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Home My WebLink About40134296 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #: 4O134296 a'-Piri #: {6154 Proiect Address: 1242 112 W Pine Sta Assessor's Parcel: 777 -777 -77 Lot: Unit: Block: NA Bldg: Tract: 1363 Address Range: Historic: No Suite Range: Zoning: Rl 4l'lLff Owner: Address: Phone Tenant Name: Contractor: Address: Owner-Builder Phone State Lic #: Lic Type: Bus. Lic #: Workers' Compensation Insurance: Carrier. Policy #: Expires. Life Cycle Management, LLC 25 Brookline Aliso Viejo, CA 92656 (949) 412-8219 01 1 1 6002 01 1 1 6002 01 1 1 6002 01 1 1 6002 01 1 1 6002 01 1 1 6002 01 1 1 6002 51 604 51 604 51 604 51 604 51 600 51 604 57770 Fee Type Amount Wall Heater/Floor Furna 68.14 Clothes Dryer - Residen 41 .92 Bathroom Fan 31 ]2 Range Fan 33.57 General Plan Update 22.95 lssuance 57.20 Microfilm Records 3.91 Qty 1.00 1.00 1.00 1.00 1.00 1.00 1 .00 Fee $68.1 4 $41.92 $31 .72 $33.57 $22.9s $57.20 $3.91 Babch*:55128 0ff ice: CTYHAccti: Rcpti:tt?93792( Tronsact i or L i fe Cvcle +/ l6/2tt2tt Trnnsit 15 Refi: +/ t6/?a2t nnosement r LL(: Building Use: Job Type: Nature of Work: Single Family Dwelling Occupancy. New Constr Type: New 2nd story attached ADLCode: Date: Date: Date: R-3, U VB cMc 2016 Mechanical for a new second-story ADU attached to new SFD (on separate permit). $2s9.41 $0 00 $259.41 Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Chavez, Dave Subject to Field: Buirdins Permit #: 1 0110261 6 Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 360 days after its issuance, or if the work authorized on the sife by such permitis suspended or abandoned for a period of 360 days after the time the work is commenced. 04t09t2020 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Tota! Notes: Fee Total: Paid to Date: Balance Due: 01 1 16002 51600 01 1 16002 51604 01 1 16002 57770 $22.95 $232.ss $3.e1 lnspector MID#: 2019-156679 i t - MECHANICAL.I NSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATION I hmby affm undc psuhy of Frjuy that I m Gxcmpt from thc Coilr.ctorc' Liccns taw for thâ‚¬ followirâ‚¬ rcmn (54.70.11.5 Buincs and Profeion Codc): Any City or County which rcquirc a p6mit to @nstruct. alts. impovq danolish or cpair uy structurq prior to its isswc, also requhc thc eplicmt for such pcflnit to 6lc a signcd samat that hâ‚¬ or shc b licoscd puuut to thc p(ovisioN of thc Cootsrctor's Lienrcd bw (Chaptq 9, Comcncing with Setion 700O of Division 3 of thc Busine ud PrcfNioBCodc)orthathcorshciscxmptthsdromudthcbasisforthcdlc1cdcxmption. AnyviolaionofscrionT03l.5bysy applicmt for a pâ‚¬nnit subjcts thc applicet to . civil pmlty of not more thm five hundred dollil ($500). -1. as owncr ofthe propcrty. or my emplolees with wages as their sclle compensation. will do the work and the stnrctue is not intended or offerd for sale (Scc.7044. Business and ho ssions Code: The Contractor's License [aw does not apply to an orvner of the property who builds or improves thereon. and who does such work himself or herself or through his or her own employees. provided that such improvanents are not intended or oflbrcd for sale. lf. howet/er. the hrilding or improvemeot is sold within one )rcar of complaion, thc Ovmer Builder will have the hrrdâ‚¬n of proving thd hc or shc did not build or improve the propoty for the purpose of sale). -1. as o\\'ner of the propcrty. am exclusively contracting with licensed contractors to conslruct the project (Scc. 7044. Business and Profession Code: The Contractor's Licensc Law does not apply to an ow'ner of property rvho builds or improves thercon. and rvho contracts for such projects with a Contracto(s) licensed pursuant to the Conlractor's License Larv). _l arn exempt under Section_. B. & P.C. for this reason. Date:_ Owner:_ WO RKER,S' COI}T PENSATION DECLARATION I hereby affrrrn under pcnalty of perjury one of the following declarations: -l have and rvill maintain a Certilicate of Consent to Self-lnsure fur rvorkers' conlpensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for w'hich the perrnit is issued. -l have and will rnaintain workers' cornpensation insurance. as required by Sc'ction 3700 of the Labor Code. for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy numbcr are: Carrier: Policv Numbcr: Exoires: -l certi& that in the performance of the work for which this perrnit is issued. I shall not ernploy any person in any manner so as to become subject to the workers' compensation laws of California" and agree that if I should bccome subject to the workers' compensation provisions of Seclion 3700 of the Labor Code. I shall. forthwilh comply rvith those provisions.. WARNING: Failure to sccure workcrs' compensation coverage is unlawful. and shall subject an anployer to criminal perTralties and civil fines up to one hun&ed thousand dollars ($100.000). in addition to the cost of compensation, damages as provided for the Section 3076 of the Labor Code, interest and attorney's fees. Annlircnl. r rcrNsED coNTRACToR . nr..t ArlATloN I hereby allirm undâ‚¬r penalty of pcrjury thd I am licâ‚¬osod under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class: License Number: flota. W I tmby affm udc FuIy of Frjury thd th@ is a snstructioo koding sBCy for thc pafmcc of thc mrt for which thb p6nh b isucd (Se. 3097. Civ. C.). Lender's Name: Lender's Address: ^ "rt ,c Nt "rc, . *n I hereby affirm under penalty of perjury one of the following declarations: Dernolition Perrnits-Asbestos Notification Fedcral Regulations ('title 40. Parl6) -Required Letter of Notifrcation -l catiry that the fedcal rcgulaiom rcgarding rebctos rmoval ue not appliceblc to this projcct. -l cdiry that I havc r@d this application ed statc that the abovc infomation is conwt. I agrâ‚¬ to comply with 8ll City and County odimncG ud State Laws rclaling to building coGlruclion and hqcby authorirc reprGotativG of this City od County to 6tq upotr thâ‚¬ above m@tioncd prcpcriy for impetion purposs. Applicant or Agent Signature:f-loto. --Pennitee nzrme Appliances t 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 Insta!lation F.D. Drop Test Above Hard Lid Above T-Bar Rough Mech. Final Test Meter Release FINAL Notes, Remarks, Etc. a BUILDING- INSPECTOR RECORD DATE COMMENTS Set Erection Pads Floor W Brown Pool Fence Final Flood Zone Certif Certificate of Remarks Etc. trrrtry affrnr uatcr frrul)uf pcrpr.v tlrJ .lill 6 l3 tr{ta frurn rlr.('rrrrrlrlrrrhr'ti"rruc l-rw tur tlr tulbrig (st\'.;0.r I .,llulrni:rr arrl Profcsira ('odc).An!C,ly rlt Couay whi'h nxllltci fIYr^{Iil firn{nlc.l.rtlr'rf,lurrrohi.dcrrrnlrhrtruttUrE.rrlr It,iurunrc.llqr rrquirr rlr .pplicru nrh;rnrril nk ftFru Jrly tat u3rrt rl:l!'uI,rtl rtlI lE i.ttcrnrd prs1rrrrltorlr.Fntkirnr rrI tl'.-.(lontrxrr'r l.rcn*d l.str (('hrprcr ,.Cornnrrrm6 rrh .$ccti,n TIIII trf l)ivgirn ttx llnrirxtrl\ufcrri'nr (irL.r tlur l:rtr.errl(la u ctrnlr thc hlru ltrr rhs crc.tllflhn ,\tl,siolrtixr of .Srttirn ?0.1t hyagplicrntIrrrlxrmrlruh^.clr thc apphc.rru lo a civrl pruh;,of rtl\ nol urrrc lh.rt livc hurrlrcd rloll;ur (lStft). 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