HomeMy WebLinkAbout40132331 - PermitL
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: 4o^1323,3{
Pin #: EO97O
/1^7*Project Address: 910 1/2 E Catalina Ave
Assessor's Parcel: 003-222-13 Lot: 133
Unit:
Block: NA
Bldg:
Tract: 1529
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Phone
MARCO BRITO
910 E CATALINA AVE
Santa Ana, CA 927063048
(7141 371-8039
Homefor2 lnc
244 Redondo Avenue
Long Beach, CA 90803
(2131 804-e636
01 1 16002 51604
01 1 16002 51604
01 1 16002 51604
01 1 16002 51604
01 1 16002 51600
01 1 16002 51604
Fee Type Amount
Furnace/Comp Combo 126.90
Bathroom Fan 30.52
Range Fan 32.30
Envir. Air Other 35.21
General Plan Update 22.08
lssuance 55.04
Qty
1.00
1.00
1.00
1.00
1.00
1.00
Fee
$126.90
$30.52
$32.30
$3s.21
$22.08
$s5.04
State Lic #. 1038048
Lic Type: B
Bus. Lic #: 370033
Workers' Compensation lnsurance:Carrier: Nat'l Liability & Fire lns
Policy #: A9WC971326
Expires: 0410312019
Botch+:{t8{3 - 7/t7l2CI19 ID: CCUEI_LAROffice: CTYH Trsns*: 123 4 o[ 6Accbi: Ref*: 10132331
Rcpt3: A2326835 7 / 17 /2fr18 1137 Pn
Transoct ion Totql t5r06{ .76
Horefor2 Inc
llechan icol $?79 .97
01 1 16002- 51604000-
Generol Plon thdqf e Fee ;72" [tS
01116CI02- 5160000tr- -
ICL Checlt 002268 t64 ,7 6
U i so $5 r tlt-ttt . tJtJConveildDtftlxlt'lnggmia AD UAtrUrS :Grcptn,
closet, llvlng room, kltchen, and bathroom.
$302.05
$0.00
$302.05
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Conversion
ADU
Amsden, Julie 07t17t2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cMc 2016
\
96793
Every permit issued 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 authoized on fhe sife by such permitis suspended
or abandoned for a period of 180 days after the time the work is
commenced.
lnspector MID#: 201 8-144134
01 1 16002 51600
01 1 16002 51604
$22 08
$279.97
t
MECHANICAL.INSPECTOR RECORD a
APPROVALS DATE ID/SIG COMMENTS OWNER BT'ILDER DELCARATION
I hcrcby affrm under pcnslty of perjury lhal I u clempl frcm ttE ContrrcloB' Lieosc kw for the following re&sn (Ss.7031.5f
Business and Profcssion Code): Any Cily or County which rcquircs s Fmil to o[druct, 8ltq, imprcrc. demlish or Epofu uy
stffturc. Fin to its issrre. alrc rcquircs thc applicant for such pcrmit to file 8 signcd stalcrcnl lhql he or shc is liccnsd puisunt
to the Eovisions of thc Contractor's Licnscd [Iw (Chlptcr 9. Comrcncing with Section 700O of Division 3 of lhe Busincss snd
PrcfessionsCode)orthsthcorshehcxetrptthercfrcmandthebssisforthcallcgcdcrcmption. AnyviolstiooofSslionT03l.5bysny
applicsnt for a pcmit subixts the applicsnt to a civil pcmlty of not mrc than five hundrcd dollus ($50O).
_1. as owncr ()f thc propcrty. or my cnlployccs with wagcs as lhcir solc conrpcnsation. will d<l lhc work atd thc sln.rc'lurc Ls not
intcmled or ofl'ercd firr salc (Sc.c'.7(X4. Busincss and Pnrf'cssions Codc': '[hc Contruclor's Liccnsc Law docs nol apply lo an owner o[
thc proprty who builtls or improves thcrcon. &nd who dtrcs such u'ork himsclf or hcrsclf or lhrough his or hcr own ctnployccs.
providctl that such irnprovcnrnts arc not intendcd or offiercd ttrr sah. ll. howcvcr. thc huilding or inprovctncnl is sokl within onc yciu
ot'conrplction. thc Owncr Buildcr will havc thc burdcn of proving that hc or shc did not huild or inrprovc lhc propcrty lirr thc purporc o[
salc).
-1.
as owncr of thc propcrty. iltncxclusivcly conlracting with liccnscd conlractors to conslruct lhc pnli'ct (Scc. 7()t4. Ilusincss
and PnrtbsskrnCodc: 'l'hcContractor'sLiccnscLawdocsnotapplyloanowncrofpropcrtywhobuildsoritnprovcsthcrcon.
ancl who contracts for such projccts with a C<lrttraclor(s) liccnscd pursuant lo thc Contractor's Liccnsc Luw).
-lantcxctnplundcrSection-.B.&P.C.ltlrthisrcason.Il.,r^.
WOIIKERS' COM PENSATION
DT'CLARATION
I hercby affirnr undcr penalty of perjury one of the following declarations:
-l
have and will maintain a Certifhate of Consent to Self-lnsure for workers' compensation. as providcd for by Section 3700 of thc
l-abor Ccde. for the performance of the work for which the permit Ls issued.
-l
havc and will maintain workers'compensation insurancc. as by Scction 3700 of thc labor Codc, for thc performance of
the work for which lhis pcrmit is issued. t\t
Lr
and plicy number are:
I
l3zLPolicy
_l ccrtify that in thc pcrformance of the work for which this prmit is issued. I shall not enrploy any person in any manncr
so as to bccornc subict to the workcrs'compcnsation luws of California, and agrce that if I should becomc suhict to thc
workers' comJrcnsation provisions of Section 3700 of the [:bor Codc. I shall. forthwilh comply wilh thosc provisions..
WARNING: Failurc to srcurc workcrs' compcnsation covcragc is unlawful. and shall subjcct an cmploycr to criminal Jrenaltics and
civil fines up to one hundrcd thousand dollars ($100.fin1. in addition to lhe cost o[ compensation. damages as providcd for the
Scction 3076 thc [:txlr Code. interest and attorney's fccs.
I)E('I,AR,\'I'I()N
I hercby affirm undcr penulty of pcrjury that I am liccnscd undcr provision of Chaptcr 9 (commcncing with Scctinn 7fin) of Division 3
of thc Busincss and Professions Codc. and my liccnsc is in full forcc ard effcct.
lo3?RLiccnseNurnhcr:
c'( )NS'I'R l-lC'l'l( )N l,llN l)lN(; A( ; l,:N('l'
I hercby affirm undcr lEnslty of pcrjury that therc is s mnstructk n bnding 8gercy for thc Faformrcc of thc work for which this pcmil iB
issucd (Scc. 3097. Civ. C.).
kndcr's Nanrc:
Lendcr's Addrcss:
,pLrcANT trECI ^ R
I hercby aflirrn undcr penalty of pcrjury onc of thc following dcclarations:
Dcnrolition Pcrnrits-Ashcstos Notificalion Fcdcral Rcgulations (Titlc 40. Part6)
-Rccluircd
Lctlcr of Notificalion
I t certify that the fcderal regulations rcgarding asbcstos removal are not applicable to this projcct.r{ I certify that I have read this application and slatc that the above information is correct. I agrce to comply
ordinances and State Laws relating to building construction, and hereby authorize representatives of this City
with all City and County
and County to cntcr upon the
abovc mentioncd pro;,crty for inspcction
Applicanl or Agent
Pcrrnilcc nrnrc
Date:7n/t
Appliances
lVletal Fire Place
Evaporative Cooler
Furnace
Compressor
It/isc. Equipment
Duct Work
Pre-lnsulation
!nsu lation
Smoke Detectors lnstalled
Rough Ductwork
Vents
Toilet Room I Clothes Dryer
Residential Ranqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rouqh Mech.1,/iz/t.,?\ q\
Final Test
Meter Release ^/ /fi A
FINAL "7;t/w I*brt4 "ffi6
Notes, Remarks, Etc.I
_ Owner:
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