HomeMy WebLinkAbout20170653 - Permit (2)Project Address: 5015 W Edinoer Ave
Assessor'sParcel: 108-381-25 Lot NA
Unit: K
Block: NA
Bldg:
Tract: NA
Address Range: 5015-5127
Historic: No
Suite Range:
Zoning: C1
Permit #:2O170653
Pin #: 42547
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
Phone:
Manny Bukiet
520 W Willow
Long Beach, CA 90806
(310) 639-71 30
Kumon
T Signs
15151 Moran St
Westminster, CA 92683
(714) 890-0932
01 1 '16002 5160:
01 1 16002 5160C
01 1 16002 5't60:
01116002 5777C
Fee Type
Signs & Neon
General Plan Update
lssuance
Microfilm Records
Amount
78.08
22.95
57.20
3.91
Qty
1.00
1.00
1.00
1.00
Fee
$78.08
$22.95
$57.20
$3.91
State Lic #: 735992
Lic Type C.45
Bus. Lic #: 174801
Workers' Compensation lnsurance:Carrier: Security Nat'l lns Co
Policy #: 5WC1221874
Expires: 'l2lO'll2O2O
Bobch+:54151 - 1/31'/2Lr2Lr ID: HGARCIA
Off ice: CTYH 1p61nsf:53 ? of 4
Acct* I Rel*: 2017r-1653
ll,: "t+:tr2981316 - L/3tt/2tt20 11:22 All
Trsnsoct ion TotaI $lrLt36.LtE
T Sisns
Gt nerol Pton Llpdste Fee $22.'r:i
trl I 1600?- 5 I {31:rrJtr0l.l-
[lectr icctl $13:i"29
L|1 1 16LlLt2-. 5161:t30Lrrr-
ll i crol i Im & Documents $3. ?i
Ltl I 16LtU2.. 57771:[Jr]0-
1,( t- Checll tltll52 $1,r:l36.Lr$
lnstall (t) led-illuminated channel letter wall sign for
"Kumon", bond paid on M-74076
$1 62.1 4
$0.00
$162.14
Building Use:
Job Type
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
{hr",.n"noez, Kathy 01t30t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Totat
Paid to Date:
Balance Due:
Commercial
Signs
Sign-illuminated
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
N/A
N/A
cEc 2019
Buirdins Permit #: 101102905
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within360 days after its
issuance, or if the work authorized on the site by such permit ls suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2020-157O4O
01 1 16002 51600
011't6002 51603
01116002 57770
$22.95
$135 28
$3.91
t^ City of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA927o2 Electrical
Qr
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEL('ARATION
I hereby aflinn undo penalty of psjury lhal I m excmpt iiom lhe ('ontractor' l,icmse Law for the following re6on (Sec.70-] 1.5
Busines md Profssion Code): Any City or County which requirs a pmit to construct. allo. improvq dmolish or rcpair my
structure. prior lo its issuilc€. also requirG thc applicant for such frcnhit lo file a signed stalment that he or she b licmed pmumt
to the prcvisions of the Contractor's Licensed law (Chapttr 9, Commencing with Strlion 7000 of Division 3 o[ lhe l]usincss and
ProfesionsCode)orthatheorshcisexemptthqefromandtheb6isfortheallcgedexmption. AnyviolalionofSalionT03l.5byany
applicant for a pmit subjsts the applicanl to a civil penally of not more lho five hundred dolltrs ($500).
_1, a ouner of the propqly, or my cmployc with wage as their ole compensation, will do the work md th€ srudue is not
intmded or offsed foi ule (Se.7044. Busines md hofsiom Code: The Conlraclor's Licme lnrv doe not apply to an orme of
lhepropqty whohuildsorinrgovcth6on.mdwhodo6suchworthimselforheselforthroughhisorheromemployes.
provided thal such improvmls tre nol intoded or offoed for sle. I[ ho*'os. the building or impovmot is $ld wilhin one ]@
ofcornplelion. the (Ivnq Buildq will have the burdo ofproving tha he or she did not build or improve the propsly for thc purpowof
sle).
I. m orvner oflhe propqly. an exclusively contracling wilh licensed conlrack)rs lo construcl the project (Sec. 7044. Bsins
and hofsion Code: 'I he Contractor's Licensc Law doe not apply to an orvno of propmy who builds or improvG thtr@n.
and ulro contracts for such projats rvith a Contractor(s) licmsed puEumt to the ('onlraclor's LicN ti$).
I atr ermDl undq Sstion-, B. & P.C. for this reon.
l)alc:Owner:
WORXERS' COIIPENSA'IION
DECLARATION
I hocby aflinn undr pcnalty ofpqjury onc ofthe following delarations:
I have md will maif,lain a Cffificate of Consent to Sclf-lnsure for workm compmation, re provided for by Setion 3700 of thc
Labor Code. for the pefomance of the rvork for which the pmnit is issued.
*have ancl will mainlain workqs' compcnsation instrrance. 6 rcquircd by Section -1700 otthe Labor Code. for the pqfonnance of
s,ork for uhich lhis nutnbq ile:
2-ol-,?d<)lblicy Numtrcr r
---Expires:,
-l
cenify that in lhe ptrformance of thc work for which this perrnit is issued. I shall nol onploy any person in any mmnr
so astobecomcsubjecttotheworkss'conpensationlawsofcalifomia.andagrcethaliflshouldbccomesubj(ttothe
rorkm' compesation provisions of Scrtion -3700 of the tabor Code. I shall. fonhu,ith cornply rvilh lhos previsiom..
WARNINGI l;ailu'c lo scure \!rkcrs'cornpensatioil covclage is unla*ful. aod shall suhjecl an onpkryt'r to oinrirral Jurallia and
civil fines up to one hundred thousand dollffi ($100,000). in addilion b thc cost of compensation. damages m [or
Setion of the Labor interGt dd allomey's fe6-s
t)I.( t,,1tL\ I t(.)N
I heeby affrm undo poally ofpsjury thal t m ticms€d undq Frovision ofChapts g (commmcing rvith Setion 7000) of Division 3
of the Busins md Profqssions Code. md my licmse is in full force md eff*t.
LiceNe Nurnber:
.on,.".o,( f-$4Al
CONSTRUC'I'ION LENDING AGENCY
I hereby amrm under FEnalty of ptrjury that lh6e is a construction loding agmcy for the pqfonnuce of the work for uhich this pqmit is
issucd (Sc. 3097, Civ. C.).t ndq's Nmc:
Lsrdq's Addrs:
-APPLICAN DECI,ARATION
I hettryalnnn undq penalty of pojury one of the follorving delarations:
Demolition Permits-Asb6los Nolification Federal Regulations (Tille 40. Pm6)
Required Lelter of Nolifi cation
_ I cffify that the fcdsal regulations rEgdding asbeskrs ronoval arc nol applicablc to this projrct.
iilforillalion is corrccl. I agre lo conrply with all Cit y and ('ounty
alrcr'e nrentioned propcny for
Applic6nt or Agent Signlture:
Prrmilce ntrnlc (priilt):
i\,6 of lhis Cit, adrfounly
-l/,^ru,t) 44
to 6ttr lhe
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildins
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rough)
Meter Release
Rough
Service Meter I
FINAL 2/z /zzl ,4-/5/41 t)
Notes Rem