HomeMy WebLinkAbout20167415 - Permit (2)Ciff of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
l nspection Requests: (7 1 41 667 -27 38 l nspector Section: (7 1 4) 647 -5853
Electrical Permit #: 2lD1t57415
Pin #: 3,4o24
Proiect Address: 2414N Tustin Ave
Assessor's Parcel: 396-26'l -55 Lot: 8
Unit:
Block: A
Bldg: '14-M Address Range:
Tract: A.B. CHAPMAN Hisloric: No
Suite Range: I
Zoning: R4
T
Owner:
Address:
Contractor
Address:
01116002
01116002
0'1116002
01116002
01116002
51603
51603
s1603
51600
51603
Amount
1.45
1 .58
1.05
22.O8
55.04
Fee
$7.25
$1 1.06
$4.20
$22.08
$55.04
Phone
The Bascom Group, LLc
26 Corporate Park Drive, #200
lrvine, CA 92606
(949) 955-0888
Fee Type
125 Volt Receptacle
Light Switches, Occ. Se
Light Fixtures
General Plan Update
lssuance
Qty
5.00
7.00
4.00
1.00
't.00
Phone
State Lic #: 1009989
Lic Type: B
Bus. Lic #: 366547
Workers' Compen salion lnsurance:Carrier: Midwest Employer's Casualty Company
Policy #: BNUWCoi39070
Expires: 0'lr0l/2019 uen e
011|
€l.ec
u11 l,
ICL
- 1U15l201S I0:
1;'sns,i:21Ref+: 201r - 1l/15/201S 11otEI t2rl
-,,d(t.-: leq
- - _r[ L-r[r
6Lr30ott-
003076Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued Byi
Sub.iect to Field:
Building Permjt #:
Date:
Date:
Date:
R-2
VB
cEc 20r6 Notes: Fixture qhange outs. Ulit,1{r";ij,;Autha
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Chavez, Dave
Every pemit issued shall become invalid unlessthe wo* on lhe site
authoized by such permit is commenced within 180 days afrer its
issuance, ot il the wotu euthoized on lhe site by such pormit is suspended
or abandoned tgt a pedod of 180 ddys after the tirne the wo* is
commenced.
't1t1512018
Account#
$22.08
$77.55
$99.63
$0.00
$99.63
MID#: 2018-147700
01 1 16002 51600
01 1 '16002 51603
Fee Total:
Paid to Date:
Balance Due:
Tenant Name:
Katerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 8r 8-r065
Botch+
off rder
Acct+r
Rcpt+i(
Ttonsq
Multl-Famlly (5 or more uni Occupancy:
Alteration Constr TyPe:
Fixture change outs (Unit't)Code:
Inspector
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE OWNER BUILDER DDITARATION
I hcreby amm undo ,.nrry of p.rt!ry rhar I @ .r.npr f$n rh. Controclom Lrc.nsc Lav fo! th.followi.s r.en (Se.7011.5
Busines md Proasion Codc): Any Cily o! Counly shicfi r€qrir6 a Dcmit to co6rrud. alla. inprolq d.oolish or r@an uy
slruclue. Fior ro ils sud.c, abo rcqunG rh. applicMr ror su.h Fmi b nl. r si8n.d slddnml rhal h. or sh. ir lictucd pmuaJn
lo lh€ I,orisioB of rh. Contrcroas Liccnsd liw (Chapre t, Commocins sith Sdtiotr 7000 ol Division I oflte A6in6 ed
Preldsions Codc) or tha! hc or shc n cx.nfl rh6.non dd rh. bsis foi Oc alllt.d donplion. Any violfllionotSdlion 7011.5 by oy
appticd foi a !.mn subjdts ihc rpplicet to a civil pemhy o t bor nor. rhm fiv€ hundrcd d!ll6 ($500)
I. .s ownd ollhe p,op€ny. or my cnDloyes with was6 s th€r sl. conposation, will do rhe work and lh€ s:lrucl@ is Nr
inrord or oilq.t for elc {S8.7O1,1. Busind tud Prclsions Cod.: 'tl1c ConlEclois Licdc Low d.6 not arply lo d ost6 of
nr pmpart sho hril.tror nnpm!6thsan. ad wno do6such m himselt o. h*lf or rhmush hi5 or h6 o*r @plor6.
providcd rhd such e!.ovflors e ht inlad.d o ors.d tur s.lc lf, how66. rh. tuildins or iftrrovffir L sold rvithin on. yw
of$dpl.rbn. lbc Ons BuiBq rill hN. th. hrd6 .t proving thd tE or 3h. did mr hrild or nnForc ih. Fopaly ft,r tlE purDos of
-1,
c oN.d olrh. Flpdrn m cxclusircly conlmdina wnh licdE d cotu{crou h odrrucl rk poJcl (Sc. 7044, BGiIK
ad PNtusion Codc The Conr4doa3 Licd. L.N do6 nol 6pply lo d oMr o apropd, who buil& or imprclB lhq@..
ed *ho conrrds for such pr.j6ls wilh r ConrBcro(s) licNd p6@r lo rilc Contrctors l-i<t4 t w)
I tun.(hpr u.dd sc.rion , B & f.C. lorrhis rc6on
voarcas:coMfEtsalroN
DESdAAIIAN
I hd.by aflm un ld pdulry olFjory oo. ofrh. follosiiS dsLrarioBr
I havc od rill nai ri. a Cdificat. ofCoMI lo S.lf'16u. lor Mrtd6 6nrp.nsalion, s pmvidol for by Saioo 1700 oalh.
Labor Cod., lor lh. Faolr@cc oath. vo* lor wnich th. patrn ie isucd.
-l havc ard will 6aint.in vorkds corFsaion ituur.n c, 6 r.quncd by Sdrion :1700 of th. l,bor Codc. for lh. Ffo,@c. of
lh. work for wnich lhh pmit is i!$.i. My workEt @hp$arion iBuu.. wid ed poiicy numb6 el
,*., ,tlll^r<l &tt -*Aa
9t< r-l rncot>ql?o
_l ccniry thar in rhc psfornran cof the *or! aor which rhis prmn is tsu.d, I sh.ll nor dnploy any rtMn in dy med
$ N ro b..ofl. sotjdt h th. wortsJ com!.nel ion laws of Califomi., md asre lhal ir I should b..os. subjd ro lhc
work6' conpmarion prolisions oas€clion 1700 of lh. I-abor Code. I s\all. fonhsnh .or!1, *ilh tho* pmvisbN..
wARltlN(;: Failrr. to su. vork6 comp.Eation covms€ is unlawful. and lhall subjdt e antlord to aininal poah6 d
civil fin6 up ro on. n6drcd Gousd dolls {t100.000). h sddilion lo lh€ cosl ol compcMrion. {tlnaa6 6 p.olidcd aor rht
:,:- lt'oii
he lihY a,xl. innY.{
^n(lI 5 20ts
I hcrcby aflir m undq poalty o I pdjury rh.l I tub licds.d u.de piovi5ion ofChagq 9 (comnHcins with S*tion 7000) ofDivision l
of rie ausi.s sd Proasions Cod.. ud my licoF is in tull forcc a.d ctrers loo"noa
d.,.
codtrBtlcuaxrf.NDllc-acllcr
I h€rcby amrn unds [gulty ol pojury rhd thd. i5 . oisltuclion Lnding agmcy for lh. pqfomamc of lhc uork for $hi.h lhi3 Frmil i!
i$u.d (Sa. 309?. Civ C ).
AfXIICAtrLDICI,AIAIII}B
I hotnyofrmun.l6 Fnaltyofpsju.y otr of lnc foUovins d€lralions:
Dcholilior Pnnits-Asberos Nolificarion !-cdtral n€suhlioos ( l ille 40. Prn6)
-Requn.d
L.1rd olNolifi cdrioo
-l
c6rit lh.t lhc f€d.r, r.sulanoB Ee&ding 6bdo. rdnoral @ nor aptli.abL lo lht pnjd
Wdn) hd I h^ e,an lnlappltr rcn ed nar€ rh.r rh. aL{v€ inaomarion is cor41. l ssrc ro omply rvhh tll (:iry and Counly
oin6c6 M,l srd. ti{ s rcl,r hs ro boildins coBrudrn, .rd h(.by aurho.izc r.F6dr.i ir6 oarnt Cny dd Coomy lo 6t6 upon lh€
ab\c m.,rioncd pftrNn, ror tutect ilot/| 5 20t8
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Building
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouoh
Ceilings (T-Bar RouOh)
Ivleler Release
Rough
Service Meter
FINAL wutt q\g$
Notes, Remarks, Etc
rD/stG.COMMENTS
Communications Cable
t.ndd'r Ad&a
Appll.ol or gd( Signrlor'
Pmlre n.ne(prhi):