HomeMy WebLinkAbout40135327 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: (7'14)667-2738 lnspector Section: (7'14)647-5853
Permit #: 4o^{35327
Pin #: 23560
Project Address: 21 14 1/2 S Cedar St
Assesso/s Parcel: 016-213-01 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Sergio Romero
309 W Juniper Ave
Santa Ana, CA 92707
(7141 381-7085
Fee Type Amount
Furnace/Comp Combo 136.71
Clothes Dryer - Residen 43.46
Bathroom Fan 32.88
Range Fan 34.80
General Plan Update 23.19
lssuance 59.30
Microfilm Records 4.05
Qty
1.00
1.00
2.00
1.00
1.00
1.00
1.00
Fee
$136.71
$43.46
$6s.76
$34.80
$23.7e
$59.30
$4.05
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation !nsurance:
Carrier:
Policy #:
Expires:
01 1 16002 51604
01 1 16002 51604
01 1 16002 51604
01 1 16002 51604
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
!
J
Building Use:
Job Type:
Nature of Work:
Accessory Dwelling Unit-D Occupancy:
New Constr Type:
ADU Code:
Julie
Date:
Date:
Date:
01 1 04164
R-3
VB
cMc 2019 Notes.
Fee Tota!:
Paid to Date:
Balance Due:
Mechanical for ADU Il-il_r'
lfrlel
01 I 151rlr2
I (:L Checl
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tLrl lPlanning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, orif the work authorized on the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
02t23t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
$23.79
$340.03
$4.05
$367.87
$0.00
$367.87
onsnctrBn lotal
iergro HomEro
6enerol F'Ion
Lrl t 16tltJ2- 51
l'lechnn icctl
lnspector MID#: 2020-1 60266
MECHANICAL.I NSPECTOR RECORD
APPROVALS DATE ID/S!G.COMMENTS OWNER BUILI'ER I'EI.CARATTON
t hacby aIfim uda poulty of pqjury ttd I m q@F EoD th Cotrrel6' Licre l:w for thc folbwjog ta$n (SGc.703!.5
Buias od Profebn Codc): Any Ciy or Couny which r€qui!6 8 pqnii to srrtnrct, altc, improvc, &mlish or Epon my.
itrudqr. Fir to its isrc, also rcquiB thc applicet for sh p6mit to 6lc a sigtr d stdmt thd hc or shc b licqscd pwat
to thc FovisioB of thE Contractor's Licascd Lrw (Chapta 9, Comming with Sctiotr 7000 of Divisio! 3 of thc Buim md
hofcssiou Codc) or that hc or drc is qqnpt thftfrom ud thc bcis for thc allcacd cxmpion Any violation of Sctbn ?031.5 by uy
spplicmt for a p6mit subjcts thc applicant to s clvil paalty ofnot morc thm livc hun&d doltas ($500).
!&, * ow of thc propsty. or my cmplole with wsg6 a thck $lc 6mpasdio!. wil do thc mrk od UE stnnw b mt
Eqlcd or ofraod for slc (Sc.7044, BBiB md Pl.ofeiou Codc: Thc Co!trG{or'3 Liw lrw do6 not eply to m ow of
tlr Fopqty who hrilds or implou theon, ud who dos sh mit hielf or ha$lf or thrcugh his q hs om aplo,rccs,
prcvircd th8t reh improiqms rc ml iotodod oroftrcd for slc, l[ how, the huiHing q itqrowm b $ld within orc ]ar
of onplabr, the OwE Builda will harc thc hrda of prcviog thr lrc or shc dil Dl tuild q inprcw tbc popaty br tlr prpo* of
$h).
-1,
u ow ofthc prcporn m acluively offeting with licqEcd coniactoF to @Etrucl th. Fojd (S6. 7044, Buin6
and Pnftssin Co&: Thc Contraclor's Licmc I:w doc not apply to m oma of prcpoty who buil& or iEproB thq@n,
ed who ontracls for such projd! with a Contraclo(s) Iicstscd pmuad to thc Contrrclor's Licre kw).
-l
m *mpt udq Scthn-, B. & P.C. for this ren.
(
I hereby affirm under pcnalty
_I have and will maintain a Cciliftcate of Conscnt to Self-lnsure for workers' comparation, as p,rovidcd for by Section 3700 of the
Labor Code for the performancc of the work for which the pennit is issued.
-l
have and will maintain workers' compensation insurance. as requird by Section 3700 of the Iabor Code, for the performance of
the work for which this permit is issucd My workers' compcnsation insurance carrier and policy numhr arc:
Policv Numbcr: Exoires:,
I !\ccrtiry that in the pcrformance of the work for which this pcrmit is issued" I shall not anptoy any person in any manncrf6as to become subject to thc workers'compensation taws of Catiforniq and agree that if I should become subjcct to the
workers' compensation provisions of Section 3700 of the tabor Code, I shall, forthwith comply with those provisions..
WARNING: Failure to sccure workers' comperuation coverage is unlawful. and shall subject an employer to oiminal pcnaltics and
civil fines up to one hundred thousand dollars ($100.000), in addition to the cos of compcnsstion. damages as provided for the
Section 3076 of the Labor Code, interest and attorn€y's fecs.^Z t/t o \(= A?- s/
LICENSED (:ONTRACI'OR
DT'fL\RATTON
I hereby affrm under penalty of perjury that I am liceosod undcr pmovision 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:
l)irtc
W
I hq*yaIImundqpauhyof pojurythat tlEcbI@o{ruclbn hoditrg8gtry forthcpcfotwofthcwr|( bru/hich$bpqnil b
issucd (Sc. 3097, Civ. C.).
Lender's Name:
tads'sAdd6:
m
I hftby alforn und6 poalty of pcrjury onc of thc following dclrations:
Dcmolilion Pmils-Asb6tos Notification FcdEal Rcgulations (Titlc 40, Pan6)
-Rcquired
trtt6 of Notification
-l
cqliry thd thc fcdaal rcgulatiom rcgading cbetos rmoval uc not applicsble to this pmjet.
.I)
*-fcertifu tha I hEvc ud this application {d state thd thc abovc infomation is corr€l. I agr to comply with all City md County
ordimncG ed statc llws rchting to building consrruaion. ard hacby authorize rcprffitativ6 of this Cily ed Couty to f,tq upon 0rc
abovc motioncd prcpsty for iNpetion purpo$
Ke, ?4^
I sl \t-o k-.
/e--,.(.? -a
Appliances
Metal Fire Place
Evaporative Cooler
Furnace tl,?(-Ll L '/;S-tl ,f)
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors Installed
Rouqh Ductwork
Vents
Toilet Room / Clothes Dryer ,/, 1l- V{ i I dt|rt 7
Residential Ranqe
Other
Hood
Type I Hood
Type II Hood
Grease Duct
Fire Damper /
Openings
Installation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech
Final Test n
Meter Release ,'1r\
FINAL -)-\G-A \r\[-\rl
z
Applicant: I
Contractor:
Applicant or Agent Signature: .4 €
Pcrnritccname @lrt}, I eY<
/
Notes, Remarks, Etc.v \,