HomeMy WebLinkAbout40135438 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: QM) 667-2738 lnspector Section: (714) 647-5853
Permit #:4O135438
Pin #: 5
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Proiect Address: 2800 N Main Sta
Assessor's Parcel: 111-111-11 Lot: 1
Unit: 282S Bldg: Address Range:
BIocK: NA Tract RESUB OF SHAFEFI-Iistoric: No
Suite Range:
Zoning: C2
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Centennia! Real Estate Company
8750 N Central Expressway #1740
Dallas, TX 75231
(9721 888-8044
Spike Construction lnc
7915 Harper Ave
Downey, CA 90241
(562) 454-7673
01 1 16002 51604
01 1 16002 51604
01 1 16002 51604
01 1 16002 53603
01 1 16002 5160C
01 1 16002 51604
PERirllT CANCELLS 1 6002 5777c
by cq1-5 rc^c-\s -
DATE:c\_\r_\_ a\
Fee Type
Compressor
Fan Coil
Appliance Not Listed
PIC - 650/o
General Plan Update
lssuance
Microfilm Records
Amount
97.17
61.20
70.64
0.65
23.79
59.30
4.05
Qty
2.00
1.00
1.00
326.1 I
1.00
1.00
1.00
Fee
$194.34
$61.20
$70.64
$212.02
$23.79
$se.30
$4.05
State Lic #: 435582
Lic Type: B
Bus. Lic #: 378785
Workers' Compensation lnsurance:Carrier: Berkley Nat'l lns
Policy #: BNUWCOl54G43
Expires: 0711312022
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INITIAL:?t
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial
Tenant lmprovement
TI
CSG Consultants
Amsden, Julie
01 106290
08/1 0t2021
09/01 t2021
Account#
Misc. Receipt: 75372
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
M, S-1
II A, SPK
cMc 2019 Tl-lnstall partition walls and hard lid ceiling to create a
service corridor, install t-bar ceiling, add pre-fab
walk-in cooler, frame in (1) i,rterior door, relocate (2)
doors, add (1) new door
APPLIANCE NOT LISTED = WALK lN COOLER
$62s.34
$102.94
$522.40
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 worl< authorized on the site by such permit is 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 53603
01 1 16002 57770
$23.79
$38s.48
$109.08
$4 05
lnspector MID#: 2021-1 65209
4r-
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M EGHAN ICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS
Appliances
Metal 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
Rouqh Mech.
Final Test
Meter Release
FINAL
Notes, Remarks, Etc
OWNER BUTLDER DELCARATION
I haeby affim unda pcnalty of perjury tha I m qmpt from the ConuadoN' Licffi liw for thc followingi'rctr (Se.7031.5
Busins ud Prcfesion Codc): Any City or Couty which rcquiB a ponit to onstruct. altc, improvg danolish or rcpar ay
strucluq irior to its iswcq also rcquim th€ applimt for such permit to filc a sigrcd stat@6t tha hc or shc b licmcd piruant
to thc prcvisioN of the Cotrtrctor's Liccnsd kw (Chapts 9. Comcncing with Setiotr 7000 of Division 3 of rhe Buiacs md r
Prcfesiom Code) or that hc or shc is q@pt th@ftom md thc bssis for thc dlcgcd amption. Any violation of Sction 703 1.5 by oy a
applimt for a permit subjets the spplicut to a civil pmlty of not more thm fiv€ hundred douils ($500).
_1, as owner of the property. or my ernployees with wages as their sole compensation. will do the work and the structure is not
intended or offered for sale (Sec.7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of
the property who builds or improves thereon, and who does such work hirnself or herself or through his or her own employees.
provided that such irnprovonents are not intended or offerecl for sale. I[, howev€r. the building or improvement is sold within one year
of cornplaion, the Owner Buildcr will have the burden of proving that he or she did not build or improve the propo'ty for the purpose of
sale).
_1. as owner of the propefly, arn exclusively contracting rvith licensed contractors to construct the project (Sec. 7044, Business
and hofcssion Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and rvho contracts for such projects with a Contractor(s) licensed pursuant to the Contractor's License Law).
-l
arn exempt under Section , B. & P.C. for this reason.
flolo.
WORKERS' COMPENSATION
DECLARATION
I hereby affrrm under penalty of perjury one ofthe following declarations:
_I have and will maintain a Certificate of Consent to Self-lnsure for work€rs'compensation, as provided for by Section 3700 ofthe
Labor Code, for the performance ofthe work for which the perrnit is issued.
YH, have and will maintain workers' compensation insurance. as required by Section
the work for which this permit is issued. My workers' compensation insurance carrier
3700 of the Labor Code. for the performance of
policy number are:
.,,
I
License Nurnber:
\_
Policy
.o-7 ll)/zL
_t certi& 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 workers' compensation laws of California, 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 coverage is unlawful, and shall subject an ernployer to criminal penalties and
civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for the
Section 3076 of the Labor Code, interest and attorney's fees.
""", 8l cl lll \r^r,{ t^ lh -tA t\luV
LICENSED CONTRACTOR
DECLARATION
I hereby aflirm under penalty of perjury that I am licensed under provision of Chapter 9 (cornrnencing with Section 7000) of Division 3
of the Business and Professions Code, and rny license is in full force and effect.
Vz(()7
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CONSTRUCTION LENDING AGENCY
I hwby affinn undo penalty of perjury Ihat thqe is a construction lmding agocy for the pqfonnace of lhe work for which this pqmit is
issucd (Se. 3097, Civ. C.).
Lender's Name:
Lrnds's Addre:
-
ATTI.IfANINESJABAII9N
I hadry alfim undo poalty ofpajury one ofthc following delaations:
Demolition Pqmits-Asb6tos Notilication Fcdqal RcgulatioN (Titlc 40, Pan6)
-RcquLcd
lf,tter of Notificatioo
-l
cqtify that the fedaal regulatioro rcguding ubctos rmoval ue not applicable to this prcj$t.
{tlt cqtiff that I have rad this application ,nd state that thc above infomation is coErcl. I age to omply with all City and County
ordimcG ed State taws relating to building consruction ud hmby authorir repffitativG of this City md Couty to at6 upon thc
above mentioned property for purposes.
D"t", oq 1" l/ a\contracror: Soi V-t- Gn- Lh , tti , r^ Yn Lt
o^,", o Q( c\ ( tlApplicant or Agent
Permitee n{une