HomeMy WebLinkAbout40132076 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702
l n spection Req uests: (7 1 4) 667 -27 38 l nspector Section: (7 1 41 647 -5853
Mecha n ica I Permit #: 40132076
Pin #: 50620
Proiect Address: 3330 S Harbor Blvd
Assessor'sParcel: 415.023-07 Lot: NA
Unit:
Block: NA
Bldg:
Tract NA
Address Range:
Historic: No
Suite Range:
Zoning: Ml
E
Owner:
Address:
Phone:
Tenant Name:
Conlractor
Address:
Tam Nguyen
3330 S Harbor Blvd
Santa Ana, CA 92704
(714l.241-0235
Robinson Pharma
Owner-Builder
01 116002
01116002
011'16002
01116002
01116002
01116002
011'16002
01'116002
51604
5'1604
51604
5'1604
5'1604
5360:
5160C
5'r604
Amount
145.28
65.57
113.24
43.62
39.14
0.65
22.O8
55.04
Qty
1.00
1.00
1.00
1.00
1.00
406.85
1.00
1.00
Fee
$145.28
$65.57
$1 13.24
$43.62
$39.14
$264.45
$22.08
$55.04
t?2.08
,16t .89
t9.87
t{93.84
Fee Type
Compressor
Air Handling
O/D Pkg H/C
Add'l Vent Sys
Humidifier
PIC - 650/o
General Plan Update
lssuance
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Bolcht:{4778 - 7/12/2$18 I0: LR0SALES0ffice: CTYH Trqnsi: 15 I of IAcct+: Refi! 4t-r132076
Rcpti:02323179 - 7/17/2ttl8 1r:r:54 AII
Tronsoct i on Totol l4?3,S4
Tnn l{sugen
Building Use:
Job Type:
Nature of Work
Planning conditions:
lndustrial
Tenant lmprovement
T.t. -
CSG Consultants
Link, Patricia
Occupancy:
Constr Type
Code:
B, F-i, S-1
III B, SPK
cMc 2016 Notes:
Generol Plon Updote Fee
01116002- 51600000-
llechon icnl
01116002- 51601000-
P./(: llechon icol
0u16002- 53603000-
ICL Check 012662
Date
Date
Date
o5129t2014
07t1212014
Account#
Misc. Receapt: 70931
Misc. Receipt:
lvlisc. Receipt:
Total
Every permit issued shall becone invalid unless the work on the sile
authonzed by such permit is commenced within 180 days after its
issuance, ot if the worl< authorized on the site by such peftnit is suspended
or abandoned for a peiod of180 ddys alter the time the work is
commenced.
$748.42
$254.58
$493.84
lnspector
01 1 16002 51600
01 1 16002 5'1604
01 I 16002 53603
$22.08
$461.89
$9.87
Fee Total
Paid to Date:
Balance Due:
Phone:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
MID#: 2018-143150
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE tD/stG.COMMENTS
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation -3 ktuld EklttDlt $ueY w4J(
lnsulation
Smoke Detectors lnstalled .A\
Rouqh Ductwork N,lu1a'Ptgwl
Vents
Toilet Room / Clothes Dryer
Residential Ranqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
F.D. Drop Test
Above Hard Lid
frtytr-ttllttyTv 7DAbove T-Bar ll UI
Rouqh Mech.
Final Test
.x-ytcqtl/.FINAL ttb/h'n 1., )
Notes, Remarks, Etc.UI
f hz- Ufnto ,L- o-t 0 oJ ,,
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I hcrcby rr"n undd p.@lry of pcriury rh,l I m crcq liDm E ConFlcron Lkctr$ tw lor thc fotbwing lNi (Se.r0Jl.5
Blsincss lnd Prcfcssbn Codc): A.y Chy or Counry whkh rcqubcs a rxrnn lo 6nsroct. alls. imprcrc. .lcmtkh or Elui. dy
sm(e, Fi'r to ir! hrur@. d$ r.qunar llE eprli.lnl tbr $ch Frnil lo lih a .i8Ed rlslemnl lhlt lE or shc ir li.cned pu^!t r
ro rhc Imlnions ol rlr G)nrEtoa. Lkcnsd (,w (Chapro 9, Collmmins *ilh Scctio. Tq)o of Division 3 of In Businc$ and
Prolcssions Codc) or ln lE orslE is cxchpl lhcaaonaid ft. hqris ror rht allcScd cxcnptiotr. Anyviolarionolse'ion1031.5byony
aprlic.nr for a ponir slbjccN rhc rrtlicot lo s civil lcnally of nol mrc lhtu fivc hundcd dollrs (3500).
-1.
as o,rer of rh€ l,lFny. or my cnplorr.s wilh waScs I lh.n sb compen$rion, wall do th. wort 8rd l,E nrtlft ir er
inr.nd.rt or ollced lor s& (Sa.?O14. Blsincss ed Prsfcssions Code Thc Conlrclol s Lic.n* ljq docs nol aruly (o e owmr of
fic pmpqry who trilds or inphh tliren dn wb dB s.h mlt himself or hcelf or fiNlgh hh q her os. rnplottc!.
torit d rhll skh irp$wm s @ ml inl.dH oroffcEn for sh. lf.lEslq. rtE h'iiuinS d inpoErd t eB sithin om JEr
oforpLrbn. ttr O*F Buillr wiu haw dE hsd.r otFovin8 thd lE or slrc dil ml t ild or inllme 0E tmFiy for lh. Frlns ol
x as o*ncr of rh. rmpdy, amcx.lxivclyconkaclinS wilh li.cnsd contr lorlo oni'd.i irE ImrNt (Ss.7044. Bu\imss
hofssir Conci Thc Contruclort Liccnsc L€w docs not arply lo !no*mr oitror.rly who huilds or imrtovB rhcrmn,
lnd who contncrs l'or \{ch porek *irh a Co mdo(s) li.cnsd pursonl lo lhe Contracrff s Lrccnse l:w).
DECI,A8AIIOtr
I hcrcby.mrmundcr pcnalry oa pe.j!ry 6e of th. louovin8 ddlr ions:
I hntc {lsillnBinrair rCcnili.rrcolconsc h s.lllinrc n sor lcr' cunpln"dnn,. a\ Ir'ovidd fd by Sccr i{nr :lr(x) o f rh.
ljhtrCodc. for rhc pcrlr).in0nccotlhc *tr[ I(n whi.hrhc trnii '\ ^\ucd.
Ihsvcandwillmainr0inworkrlcomp.nsalionanslrancc.{slcqdrcdbySeiion371{orthcklhtCodc,lorlh!pcorm.ccof
thc vorl ior *nich $is p.rmir is iss.t, My work6 compcns,rnrn in$.mcc oricr md lolicy nun$c, rc:
-l.cnifyfill
in rhc pcrforrotue of rh. {ork ror whhh rhil Fmir h issucd. I shlll nol cdploy rny p.mn in lny nwftr
$!srob€sftiubjerrorhc*o.6.omF.solionlawsofcolifomir.andaeBrharilIrhouldbc.omslbjcdlorh.
sort6 @opcns ion povisio of Setion 3?0O of lhc L{Er Codc. l shall, lodhwilh comply wirt lln$ Imvliio.r"
IVARNIN(;: r_dilurc !) $.urc workc^ comPcnsulior covcrrar is unhstul. rDd {rall suhiccr ur cnlnoycr ro dimirrl Pcmlrics rnd
civil fin.s np lo onc hundrcd lhousand doll$ (Sl conrpcnsrio.. ds.De.s 0s Drovidcd for rhc
Codc. inlcrcsl lnd dttrruy srLI(]jNIDD-II)IIXAIIIIBDli(lt8/lltu\
-
ContBlor:
QNSIX!!.UAtLLIiJDLlllrI{ili:CL
I hcrcb, artrm und.r Fmlry or pcrjury lhd thcrc k a .on(ruction lcndins ng.ncy ro. rhc ,Erfonmmc of I hc wor* r(tr whf,h rhis rrmir i!
hsucd (Scc 3097,Civ. C )
A.TILICANI.!&EIIBAUA!
I tu$y aninn uRlcr pcnlht oft*rjurt o.c orthc rollowirS dcclitdn,trs:
Dcnx,lirion PcrmnrAsh.{osNorificalion Ederul Reg!brn,n\(Tirl.40, Pd6)
Rcquircd t ncrofllolifi. i.o
-l
ccnify rhar rhc fcdc,al rcgubrions c80dinS osh.nos rcmvd sc nor q]plictrhL l. rhis tmj..l
-,
ccn ify rhor I lElc rcld rhl dnpli.nrion Md $.rc rhar lhc |k,vc informlion is c6ftd LEm ro cohply sirh lll Ciry ond Counry
.rdihlkcs md Strtc Llws rcllln'E
8k,vc mntiomd ,mpcny lor
Applicanl or AEc Sisnalure:_
D
hcrcby,urhorizc rctrcscnlolivcs "'":":"'a;l;',;'"
Meter Release
Poli.y N!mbc.-xpiEs:
I hcrcl,yalftmundcr pc.alryolpcrjuryrhnr I n li.dtrwl uid.r pturi{nr oiclupr.r 9 l$ nk cin8wnhscclion7000)orDivi\n,n.1
of rhc ausnrs rnd Pdt$iux (inlc. and my li.di\t i\ irr fulliar.c tclltcr.
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