HomeMy WebLinkAbout40135153 - PermitCify of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Mechanical
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714')647-5853
Project Address: 1241 E Dyer Rd
Permit #:4O{35153
Pin #: 45O9O
Assessor's Parcel: 411-131-36 Lot: NA
Unit: 200 Blds:
Block: NA Tract NA
Address Range: 1231-1241
Historic: No
Suite Range:
Zoning: SD63
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Greenlaw Partners
1231 E Dyer Rd #240
Santa Ana, CA 92705
(949) 331-1 316
KPRS Construction Seruice:
2850 Saturn St
Brea, CA 92821
(7141 672-0800
01 1 16002 51604
01 1 16002 51604
01 1 16002 51604
01 1 16002 51604
01 1 16002 53603
01 1 16002 5160C
01 1 16002 51604
01 1 16002 5777C
Fee Type
Compressor
Heat Pump
Alter Vent Sys
Fire Damper
PIC - 650/o
General Plan Update
lssuance
Microfilm Records
Amount
97.17
97.17
46.99
70.64
0.65
23.79
59.30
4.05
Qty
17.00
17.00
17.00
58.00
8,199.73
1.00
1.00
1.00
Fee
$1 ,651.99
$1 ,651.89
$798.83
$4,097.12
$5,329.82
$23.7e
$59.30
$4.05
I
!
State Lic #: 751130
Lic Type: B, A
Bus. Lic #: 188704
Workers' Compensation I nsurance:Carrier: Everest Premier lnsurance
Policy #: CA10004028201
Expires: 10101 12021
'i ce: CTYH
-$lr,lr?.iti: L'33265j
rnsnrt ion
KFRS Constru,:t ior
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Commercial
Tenant lmprovement
Tl/Rf Mtd Equip
Consultants
Notes:
Fee Total
Paid to Date:
Balance Due:
Mechanical for Tl
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B
V B, SPK
cMc 2019
00Ee
t-rtttt-
umen
0tltr-
0s/1 8t2021
06t24t2021
Account#
Misc. Receipt: 75047
Misc. Receipt:
Misc. Receipt:
Total
Amsden, Julie
Buildins Permit #: 101 105453
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 fhe site by such permit ts 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 57770
$23.79
$8,259.03
$4.05
$1 3,616.69
$5,329.82
$8,286.87
lnspector MID#: 2020-163257
M ECHANICAL-I NSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS
Appliances
Metal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work t I t a
Pre-lnsulation c llt 7)bv,YA
lnsulation 'l
Smoke Detectors Installed
Rough Ductwork
Vents I n
Toilet Room / Clothes Dryer ?T
Residential Range ,l
Other
Hood
Type I Hood
Type Il Hood
Grease Duct
Fire Damper
Openings
Installation
F.D. Drop Test
Above Hard Lid lt -l ,.1
tlrdAbove T-Bar o /
I r/rl
Rough Mech.
Fina! Test
Meter Release ll A tl o,
FINAL \ I r,t\U /
yNgtes, Remarks, Etc.l
'Pl I Y aCQWotuO S€c 1 -r-,
-)-D+
-? lt;l?r '- bla-'u/ruro 'r vrvqnh iaU I !L bM_&l
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OWNER BUILDER I'ELCARATION
I hcby affm undc pcoalty of pajury thd I m ampt from thc Contrscto6' Liccns [rw for thc following ren [Sc.7031.5
BBin6s sd Pmf*ion Codc): Any City or County which rcquirc a pannit to @ngruct. alt6. imprcvc. danolish or rcpair my
stracturq pdor to its issumcc. also rcquirc thc applicmt for such parnit to filc a signc{ stamot tha hc or slc b licoscd prcuiat
to thc provisioB of thr ContrEclo('s Liccnsd Lrw (Chapt6 9. Comcncing wilh Setion 700O of Division 3 of lhc BBins ud
Prcfcsions Codc) or that hc or shc is cxmpt th@fiom md thc b6is for thc allcgcd cxoption. Any violation of Sction 7031.5 by ey
applicilt for a permit subjets thc applicmt to a civil pcoalty of not moE thu fivc hundrcd dollars ($500).
-1.
as ownef, of the property. or my employees with rvages as their sole compensation. rvill do the rvork and the structure is not
intended or offered for sale (Sec.7M4, Business and Professions Code: The Contraclor's License Law docs not apply to an orvner of
the propcrty who builds or improvcs thcron. and who does such work himself or herself or through his or her own employees.
provided that such irnprovonants are not intended or offered for sale. lf. howwer. the building or improvement is sold within one )ear
of complaion. the Orvner Builder will have the burden of p,roving that he or she did not build or improve the propcrty for the purposc of
sale).
-1.
as owner of the propcrty. am exclusively contracting with licensed contraclors to construct the project (Sec. 7M4. Brsiness
and Proftssion Code: The Contractor's License Law does not apply to an owner of property who builds or improves thcreon.
and who contracts for such projects with a Contraclo(s) licemcd pursuant to the Contrac{or's License l-aw).
-l
am exempt under Section-. B. & P.C. for this reason.
f)olo'( )n ner:
WORKERS' CONTPENSATION
DECLARATION
I hereby affrrm under penalty of pcrjury one ofthe follou'ing declarations:
-l
havc md will mintsh a Cali6cstc of CoMt to Sclf-lBurc for wrkerr' @mpcnEtion, s prcvidcd for by Sction 3700 of thc
t bor Codc. for thc pqfotrMcc of thc rcrt for which thc pqmit b isucd.
AI bavc ild will maintain workeru' compcnsstion irourucc, r rcquirrd by S€tion 3700 of the trbor Codc, for thc pqfomcc of
thc wrk for which this pqrnit is isrcd My worka' ompansation imuue ffi6 atd policy aumba m:
All ;-*l la;5ortr.3c $2,tvloe) - l*,
poricy Nu^*r. CA lOOOlO2S2ol Expires:a.bt - eo, I
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certi& that in the performance of the work for which this permil is issued. I shall not enrploy any person in any manner
so as to become subject to the wort€rs' compcnsaion laws of California. and agree that if I should bccome subject to the
rvork6s' compensation provisions of Section 3700 of the tabor Code. I shall. forthwilh cornply rvith thosc provisions..
WARNING: Failurc to Guc wrkm' compqration ovaagc is unlawful. md shall subjct s mplo)€r to qiminal pouhks ud
cMl fina up to onc hundrcd ahormd dollm ($100.000). in addition to th€ cost of @mpcnstion, d.rug6 B prcvidcd for thc '
Setion 3076 of thc Lrbor Codc, intaet md attomey'r fce.
'2q -}ot I TL'*'? D-*hou.-
LICF'NSED CONTRACTOR
DECI..AEAIION
I hereby affrm under pcnalty of perjury that I am licenscd under pnovision of Chapter 9 (commancing with Section 7000) of Division 3
of the Business and Professions Code, and my licerse is in full force and effect.
a
t-
a
License
Date:
Chss' Dy't License Nurnber:75tt *
b-2.1- bz Conrracro r. -f -r.*.. ?.hlo--t ' Kt?[) ( r.tl.
CONSTRUCI'ION LT'NDIN(: AGENCY
I heeby affirnr undo penahy of p€rjury Ihat thqe is a coNtruction lending agency for the pcfomocc of the rvork for which Ihis lEtnil b
bsued (Ss. 3097. Civ. C.).
Lender's Nanre:
Lender's Address:
Aprt tcANT rr"cl *n
I hereby allirm under pcnalty of perjury one of the following declarations:
Demolition Pennits-Asbcstos Notification Federal Regulations (Title 40. Part6)
-Recluired
Letter of Notification
-l
certify that the federal regulations regarding asbestos rernoval are not applicable to this project.
@rcertis that I have read this application and stare that the above infltrnnation is correct. I agree to cornply rvith all Ciry ancl County
ordinances and Statc Laws relating to building represortatives of this City and County to cxter upon the
above mentioned property for
Applicant or Agent ,ur". 3'l'l' Tocl
pennitee name (prinr): Tn^a- D{ata va/
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