HomeMy WebLinkAbout40132058 - PermitCity of Santa Ana
Permit Counter: (714\ 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702 ilf,I Mechanical Permit #: 40{32O5E
Pin #: 48605lnspection Requests: (714\ 667-2738 lnspector Section: (7'14) 647-5853
Project Address: 1202 W Edinger Ave Unit:
Block: NA
Bldg:
Tract: NA
Address Range; l50l-1533 S
BristoU1202
Historic: No
Suite Range:
Zoning: OAssessor'sParcel: 013.040-29 Lot: NA
Owner:
Address
Roman Catholic Bishop Of Orange
28ll E Villa Real Dr
Orange, CA 92867
011 16002
01116002
01116002
01116002
011 16002
0'1116002
51604
51604
51604
5360:
5160C
51604
Fee Type
Compressor
Envir. Air Olher
Vent Fan/Comm
P/C - 650/0
General Plan Update
lssuance
Amount
90.19
35.21
43.62
0.65
22.08
55.04
Qry
3.00
1.00
1.00
336.99
1.00
1.00
Fee
s270.57
$3s.21
$43.62
$219.04
$22.08
$55.04
Tenant Name:
Contractor:
Address:
Bomel Construction Co. lnc
8195 E. Kaiser Blvd.
Anaheim, CA 92808
(7r4) 921-1660
Stale Lic #: 265409
Lic Type: B, A, C-8
Bus. Lic #: 366252
Workers' Compensation lnsurance:
Carrieri Federal lnsurance Company
Policy #; 54303157
Expires: 0710112019
Building Use:
Job Type:
Nature of Work:
Other
New
New Parking Structure
Occupancy:
Constr Type:
Code;
s-2
I B, SPK
cMc 2016 Notes: fee pd on M-71596
Planning Conditions PAID
Planning Approval By:
Plan Checked By: West, Glen
Permit lssued Byr Hernandez, Kathy
Subject to Field:
Buirdins Permit #: 10196247
Date:
Date:
Date:
Misc. Receipt: 70913
Misc. Receipt: 71596
Misc. Receipt:
Total
SEP 28 2(]IB
City of Santa Ana
Evory permit issued shall become invalid unless the wo* on the site
authorized by such permit is cofinenced within 180 days aftet ils
issuance, or if the wotu authoized on tha site by such pemit is suspended
or abandoned lor a peiod of 180 days aftet the time the work is
commenced.
$645.56
$645.56
$0.00
lnspector MID#: 2018-142922
N/A - No Balance Fee Total
Paid to Date:
Balance Due:
Phone:
Phone:
o5t2912018
o912412018
Account#
MECHANICAL.INSPECTOR RECORD
()l!Nt,tR B(r ,t)tR I)t:t,( aR,\ ll(rN
I h.rchy rrtrm und.r pcMlly of pdjury rhd I d.rcnq fmm fi. ConlEclm' LiccM Lrs fo, rlE follo*ing rcr$n (ss.7011.5'
Busin.* !tu Pmfcssion Codc) tuy Cily or County whicn Eauires s pcmir lo connrucl. slls. irymt, d.mliti or Epln 3ny
strucrurc. p or ro irs issuune. aho ctuiEs th€ .0pli€ant aor slch Frmil ln tilc. siSncd slatftnl lhd hc o, ihc i\ liccnsd Pu*uMt
ro ltE tmvi\ions of dE Conlr!€loar Lien*d Lrw (CttPte,9. Conmmin8 oilh Sc.rion ?000 of Division 3 oflh. Bu.incs lnd
Pmfcssions Codc) or rhlr hc or sh. i. .rcnrl lh.rcfrcm and lh. tEsis for rhc alhgcd ercnlPlion. Ary violllk'n of Seritn ?01L5 6y sny
smlicont lor a l. rnir suhjers lt lpplicanr lo a civil pcnalry oi nor mE ihd filc hondrc{ dolle. (1500)
-l-h
o*i.rofihcpn,Fnl,ornry.mploylt\wirhwxsc\asrhcnv,b.o rr.nsarior.qilldorhcworla lrhc{M1uEistrn
imcMrd orrn rcJ lnr $lc (Sn-. 70{,t- Burird* r.d Pnnrsn
'\ Codcr'l hc (onlli.lm s Lic.n\.If,w doc\ nol aPfl} io m o$ncr or
rhe pn'Fdy uho 6uild\ or nnprolts drrofl. Mtl who doc\ snch soll hnn\clt or h.r{lfor rhmush his or hcr.utr c'ryloy.rs,
tmvn[d rhrr Nrh nnnn,vcnr$ @ nor idcnlcd or ofi.reJ ntr s|t Il, h,scvcr. rhc huikliB o, i.IlpmsnEnr is $kl *irhm oE }tar
oicotrIhrion. rt* O*ncr Btrikld will hr\r thc hLldctr ol B)vina rluf lrc or \hr dit mr huild or inryovc rhc nnlrny lar rhc !uqr){ of
I.*owncrofrhcpft,|tny,amct(lu\i\clyconkscrir!Qiihli.c\cd..trridocroconnrudrhclr,ljt(r(Scc.r(ll'{-An\i'(s
n8l l\olislira, .:'thcCo tn.rolsLiccnscL!*docs.oraltlyr.3no*n$or|nrp.rly'h('huili\orn pmlcs rhc.co..
rid sho.urrncrlir\uchpmicts$irhrComE.t)rl()li.cn*lPurmnrlorhc(i)nka.t \t.i.${tisl
_l r crc rpr undcr Scdio D &PC ror G rcnson
IA&IEIS:.CO!4TENSAIIAN
DECLAtrAUI'!
I h.rcby rfirnund& pcmhy ol pc.jury otu of rh. rollowing delarn'hns:
Ihrvcmdwillroir riraCerli[colcofcoi\cnrr.scl trsurc lot workcN omFnsrrion, ,s l,tuvidc{ aor by ScclnD :]7{D ol lhc
Latxtr Gic. f(, ih. F forlwre of lh! *orl n, which rhl p.rntir r\ issu.d
-l nrvc and will mohllitr Norkcrs conFnsrlion insuranc., as Bquircd bl Selion l70O of rh. t2bor Code, tor rh. P.rfollrMc of
rh. wrk lbr ehich lnis Frnil ir iintn, My eo.kdl .onp..slhn insuErcc @t d lbli.y num66r @:
lj'.Y-
-l
ccnitith.l in ltE !'cdorn1nN ollhc sork aor wtkn Inis Pcrmir is hsu.d.l shru nol €q,loy any llcBo. a. !., msnncr
s, 8 16 tr.om subjcd ro rlE srl6{ @n{tnsrio. laus orcdilomie Md o8E lill if I qthuld beom subj.ll to llt
workc* ompcnsltion lovisions o{ Sdlion l70O of rhc t ho. Cdc. I shnll. fofltsirh oq)ly wirh lhoe Provisionr.
WARNING: l:lituE lo *ue *oll.( .omFnsalion .ov.a8. n unhDfol. a.d bjed e.m0loyer to nmnEl Fdhies lnd
civil fincs up lo oDc hundrcd rhousond doll-s (1100.000), in 0ddilion lo rhc dBmssc{ ds tovidcd for thc
1/zr inrerc{ dd dlfmy s f!cs.
DticLA&u0N
I hcrchy.flirm undcr l'cnrlly oiFrJUry rhnr I m li.cn*l undcr |n,visn,n ol ChlPr& 9 (.onnnctrcirrg wilh Section 7f)0) nfl)iviltrn I
.f rh. B!\in \\lnd Ptufcs(i(ins Corjc. anl ry lkcn\c i\ i'r full f(rQ dt cllccl
.1 ?
I hcrcby affirm undcr lcnuhyofpcrjryrhotlheE h o onrn'crtun kndi.8 ugcncy fn lfic pcrfomatc olrhc work aor which rhh [tdi h
i$ucrl (Se 1097. Civ. C.)
I.cnify rhnr I luvc rc.d lhis alplicalbl axl {[. rh r rhc inforturion ir.od6r 1lgrc loorylyrirhull cilyond counly
ordiMtres and Sralc Lrw\ EbrirS ro blildiry conrmcl ioc
brc mnri.ned pbFny ror inspcclion puqrss
of thN C y dd Counlt lo c.ld upon dE
*," q/z{
Apt'lica or Asenl Si8oalut
APPROVALS ID/SIG.COMMENTS
Appliances
lvletal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rouoh Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Ranqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinos
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rouqh Mech.
Final Test
Meler Release
:L4)FINAL q,lw4 \
Notes, Remarks, Etc.ut
DATE
Duct Work I
f-------T------
l
tt
I
I
kndca\ ddrc$:
-
lppr ru nilrrii,ln eii
I rENhy a,nm undcr pcnallyoapcrjury onc orrhc iolbwinB dlthrln,nsl
Demolirion Pcnnn+Asbcios Noliticarion Fcdctul RcgUarions (f irl. 40. Pon6)
-R.quired
l,clrcrorNorifi.,rbn
-l
ccnily ltu thc ,cdcral rcgul,rions ESslins .strno\ rc.Eval aE nor rppli..bh ro thh lrcJecl