HomeMy WebLinkAbout40132301 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702 Mechanical Permit #: 4()1323()1
Pin #: 95471
l nspection Requests: (7 1 4) 667 -27 38 l nspector Sectaon: (7 1 41 647 -5853
Contractor
Address:Bqtchi?4469t1 -
0ff ice: CTYH
7/?/20t8 ID!
Tronsi: 68Ref+: 1|]1_ l,t9l2lrlg i..ttl
.-R0
2
323
P11
.30
ol
8lPhoneAc,:ti:
Rcpt,'3 (r2321666
Iroosoct ion Totol .:,
Senv i ce Chnlp i ons
llechan icnl
01116002- 51604000-
6pnerol Plon updote Fee
01116002- 516000ri0-
ICL Check t-15741!i
$181 . 94
+544 , 3r"r
Building Use:
Job Type:
Nature of Work
Single Family Dwelling
Miscellaneous
A/C change out
Occupancy:
Constr Type
Code:
R.3, U
VB
cMc 2016 Notes: A/C change out.
Planning Conditions:
Chavez, DauegU
Date:
Date:
Date:07/09/2018
Account#
l\4isc. Receipt:
l\4isc. Receapt:
Misc. Receipl:
Total
Every pemit issued shall become invalid unloss the wod( o, lhe srle
authorizad by such pemit is commenced within 1 80 days aftet its
issuance, or il the wo* authotized on the site by such permil is suspended
ot abandoned for a peiod of 180 days aftet the time the wo* is
commenced.
$22.08
$181 .94
$204.O2
$0.00
$204.02
lnspector MID#: 2018-144514
01 116002 51600
01 't16002 s1604
Fee Total:
Paid to Date:
Balance Due:
P-1"
Assessor's Parcel: 003-08'l-13 Lot: 9 Block: A Tract: 359 Historic: No Zoning: Rl
Owner: JUDYWTSCHETTER Fee Type Amount Qty Fee
Address: 2425 N Poinsettia St 0111600251604 Furnace/Comp Combo i26.90 1.00 $126.90
SantaAna, CA 927062051 0111600251600 General Plan Update 2218 1.00 $22.08
phone: (7141972-1762 01 116002 51604 lssuance 55.04 1.00 $55.04
Tenant Name:
Service Champions
3150 E Birch Street
Brea, CA 92821
(7141777-7777
State Lic #: 799'170
Lic Type: C-36, B, C-2, C-20
Bus. Lic #: 196430
Workers' Compensation lnsurance:Carrier: Pacific Compensation lnsurance Company
Policy #: WA00060703
Expires: 0312212019
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
MECHANICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNEN EULDER DELCARATION
I lErcby affirm undcr Fmlry of !€rjrry rhir ! m cictr{,r 6!m rhc Contr..los Liccoe L!, for rh€ followi.S ..sn (s< 7Ol I 5 '
Busi,csr .r{ Prolcsion Codc) Ary City or Coumy whbh reqliEs ! Fmir ro onsldcl. dl6, improrc. d.rchh or t,!n y
sttucr*. pri,r lo ns nsuakc, al$ rcqlncs rhc appli.ul for sEt Frmir ro lih ! sisdd sr.reft rhat h. or shc is liccnrd Furslnr ,
lo lh. Fovisionr oftlE Conlrebls Lic.nsd Law (ClBplcr 9, CohmminB *ilh Sslion ?Om ofDirision I of lh. aurincss a.d
Ptufr$ions Codc) or thlr lE or st* t cx.hpr rhcEfrom s.d rlE bssiF for rh. allcg.d crcrgrion. Ary viokrio. of Sdtb, ?0.t1.5 byuy
aptlicait tor a pcnnir subjds the ltplicdnl lo a.i!il l,celr, ot mt mE rh6 fivc hudrcd douos (S5@).
-1.ac
ownr.frh€prcFny. my cnplojEs wilh wa8cs ar rlEi $lc@mp.nslior. *iI.lo thc*ort a llt*ltlmiiNr
ime'd.d or oftcrcd fd sL (Se 7044. BlsiBs .nd Profc$ions Codc: Tlr Conrtuloa. Licde LrB {k'.s m! .p!ly to s owmr of
tncpmrEnt who builds or trFm!.s tlEmtr rnd wlb do.s 3uch mlt himsclf or h.n.lfor lhmu8h his or hs own cnphrci.
pmvi.hd lhd.uch ia'IroEr ! & mt i.rdrHorolf.Ed fo. slc,lf.lE*cm. tl.t t{iuingori.FroEm k$ldwithhomFd
of @npLlbr tlE o'rM Builds qiu har tu h,rd.n of p,!li4 oEr lE or shc dij hr hiild or in+or UE t trIEr, for tlE purpos or
_1, N owftr ofrhc rmpeny, amciclusivcly.onracrios sirh liccn$d coorar66 ro mn{ocr rlE tmirl (SN.7044, BNm$
ard Eofa\ion Codc Th. Co r.clolsLic.nr.Losdocsmr{!!lytoatropncrofrnpcrly*hobuildsorimtolcsrhcrco.-
ad *lD con|flds forsuchIlrjers pirh ! Co.tEcro(, liefl*d plnu lo rhc CoflricroCs Ltcn* t w).
-l
m cr.ofl undcr SeriorL- B. & P,C, for rhis Ea.on.
YA$EIIECII4fENI,AIIAN
DECI ARATION
I h.r.bt ainrn und.r rcnrlry or ldjury o.c ol rh. folb{irg dshrari.nr
-I
harc rld willdinl8in a Ccnificarc olconFnr ro S.lfinsur. ror workcG ompcnsarion. * Folid.d for by Ssrion l?0O of rhc
tihor C.dc. ro. rhc Frfr)mNc oa llE wo* fo. whih tlx Fmi, h irsucn.
fi";*;lllir.intsin workcrs .omrcnsarion insumncc.0s rcquncd bySccrion 37(Xrotrn€lj$orCode, for rh. p.{or@n.. of
lhn pcmil h issEd. My *ort6 coqEnsalion iNumm fficr dd ,nlic, nrdbcr e:
<:_
_l ccnif, that inrhc FiformNc oltrxvork aor*hichrhi*Frn h kskd. l shall mr enploy lny pcMn in lny maflncr
s Ilo h.com subi*' to lh. vorkac omrBnerion hwr of C.liforni!. ofld lee ltol if I sbub tt od 3lhjccr ro rhc
worr.rc'omFnsrlio.t6vkio.sofSetiotrST00oflhcL{borCod..leh!!l,fonhwilhomrly*ithltosprovisio.s..
WARNING: Frihrc to suc sortc6' odptn\di6. cotBsc i$ !.lawtuL dd rhnll subicct on .n9lorlt lo aiminal trmhts lnd
civil fin s up ro onc h!.drcd rhoueod dolld (S100.m0), in addiri,n ro thc.os or.onqEnsalion. d!.E8cs !s lrolilcd for llE
€Applldnr: / z-
LII;DIIEI]I;I]NIAA1:IIIB
IIEIIdAAIION
I ncrcbyafiird undcr lcnahrolpcrjury lhrr I !m lntir{ undcr rn,vilnrnolChaprur 9 (..mnEncnr8 wilh sdn,n ?uxr) oiDivnion l
oi rhc Busiocssrnd Pnra\siors Co{lc.0d nryliccnr n intullfr.c {rrd.flNl
E c <1 e96
? .."-",o" -
CONf,If,IEUONIENDIIC.&OINCI
Ihcrcbtafitnrr.rnnalryofrrrjuryrhdrhcrcissronlrtucii,,nLdin!rsci.y(trrlrF,rri)nnm.coirhcMrkturtrhi.hlhi\pcnili\
nnd (Scc 1097, Civ. C.r
AIILIIANLIECI,IBAIroN
I lf,Nhy,finn un{l$ lr.trrlry of p-rjur} otrc olrhc lollowins dc.hidn,n(:
Dcnnlirion Pcrmir!Ash(\ro\ Norificnrion redc.llREruhrions (-Iirlc 40, P!n6r
R.qoirud tr(d of Noif.{tun
I cdifyrhtrr rhc a.d.ml rcSulrions Eg,nlinB lsb.nos r.mvalm nolapnlicablclo rhis pmi{l
_l .enify rh.r I haw rcld rhi. atpli.drioo atrd arc lhar rlE ,h,vc iotomrion is co,mr. I aBc ro .ompl! sirh lll ciry nd counry
ordimn(cs and Srarc l-ass rclding rn huildirE .on{rucrion. !M hcr.hrruihoriz. {lrcscnrdrivcs ofrh( Cirynnd
ahorc tutrrn,rcd prepcny fo, inrpccr
Apdic.nl o. A8Etrr Signolurc I
Appliances
Ivletal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rouoh Ductwork
Vents
Toilet Boom / 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
Above T-Bar
Rouqh Mech.
Final Test
Meter Release
FINAL I h*l/l 4vtt*u tltl -/
Notes, Remarks, Etc.
poti"yxu *,,@^ n'
43:
II
[------T------