HomeMy WebLinkAbout40132844 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Mechanical Permit #:40132844
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 2626 S Shelton St-a- -
Unit:
Block: NA
Bldg:
Tract 2461
Address Range:
Historic: No
Pin #:
Suite Range:
Zoning: RlAssessor's Parcel: 140-134-15 Lot: 15
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Building Use:
Job Type:
Nature of Work:
Planning Gonditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Martina Tolentino
2626 S Shelton St
Santa Ana, CA 927073323
(7141 540-1 227
Service Champions
3150 E Birch Street
Brea, CA 92821
(7141 777-7777
Single Family Dwelling
Miscellaneous
Ducts
Zuniga, Allissa
Fee Type
01 1 16002 51604 Alter Vent Sys
01 1 16002 5160C Genera!pdate
01 1 16002 51604
Amount
43.62
22.08
55.04
Serv i ce Chomp i ons
Generol Plon Updote Fee
0l t 16002- 5160ffi00-
llechon icol
01u6002- 5160{000-
ICL Check 0000001290
Qty
1 .00
1.00
1 .00
Fee
$43.62
$22.08
$s5.04
122.09
t99.66
1120 .71
Botch+:46839 LllS/2018 t0: ilGARCIA
tlf f i ce: CTYH Tronsi: $6 I of 1Acct*: Ref*: 10152944
Rcpt*:02{39569 lL/8/2018 12207 Pn
Tronsoct ion Totol t120 ,74State Lic #: 799170
Lic Type: C-36, B, C-2, C-20
Bus. Lic #: 196430
Workers' Compensation I nsurance:Carrier: Pacific Compensation lnsurance Company
Policy #: WA00000703
Expires: 0312212019
Occupancy:
Constr Type:
Code:
Date:
Date:
B
cMc 2016
11t08t2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
01 1 16002 51600
01 1 16002 51604
$22.08
$e8.66
$120.74
$0 00
$120.74
Every permit rssued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 180 days after the time the work is
commenced.
lnspector MID#: 201 8-147542
@
M ECHANICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUIII'ER DELCARATION
I hqcty affm undo pcnalty of pcrjury thst I m qmpt from thc CoilncroB' Licfilc law for thc following twn (Se.7031.5
Buincs and Profeion Codc): Any city or County which rcquiG I psnit to coNtruct. altq. improvc, dmolish or npair uy
structurq prior to its isumcc, a.lso rcquira thc qplicmt for such pcrmit to filc a signed ststmot thd h€ or dE b licoscd pmuet
to thc prcvisioc of thc Contrrctor'3 Liccnscd kw (Chapt6 9. Comacing with Setion 7000 of Divisioo 3 of thc Buine qd
Prcfeioro Codc) or thst hc u shc b cr@pt thqsfrom ed thc bosis for thc dlcgcd daption. Any violatioo of Scrbo 7031 .5 [ uy
applicmt for a pamit subjcts rhc applicut to a civil pcnalty ofnot morc the Iivc hundrcd dollm ($500).
-1.
as owner of the property. or my employees with wages as their sole compcnsation. will do the work and the stnnure is not
intended or offered for sale (Sec.7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of
the property who builds or improves thcron. and who does such wort himself or herself or through his or her own employecs.
provided that such improvanrents arc not intcndcd oroffered for sale. If, howevcr. the building or improvement is sold within one )€ar
of complaiou the Orvner Buikdcr will have the hrdm of proving thd he or she did not build or improve the property for the purposc of
sale).
-1.
os owner of the prop€rty, am exclusively contracling with licsnsed contracloni to construct the project (Sec. 7044, Bwiness
and hoftssion Code: The Contractor's License Law does not apply to an owner of property who builds or improves thcreon,
and who contracts for such projects with a Contraclo(s) licensed pursuant to the Contractor's Liccnse l-aw).
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am exempt under Section-, B. & P.C. for this reason.
()s rter:
WORKERS' COMPENSATION
DT'CLARATION
I hereby aflirm under panalty of perjury one of the follorving declarations:
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have md 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 wor.k for which the pcrrnit is issued.
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have and will rnaintain 3700 of the Labor Code. for the performance of
the work this and policy numbcr are:
'l
oPolicy0o I
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certify that in the performance of the work for which this permit is issued. I shall not onploy any pcrson in any manner
so as to become subject to the workers' compensation laws of California. and agree that if I should become subject to the
workers' compensation provisions of Section .1700 of the l-abor Code. I shall. forthwith comply with thosc provisions..
WARNINC:lo secure workers' compensation and
civil fines to one thousand dollars the
Section interest and
rl
I hereby affrm under penalty of perjury that I am licensed 9 (commencing with Section 7000) of Division 3
of the Busincss and Professions Code. and my license is in full force and "ryt.w1 vLicense
I hereby affrm under penalty of perjury that there is a construction landing
issued (Sec. 3097. Civ. C.).
for the performance of the work for which this perrnit is
Lender's Name:
Lender's Address: prr rc Nr "rcLAR.tI hoeby affirm under penalty of perjury one of the following declarations:
Dernolition Permits-Asbcstos Notification Federal Regulations (Title 40. Part6)
-Required
Letter of Notification
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certi& that the federal regulations regarding asbestos removal are not applicable to this project.
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certi& that I have read this with all City and County
ordinances and State l-aws relating and enter upon the
above mentiond property for
Applicant or Agent
Pennitee name vl,Ctz
It (g
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
L
lnsulation
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
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Fina! Test
Meter Release It ,t rl
FINAL )17ta DWJ4i ,X7
Notes, Remarks, Etc.
r(
ort., I l-I $_