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Home My WebLink About20170926 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical Permit Counter. (714)647-5800 lnspection Requests. (714)667-2738 lnspector Section: (714)647-5853 Permit #:2lJ17lJ926 Pin #: E,8297 Project Address: 640 E Dyer Rd unrt:MTR01 Block: NA Bldg: Tract: NA Address Range: Historic: No Suite Range: ZoningAssessor's Parcel: 411-141-12 Lot: Owner: Address: Shea Properties 130 Vantis Dr. #200 Aliso Viejo, CA 92656 (949) 389-7295 Fee Type 0'l 1'16002 51603 Temporary Electric 01 1 16002 51600 General Plan Update 011'16002 57770 Microfilm Records Amount 253 66 22.95 391 Qty 1.00 000 000 Fee $253.66 $0.00 $0.00Phone Tenant Name: Contractor Address: Pacific Construction Group 17895 Skypark Circle #K lrvine, CA 92614 (949) 748-1s00Phone State Lic #: 742676 Lic Type: B Bus. Lic #: 347876 Workers' Compensation lnsurance:Carrier: Everest National lnsurance Company Policy #: 2600014602191 Expires: 0310112020 Building Use: Job Type: Nature of Work lndustrial Miscellaneous 30-day temp Elec.Bldg #1 Occupancy: Constr Type Code: B, S-2 IIIB, SPK cEc 2019 Notes: 30 day temp electrical. Bond posted on M-74235 Planning Conditions: Planning Approval By Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Chavez, Dave Date: Date: Date:03t03t2020 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total9+" Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced wnhin 360 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. Fee Total: Paid to Date: Balance Due: $253.66 $0.00 $253.66 lnspector MID#: 2O2O-158180 01 1 16002 51603 $253 66 ELECTRICAL.INSPECTOR RECORD Bev.08-07-2015 APPROVALS DATE ID/SIG.COMMENTS OWNER BUII,DER DUI,CARATION I hcrcby afltrnr uDdcr pâ‚¬nalry of Frjury that I m excnpt fioft thc Cbolra.loB' Liccnsc liw for thc followinS rcen (Scc.7031.5 Busincss and Prolbssion Codc): Any Cily or County which rcquircs . pcrmit to construct, alts, irnprove. dcmlish or rcpair my structurc, prior to ils issuancc. Erlso rcquircs thc applicilil for such lEmut lo lile a sigrcd statcmil lhat ha or stE is liccred pusudl to lh( pmvisions of thc Conlracbr's l,iccnscd law (Chapter 9. Co,nmencinS wilh Scction 7000 of Division J of the Busine$ md PrcfessionsCode)orthatltorsheiscxenrptthe.efromandthebasisfortltallegedexenrptbn. ADyviolalionofSeclionT03l.5byany applicnnt for a pcmit subjects the {pplicunt to a civil pcnalty of not mrc than fivc hundred dollars ($500). _1. o owncr olthc proFrcny, or my cmployecs with wagcs as thcir solc coml*nsation, will do thc work and thc sttudm is mt iDterr.l,al or oflcrad for $lc (S6.7(X4. Business and Prcfcssions Codc: The Contractor's Liccn* bw d@s nol apply lo e owrcr of the profuly wlF builds or itrprovus lhermn, and wlm d@s such work hiNelf or lErself or throuBh his or her own enrployes. provided that such improwrcnts re mt iilcnded or olle[{ for slc. lt, howcver, 0E buiHitrg or itrprewmil is $H within orc ,ed ofcomplclio[ lhc Owmr Builder will luve thc bunlen ofpmving tha hc or shc did fttr buill or irpNvc fr pntpdly for lhc purpo* of sde). _1, as owner ofthe prpefly, am exclusivcly conlracting with licensed conlraclors to conslruct lhc project (Scc. 7(X4. Business ad f'rctssboCode:TheContrachr'sLicenseLawdcsilolapplytoailownerofpropcnywhobuildsorimproveslhereon. and who conuacts for such projccls with a Conlractor(s) liccNd pursuMl to thc Contraclor's Liccnsc trw). -l mrcxemp( und{ S.crion-, B. & P.C. for this ENn. Dsac:- WORKT]RS' COM I'f,,NSATION PEC!,ABAUgN I hercby aftirm undcr pcnalty ofpcrjury onc oftlrc fdlowing dccl&atio6: _lhavatrdwill nDintainuCenilicatcofconscnttoSclf-l[sureforworkcrs'coDrpensation,as pmvidâ‚¬dforbyScction3T0Oofthâ‚¬ Labor Code, for thc lrrfonurcc of thc work for which thc petmit is issucd. _l havc atrd will nEintain workcrs' conlpcrsation insurance, as rcquircd by Sation 3700 of lhc libor Codc, for lhc fErfomurcc of the work for which lhis Frnut is issued. My workers' corp!'nsation insutscc cmicr afil policy rumbcr ue: cmicr: Etâ‚¬tt$f vvA-l(d,r/4 ( (NS r/lLANcâ‚¬ co '7 bO OO tq @2 MPolicy _lixpircs: _l ccflili that in thc lErfornunce ol'rhc work for which this pcrmi! is issucd, I shall not cnrploy my 1rcrun rn any manncr s astobccotrEsuhjccttolhcworkch'coilrpcnsationlawsofcalifonlia,anda8rccthatiflshouldbecorrcsubjecttothc sorkers' compensatioD prolisiotrs of Section 3700 of the l-abor Code, I shall, fonhwith corilply with thos provi$ions.. WARNING: Failurc to scurc workcrs'mmpensation covcfrg. is unlawful, md $hall subjcct m crplorcr to oiminal pcmltics und civil titrcs up b one hundred thousand rlollars ($100.01J0). iI addition to the ol cornpensatiul, danuges as l)rovided tbr the lccs. I I hcrcby affrrl undcr penalty of pcrjury that I anr liccnsl undcr prcvision of Chaplc] 9 (conlrcreing with Scctbn ?000) ofDivision 3 of thc Busincss and Pmfcssions Codc, anl mv licens is in full forcc a8l effcct. 'Z 67e I Liccose zo, W I hcrcby al lirm undcr ff,nalty of pcrjury lh^t thcrc is a construction bnding agcrcy frrr thc pcrl-oflnarcc of thc work lt r which lhis pcrmit is issued (Scc. :1097. Civ. ('.). Lcnder's Nadrc: lrndcr's Addrcss: APPI,ICANT DECI,ARATION I hrebyaflimr undcL pcDalty ofpcrjury onc ofthc tbllowif,g dcclrations: DenDlition Pcrnrits-Ashcsk)s Nolification Fcderal Rcgulutions (Titlc 40, Pm6) _Rcquircd kttcr of Notification -l cdily lhd thc federal reguhtions rcguding abcstos rcmval rc not applicable lo lhis pmirt.rsL_lLl cdify tlut I luvc rcad this applicalion dd state tlut lhc above informtion is coffi. I aSreto @nply with aU Cily End County ordinmces md Statc llws rela(in8 kr building construction, and hcrehy authorizc rcprcscntalivcs oI this City and County to rbovc mcntioncd pmpc(y for Applic{nt 0r Agent I'cmilcc nonrc purF)ses. upon thc Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Siqns (monument) Life Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding / Grounding / UFER Transformers Torqueinq Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilinqs (Hard & Soffit Rouqh Ceilinqs (T-Bar Rouqh) N/eter Release Rouqh Service lVleter /\ FINAL 6'10.ll t+"t4-l[,) Notes, Remarks, Etc.