HomeMy WebLinkAbout40133473 - PermitProiect Address: 123 N Jackson St-a- -
Assessor's Parcel: 198-25242 Lot: 147
Unit:
Block: NA
Bldg:
Tract: 540
Address Range:
Historic: No
Suite Range:
Zoning: R2
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 4o^13,3473
Pin #: 397Oot//
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Alexander Dantes LLC
17300 Redhill
lrvine, CA 92614
(949) 383-8309
Cirus Development
17300 Red Hill Ave. #280
lrvine, CA 92614
(e16) 852-5575
01 1 16002 51604
01 1 16002 s1604
01 1 16002 51600
01 1 16002 51604
Fee Type
Bathroom Fan
Range Fan
General Plan Update
lssuance
Amount
30.52
32.30
22.O8
55.04
Fee
$30.s2
$64.60
$22.08
$55.04
.'' r,
$172 24 ',
$172.24
Qty
1.00
2.OO
1.00
1.00
State Lic #: 523605
Lic Type: B
Bus. Lic #: U6797
Workers' Compensation I nsurance:Carrier: Hartford Underwriters lns Co
Policy #: T2WEZO3188
Expires: 06/30/2019
Building Use.
Job Type:
Nature of Work
Single Family Dwelting OccuPancy:
New Constr Type
Single Family Dwe!ling/OPsvCode:
Date:
Date:
Date:
R-3
SPK
cMc 2016
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Buirding Permit #: 1 0197831
Every permitissued 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 site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
!nspector MID#: 2017-136574
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
04t2512019
Account#
Notes:
Fee Tota!:
Paid to Date:
Balance Due:
DeveI op rnen t
New pre-fabricatedlmanufactured sfd with (3)
bedrooffis, (2) bathrooms, laundry room, dining,
kitchept,{yq-g:r.:qtm1&__oBgq:p, lli ip frop[, G,fi,II,FP: , . I !I
#5150"i;,., 0.,. l":'ll li,(rrrl,fl Ii i j: r:i :,
;\"
''i. 1'' l;:r:|*; .ir:, t{.iii ,;j
,,:lt::'l ' :'.,..,i.: -':;!1!/ .. 1,..,',ll'irlt.l.! it I lf li !:il'l
i: ''., ii''-. '...ti !F-',ri)1,li,'\'
Chavez, DaveY?
01 1 16002 51600
01 1 16002 51604
$22.08
$1 50.1 6
General Plnn Updnte Fee
01116002- 51600000-
Ilech on i ca I
01116002- 5160{000-
ICL Check 1262
I
M ECHANICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATION
I hmby affm undc pcaalty of pcrjury that I m qcmpr fiom thc Contractorc' Licene Lrw for the following wn (Scl7o3lii
Buincs sd Profsion Codc): Any City or Coutrty which rcquirc a pcmh to corutruct. akq. improvc, damlisl or rtpoir aS
structur, prbr to ias issumcc. also rcquirs thc applicot for such pcrmit to filc a signcd statoot that hc or slE b licccd ptNut
to thc provisioE of thc Contractor'! Liccnrcd t:w (Chapta 9. Comcncing with Sction 7000 of Division 3 of thc Busins ud
Prcfsiom Codc) or that hc or she is qcmpt thq€from md thc basis for thc allcged emptiotr. ADy violation of Sclion 7031.5 by ey
applictrt for 8 pcrmit subjcts thc applicmt to a civil pmlty of not morc the livc hun&ed dollus (5500).
-1.
as owner of the property. or my employees with wages as their sole compensation, will do the work and the stnrfirc is not
intcnded or offered for sale (Sc.7044. Business and hofessions Code: The Contraclor's Liccnsc [-aw does not apply to an owner of
the propcrty who builds or improves theron" and who does such work himself or herself or through his or her own employees.
provided that such funprovanents are not intended or offerrod for sale. l[, howwer. the building or improvcmcnt is sold within one ]Ezr
of complction, the Orvner Buildcr will have thc hudo of proving tha he or she did not build or imp,rove the propoty for thc purposc of
sale).
-1,
Bn owner ofthe propcrty, 8rl cxclusively contracting with ticeosod contracton to construct the project (Sec. 7044, Business
and Proftssion Code: The Contractor's License Law does not apply to an owncr of property who builds or improvcs thereon,
and who contmcB for such projects with a Contracto(s) ticenscd punuart to the Contractor's Liceosc l-aw).
-l
am exempt under Scction-, B. & P.C. for this reason.
l)ul c:
WORKERS' CONTPENSATION
DECLA]TATION
I hereby affirm under penalty of pojury one of the following declarations:
-I
have and will maintain a Certificate of Conscnt to Self:lnsure for workers' compensation, as provided for by Section 3700 of the
Labor Code. for the performance of the work for which the permit b issued.
-l
have and will maintain workers' compensation insurancer as required by Section 3700 of the Labor Code, for the pcrfornrance of
the work for rvhich this permit is issuod. My workers' compensation insurance carrier and policy number are:
-ll a 0-T [)n "\4(.-,;at \r-e-s T PS-C o
Policy \r-J E ,7 I a lo'JG - Zc, l9
_l cerri& that in the performance of the work for which this permit is issued. I shall not employ any person in any manner
so as to become subject to the workers'compansation laws of California. and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the t-abor Code I shall. forthwith comply with thosc provisions..
WARNING: Failure to sccure workers' compensation coverage is unlawful. and subject an crinrinal penalties and
civil fines up to one hundred thousand dollars ($100,000).
Section 3076 of thc Labor Code interest and anorney's fees.
the as provided for the
t
DECI ^ RATION
I hereby aflirm under penalty of pcrjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
b jw
License ,
F 2 5 1
CONSTRUCTION I T'NDING AGENCY
that there is a construction lending agency for the performance of the work for which this pennit is
Lender's Address:
,rr tcANr "".LARATI hereb,, affrnn under penalty of perjury one of the follorving declarations:
Demolition Permils-Asbestos Notification Fedcral Regulations (Title 40. Part6)
-Required
Lrtter of Notification
-l
certi& that the federalregulations rcgarding asbestos removal are not applicable to this projed.
I agree to comply with all City and County
of this City and County to crter upon the
above mentioned property for
Applicant or Agent 1
Pennitee nzune v\
and state that infonnation is
g-- I
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
Insulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
Installation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release ltr
FINAL Q-L,12 t/l (LC tc.vsllg -Lrl
Notes, Remarks, Etc.
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Contractor:$-!.-\
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