HomeMy WebLinkAbout20166537 - Permit (2)City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electriga
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 ?
Permit #:20166537
Pin #: 554E2
Project Address: 2001 3/4 E Dyer Rd
Assessor's Parcel: 430-221-13 Lot: POR 105
unit: POW05 Bldg: Address Range:
Block: 9 Tract: IRVINE SUB Historic: No
Suite Range:
Zoning: M1
Owner:
Address:
Phone:
Tenant Name:
Contraclor:
Address:
Phone:
Heritage Village LLC
450 Newport Center Drive
Newport Beach, CA 92660
(949) 706-8468
S R Bray LLC dba Power Plt
1210 N Red Gum St
Anaheim, CA 92806
(714) 507-1881
Fee Type
01 1 16002 51603 TPP
01116002 51603 Dist Pole
01116002 51600 General Plan Update
01 1 16002 51603 lssuance
Amount
103.07
24.80
22.08
55.04
Qty
1.00
1.00
1.00
1.00
Fee
$103.07
$24.80
$22.08
$55.04
s
Bstchi:45031 - 7/26/21:ttg ID: LR0SAL0ffice: CTYH fnonsi: 19 2 otAcct}: Ref ,.: ?r_1166537
Rcpt?:023{2379 - 7/26/2tttg t?:iI plt
Trsnsoct i on Totsl l8l4 .91
ES
State Lic #: 980589
Lic Type: B, C-10, D-31
Bus. Lic #: 344085
Workers' Compensation lnsurance:Carrier: FEDERAL INSURANCE COMPANY
Policy #: 54309652
Expires: 0313112019
S R Brsc LLC dbo Pouer Flus
Generql Plan Updote Fee
01116002- 5t6Cr00Cr0-
Electr i col
01 I 16002- 5160300rr-
V isa
CC+: xrrrrrrrrrrr33T4
,22. r:rg
t182.91
t6t4.?7
Auth*:rr22833
Building Use:
Job Type:
Nature of Work:
N/A
Miscellaneous
TPP
Occupancy:
Constr Type:
Code:
Date:
Date:
N/A
N/A
cEc 2016
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Every permit issued shall become invalid unless the work on the site
authorized by such permil is commenced within 180 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.
07t26t2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
01 'l 16002 51600
01 1 16002 51603
$22.08
$182.91
$204.99
$0.00
$204.99
lnspector MID#: 2018-144956
ELECTRICAL.INSPECTOR RECORD
I
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underoround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq / Groundinq / UFER l.al- t9 J J zJ*l o(.tb
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 u
I
Rouqh
Service Meter ?t t,\l - t9-D.E*?t?/
F!NAL 3*o/ztzo -D-Glo(?n)
Notes, Remarks, Etc
OWNER BUILDER DELCARA'I]ON
I hcrcby affirrn under pcnalty of pcrjury lhal I am cxcmil frenr thc Conlraclors' l-icensc law for lhc lolk)wing rcason (Scc.7l)J1.5
Busincss arxl ProLssion Codc): Any Cily or Counly which rcquircs 0 lErmil lo construcl. altcr. improvc. dcnrclish or rcpair ary
slruclurc.pri)rk)ils issuancc.ilsorcquireslhcapplicantforsuchFErmillolilcasigncdstatcrmnl thsthcorshcislicenscd pursuant
kr the provisions of thc Conlmctor's Lice[scd liw (Challcr 9. Commcncing wilh Scction 7(Xn of Division -3 of the Busincss and
ProfcssionsCodc)orlhathcorshcisexcmplthcrcfromandthcbasisforthcollcgcdcxcmption. Anyvk)lnlionofScctionT0.ll.5byrny
applicant for a pcrmit suhjccts thc applicant to a civil penuhy of not nmre thun l'ivc hundrcd dollars (S5(X)).
_l,as owneroflhcpropcny.ormycmployccswilhwagesastheirsolcconlpcnsutiur.willdolhcworkandlhcslructurcisnot
irlcndcd oroflcrcdlirr*rlc(Src.7044.BusincssandPmt'cssionsCode:'lhcCuilraclor'sLiccnscl-awdocsnolrpplytoanowncrol'
thc pn)fEny who huilds or improves thcd)n. snd who d(rcs such work himsclfor hcrsclfor threugh hi\ or hcr own cmployees,
providcdthatsuch irnprovetrrntsmnoliilcndcdorofltrc{forsle.ll.howcvcr.thcbuildtigoririlprovcrrcnlisy)klwithinoncytru
of completion. thc Owncr Buildcr will havc thc burden ofproving lhd hc or shc did Dot build or improrc lhc pmFny tbr lhe purJb* of
slc).
_1. {s owncr of lhc propcrly. anr cxclusivcly coillrtcl in8 wilh liccilsed coillrilclors lo conslruct thc proiccl (Scc. 70"14. Business
and Pnrfcssir:nCodc:'lhcConlrrctor'sLiccnsc[-rwd(,csnotapplyk)anowncrolpropcrt]whohuildsorimprovcsthcrco[.
and who conlracts lbr such projccls with u Corilrrclo(s) liccnscd pursuanl lo lhc Contraclor's l,iccnsc lrw).
-lantcxcntplunJcrsccli()n-'B,&P'C.lbrlhjsrcnson,D!te:_ Oen€r-
WORKFRS' CONTPENSA'TION
DECI.AEAIIAN
I hcrcby affirm undcr lcnllly ofperjury onc ofthc [ollowing dcclarations:
_l hlve and will nulillailr u Ccrtiticatc ol-Conscnl k) SelHnsure tor wrrkcrs' corrrpcnsalion. as I&vidud lirr hy Scction -j7(X) of lhc
l-ahor Code. ttrr thc pcrlirrnrancc ofllrc work for which thc pcril]it is issucd.
_l havc and will maintain workcrs' comlrcnsnlii)n insurancc. as rcquircd hy Scction 37tn oflhc lih(rr Codc. [br thc perfonnancc ol'
lhc work for which lhis pcrriit is issued.insurancc curicr and nunrhcr uc:
Policy 3.3\. \q
_l ccrlity lhal in lhc pcrlormflncc of lhc work li,r which lhis pcrnril is issucd. I shrll nol cnrploy any pcrson in any illanncr
so as lo bcconrc subjccl k) lhc workcrs'cotrrpcDsrltm laws ofcalilbrnir. and agrcc lhrl if I should bcconrc suhjccl to thc
workcrs'coillpcnsationp()visionsofScctioD3T(X)oIlhct-iltnrCodc,lshrll.li)flhwilhcomplywiththoscproviskxrs..
WARNING: Irilurc k) r'curc worlcr\'coverage is unhwful. rnd shall subject an cmploycr lo friminal FEnaltics and
civil fincs up to onc hundrcd thousand dollars in additioil to lhc c()st of conrpcnsrli{)n. drnilgcs as providcd li)r thc
Scct )n 1076 of thc l.rlx)r ( odc.xrtrl SP.u,,t", ? . Zl-'
I hcrchy affirtn undcr pcnalty of I rnr liccn\od utrdcr provision ol ( hnflcr I (cotrnncn(iilB u'ilh Sc(l ion 7(XX)) ol Di\ ision .1
of lhc Business and Profcssions Codc- illd mv liccnse is in full forcc uxl cfltct
[,icensc Nutrrhcr:
a
I hcrcby affirm undcr Jrcnahy ofpcrjury lhal
issrcd (Se. 3097. Civ. C.).
bndcr's Namc:
construction lcnding agcncy for thc Jrerformancc ofrhc work for which this fErnlit is
hndcr's Addrcssi
APPLICANT DECLARATION
I Mry afllm undcr penalty of perjury one of lhc following declarations:
Dcmlilion Pcrmits-Ashcstos Notification Fcdcral Rcgulalions (Titlc 40. Pan6)
_Requircd lIl(cr r)f Nolifrcalion
_t lhc Icdcrill rcgulalions rcgnkling il\tErk)s rcrnovnl arc nol applicilblc lo this projccl.
I hnvc rcrrl this iln(l slnlc lhil lhc ntx)vc inli)r nilli()il wilh illl City and (i)rnly
Slntc l.a\\s an(l (bunly to cnlcr uF)r Ilrc
rbovc
or Agenl
l'crnr i 1(\{I nr c
lo huilding conslrucl
,,^^1 'ZU'18
tc n7 an{ (
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