HomeMy WebLinkAbout40135826 - PermitCity 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^{3582fi
Pin #: 67817
,/.n7*Project Address: 2144 N Greenleaf St
Assessor's Parcel: 002-081-08 Lot: 7
Unit:
Block: NA
Bldg:
Tract: 879
Address Range:
Historic: Yes
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address.
Phone
FREDERICK TURNLEY
214/- GREENLEAF ST
Santa Ana, CA 927062534
(7141 585-7105
Service Champions
3150 E Birch Street
Brea, CA 92821
(7141 777 -7777
01 1 16002 51604
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
Fee Type Amount
Furnace/Comp Combo 136.71
General Plan Update 23.T9
lssuance 59.30
Microfilm Records 4.05
Qty
1.00
1.00
1.00
1.00
Fee
$136.71
$23.79
$se.30
$4.0s
$23 .79
$196,(tl
$4. [|:i
$337, 7[l
Bobch+:6113?g - 8/l3l?tt21 I0: ovlctoPl{
lf f icei (:TYH Trons*: 57 I of 2Acct*: Ref # : lul 35826
tcpt*:t13378196 8/13/2trZI 12:26 PH
Transoct i on Total t337 .7$State Lic #: 799170
Lic Type: C-36, B, C-2, C-20
Bus. Lic #: 196430
Workers' Compensation I nsurance:Carrier: Everest Premier lns Co
Policy #: RM8WC000S4-211
Expires: 0410112022
iEr v r ce t.h 0fip r or
[ienersl l-'lsn Updo[e l'ee
01 1 16tttr2- 516ttti(ttt0-
I'lechon iccrl
01 1 161102- 516rt+[r[r[r-
rl icr'of i ltrt & Dacuments
r-rl 1 16(rtr2- 177 Ttt8rtu-
Building Use: Single Family Dwelling
Job Type: Miscellaneous
Nature of Work. A/C Change out
I
Plannlng Conditions:
Occupancy:
Constr Type:
Code:
Date:
Date.
Date:
R.3, U
VB
cMc 2019 Notes: Change out of existing A/C unit.
Fee Total:
Paid to Date:
Balance Due:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Martin, Eric
Chavez, Davez?
08/1 3t2021
08/1 3t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
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.
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
$23 79
$196.01
$4.0s
$223.85
$0 00
$223.85
lnspector MID#: 2021-1 68088
M ECHANICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATION
I hoety affrm undo penalty of pajury thst I m cxmpt frcm thc Conraclon' Licre Lrw for thc following'ren (Se.?031.5
Bwincs srd Profeion Codc): Any Chy or Couty which roquirc a pannit to @Ntrucl, altq, improvc darclbh or rraair uy
struclrc, prior to its isme. also rcquirc thc applicur for such p6mit to filc a signcd stdmat $d hc or strc b lic6€d pwut
to thc provisioG of thc Cotrtraclor's Licoscd Law (Chapt6 9, Comcncing with Sdtion 70fl) of Division 3 of thc Buirs ud
Prcfeions Codc) or that hc or shc is qmpt thqcfrcm and thc basis for the allcgcd croption. Any violation of Sdion 701I .5 by oy
appliffit for a pcmit subjets the spplicet to a civil pcmlty of not morc th4 live hun&cd dollas ($500).
-1,
dS owner of the property, or my employees with wages as their sole compersalion. will do the work and thc structue is not
intended or off€red for sale (Sec.7044. Brsiness and Professioru Code: The Contractor's Lic€nsc [-aw does not apply to an owncr of
thc p,roperty who builds or improvs thcron. and who does such work himself or hcrsclf or through his or hcr own employ€e,
provided that such improvanents are not intendcd orofftrcd for sale. I[, howwcr. the building or improvement is sold within one ]ryr
of compktion the Orrner Buildcr will have the burdcn of proving thd he or she did not hrild or irnp,rove the propcrty for the purposc of
sale).
_1. as owner of the propcrty. arn exclusivcly contracting with liccnsed contractors to consitruct the projcct (Sec. 7044, Business
and hofession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projccts with a Contracto(s) liccnsod punuant to the Contractor's Licensc Law).
-l
am cxempt under Section-, B. & P.C. for this reason.
f)q I r''O*ner'
WORKERS' COM'ENSAT
DECLARATION
one of the following declarations:I hoeby affinn under penalty of pojury
-l
have and will maintain a Certificate of Conscnt to Self-lnsure for workers' compensation, as provided for by Section 3700 of the
I-abor Codc for thc pcrformance of the wort for which thc pcrmit b issued.
_l have and will maintain work€rs' compensation insurance, as required by Section 3700 of the l-abor Code, for the performance of
the work for which this perndt is issued My workers' compensation insurance carrier and policy number are:
a
.t,//61 13>Policy
_l ccrri& 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 workcrs'compensation laws of California, and agrec that if I should bccome subjcct to the
workcrs' compensation provisions of Section 3700 of thc l-abor Code I shall. forthwith comply wilh thosc provisions..
WARNING: Failure to sccure workers' compcrsation coveragc is unlawful, and shall subject an onployer to oiminal poahies and
civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compcnsation, damages as provided for the
Section 3076 of the Labor Codc, interest and attorney's fe6.
o,r", d/ 13/2/rc d{L
LTCENSED CONTRACTOR
DECTI\RATION
I hereby affrm under pcoalty of perjury that I am licensod under pnovision of Chapter
of the Business and Professions Code, and my license is in full force and effect.
)
9 (commencing with Secrion 7000) of Division 3
\.c7D l7c
License
tj
CONSTRUCTION LENDING AGENCY
there is a construction lording agency for the performance of the work for which this permil isI hereby affrrm under poulty of pcrjury that
issucd (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
AfII.ICANI.DECI,ASAIION
I hadyaf&rn undc porahy ofperjury onc ofthc fotlowing dclarations:
Dcmolition Pmits-Asb6tos Notification Fedml RegulatioB (Titlc 40. Pan6)
-Rcquircd
kltfi of Notifietion
-l
cqliry thsl thc Hqsl regulatioro regrding cbclos rmoval ac not applicable to this prcjet.
DLI cdify that I havc red this application and statc that thc abovc iafomdion is corel. I agrc to smply with all City and County
ordinancB 6d Statc hw rclating to building corotruciion, ed h@by authorire reprcotative of this City ad County to otq upon thc
above mentioncd property for
Applicant or Agent
Pennite-€ name
D^,", N/3/)l
Appliances
lvletal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
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.
Final Test
Meter Release tt ,l
FINAL \o\ U,tt'Z "DU.\^ryX
Notes, Remarks, Etc.\\
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