HomeMy WebLinkAbout40135064 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: Q1$ 667-2738 lnspector Section: (714) 647-5853
Permit #: 4o^{35064
Pin #: {8328
Project Address: 2418 W Elder Ave
Assessor's Parcel: 109-1 23-04 Lot: 81
Unit:
Block: NA
Bldg:
Tract 1346
Address Range:
Historic. No
Suite Range:
Zoning: Rl
Owner:
Address:
LDM Properties LLC
909 W Walnut Street
Cerritos, CA 90703
(7141 501 -726e
01 1 16002 51604
01 1 16002 51604
01 1 16002 51604
01 1 16002 5160C
01 1 16002 51604
01 1 16002 5777C
Fee Type
Furnace
Bathroom Fan
Range Fan
Genera! Plan Update
! ssuance
Microfilm Records
Amount
70.66
32.88
34.80
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
1.00
1.00
Fee
$70 66
$32.88
$34.80
$23.7e
$se.30
$4.05
Phone
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
. Policy #:
Expires:
Building Use:
Job Type:
Nature of Work.
Single Family Dwelling
Addition
Addn/Remodel/Demo
Occupancy:
Constr Type:
Code:
R-3, U
VA
cMc 2019 Notes. Mechancial foraddition/remodel.
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buirdins Permit #. I 0110281 9
Date:
Date:11t03t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit rssued shall become invalid unless the work on the site
authoized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
$23.7e
$197.64
$4 05
Fee Total
Paid to Date:
Balance Due:
$225.48
$0.00
$225.48
lnspector MID#: 2O1 9-152268
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M ECHANICAL.INSPECTOR R ECOR D
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hercby affrm undcr pen8lty of perjury that I m excmpt fiom thc Contnc{on' Liens Lrw for thc followitrg rc.sn (56.7031.5
Business and Profcssion Codc): Any City or County which rcluircs I permit lo soslrucl, alt6, imprcve, &mlish or qEir my
struc{urc, prior to its issusce. rlso rcluircs thc applicant for such lErmit to filc s signed starcmnt that hc or 3he is licenEd pur$ot
to thc Fovisions of the Contnctor's Liensd lrw (Chsptcr 9, Comming with S6lbn 7fi)O of Division 3 of thc Busincss snd
Prcfcssions Codc) or thoa hc or slE is crempt thcrcfrom ed rhe bsis for thc allegcd cxcmption. Any vblstion of S6tbn 703 I .5 by any
Epplicsnl for a permia subjcas the applicant to s civil pemlty of ml mrc thu live hundrcd dollars ($50O).
-1.
as owner of the propcrty, or my cmployees with wagcs as their sole compcnsation, willdo the work and the stnrturc is not
intendcd or offered for sale (Sec.7044. Busfuress and Profcssions Code: The Contractor's License l.aw does not apply lo an owncr of
thc proFrerty who builds or improrcs thereon. and who does such work himsclf or hcrself or lhrough his or hcr own employccs.
provided that such improvenrcnts are not intended or offcred for salc. lf. however. the building or inproverrnt is sold within one )rar
of complction. the Owncr Builder will have thc burdcn of proving that trc or shc did not build or improve tlre propcrty for the purlnsc of
sale).
-1.
as owncr of thc property, ant cxclusivcly contracting with liccnsed conlraclors lo construct the project (Sec. 7W. Busincss
arrl Profession Code: The Contraclor's Liccnse Law docs not apply lo an owner of property who builds or improvcs thcrcon.
and who conlracts for such projccts with a Contracto(s) liccnsed pursuBnt to the Contractor's Liccnse Law).
-l
am undcr B. & P.C.
I hcreby affirm undcr pnalty of Jrcrjury onc o[ the following declarations:
-l
havc and will maintain a Certificale of Consent lo Self-lnsure for workcrs' compensBtion, as provided for by Section 3700 of the
I-abor Codc. for the pcrformarrce of thc work for which the prmit is issued.
_l havc and will maintain workers'conrpcnsation insurancc. as rcquircd by Scction.1700 of thc l-abor Codc, for thc pcrlbrrnancc of
thc work for which this perrnit is issucd. My workcrs' comlrcnsation insurancc carrier and plicy number arc:
Carrier:
Policv Number: Exoircs:
_l certify that in thc ;rcrformancc of thc work for which this permit is issucd. I shall not employ any person in any manncr
so as to bccomc subjcct to thc workcrs' compcnsation laws of California. and agrcc that if I should become subject to the
workcrs' comJrcnsation provisions of Section .1700 of thc ktnr Codc. I shall. forthwith comply with thosc provisions..
)
a
WARNING: Failurc to sccurc workers'
civil fincs up to onc hundred thousand
Scction 3076 of thc l^atnr Codc. intcrest r
compcnsulion is unlawful. and shall subject an employcr to criminal linalties and
compensation. damages as provided for thein addition to the cost of
and
LICT'NSED CONTRACruR
DFCLARATTON
I hcrcby af'frnr undcr pnulty of prjury thal I am liccnsc'd undcr provision of Chaptcr 9 (corttrtrcncing with Scction 7(XX)) of Division .l
of the Busincss and Professiorts Codc. and nry liccnsc is in full frrrce and eft'cct.
Liccnse Class: License Number:
I)ale:
CONSTRUCTION I -T'NDING AGI'NCY
I hcrcby lflirm undcr Fnolty of pcrjury th[t thcrc is o snstructk n lcnding agcncy for thc pcrfomrcc of lhc work for which this prmit is
issucd (Sa. 3097. Civ. C.).
bndcr's Namc:
[-cndcr's Addrcss:
APPLTCANT DFCLARATION
I hcrcby affnm undcr penalty of pcrjury onc of thc following declarations:
Dcrnolition Pcrmits-Asbcstos Notification Fcdcral Rcgulations (Titlc 40. Part6)
-Rcquired
Lrttcr of Notification
_l certify that thc fcdcral regulations rcgarding asbcstos rcmoval rrrc nol applicable to this projcct.
-l
ccrtify that I havc read this application and slate lhat thc above information is corrccTTfpircrto comply with all City and County
ordinanccs and State [:ws rclating huilding construclion. and hercby aulhorizc rcprcsenlatives of this City and County lo cnler uJxrn thc
abovc nrcnlioncd propcrty for
Applicant or Agcnt
Pcrrnitcc narrrc
h,", tt f blLo
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
It/isc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room I Clothes Dryer
Residential Ranqe
Other
Hood
Type I Hood
Type Mood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release
FINAL 1-A-A til ID
Notes, Remarks, Etc \
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