HomeMy WebLinkAbout40134921 - Permitt City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Mechanical
Permit Counter: (714) 647-5800 lnspection Requests: (7'14) 667-2738 lnspector Section: (7'14) 647-5853
Permit #:40134921
Pin #: 6,8821
Project Address: 1811 N Greenleaf St
Assessor's Parcel: 002-104-26 Lot: POR 1
Unit:
Block: B
Bldg:
Tract: 256
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Janna Middel
181 1 Greenleaf St
Santa Ana, CA 92706
(7141 356-2734
01 1 16002 51604
01 1 16002 51604
01 1 16002 5160C
01 1 16002 51604
01 1 16002 5777C
Fee Type
Furnace
Compressor
General Plan Update
I ssuance
Microfilm Records
Amount
70.66
97.17
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1 .00
1 .00
Fee
$70 66
$97.1 7
$23.79
$s9.30
$4.05
Phone:
Tenant Name:
Contractor:
Address.
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
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-ur", $/
Occupancy:
Constr Type:
Code:
Date.
Date:
Date:
R-3
VB
cMc 2019
09/1 9t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Total
Notes: Mechanical
Fee Total
Paid to Date:
Balance Due:
N/A
N/A
No Balance
No Balance
$254.97
$2s4 97
$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 permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#:2020-1 61587
M ECHANICAL.INSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS OIVNER BUII,DER DEI,CARATION
I hcrcby ollirm undcr pcn{lty (rf pcrjury lhul | {m cxcmpl fronr thc Cdilrnck)rs' Liccnsc lf,rw for rhc lblk)wing rcason (Scc./tlJ3l.5
llusitrcss n[l Profcssk)n Codc): Any C'ity or Cr)utrty which rcquircs a Jrrtrril to corslrucl. altcl iuprovc. dcnnlish or rcplir any
slructurc. prtrr to its issuancc. also rcquircs the applicant li)r such lErnril kr l'ilc l signcd slulctrrcnl lhrl hc or shc is liccnrcd putsuant
to lhc provisk)ns of lhc Contrnck['s Liccnscd hs (Chtptcr 9. Cornrrcncing wilh Sccli(nl 7000 of Division 3 of lhc Busirtcss anrl
ProlcssionsCodc)orthathcorshciscxcmpllhcrcfromnndthchasislorlhcallcgcdcxcnplhn. AnyviohliorolScclhnT0.ll.5byany
upplicrntlbrrJ,crmitsubjcclslhc applicanltorcivilpcililhyofnotn()rclhanlivchundrcddollilrs(S500).
_1. as owncr of lhc prcJf,rty. (,r nry cnrpk)yccs with wrgcs as thcir *)lc conrpcnsalion. willil) llrc work ilrd thc stMlurc is fiil
iltclxlcd orollcrslforelc(S(.T044.BusincssandPnrlcssionsC(dc:'lhc('ililr0ctrr'sl-iccnrl:wdr)csnolapplyloilnosncrof
lhcpmFny *hrbuildsorirqrrrrcslhcBln.an(lwhod(E\suchuorkhitrrsclforhcrsclforllrrouShhisorhcrowncmployccs.
providcd that such imp()vcmnts arc fril iilcndcd or ofllrc(l tif srlc. ll. howcvcr. thc huildiilg or irrprrvctrrnl is srld within onc ]rtr
ofcoNphti(nt thc Owncr Buiklcr will hrrc thc hurdcn of prrving thd hc or shc (lkl not buikl or hr[rovc lhc pn,Fdy for tlrc purfxrs of
vrh).
-1.
as owner of thc propcrty. am cxclusively contracting with licensed conlraclors lo conslruct the pmject (Sec. 7W, Busincss
and hrrfesshn Codc: The Contractor's Liccnse Law docs not spply to nn owncr of prolrcrty who builds or improves thereon.
and who contracts for such projccts with a Contracto(s) liccnscd pursuant to the Contractor's License Law).
-l
amcxempt under Seclion-. B. & P.C. forthis reason.
I)llt: ()rrlttr.
WORKF'RS' COTVIPENSATION
DI'-CLARATI,N
I hcrcby affirm undcr penahy of Jrrjury one of lhe following dcclarations:
-l
have ald will maintain a Certil-rcatc of Conscnt to Self-lnsure for workcrs' compcnsalion. as provided for by Section 3700 of the
L-abor Code. for the performsnce of the work for which thc Jrermit is issued.
-l
have and will maintain workcrs' compcnsation insurancc. as requircd by Scction 3700 of thc Lahor Code. for the pcrfornunce of
thc work for which this pcrmit is iszued. My workcrs' conU)ensation insurancc ciurier and plicy numhr ef,c:
Policy
_l certily that in the Jrcrformancc of thc work for which this Jrcrmit is issucd. I shall nol employ any lrcrson in any manncr
so as lo trc-conrc subjcct to the workers'comfrnsation laws of Californin. and agrcc thal if I should bccomc suhjcct to thc
workcrs' compcnsation provisions of Section 3700 of thc l-.abor Codc. I shall. forthwith cornply with thosc provisions..
WARNING: Failurc to sc.cure workers'comgrcnsation covcrage is unlawful. and shall subjcct sn employer to crinrinal penaltics and
civil fincs up to onc hundrcd thousand dollars ($l0o,finl. in addition lo thc cost of compcnsation. domrgcs as providcd for the
Scction 3076 of thc Latnr Code, interest and attorncy's fees.
,\pplit'trtl:
LICENSED CON'IRAC'I'OR
DFCLAIIATION
I hcrcby alf irnr ulrdcr pcnalty of pcrjury lhat I arn liccnscd untlcr provisiott of Chlplcr 9 (cottuncncing u'ith ,Scction 7(Xm) ol'Division J
o[ thc I]usirrcss and Prol'cssiorrs Codc. arxl nty liccnsc is irr lirll lirrcc anrlcl'l'cct.
License Class: Liccnse Numbcr:
Dale:_('onlrttclor:
CONSTN.UCTTON LENDINC AGI:NCY
I hcrcby amrm undcr lrcnillty of Frjury thdt lhcrc is c conslruclion lcnding ngcncy lor lhc ltrli)nurrrcc of lhc sork titr which lhis firmil is
issucd (Scc. -109?. Civ. C. ).
Lcrtdcr's Narttc:
l'cndcr's Addrcss:
,*LICAN' ITECLAR ,
I hcrcby aflinn undcr pcnalty of pcrjury onc ol'thc following dcclurations:
Dcmolition Pcrmits-Asbcstos Notilication Fcdcral Regulations ('Iitle 40. Part6)
-Rc<luircd
[rttcr of Notification
_l ccrtify that the fcdcral rcgulations rcgarding asbcstos rcrxrvalare nol upplicablc to this projcct.
_l certify thst I h8vc Esd lhis application ad state lhat thc abovc informlkrn is coret. I agrc lo @mply wilh 8ll Citysnd County
ordin8res snd Statc kws Elating lo building construction. ad hcrcby authorizc Eprcsnlativcs of lhis City ud Counly to enlcr upon lhc
otnve mntkrrcd prcperty for ioslrcdion putnss.
Applicant or Agcnt Sigrralurc:
Pcnnilcc nanrc (prinl ):_-
[)ltc:
Appliances
[Vletal Fire Place
Evaporative Cooler
Furnace
Compressor
Misc. Equipment
Duct Work
Pre-lnsulation
lnsulation
Smoke Detectors lnstalled
Rouqh Ductwork
Vents
Toilet Room I Clothes Dryer
Residential Ranqe
Other
Hood
Type I Hood
Type ll Hood
Grease Duct
Fire Damper
Openinqs
lnstallation
F.D. Drop Test
Above Hard Lid
Above T-Bar
Rough Mech.
Final Test
Meter Release l/^l )
FINAL t2ltt /7 r wilrt ME\
Notes, Remarks, Etc.I
_Expircs:
\