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