HomeMy WebLinkAbout40336079 - PermitCity of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA927O2 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 1607 E McFadden Avea
Permit #: 40336079
Pin #: 62055
Assessor's Parcel: 402-322-17 Lot: NA
Unit: A
Block: NA
Bldg:
Tract NA
Address Range: 1S01-1609
Historic: No
Suite Range:
Zoning: Ml
Owner:
Address:
Phone:
Tenant Name:
Reza Semsarieh
1607 E McFadden Ave, A
Santa Ana, CA 92705
(7141 352-6990
Daily Hug Coffee Roasters
Owner-Builder
01 1 16002 51604
01 1 16002 51604
01 1 16002 5160C
01 1 16002 51604
01 1 16002 5777C
Fee Type
Air Handling
Vent Fan/Comm
General Plan Update
lssuance
Microfilm Records
Amount
47.95
46.99
23.79
59.30
4.05
Qty
1 .00
1.00
1.00
100
1.00
Fee
$47.95
$46 ee
$23.79
$s9.30
$4 0s
/
Contractor:
Address:
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Bstch*360?40 gftA/2021 I0: HCAZALE
0ffice: CTYH Trsns*: 1S 3 of 3
Acctt: Ref*: 10336479
Rcpti:03428872 I fiA/2021 1l 3 13 AH
Tronsoct i on Totol 1777 .66
Re;g Semsor i eh
Generol Plon Updobe Fee
01116002- 51600000-
Flechan icnl
01 1 16002- 516r-14r-100-Building Use:
Job Type:
Nature of Work:
Plan Checked By:
Permit lssued By:
Subject to Field:
lndustria!
Alteration
Mechanical
Occupancy:
Constr Type:
Code:
B
ilt B
cMc 2019 Notes:
Fee Total
Paid to Date:
Balance Due:
Uiso
CC+: rr*rrr**rrr*5$32 Authi:07131
$182.08
$0.00
$182.08
Ma ke-u fl h{{ $ld*t",hffiilffifit =
Planning Conditions:
Planning Approval By:Date:
Date:
Date:, Julie
Buildins Permit #: 1 031 08117
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 rs suspended
or abandoned for a period of 360 days after the time the work is
commenced.
09130t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 51604
01 1 16002 57770
$23.79
$154.24
$4 05
lnspector MID#: 2021-1 69 176
ro
\
M ECHAN ICAL.! NSPECTOR RECORD
APPROVALS DATE !D/SIG COMMENTS OWNER BUTLDER DEIrcARATION
I hdcby affirm undff poalty of psjury thar I m qempt fiom thc Conhmtos' Licre tJw for thc followirg twn (Sa.7031.5
Buines atd Profesion Codc): Aoy City or Coudy which rcquis a pornit to coNtruct. alta, improvc danolish or Epair my
suuc{ure. prbr to its issuacc, also rcquire thc applicut for such pcmit to lilc I signed statmmt thd he or drc is licascd pEmt
to th€ prcvisioN of thc Contrrctor's Lieucd Law (Chapt6 9. Commcing with Scrion 7000 of Divisioo 3 olthc Buirc md
Profsiom Codc) or that hc or shc is qcmpt th@from and thc bssis for thc allcgcd qmption. Any viohtion of Setbn 7031.5 by uy
applicmt for a pcrnit subjets thc applicut to a civil pcrulty of not morc th6 fivc hundrcd dolla ($500).
-1,
as owner of the p,roperty. or my employees with wages as their sole compersation. will do the work and the stnrclure is not
intendod or offered for sale (Soc.7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of
the property who builds or funproves theron, and who does such work himself or herself or through his or her own cmployees.
provided that such improvanents are not int€ndod oroflbred for sale. l[, howwcr, the building or improvernent is sold within one ]€ar
of cornplaion, the Orner Builder will have the hrden of proving tha he or she did not build or improve the propoty for the purposcof
-&\ffiTsllf,ffi
rEJ;H'.rilH"ffJffi T$l;ffi ;:ffi :l",trffi,iff ffi,'r"fff ;]"H,H:T
who contracls for such projecrs with a Contractor(s) licensed pursuant to thc Contractor's License l-aw).
am exempt B. & P.C.reason.
I hereby afftnn unds penalty of pojury one of the following
_l have ard will maintain a Certificate of Consent to Self-Insure for workers'compqrationr as pr,ovidcd for by Section 3700 of the
I-abor Codc for the pcrformance of the work for which the perrnit b issued
-l
have and will maintain worketrs' compensation insurance, as required by Setion 3700 ofthe Labor Codc, for thc pcrformancc of
the work for wNch this permit is issu€d My workers' compersation insurancc carrier and policy numbcr are:
\
WARNTNG: Failure to sccure workers' compensation coverage is unlawful. and shall subject an enrployer to criminal pcnalties and
civil fines up to one hundred thousand dollars ($100,000). in addition to the cost of compcm{ltion, damages as provided for the
Section 3076 interest and attorney's foes.
LrqENsEp CoNTRACTOR
DECTI\RATION
I hereby affirm under pcnaltyof ffiury tha I am lic€osod under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code, ard my licensc is in full forcc and effect.
Licensc Class: Licease Number:
Date:
W
I hodry affirm undq p68lty of pqjury thd thft b a @ngilclion ladiry ag@y for thc pafomcc of thc mrk br which this Fnit b
icaucd (Se. 3097, Civ. C.).
Lcndcr's Name:
Lender's Address:
A,,LICANT DE.LARATION
I h€ldryaffirm under pcnalty of perjury one of the following declarations:
Demolition Permils-Asbestos Notification Federal Regulations (Title 40, Part6)
-Required
letter of Notification
with all City and County
above mentioned property for
County to entcr upon the
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
Rough Mech.
Final Test
Meter Release JI
FINAL /0-fY?Z(/cctt /uFb 5 -Xtl
Notes, Remarks, Etc.
\
that in the performancc of the work for which this perrnit is issued. I shall not employ any pcrson in any manner
so ,ls to become subject to the work€rs' compensation laws of Californiq and agree that if I should become subject to thc
workcrs' compensation provisions of Section 3700 of the Labor Code, I shall. forthrvilh comply with those provisioru..
Contractor:
q &hr