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Home My WebLink About40133013 - Permitar' I <F r^City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Mechanical PermitCounter: (7'14)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714) 647-5853 Permit #: 40{33O{3 Pin #: 29869 Project Address: 3901 W Crystal Ln Assessor's Parcel: 108-722-01 Lot: 1 Unit: Block: NA Bldg: Tract 8924 Address Range: Historic: No Suite Range: Zoning: Rl Owner: Address: Santa Ana 3901 W.Crystal Lane Santa Ana, CA 92704 (7141 514-9950 01 1 16002 51604 01 1 16002 51604 01 1 16002 51604 01 1 16002 s160C 01 1 16002 51604 Fee Type Furnace Compressor Bathroom Fan General Plan Update lssuance Amount 65.59 90.1 I 30.52 22.08 55.04 Qty 100 1 .00 2.00 1 .00 1 .00 Fee $6s.5e $e0.1 I $61.04 $22.08 $55.04 Phone: Tenant Name: Contractor: Address: Owner-Builder Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation ! nsurance: Carrier: Policy #: Expires: Building Use: Job Type: Nature of Work. Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Single Family Dwelling Miscellaneous Mechanical web user Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Notes: Mechanical Fee Total Paid to Date: Balance Due: Occupancy: Constr Type: Code: Date: Date: Date: R-3 VB cMc 2013 12t30t2018 Account# $293.94 $293.94 $0.00 Every permitissued shall become invalid unless the work on the site authorized by such permit is commenced within 180 days after its issuance, or if the work authorized on the site by such permitis suspended or abandoned for a period of 1 80 days after the time the work is commenced. ) Inspector tvllD#: 201 B-148475 N/A - No Balance / M ECHANICAL-INSPECTOR RECORD a APPROVALS DATE ID/SIG.COMMENTS oWNERBUTLDERDEL(XRATTON . . ia I hercby affrm undo peoalty of perjury thsl I m crcmpt fom the Conlrcto6' Lkcns lrw for thc following Mrcn (Src.7)..j1.5 Busincss ard Pmfcssion Code): Any City or Couny which rcquircs a [mit to @nslnrct. alaei improre. &mlish or rcpoir ar.y slruclum. prk r lo its issurrce, 8ls rcquircs thc qpplhet for such Fmil to filc 8 sigrcd statemnt lhsr hc or shc is liensd puruut to the pmvisions of thc Contrctor's Liccnsd tiw (Chspter 9. Comcrcing wilh Section 7000 of Division 3 of thc Busincss and Prcfessions Codc) or that hc or shc is cxcmpl thcrcfrcm and thc basis for ihc sllegâ‚¬d cxctrlption. Any violation ofscrion 703 1.5 by any applicsnt for 8 pcmit subjccts thc spplisant lo I civil penrlty of not mrc than fivc hundrcd dolltrs (5500). _1. as owner of the property, or my cmployees wilh wages as their solc compensation. will do thc work and the structurc [s rmt intendcd or offered for sale (Scrc.7044. Business and hofessions Code: The Contractor's License l-aw does not apply to an owner of thc propcrty who btrilds or funprovcs lhc{con. ard who docs srch work himsclf or herself or through his or hcr own employees. providcd that such improvenrnls are not inlcrded or offered for sah. lf. howevcr. ttrc building or in{norrenEnl is sold wilhin one }tar of complcthn. thc Owner Builder will havc thc burden of proving that tE or shc dkl not build or inqrrove ttrc fnop"rty for thc purpsc of sale). _1. as owncr ol'thc propcrty. anr cxclusivcly conlracting with liccnsctl c()nlraclors lo construct thc projccl (Scc. 7(M, Busincss and l\uli:sskln(}ldc: ThcContractt)r'sl.iccnseLawdocsnotapplyloanowncrol'propcrtywhohuildsorirnprovcsthcrcon. and who conlrncts lilr such projccls with a (lontractor(s) licenscd pursuunl lo thc Contraclor's Liccnsc l-aw). -latttcxctIlplultdc.rScction-.B.&P.C.filrlhisrcastrn, ( )rr ncr: WORKERS' COMPFNSATION DECLARATTON I hcrcby alfirm undcr penalty of pcrjury one of thc following dcclarations: -l havc and will maintain a Certificate of Consent to Self-lnsure for workcrs' compensation. as provided for by Section 3700 of the I-abor Codc, for the performance of thc work for which the permit ls issucd. -l havc and will maintain workers' compcnsalion insurance. as rcquircd by Scction 37fi) of thc l,rrbor Code. for thc grcrformnncc of thc work for which this prmit is issucd. My workcrs' comlrcnsation insurancc carrier and plicy numbcr arc: Carrier: Policv Number: Exoires: JI -l ccrtify that in thc performance of thc work for which this pcrrnit is issucd. I shall not cmploy any pcrson in any numner so as to bccomc subjcct to the workcrs'conrpcnsation laws of California. and agrce that if I should bccomc subjcct to the workcrs' compcnsation provisions of Scction 3700 of the Labor Code. I shall. forthwith comply with thosc provisions.. WARNING: Failure to sc-cure workcrs' compensation coverage is unlawful. and shall subict an enployer to criminal pcnalties and civil fincs up to one hundred thousand dollars ($100.000), in addition to thc cost of compensation. damages as provided for thc Sc'ction 3076 of thc labor Codc. inlercst and attorney's fees. Date: LICENSED CONTRACTOR DECLARA'I'ION I hcrcby af'lirrn urrdcr penaltyof pcrjury that I arn liccnscd undcr provisiorr ol'Chuptcr 9 (commcncing with Scction 7Un) of Division 3 ol' thc Ilusirrcss and Profcssiorrs Codc. antl nry licensc is in full [<rrcc imd cl'll'ct. Liccnsc Class: Liccnsc Number: Dsle: Conlraclor: W I hcrcby alljrm undcr Fnalty of pcrjury lhdl lhcrc is a conslruction lcnding ugcrey for Ihc pcrlbrntarcc ofthc wrrk for which lhis ttrtrril is issucd (Scc. 3097. Civ. C.). kndcr's Namc: Lrndcr's Addrcss: APPLICANT DFCLARATION I hcrcby atfinrr undcr pcnalty of pcrjury onc of thc following dcclarations: Dernolition Pcrrnils-Asbcstos Notification Fcdcral Regulations (Title 40. Part6) _Rcquirccl ktlcr of Notification -l enify thrt the fcdsal rcgulalions rcgsding sbestos rcmBlrc not appttsble to thir pmjet. -l cgtify thar I hsw rcad this applbstion atd srde lhrt 0r sbow infomtion ir cmt. I 8gE to @mply wilh sll Cily snd County ordiores aod State [iws clstitrg to building on*nrcrbn ard hoeby sulhoriz rcprcsilrtiB of lhh Ci]y ard Couty to eots upon thc abow miliored prcperly for insFction purlDss. Applicant or Agcnt Pcrnrilcc rttruc l\otn. Appliances lVletal Fire Place Evaporative Cooler Furnace Compressor [tIisc. Equipment Duct Work Pre-lnsulation lnsulation Smoke Detectors lnstalled Rouqh Ductwork Vents Toilet Room I Clothes Dryer Residential Range Other Hood Type I Hood Type !l Hood Grease Duct Fire Damper Openings lnstallation F.D. Drop Test Above Hard Lid Above T-Bar Rough Mech.cltlltd ,r,t2) Fina! Test ttl I (-.- Meter Release ,--r\ FINAL NoteslRemarks, Etc.q -? i-?b fu-T?'6 il \-.7 L - -----r----- Dale: Applicrant: