HomeMy WebLinkAbout20166424 - Permit (2)City of Santa Ana
Permit Counter: (7 1 41 647 -5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Electrical Permit #: 2()1fi6424
Pin #: 69607
Assessor'sParcel: 400-062-05 Lot: POR I
unit: 107
Block: NA
Bldg: E
Tract: 678
Address Range:
Historic: No
Suite Range:
Zoning: P
q
Ownerl
Address
Phone:
Tenant Name:
Contractor
Address:
Parkcourt LLC
18010 Sky Park Circle #'150
lrvine, CA 92514
(9491752-7274
Ark Mercury
KSM Services lnc. dba Mod(
12112 E 166 Street
Cerritos, CA 90703
19491 7s2-7274
01116002
01116002
01116002
01 1 16002
01 1 16002
0't116002
51603
51603
51603
5'!603
51600
51603
Qty
11.00
14.00
1.00
4.00
1.00
1.00
Fee Type Amount
125 Volt Receptacle 1.45
Light Fixtures 1.05
LowVoltage/Comm 33.88
Add'l Devices/Low Volt 3.20
General Plan Updale 22.08
lssuance 55.04
State Lic #: 949710
Lic Type: C-10
Bus Lic #: 370130
Workers' Compensation lnsurance:Carrier: Ohio Security
Policy #: XWS56716035
Expires: OSl17l2O19
Eotch+i45073 - ?fiA/ZJtg ID; 1pg541ttofficer CTYH Tpflns+r 7? 1 of ?Ac(L+: pef+r ?t1166424Rcpti:(r?344889 - 7,/B(r,/Zr"rtg J:44 Ft1Tronsoct ion Totql t J l _{.45
KSI'I Senvices Inc, dbcr flode Ar/
Genero I Plon Updote
r.r1 1 16002- tl 60n0tt0-
E lt-rr;Ir i':s1
011160(12- 516030(r(r-
ICL Check 0055
Fee $22. ('rg
i13?.37
t31J . 45
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By
Plan Checked By
Permit lssued By
Subject to Field:
Building Permit #
Commercial Occupancy:
Alteration Constr TyPe
Outlets/Fixlures/Low Volta g'Code:
Date:
Date:
Date:
Notes: Per Notice To Correct Work. Auth. filed.
07 t30t2014
Account#
eri
Every pefinit issued shall becomo invalid unloss lhe work ort lhe sile
authonzed by such pernit is commenced within 180 days attor its
issuance, or if the wotu authorizad on lh6 sito by such peinit is suspended
or abandoned for a peiod of180 days aftet lhe time tho wo* is
commenced
$154.45
$0.00
$154.45
lnspector MID#: 2018-144675
011 16002 51600
0'l '1 16002 51603
$22.08
$132.37
Proiect Address: 1801 E Parkcourt Pl
Fee
$15.95
$14.70
$33.88
$12.80
$22.08
$55.04
Phonel
B
VB
cEc 2016
Misc. Receipt:
Misc. Receipt:
Misc. Receipl:
Total
Fee Total:
Paid to Dale:
Balance Due:
APPROVALS DATE IDiSIG.COMMENTS
Site-Work
Underground
Pole Bases
L ight Standards
S pas, Pool, Fountains
Si gns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondin g/Grounding/UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
lQeilings (Hard & Soflit Rouqh
Ceilings (T-Bar Rouoh)
lVleter Release
Rough
Service lvleter
FINAL y/t/ltr ,?&"rl ')
7 --VI
t1
OWNER BUILDNR DELCARATION
I hcrcby o,ltm utuc{rnally {,f pcrjury lh l m .xcmfl ftud rh. Contra.rou Liccnsc tra lor rhc followi,rt rcosn (S.c 7031 5
Ausin.sa r l Pmf.ssn,n Cdlc) Ant Ciry or Coonry *hkh rcquncs ! Frn ro con{ocr. alrcr, imrrovc. dc'hli* or tot n my
struciurc. prkrlo its issusncc,olso Elutcs lhc.,'di.Mt ror su.h ttrmt ro lik i siBncd slarcmnl th,t rror shc n liccnrd purua
r(, rhc Frvixio.\ .f $. Conrm.kr's Li..n*cd kw (Chapr.r S. Conmencin8 {irh Sc.rhn ?O0O nf Divhion I ofrhc Businc$ and
ProfcssionsCodc)orrhathcorshciscxcnfllhcrciomondrh.b,sirrorrh.sllcgcd.xcnflfn.turyv,olalionofSalioD?03l5byany
alplicail lbr a ricrmil subJcch lhc applicanr lo a civil lrmlty of nor mrclhln firc hundrcddoll&s ($5o0).
-1.
0s ouncr nl rhc ,)orcny, or my .nrf lor.cs with wDgcs * rhcn {,h c!'nn treriotr. will do lhc wo* old rtE (BlN h nol
i.ren&i or oficred for slc (Se 7ilr4- Burircss and Prolt$ions Code: Ttc Conlncl.ir l,iccnsc ti* docs ml oDpl, ro d o*ncr ol
rtu pmprdy whot ikLl or inp rs rh.mn. aild eh) dNs skh lort himr.lfor h.^elf.r ihdogh ht or h., o*o.dployc.s.
tmvidcd rul such inDmrcnr s orc mt inl.rxL{ n orcrcd ror sdh. Ir. how$tr. rh. huitlin8 or inDms!rcnr ir skl withrn nnc t!.u
of con{rtlion. lhc OqDcr Buildcr will haK ih. budcn ol l)bving rhd hc .r rhc did mr brild or nrF.ovc rhc pmpcny for thc Nr|ne of
l- asowncroflhc proneny. ancrclusivclyconlliclins wilh licc.scd confuktrs ro con(rucl rhc 0mrccr (Sa. 704,1- Bu{ncs
Jtrd Ptuftsshn Codc: Thc Contrcttr\ Liccnsc L"* doc\ nor,pI,ly ro 0n o*ncr urpmpcn, wh,, build\ nr ihpbvcs rhcrcon.
3Dd who conrracrs i.r such rm]ccrs *irh 0 Conrracto(9liccns.{ purui io rh. Ctnrrrktrt Ltcctrrc La* )
L.rcn,fl tr cr Sccl
(rPner:
]loxtrEls:ronruN$ItoN
l,Dr;t t&rrlatr
I he,c6y r|ri.nunder Fnailyoip.rjur, onc oirlE idn,winE dcclirnriors:
I nrvc zd will nEint.in a Ccnificare ol Con$nl h S.li lnsur for wo*ss onpensori.n. as ,mvidcd for I'y Sd ion l7(x) ol ih€
litnr Qnle. for th€ Frformncc of Ihc woll lor which lhc pcrn r is hsucd.
_l havc and will munrl.in *orkcn comp(nsalion insururcc. s rcquicd by SNlion 1700 otlh. Latrx Codc, td lhe pcrlordrkc of
rhc No,k fo. which lhn pcmil is hsEt My workcm' €omF.srion insumrcc caEtr and plicy numhcr e
PolicyNuo Er:-Expircs
l.cdi,yrhar rhrFrronn,nccorrl'c worl n, shichrhispcnnir i\ hsucn,I lhDll n.r c doydnyI.B.n in trny,n ncr
s as to h$nnE subrc.l ro rhc worktr{ onDc,salion l.ws .r cahlaiirii. and .rNc rhnr il ! shuld trox sutrtcr Io rtE
aorkcn' omllcnsd ion prcvnion! of Sccr inn 3?ur oi rh. tjtrr cod.. ! sh,ll. lon hf,irh compl, wnn rhsc pmvtions
civil fincs u! lo orc hundrcd I
Sccti.n 10?6 of thc tibor Codc.
Del€:
00O), in ddirk,n tu rhc cosr ol
I hc'chy nrfirrn u .r |rn lrt ofprudry pn,vi\ioolChr cr9l.o'nrg wih Sftrion 7(X{D alDivisi({ l
of rhc llusincls rnd ttorcsiorlc.d.. rnd ryti..n\c ir i,r lirllnr.. iHl.1li.r
I hcrchy ritl.n und$ Fffllrorrerjurylhd
issucJ(sN .r097.civ c)
,!cNy l rhc Frforinnrcc
Ar&IANLDIC]r|BAUA!
I M)y dnm undcr p.nalry of txrtury oft ofrh. follosing d.cbErtr\:
Dcn{niion Pcrmih Asbcsros Nolific0li.n kncral Rcsuhriotrs (firlc,l0. P{n6)
Itrquncd l..rrrr ol Norifirxri)n
lad(i I E8u lir ions nB$dii8 arh.{os rcnDvrl ,rc nor adi.nhlc b rhil [o].ci
,ncci lr8rccioconrplysirh0llCiryxndCotrniy
i{\ ol rhh Cny iM Counryb cnrr ulx)n ih.
I Mvcrldrhn rld,lqriotr md (dcrharrhcnh,rc ill{.nution r
LP
ELECTBICAL.INSPECTOR RECORD
Notes,. Remarks, Etc.
\
L.ndo .r Addrcs