HomeMy WebLinkAbout40135972 - PermitCity of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA92702 Mechanical Permit #:4Oi35972
Pin #: 5PermitCounter: (7'14)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714) 647-5853
Project Address: 1024 N Olive St
Assessor's Parcel: 405-283-20 Lot: 34
Unit:
Block: NA
Bldg:
Tract: 354
Address Range.
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Salvador Ramirez
1024 N OLIVE ST
Santa Ana, CA 927032334
(7141 884-2454
01 1 16002 51604
01 1 16002 5160C
01 1 16002 51604
01 1 16002 5777C
Fee Type
Bathroom Fan
General Plan Update
lssuance
Microfilm Records
Amount
32 88
23.79
59.30
405
Qty
1.00
1.00
100
1.00
Fee
$32 88
$23 79
$5e.30
$4.05
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
*Workers' Compensation I nsurance:
C.rrrier:
Policy #:
EXptres.
Botch* zb0{x.7 8/25/2t721
Off i ce: CTYH Trnnsi: 6Acct*: Refl:Rcpti:03386993 8/21/202I
Tronsoct ion Totsl
Snlvndor Rnr i rez
Notes:
:t
Mechanical for closeUbathroom conversion
Building Use:
Job Type.
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Alteration
New Bathroom
Zuniga,o,,,r.$
Occupancy:
Constr Type:
Code.
Date:
Date.
Date:
R-3
VB
cMc 2019
08t25t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Recerpt:
Total
Buirdins Permit #: 1 01107772
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 permit is suspe nded
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 7e
$e2 18
$4 0s
Fee Total
Paid to Date:
Balance Due:
$1 20 02
$0.00
$1 20.02
lnspector MID#: 2021-168434
,
M ECHANICAL-I NSPECTOR R ECOR D
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby arlirm undcr pcnElty of perjury that I m excmpt frcm thc ContretoN' Licn$ trw for thc followirg.rcarcn (58.7031.,
Busincss ard Profcssion Codc): Any City or County which requircs a pcmit to @ns|ruct, altr, impove, demlish or rcp8lr my
suucnrc. Fior to its issm. slso rcquircs the applbsnt for swh pcmit to tilc I sigrcd stslcrenl thal hc or CE is lieosd pwul
to tlE prcvisions of the Conuetor's Llrnsd trw (C-hapter 9. Cotmrcing with SGibn 7000 of Divisbn 3 of thc Eusircss md
Prcfcssions Codc) or that he or shc is cxempt lhcrcftom ard thc btris for the allcgpd cxcmption. Any viololion of S6tbn 703 I .5 by any
spplicanr for a lErmit $ubjects thc applicant to a civil pcmhy of not mrc the livc hundrcd dollm ($500).
-1.
as owner of thc propcrty, or my employees with wagcs as thcir sole compcnsalion. will do tlre work and the stnrture is not
interdcd or offercd for sale (Sec.7044, Business and Professions Code: Thc Contractor's Liccnsc [:w does not apply to an owner of
thc property who builds or improves thercon. and who does such work himsclf or hersclf or through his or her own employecs,
provided that such improvenrnts arc not intendcd or offcred for sah. If. howevcr. thc building or improverrcnt Ls sold within one )€ar
of conphtion. the Owner Buildcr will have thc burden of proving thal trc or she did not build or inprove thc proprty for ttre puryrcsc of
sale).
-1,
as owner of the propcrty, am exclusivcly contracting with licenscd contraclors to construct thc proict (Scc. 7044, Busincss
and Profession Code: Thc Contractor's Liccnsc Law docs not apply to an owner of property who builds or improves thcreon,
and who conlracts for such projects with a Contracto(s) licenscd pursuant to thc Contractor's Licensc l-aw).
I am excmnt B. & P.C. for
L Z /
I hcrcby affirrrr under penalty of prjury one of thc following dcclarations:
I have and will maintain a Ccrtificate of Consent to Self-lnsure for workcrs' compcnsation, as providcd for by Sc.ction 3700 of thc
I-abor Code, for thc perfornrancc of the work for which the permit ls issued.
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havc and will maintain workcrs' compensation insurancc, Bs rcquircd by Section 3700 of thc [:bor Codc, for thc lrcrfornuncc of
thc work for which this pcrmit is issucd. My workcrs' compcnsation insurance carrier and p,olicy number arc:
Crrrier:
Policy Number: Expires:
_l ccrtify that in the performance of thc work for which this pcrmit is issucd, I shall not cmploy any pcrson in any manpr
so as to bcconre subjcct to thc workcrs' comgrcnsation laws of California. and agrce lhat if I should becomc subject to thc
workcrs' compcnsstion provisions of Section 3700 of the Labor Codc. I shall. forthwith comply with those provisions..
WARNING: Failurc to securc workcrs' corrrpcnsation coverage is unlawful. and shall subjcct an cmploycr to criminul pcnaltics and
civil fincs up lo onc hundrcd thousand dollars ($100,000). in addition to damages as providcd for the
Scclion 3076 of thc Code.and atlorncy's fecs.J
G Z
I hcrcby affrm under penalty of pcrjury that I am liccnsed under provision of Chaptcr 9 (comnrncing with Scction 7000) of Division 3
of thc Business and Professions Code, and my license is in full forcc and effcct.
Licensc
Dale:
Nuntr,'ur:
W
t h€rcby affrm undcr Fmlty of Frjury that tlm is I oostructbn hDditrg 8gcrcy for thc Frfoffi of thc wk for which this pcmil k
issued (Se. 3097, Civ. C.).
l-cnclcr's Narnc:
[.cnder's Addrcss:
APPLICANT NECLAITATION
I hcrctry affrnn undcr pcnalty of pcrjury onc of the following declarations:
Dcmolition Pcrnrits-Asbcstos Notification Fcderal Rcgulations (Title 40, Part6)
-Requircd
lrttcr of Notification
\_l ccrtify that thc federalrcgulations rcgarding asbcstos rcmovalare not applicable to this project.
_l ccrtify that I havc rcad this application and statc that thc abovc information is correcl. I agrcnc to comply with all City and County
ordinances and Statc Laws rclating to building construction.the
abovc mentioned property for
Applicunt or Agcnt
Pcrnrilcc namc
rcpresentatives of this City and lo cnlcr
Z/
Appliances
lVletal Fire Place
Evaporative Cooler
Furnace
Compressor
tMisc. Equipment
Duct Work
Pre- Insu lation
Insulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room / Clothes Dryer
Residential Ranqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
!nstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar ,
ra I I tl t .a
Rouqh Mech.Drttffn 7t il\
Final Test | 'l
Meter Release l\
FINAL loll)na A/Nh
Notes, Remarks, Etc.I I \I\)
Sa /veP r?L
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