HomeMy WebLinkAbout40135125 - Permita City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Mechanical
Permit Counter: St14) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 4lJ{35125
Pin #: 5fi,o^77
y'n r't
Project Address: 3709 S Alder St Unit:
Block: NA
Bldg:
Tract: 6308
Address Range:
Historic: No
Suite Range:
Zoning: R1
v-
Assessor's Parcel: 410-031-03 Lol.27
Owner:
Address:
Cristina Ferguson
3709 S. Alder Street
Santa Ana, CA 92707
(562) 318403s
01 1 16002 51604
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
Fee Type
Range Fan
General Plan Update
I ssuance
Microfilm Records
Amount
34.80
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
Fee
$34.80
$23.79
$59.30
$4.05
Phone:
Tenant Name:
Contractor:
Address:
Flat Rate Remodeling lnc
369 N Fairfax Ave #7
Los Angeles, CA 90036
(323) 761-7s40Phone:ll/3tl/2t
TronEi:
State Lic #: 996391
Lic Type: B
Bus. Lic #: 376268
Workers' Compensation lnsurance:Carrier: State Fund
Policy #: 911 2811
Expires: 0912312021
4UI
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Addition
Addition
Occupancy:
Constr Type
Code:
R-3, U
VB
cMc 2019
t 6(14tttttt-
Documen t s
777ftfif tft-
Notes: MechitfiEtt [of-*S$llip{S r r$?i,
Planning Conditions:
Planning Approval By:Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Plan Checked By:
Permit lssued By:
Subject to Field:ryAmsden, Julie 11t3012020
Account#
Buirdins Permit #: '101104621
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 s1600
01 1 16002 51604
01 1 16002 s7770
$23.79
$94.1 0
$4.0s
Fee Tota!:
Paid to Date:
Balance Due:
$t 21 .94
$0.00
$121.94
lnspector MID#: 2020-1 61 401
MECHANICAL.I NSPECTOR RECORD
APPROVALS DATE !D/SIG COMMENTS
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
Insulation
Smoke Detectors I nstalled
Rouqh Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Range
Other
Hood
Type I Hood
Type II Hood
Grease Duct
Fire Damper
Openings
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release l\
FINAL lc\l1 7)t\z(q40
Notes, Remarks, Etc.lt \\\
I hereby aflirm under penalty of pcrjury that I am exempt from the Contractors' License law for the following reason (Sec.703l
a
.5
Buines and Profsion Codc): Any City or County which rcquirs a pcmit to coctruct. dt(. imprcvc, danolish or rcpair my
structue, Fbr to its issumcc, also rcqutB rhc eplicot for such pcmh to filc a signcd staldmt rhd hc or shc b licoscd pu6ust
to thc povisioro of thc Contractor's Liensed trw (Ch8fl6 9, Comocing with Setior 7()0() of Division 3 of thc Buine md
PrcfcsionsCodc)orthathcorsheiscxcmptthqrftommdthcbssisforthcdlcacdaoption. AnyviolationofSetionT03l.5bymy
applicma hr I p6mit subjcts the applicart to a civil pcmlty of not more lhu livc hundred dollm ($500).
-I,
as owner of the property, or my anplopcs with wages as their sole compensation. will do the work ard the *nrtune b not
intetrdod or offered for sale (Sec.7044, Business and Professions Code: The Contractor's License l-aw does not ap,ply to an owner of
the propcrty who hrilds or impnoves thcron, and who docs such work himself or hersclf or through his or her own cmployees.
provided that such impnovcnreots rc not intcndod oroffirod for sale. I[, howerrcr, ttrc hlilding or inpnovernent is sold within one ]cr
of complaion the Orvner Buildcr will have the hrden of proving ttra he or she did not build or improve the property for tlrc purposc of
sale).
-1,
as owncr of the propcrty, am exclusively contracting with licemed contraclors to construct the project (Sec. 7044, Buiness
and Profession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon.
and who contracts for such pnojects with a Contraclo(s) licensed pursuanl to the Contrac{or's License l-aw).
-l
am exempt under Section-. B. & P.C. for this reason.
l):rlc:
I hereby affrm under pcndty of perjury one of the
WORKERS' CONT PENSATTON
DECLARATION
fo I low ing declarat ions :
<LJ have ad will maintain 8 Cqlificatc ofcoNat to Sclf-lNurc for workas' conrpensation, r providcd for by Sction 3700 ofthc
/abor Code, forthc psfomuce of thc work for which the pmit b issucd.
work
and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for thc po'formance of
for which this pcnnit is issued. My workers' compe'nsation insurance carrier and policy number are:
s f at n&S
Policy l lzt) zr
_l certi& that in the performance of the work for which this permit is issued. I shall not employ any person in any manner
so a:i to bccome subject to the workcrs' compensation laws of Californiq and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code I shall. forthwith comply with those provisions..
WARNING: Failure to secure workers' compensation coveragc is unlawfut. and shall subject an ernployer to criminal pmahics and
civit fincs up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for the
Section 3076 of the Labor Code. interest and attorney's fecs. ( _
oarc. lt lTol %)o
I ICENST'N CON'I'TUACTOR
DECI ARATION
I hereby affrm under penalty of perjury that I am licenscd under provision of Chapter 9 (commencing with Section 7000) of Division -1
of the Business and Professions Codc, and my license is in full force and effect.
License cr*, 6 License Number: d 0 G 7g I
oete: lt lTol z-Lo
('()NS't'Rtl("t'loN t,llN Dl N(; A(; ItN('l'
t hrcby aflim unda penalty of pqjury that thqc is a @nstruction lending agocy for the pdfomcc of thc work fur ttich this pqmit b
issued (Sec. 3097. Civ. C.).
Lender's Name.
Lender's Address:
APPLIC ANT NF'CLARATION
I her€by affinn under pcnalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Required
l-ctter of Notificaion
-l
certiff that the federal regulations regarding asbestos removal are not applicable to this project.
that have read this application and state that the above inlbrmation is correcl.agree to comply s'ith all City and County
and State Larvs relating to building constnrction.hereby authorize representat ives of this City and County to enter upon the
oate, t ll\olbLe
mentioned property for inspecrion purposes.
Applicant or Agent
Perrnitee name
and
+,
Signature:_
(print):_c*v+I