HomeMy WebLinkAbout40134879 - Permit{'Project Address: 1570 E Seventeenth St
Assessor's Parcel: 400-251-07 Lot: NA
Unit:
Block: NA
Bldg:
Tract NA
Address Range:
Historic: No
Suite Range:
Zoning: C5
a City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #= 4o^134879
Pin #: 663 17
t
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Easter Seals of Southern Calif
1063 McGaw
lrvine, CA 92614
(7141 724-9157
JLC Associates lnc.
3198-A Airport Loop Drive
Costa Mesa, CA 92626
(7141 2414430
01 1 16002 51604
01 1 16002 51604
01 1 16002 53603
01 1 16002 5160C
01 1 16002 5777C
Fee Type
VAV Box
Bathroom Fan
Revision
General Plan Update
Microfilm Records
Amount
47.95
32.88
239.34
23.79
4.05
Qty
15.00
2.00
2.00
1.00
1.00
Fee
$719.2s
$65.76
$478.68
$23.79
$4.05
State Lic #: 645576
Lic Type: B
Bus. Lic #: 177048
Workers' Compensation I nsurance:Carrier: INSURANCE COMPANY OF THE WEST
Policy #: WSDS04S216
Expires: 0110112021
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial Occupancy:
Revision Constr Type:
Revision due to vandalism Code:
A-3, 14
V B, SPK
cMc 2019 Revision to 40133943 - due to vandalism - replace
rooftop equipment & bathroom fans
CSG Consultants
Hernan dez, Kathy
09/1 1t2020
09t24t2020
Account#
Misc. Receipt: 74702
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date.
Balance Due:
Date:
Date:
Date:
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 permit is suspe nded
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2019-149352
01 1 16002 51600
01 1 16002 51604
01 1 16002 s3603
01 1 16002 57770
$23.79
$306.33
$478.68
$4.05
$1 ,291.53
$478.68
$81 2.85
MECHANICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hercby smrm under rcmlty of Frjury thst I m exempt from the Contmclom' License lrw for the folloving rc&tr (Scc.7031.5
Busincss and Prcfcssion Codc): Any City or County which rcquircs a lxmil to onstruct, sltr. imJrrcvc. dcmlish or epair an/
structurc. Fior 1o its issure. als rcquires thc rpplbanl for sch pemit to fih a sigrcd stalercnt lhat lE or slE is lico$d puNanl
to thc Imvisions of the Contrctor's Liensd ljw (Chaptcr 9. Comrcing with Sstion 70fl) of Divisbn 3 of the Busircss and
PmfcssionsCodc)orthstheorshciicrcmptthcrcfrcmandtheb&sisforthesllegcdexcmption. AnyviolstionofSathnT03l.5byany
applicant for a pcmit subjccts the applicanl lo s civil pcnally of nol mrc than five hundrcd dollus ($50O).
_1. as owner of the or my cmPloyees wilh wages as thcir sole comlrcnsation.
and hofcssions Code: Thc Conlractor's
will do lhe work and the structure is nol
License Law docs not apply lo an owncr ofl0d{. Susinsss
thc propcrly who huikls or inqrrovcs lhcrsxr. an<l who docs such work hirttsclf or hcrscll'or lhrough his or hcr own clnployccs.
o[corrrpktion. ltrc Owncr Builder will havc thc hunlcn of proving thtt hc rlr shc ditl not huild or irttltrovc thc pnrJrcfly for thc purJxrscof
srlcl.
-1.
us owner of the propcrty. am exclusivcly contracting with liccnsed contraclors to conslruct lhc project (Scc. 7W, Busincss
and hofcsshn Code: Thc Contractor's Licensc Law does not apply to an owner of propcrty who builds or improvcs thcreon.
and who contracts for such pmjccts with a Contractor(s) liccnscd pursuant to thc Contractor's License taw).
-lamexemptunderSection-.B.&P'C.forthisrcason.l):rle Orr ner
IVORKERS' COI\I PENSAI'ION
DFCI ARATTON
I hcrchy alllrrn undcr pcnalty of pcrjury one of thc following dcclarations:
-lhavcandwill
nnintainaCcrtiticateo[CorrscrtlloScll'-lrrsurcforworkcrs'contpcnsalion.ils provicledforbyScctiolt3T(X)ofthc
Lrhrr Crxle. for thc Jrcrformancc ol'thc work ftrr which thc pcrnrit is issucd.YI I h:rvc alrd will nrnintain workcrs'compensatiorr insurancc. os rcquircd by Sc'ction 3700 ol'lhc Lahor Codc. frrr thc pcrt'orntattcc ol'
thc work which this pcrrnit is issucd. My carricr arrd Jxllicy numbcr arc:
0 IrluPolicy
-l
ccrtify that in thc Jrcrformance of the work for which this Jrcrnrit is issucd. I shall not cmpkry any person in any mnnner
lio as to hccome subpct to thc workcrs'compcnsation laws of California. and agrcc lhat if I should bccomc subjcct to thc
workcrs' compcnsslion provisions of Scction 37fi) of the l.abor Ccxlc. I shall. forthwilh cornply with thosc provisions..
WARNING: Failurc to riccurc workcrs' comlrcnsation iutd
civil tincs lo onc hundred thousand dollars ($1ff).firu). in thc
.Sccl iorr lhc Codc. inlcrest and attorncy's fees.
LTCENSED CONTRAC'I'OR
IIECI .IRATION
I hcrcby al'llrrn undcr pcnalty of pcrjury that I arn liccrrscd undcr provision of Chaplcr 9 (corrrrncncing with Scction 7Uru) ol'Division .l
of lhc Busincss arrtl Prot'essiorts Codc. arrd my liccrtsc is irt lull lirrcc and ctTccl.
t_
Liccnse ctors V Liccnse 45 &
CONS TRUC'ION LFNDING ACENCY
I hcrchy itfrm undcr lEmlty of pcrju]y lhat thcrc is a comtrcti([ lcfding {gcncy for thc pcrlinnarxr ofthc work l'or which lhis frrmil is
issucd (Scc. 3097. Civ. C.).
knder's Name:
Lcndcr's Addrcss:
,"LICAN,'.r.rrcl
I hcrcby atlinn undcr pnalty of pcrjury one of thc lirlkrwing dcclarations:
Dcrnolition Pcrmits-Asbcstos Nolil'icalion Fcdcral Regulations ('l'itlc 40. Parl6)
-Rcquircd
Lcttcr of Notification
_l certify that thc fcdcral rcgulations regarding asbcstos rcnxrvalare not applicable to this projcct.
_l ccrtify that I havc rcad this application and stale that thc ahrve inforrnation is correcl. I agrcc to comply with all City and County
ordinarrccs arrd Statc laws rclating lo
above nrcnlioned propcrly for inspction
Applicant or Agent
l)cnttilcc ltlrnc
and hcrchy authorizc rcpresentativcs
::Eriry'fi*"'.
Appliances
t\Ietal Fire Place
Evaporative Cooler
Furnace
Compressor
lVlisc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room I Clothes Drver
Residential Ranqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rouqh Mech.
Final Test
Meter Release I I t,
FINAL lnlbn-t I)|ff,,?
Notes, Remarks, Etc.t,
\
-l:x;lircs:
-
Contractor: )L