HomeMy WebLinkAbout20166417 - Permit (2)20 Civic Center Plaza (N4-19), Santa Ana, CA 92702
lnspection Requests: \7'14) 667-2738 lnspector Sectjon: (714\ 647-5853
Electrical Permit #: 2lJ166,417
Pin #: 9OO{4
City of Santa Ana
Permit Counter: (714) 647-5800
Project Address: 5410 W Crystal Ln
Assessor'sParcel: 108-591-18 Lot: 31
Unit:
Block: NA
Brdg;
Tract: 4560
Address Range:
Historic: No
Suite Range:
Zoning; R1
bP
Owner:
Address
Contractor
Address:
White Mechanical, lnc-
23601 Ridge Route Dr, #B
Laguna Hills, CA 92553
(949) 7r6-8379
Fee Type
01116002 5'1603 Air Conditioner
01'116002 51600 General Plan Update
01116002 5'1603 lssuance
Qty
1.00
1.00
1 .00
Fee
$96.90
$22.08
$55.04Phone
Tenant Name:
State Lic #: 822174
Lic Type: C-20
Bus. Lic #: 324552
Workers' Compensation lnsurance:
Carrier: lnsur Co of the West
Policy #: WVE5024604
Expires: 10/01/2018
Uh i te liechon i ((r1 ' Inc.
Generol Plon Update Fee
n11150(12." i16tr(t000-
F lectr ico I
111116002- i1603000-
ICL Check Url9716
Building Use:
Job Type:
Nature of Work
Planning conditions:
Planning Approval Byl
Plan Checked By
Permit lssued By:
Subject to Field:
Building Permit #:
Amsden, Julie
Every permil issued shall become invalid unless the wolk o, the sile
authorized by such pemit is commenced within180 days after its
issuance, or if the wotk authoized on the site by such pennil is suspended
ot abandoned for a period o1180 days aftet the time the work is
commenced.
R.3, U
VB
cEc 2016
07116t20'18
Account#
Notes: Direct change-out of furnace; lst time installation of
alc
$174.O2
$0.00
$17 4.02
Single Family Dwelling
Miscellaneous
HVAC
Date
Date
Date
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
lnspector
0'11 16002 51600
01116002 s1603
$22.O8
$151 .94
Fee Total:
Paid to Date:
Balance Due:
David Juarez
6510 w Crystal Lane
Santa Ana, CA 92704
(714) 856-9891
Amount
96.90
22.O8
55.04
8qt.h+:44915 - 7 / l6/2trt9off ice: (TYH TronEi; 6?Acct+: Ref+:
Rcpt+r023256(11 - 7/16/2tt19
Tronssct ion Totol
Phone:
Occupancy:
Constr Type:
Code:
MID#: 20'18-144655
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Lile Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Bondinq / Groundino / UFER
Translormers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouoh)
Ceilinqs (Hard & Soflit Rouoh
Ceilings (T-Bar Rough)
Meter Release
Rough
Service lvleter
FINAL *l)nlt\Itufil*€{aa)
Notes, Remarks, Etc I U\)
OWI!ER AUTLDEN DELCARATION
I hcrcby lffinn u.do pcMlry of Fljury riar I am cxcnrpt rion rhc Conrrocron Ltcn\e Lns ro, rhc rollowin8 E.$n (Scc?oll5
B$in8s and Prorcssiod Codc): An! Cily or G,utrry whi.h rcqxir.s . llcr.tl lo condrucr, all.r. nq,mvc. dcmlhh "r rcIr3n oiy
ed.rm, pii$ ro ir! issurtu.. de rcquircs thc q,tlhanr ror sn h Frn ro filc a si8trcd srarcmnl rhar hcor shc is li.cn€d pu^unnl
ro rh! pnvtiotrs oI rhc Conlractoas l,ich{d l,w lchrpr.r 9. Co $rfti.g wirh Scc'ion ?ux) ol Divnion 3 ofltc Bucincss 8nd
Pnfcss nsCod.).rrhartEorrhchcx.mpllhcrcftorond'hrh€sislorrh.,llcBcdcxcq'tiotr.AnyviolarinnofS*rirn70ll5by,ny
omli.!tr| lb! a pcirnil subjcch rhc amlicant ro a civil l)cnrlry oI nor mrc rhan filc hundrd dollds ($50o).
-1.
us oqrcr of lh. pmtEny. or nry cnDloyccs iith ruBcs !s Ihc ir $lc ompcnssri('n. will do rh. eolk ud rtr stdurc h mt
inrcndsl or oflc.cd lbr qle (Sq 7(X-,1, Bxsiftss snd E r..\nrns c(d.: Th. C.nta.k, s Ltcnsc ljw dms nol alply ro an o*t, of
thc pmlEny Bho hoilds or in{,mrs rlENn, ard who drs uh m himsrlf or &rclf or rhrurgh hk or h.r ow. cmnb)ec\,
ptuvidcd rhat such impmrnrnrs d tul int lcd n ofrcNl lor srk Il hows. th. tDilding or irymwnrnl is vrld wirhin om ,!U
of coDplclion, th. Owncr Buildcr will hovc ltE buracn of F)vins lhll hc .r shc did n.r t'uild or nr$rorc rhc tmFiy for llE IUID9 of
_1,,so$rcrolrhcnmFny.ahcr.lulivclycont&rintswi'hliccn*d.onr t s tr con\dd lhc lmicl lsa 7(N4, Bu\im'1
,M t\iLs$n Codc ThcConlmcrols Liccnsc Ltrwdes.ot aptlyto anowncrolptr,pcnyrho build\or impmvcs thcrmtr.
rnd who contfts ior sucn nmjds wnh a 6nrr!.r.(9 liccn*d plruor rorhc Grir*.r.r's Liftn{ hw).
I m cxctrrrr utrds Sdio
Dorc O*ner:
wotxers colnPrnsariorv
DECLAAA.IIIIN
I hcrchy rilifln undc. p.nnltyolpojuryom ollhc tuln,qins dcclurnnr\l
-l
h,vc dwillNinrainiCcrriararco,G,n*orroSclalosurcfffuortcB.oqxns,,'o6.ns pmvidcd for bySNtion 1700orrfie
trrbr Codc. for th. tdrormkc or thc *olk for whth lhc nom is nsucd
llman,rai', sorkch co rp.trrrrion iNunicc. r\ rrquir.d hySc.tmtr:17(x)olihc liho! Codc. for lhc Icrfortun.c ul
ichthispcrnn i\ i\su.d. My workrs onrpcnrdnrn rnsu$nccca .ru.d,xnicynumtc.uc
l.cnitirhar i', rhc p.rrormtuc ol thc work for *hich rh( pcnnn h issucd. I sholl nor cmpk,, !n, pcron in rny numt
$ ns b bc.om \ubiit io lhc wodcrs comlcnelion la*s oiCllifo.nia- lnd lsEc rhrr if I \h,nld bc.om sub.j..l lo th.
wo*cn comr.nsari.r povhionsofSarion 3?drofrhe L n Codc. l shrll. fonhwirh .onply wirh rh.s lrovisio s..
WA|ININC: Failurc t,, rcurc workc*
civil ntrc\ !p k, one huodEd rhou\a d
Sccrnrn .llr?6 ol lhc Llhr Crxic. inr.dr
.omp.nsdion covcrnlc is unlawrul. .nd sholl slbj.rt cmploycr lo qi6id p.roltid md
dotle. (lll)o.Ux)). i. dnion r. lh..ost ofcompcnsolion. drmaes ar Piovid.d ror lh.
,id hmy . r.f /,
'' , fiFrsen<wrnrtrui-ft". 7fi ulrE
DECIAaAIII}N
I h.rby dfllrn lnder F.sli, or p.qury thd I am li.cnsd undcrymvision oichlt s 9 (.omRftins oirh s6thn 7m0) ol Division l
ol lne Busirc$ ad Pmf.srions Cod., md ny li.€n* ir i. tull tnr.. ,rd cff.cl.
c) ()gDY 7 I
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CONIiIB]JI]IIONIEIDING.AIiINII
I hcnhy 0lltrn unil.r FnahyolNrjuryrhd rnqc h B c-ndrucli,n hndiry fla.n.y r(r rhc t'.rionmno oithc wort tor whth rhh Flnir G
i*ucd rS.. ltl97.Civ C ).
AITIICANIIEQAAAIITN
I hdrtly ,flmr undn p.n,lry oI t rju.y om of lhc followins d(loEt ions:
Demrirnrn P.rdirs Asbcdos Nori6c.rion Fcd$rl RcSul.li.ns (Tnh 40, Pd6)
RcquiEd lx (.f Norill.nlion
I ccnifyrhar rh. f.dcral rcBulrl i()ns rcEsdin8 ashc(o\ rcflDul rrc frn atplicrhlc t, rhi\ pt,i.r
!lcrdifyrhrr lhJlc rcal rhis urltrrn rrtrd!{rcihn hc nh,vc hrnx iotr i\ conc.r lrlreiocomply*irhrllCiryrtrd Counly
ordi'rnrc\ xnd sirrc u$!'rl,iingn, huildrnS.on(rucli(,r. dhcrchy0urhorizcrcprcscnrllivcsolrhi\Ciiyrndc(,utrrytuctrrcrullnrthc
abovc m iomd ftupcny hr ,"rr*'
lk\ ,{ppliconl or AAEnr SiAnrrurc
ff"-n**.",0n,',I hl S,tctlr'n ^"ty'rufe
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ELECTRICAL-INSPECTOR RECORD
Under Slab / Floor
lr & P.C. r'orrhn rc on
ta:=
t nJ.r'l Adtte{q.
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