HomeMy WebLinkAbout20164458 - Permit (2)1
City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 }J
Permit #:2lJ164458
Pin #: 12726t
Proiect Addressi 4518 Westminster Ave
Assessor'sParcel: 100-190-36 Lot: NA
Unil: A
Block:NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning'. C2
Phone:
Tenant Name: Smog Test Only Center
Owner:
Address:
Contractor
Address:
Phone:
MK&SONS
4518 WESTMINSTER AVE
Santa Ana, CA 927031221
T&KConstructionCo.
17660 Newhope Street, #B
Fountain Valley, CA 92708
(7141875-6877
01 I 16002 51603
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
Fee Type
125 Volt Receptacle
Min Fee Adj
General Plan Update
lssuance
Amount
1.40
65.04
21.25
52.98
Qty
4.00
1.00
1.00
1.00
Fee
$5.60
$65.04
$21.2s
$52.98
State Lic #: 793124
Lic Type: B, C-10, C-39, C-15, C-46
Bus. Lic #: 310345
Workers' Compensation lnsurance:Carrier: State Compensation lnsurance Fund
Policy #: 9092246
Expires: 11l0gl2017
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
\A ,",r,"ndez, Kathy
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
Commercial
Miscellaneous
Outlets
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
F-1
VB
cEc 2016
10t26t2017
Account#
01116002 51600
01 1 16002 51603
$21.25
$123.62
$144.87
$0.00
$144.87
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 1 80 days after its
lssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 180 days after the time the work is
commenced.
lnspector MID#: 2017-139538
ELECTRICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS ()\\'NFtR BtJIl.I)!tR Dl].( ARA.l l()N
I haeby aflim undo penalty of psjury lhat I an exempt fiom lhe ContracloE' Licmse lzrv for the follorving ree)n (Ss.]031.5
llusincs ad Profeion Codc): Any Cily or County rvhich requirs a ponit lo coNlruct. allq. imdrove. dem,.lldr or rcp,,r any
slruclure. prior lo its isuance. also reauirG lhe applicanl for such pmit to file a si8ned stalmfit thal'he or shc is lilensed p. ;11 ,nt
to rhe provisions of the Conlraclor's l-icenscd ljw (Chapltr 9, Commencing wilh Section 7000 of Division 3 of thc Businefand
Profesions Code) or that he or she is exempl thseliom md th€ b6is for the allcged ermplion. Any violalion of Seclion 70-l 1.5 hy any
applicantforapmitsubjectsthe applicantloacivilpenallyofnotmorethanfivehundrcddollils($500).
I
_1, ru orvner of the prop€ny. or my employecs rvilh wage c their sole compensalion. will do the work md the strxclrlr is nol
intmdsl or of[sed for sale (Se.7M4. Business od Profesions Code: The Contraclor's l,icense Law does not apply to an owner of
thcprepqly whobuildsorirnp(rvslhqen.mdwhodo6suchrvorkhimselforhoselforthroughhisorherownemployed.
provtled that such improvqnols de not intmded or offqed for ele. If. howwq. the trrilding or improvment is old rvithin one )qrr
ofconrpletion. the (hvner Uuildo uill have the burdm ofpreving that he or she did not build or irnprove the propsty for the purB)se of
sle).
_.1, 6 os,nq of the propay. an exclusively contracting wfuh licmcd contradom lo comtrud lhe lrojed (S{. 7044. B6ins
md ProftsionCode:TheContractor'sLicenseLawdo6notapplytomownqoIpropcrlywhobuildsorirnproveslhermn.
and rvho contmcts for such projels with a Contrado(s) licfised puEuill lo lhe Contraclor's Licsse Las ).
_l en exempt unde 56lion B. & P.C. for this re6on.
O*ner:_
WORKERS'COMPENSATION
DECLARA'I'ION
I haeby aflirm undo penalty ofpojury one ofthe following dalarations:
lhavemdwillmaintainaCerlificateofconsmltoSelfJNureforworkss'conrpensation.6 providedforbySslion3T00ofthc
Labor Code. for the pqfonnmce oflhe work for which the p6mit is isued.
. lhaveandwillmaintainwork6 cornp€nsationisura.ce.6 rcquircdbySdlion.lT00oftheLaborCode.forlhepofonnarlceof
the rork for rvhich this pemit is isucd. My works' compensdion iNurmce cmier md policy numbo ae:
Policy Numbq:-
-Expires:I ce(ily that in the pertrrnrancc oflhe work for $hich this pernrit is issucd. I shall not ernpk)y any person in an),manner
so ns b beconre subjecl k) the workq s' compcnsation las,s of Cali fornia. anrl agre that i f I should become subiel lo thc
workq's' compensalion provisions ofScclion 3700 ofthe Labor Codc. I shall. forthrvilh cornply wilh lhose provisions..
WARNINC: Failure to wurc workers'compensation covemge is unlarvful. md shall subi(t an mployo to fitninal p6.llis and
civil finesuptoonehundredthousanddollars($100.000).inadditionlolhccoslofcompensation.damagesasprovidcdforthc
Setion 3076 of the Labor Code. inltrd md dlomey's fs.
o,,u,4i-2L2tl')
Dlt( 1.,\R.tiloN
I hoeby affirm unda porahy of perjury that I m licens€d undtr provision ofChapto 9 lcommmcinS with S(tion 7000) of l)ilisior l
of the Busines and Profcsions Codc. od my licmse is in full force ad effect.
Li."nr.Ctu"r, R/L
-License
Numbcr:14,2_
I hreby affim undo petrahy of perjury that thse is a coNruclion lmding agmcy for lhe psfommcc of thc work for which lhis pqrnit b
issued (Se. 3097. Civ. C.).
Lendq's Nme:
l-ends's Addr*:
APPLICANT DECLARAl'ION
I heeby affnn unde pmalty of perjury one ofthe follorving declaations:
Dcmolition Pnnits-Asbestos Notillcation Fedqal Regulations (Title 40, PadO)
-
Required [,etter ofNotificalion
I cerlify thal lhe federal regulations regrding asbeslos renroval ac nol applicablc lo lhis prcjecl.
I cdiry lhat I hare read this application od slale that the above infonnalion is cor@t. I agre lo comply with all City and County
r reprsqlativB of this City ed Counly lo otq uB)n lheordinancs md State [aws relating lo comtruction. od hqeby autkrrize
above nrmtioned propeny for ircpecl
Applicsnl or Agcnt Signa(trrel Date: Cr(: J
r. I l.Permt(e nsme (prino, To \r t\)r*1glJ -2-L+%f
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Rouqh)
lvleter Release
Rouqh tolzt ll7 .,oq4/t D
Service ltleter I
FINAL I I - /{,17 m/<_/q .>^./ O,,itnj',ilV
Notes, Remarks, Etc.I
Cmiq:
o"", \ (I 2-L f 2.al} contractor: X
@