ol lhc Bu\ircs\rnd Pm,cssion\Codc, rtol nrr licco\r i\ i,r lnllr{nftaidrffmr
7->o-1tr
CqNSIAIIGIIANI&DAC.ACENIA
I lEEby aflirmrnd.r FtultyofFilry$d rhd. h !onlltoctbi hndingogdcy fo.rhc Frf.'!rrl.E 6fuc rc fo. vhih this Fnl b
issd (Sm. 309?. Civ. C.).
Ltruc NLDEcrin roN
I L*(ny nnnru .r !.rJlr, ol r^-rrury otrc.l'rh. n)llo*nr8n..l iri, r(
I)rnrn ri,,n l'$n ts \hc{o\ N.riri.Ji,r lrcdcrrl k.guhri,nr ( Iirlc.lo. I'xn6)
Rcquirctl lrfi cr of Nolifi corioi
Icdilyrh,' rh. fcdcral Eguhlions rcBeding aslf,r'os rcnxrvtrl m nor oflrlic.hle ro lhis pmj.rl
l.cnify rhdr I hav. rud i.0rion uld 3rar. rh.! rh. obov. nr6nMion is corer. I !E d to mry)ly snh aI Ciry and Colnry
ordi'rncc\ rdd Srar.l-rtrs h.rcby *rhuria rcpEsnr.tivcs ollhn Cityand Counryh.nrc. upon rh.
nh.vc nriridrd pmNny lnr
Atpli.,m or AScnr Si8nar J, 7-'za-ttr
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release
Notes, Remarks, Etc
6r'4 {
lnstallation
FINAL