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HomeMy WebLinkAbout40135810 - Permita City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Mechanical Permit #: 4O'l35EtO Pin #:TIICIt?/ Project Address: 2121 N Westwood Ave Unit: Block. NA Bldg: Tract: 2977 Address Range: Historic: No Suite Range: Zoning. RlAssessor's Parcel: 001 -1 65-08 Lot: 18 Owner: Address: Dennis Heathcock 2121 N Westwood Ave Santa Ana, CA 92706 (7141 856-5634 01 1 16002 51604 01 1 16002 51600 01 1 16002 51604 01 1 16002 57770 Fee Type Furnace/Comp Combo General Plan Update I ssua nce Microfilm Records Amount 136 71 23.79 59 30 405 Qty 1.00 1.00 100 1 .00 Fee $1 36 71 $23.79 $5e 30 $4.05 Phone: Tenant Name Contractor: Address: White Mechanical, lnc. 27221 Burbank Foothill Ranch, CA 92610 (e49) 716-8379Phone: State Lic #: 822474 Lic Tvpe: C-20 Bus. Lic #: 321552 Workers' Compensation lnsurance: Carrier: Travlers Property Casualty Policy #: UB3R5812182026B Expires: 10/,01/,2021 Building Use: Job Type: Nature of Work. Single Family Dwelling Miscellaneous Mechanlcal Occupancy: Constr Type: Code: R-3 VB cMc 2019 Notes: Mechanical Planning Gonditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: web -ra"( Date: Date: Date:08t09t2021 Account# Misc. Receipt Misc. Receipt Misc. Receipt Total Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 360 days after its ,ssuance, or if the work authorized on the sfie by such permit is suspended or abandoned for a period of 360 days after the time the work is commenced. N/A - No N/A - No Balance Balance Fee Total: Paid to Date: Balance Due: $223 85 $223.85 $0.00 Inspector M lD#: 2021-167914 t INSPECTOR RECORD SITE-WORK DATE !D/S!G COMMENTS OWNER BUILNER DELCARATION I hereby affirm under penalty of periury thal I anr exempt form the Conmclors' License Law for the follorving re.ason (Sec.70-11 .5 Business and Profession Code): Any City or County rvhich requires a permil to construct. alter. improve. dernolish or repair any struc1ure, prior to its issuance. also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant lo the provisions of lhe ('ontractor's Licensed Larv (Chapter Q. Cornrnencing with Section 7fiX) of Division .1 of the Business and Professions Code) or that he ff she is e!(empt therefrom and the basis for the alleged exemption. Any violation of Section 7031 .5 by any applicant for a pcrmit subiects the applicant to a civil penalty of not more than fir,e hundred dollars 1$-s00). No-t. ,* owner of the property. or my employees rvith rvages as their sole compensation. will do lhe work and the stnrcture is not inrende<l or offered for sale (Sec.7M4. Business and Professions Code: The Contractor's License law does not apply to an own6 of the foperty u,ho builds or imlnoves thereon. and who does such rvort himself or herelf or through his or her own employees. provided that such improvements:ue not intended or offered fcrr sale. lf. hos,ever. the building or improvemcnt is sold within one year of ccmrplaion. the Orvner Builder will have the burdcn of proving that he or she did not build or improve the propertv for the purpose of sale). NO I. a. owner of the ptoperty. am exclusively conh'acting rvith licensed contr?ctorr lo constnrct the project (Sec. 7044. Buiness and Profession ('ode: The ('ontractor's License l.arv does not apply to an owner of property who builds or improves thereon. and u,ho contracts for such prnjecls rvith a Contracto(s) licensed pumuanl to the Contractor's License Larv). No-l .* exempt under Seoion . B. & P.('. for this reason. }I'OR.K FRS' COM PT'N SATION DFCI A,R.ATION I hereby affirm under penalty of perjury one of the following declarations: No I h.r. anct will maintain a Cerlificare of ('onsent to Self-lnsure for rvorkers' compensation. as provided for by Se<tion -1700 of the l.abor ('ode. for the performance of the work for which the permit is issued. YES lhaveandrvill maintainworkerc'compensationinsumnce.as requiredbySectionlT00ofthel,aborCode.fortheperformanceofthe *,ort for u'hich this pcrmit is issued. My workers' compensation insurance carrier and policy number are: Travclerr Carrier: uB-3Rs812r &20-26-Gl'olicr Nrrrtther': 10to112021 F.xpires: NO I cerrify that in the perfrrnnance of the u'ork for s'hich this perrnit is issued. I shall not emplo)' any person in any manner so as to become suh.iect to the rvorkers' compensation larvs of ('alifornia. and alree lhat if I should become subiect to the workers' compensation provisions of Section .1700 of the l-abor Code. I shall. forthrvith cornply rvith those provisions.. WARNIN(i: Failtne lo securervorftets'compensation coverage is unlawfirl. and shall subiect an employertocriminal penaltiesand civil fines up to one hundred thousand dollars ($100.000). in addition to the cosl of compensation. damages as provided for the Section 3076 of the l.abor Ccxle. interest and attomey''s fees. LI('FNSTD ('ONTRACTOR NECI A]TATION I hereby afTirm under Srnalty of prjury that I am licensed under provision of Chapter Q (commencing rvith Section 7000) of Division .1 of the Business and Professions Code. and rny license is in full force and effect. c20 l.icense Class: 822171 l.icense Numher CONSTRTICTION I FNDING AGENCY I herehy alTirm under grenalty of grerlury that there is a construction lending agency for the performarce of the work for which this permit is issued (Sec. .1097. Civ. C.). lrnder's Name: l.ender's Address: APPI l(-ANT DF('L^ RATION I herebv affimr under penaltv of perluw one of the followrng declarattons l)enxll rtion Perntits-Ashestos Notitication Federal Regulatrons (Title 40. Part6) Nl Required l.etter of Notification YEs I cefliry that the federal regulations regarding asbestos removal are not applicable to this pro.iect. YES I ..,rifi, thar t have read this application and state that the abol'e information is correct. t agree to comply wirh all City and County ordinances and State las's relating to building corLstruction. and hereby authorize representatives of this City and County to entcr upon the above mentioned properly for inspection puryoses. Reroof Roof (Diaphragm Sheathing/Frame) Structural Final Plumbing Under FIoor I Under Slab Rough Shower Pan / Tub Test Water Service Sewer / Sewer Cap Gas Air Pressure Test Plumbing Final Electrical Service (Meter I Panel) Grounding / Bonding Rough Electrical Final Mechanica! Gas Air Pressure Test Rough Piping (HW, CW, etc.).A Exhaust Ducts r.htt, bt ?{) bD Mechanical Final Ilaht Er,r6.I.-7 Notes, Remarks, Etc. I