HomeMy WebLinkAbout40136049 - PermitCity of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA927o2
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Mechanical Permit #: tn{I604e
Proiect Address: 141 7 W St Gertrude PI
Assessor's Parcel: 408-336-10 Lot: 9
Unit:
Block: NA
Bldg:
Tract. 2209
Address Range:
Historic: No
Pin #:
Suite Range:
Zoning: R3
Oulner:
Address
Phone:
Tenant Name:
Contractor:
Address:
Phone.
Jose Montes
1117 W St Gertrude Pl
Santa Ana, CA 92704
(7141546-0086
Specialty AC Heat
4650 Arrow Highway, Suite C6
Montclair, CA 91763
(909) 982-7999
01 1 16002 51604
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
Fee Type
Furnace
General Plan Update
lssuance
Microfilm Records
Amount
70 66
23.79
59 30
4.05
Qty
1 .00
1 .00
1 .00
1.00
Fee
$70.66
$23.79
$59.30
$4.0s
State Lic #: 784495
Lic Tvpe. C'36, C-20
Bus. Lic #: 349795
Workers' Compensation lnsurance :
Carrier: Security National lns Co
Policy #: SWC1307380
Expires: 1012312021
Building Use:
Job Type:
Nature of Work.
Plannlng Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Mechanlcal
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cMc 2019
09t21t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Notes. Mechanical
Fee Total:
Paid to Date:
Balance Due:
)
web_user V
Total
N/A - No
N/A - No
Balance
Balance
$157.80
$157.80
$0.00
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe sife by such permit is
suspended or abandoned for a period of 360 days after the time the work
is commenced.
Inspector MID#: 2021 -168907
INSPECTOR RECORD
SITE.WORK DATE ID/S!G COMMENTS OWNER BUILDTR DTLC ^ RATION
I hereby affinn under penalty of periuW that I arn exanpt form the Contractors' License Law for the following reason (Sec.70.31.5 Business
and Profession Code): Any City or County which requires a permil to construct, alter. improve. demolish or rtpair any structure. prior to its
issuance. also rcquires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the
Contractor's Licensed law (Chapter 9. Commencing rvith Section 7000 of Division 3 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption Any violation of Section 70-11 .5 by any applicant for a pcrmit subjecs the
applicant to a civil penalty of not more than five hundred dollars ($.s00).
!O-t. ur owner of the pro;rcrty. or my employees wirh rvages as their sote compensation, rvill do the work and the structur€ 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
rvho builds or improves thereon. and who does such wort himself or hcrself or through his or her own cmployees, provided that such
improvanents ar€ not intendod or offered for sale. lf. however. the building or improvement is sold rvithin one ye r of complaion. the
Orvner Builder will have the burden of p,roving that he or strc did not build or improve dre propertv for the purpce of sale).
Y5. a. owner of the progrrty. am exclusively conracting rvith licensed contractors to constnrct the project (Sec. 7044. Business and
Profession Code: The Contractor's License Las, does not apply to an owner of property rvho builds or improves thereon. and
rvho contracts for such projects rvith a Contracto(s) licensed pursuant to the Contractor's License Larv).
!o_l urr't exempt under Seclion B. & P.C. for this reason.
\['OR.KTRS' COMPFNS{TION NFCI ARATION
I hereby'affirm under penahy- of periury one of the following declarations:
No I h.u. and rvill maintain a Certificate of Consent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
Labor Code, for the performance of the wort for which the permil is issued.
YES
_ I have and will rnaintain u'orkers' comf,ensation insurance. as required by Section -3700 of the [abor Code. for the performance of the
rvork for u'hich this permit is issued. My workcrs' compensation insurance carrier and policy number are:
. Securlty Natlonal( atTrer:
sWC13073C0
Policy Number:__Expires:
10t2312021
NO
_ I cerrifo that in lhe grcrformance of the rvork for which this permit is issued. I shall not employ any person in any manner so
as to become subiect to the rvorkers' comp€nsation larvs of California. and agree that if I should become subject to the worters'
compensation provisions of Section -1700 of the l^abor Code. I shall. forthwith comply with those provisions..
II'ARNING: Failure to secure rvorters'comgrnsation coverage is unlarvful. and shall subject an employer to criminal penalties and civil
fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as providcd for lhe Section -i076
of the Labor Ccxle. interesl and attorney's fees.
LICF'NSTN CONTRACTOR DFCI {RATION
I hereby affirm under penalty of perjury that I am licensed under provision of Chapter g (commencing rvith Section 7000) of Division 3 of
the Business and Professions Code. and rny license is in full force and effect.
l.icense
c20 c36 784495
License NurnberClass:_
(.ONSTRUCTION I FNNING {GTNCY
I heretry affinn under penalty,of perjur)'that there is a construction lending agency for the perfornurrce of the work for which this permit is
issued (Sec. .1097. Cir'. C.).
[-ender's Name:
l.ender's Address:
APPI ICdNT NTCI ARATION
I heretry atlnn under penalN of perjury one of the followrng declaratrons
I)enrolrtion Pernuts-Asbe$os Notificatron Federal Regulatrons (Trtle 40, Part6)
N! Required Letter of Notification
YEs I cerlify that the federal rcgulations regardirrg asbestcx rernoval are not applicable to this proiecr.
ttl , certiS/ rhat I have read this application and state that the above informarion is correcr. t agree to comply with allCity and Cowrty
ordinances and State Laws relating to building construction. and hereby authorize representatives of this City and County to entcr upon the
ahove mentioned property for inspection purposes.
Reroof
Roof (Diaphragm Sheathing/Frame)
Structural Fanal
Plumbing
Under Floor I Under Slab
Rough
Shower Pan / Tub Test
Water Service
Sewer / Sewer Cap
Gas Air Pressure Test
Plumbing Final
Electrical
Service (Meter I Panel)
Grounding / Bonding
Rough
Electrical Final
Mechanical
Gas Air Pressure Test
Rough
Piping (HW, CW, etc.)
Exhaust Ducts ,l
Mechanical Final p/zt/zt
(/v
,
Notes, Remarks, EJrc
V v
I