HomeMy WebLinkAbout20166169 - Permit (2)City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical Permit #: 2O166169
Pin #: 57942lnspection Requests: (714) 667-?738 lnspector Section: (714) 647-5853
Project Address: 2000 E Seventeenth St Unil:
Block: NA
Bldg:
Tract: MAYBURY
Address Range: 2000-2278
Historic: No
Suite Range:
Zoning: C1
E
Assessor'sParcel: 40O-12'l-O1 Lot: 1
lnterstate Consolidated lndust
2'130 E Sevenleenth St Unlt# D
Santa Ana, CA 9270'l
Amount
23.87
21.25
52.98
Qty
100
1.00
1.00
Fee
$23.87
$2',1.25
$52.98Phone:
Tenant Name:Santa Ana H.S. Band Boosters
Owner-BuilderContractor:
Address:
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use;
Job Type:
Nature of Work
Other
Miscellaneous
Fireworks Stand
Occupancy:
Constr Type
Code:
N/A
N/A
cEc 2016 Notes: Handout given/fees pd in full on M-71110
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Link, Patricia
Date
Date
Date 06/13/20't8
Account#
Misc. Receipt: 71110
Misc. Receipl:
Misc. Receipt:
Total
Every pennit issued shall becorne invalid unless the wo* on lhe site
authoized by such pefinit is commenced within180 days dfter its
issuance, ot if the wo* authoized on the sito by such permit is suspended
or abandoned lor a pedod ol 1 80 days after the time the wo* is
commenced.
$98.10
$98.10
$0.00
lnspector MID#: 2018-143981
N/A - No Balance Fee Total:
Paid to Date:
Balance Due:
Owner:
Address:
Fee Type
01116002 51603 FWU
01116002 51600 General Plan Update
01 1'16002 51603 lssuance
ELECTRICAL.INSPECTOR RECORD
APPROVALS ID/SIG.COMMENTS OWNER BUILDEN DELCARATION
I h.rcby stfirm udcr Fnahy ot pcrjur, rhul I m ciempr iiom rhc C.nra.bF Lic.trs. bw ior lh. followin8 rcasn (5(.'.?031 5
Busiic$ !M Profe*ion Code,: Any Ciry o. Cou.ry whi.h {quies r lrmit lo cotrndcl, alts. improlc. &m,hh 6r rcpan lny
nrudud. pri.r b irs issuakr. alm rcquircs thc 0prli.ant ior such pcfl l ro lilc a sisned rhrentnr rhlr h.orsh. h liens.d l)usurnr
ro rhc rrovhinns or rh. Conk..roai Liftn*d hw (Ch,flcr 9. ConnmNitrg wilh Scclion 70m oa Divtion :l orrhc Businc$ dnd
Pn,lcsntrs Codcr or rhrr h. or shc r crcmDr lhcEfionrlndlhc hosh lor rhc llkscd ci.mprbi ny violariooolScclionT0ll5 t, any
rdllt,-n,ri., nn",.n *r'l(*,hc omhu;l'n a.i,ilI.trulr) nl'nor m,'R rhnn,'vr hdnJrJdullo^rlroo,ht\v, I laotrftrnrrhcF'Fnr.^rmyc'nnh'trcitr h wrecs ns rnct snc .onlrnsulion- will do rht wolk srl rtr strtm is mr
'inr.ftld 'rollcEJ ror solc (Scc 7(},la. Busi'rc$ ond Profc$ions Cod.'l h. Cont.c'or's Liccnc ljw dcr nor rpdyio o*noor
rhc ptr,r.d, who buildsor nryows rtr@n. ud *ho drci srch m* hinrclf.r h.r*lfo. rhouBh hh or hcr o$n enPhrecs,
p,ovidcd th.! such inrItrormnh @ nor inrcndcd or .ns.{ roi {lc ll lk,wcE., lhc buitlinS or inpmrm is r,l1 sirhin onc )td
orompkrion. rh. o{nfi Buildg *ill h,n rnc burd.tr ol pmlnE rMr L or sh. dn ml build or itrwove lh. pnFrly ror rhc ,urrsr of
l. $oqncrol(hc J,ro$ny. rnrexclusivcly conl!!(inr wirh liccn*d conra.tm ro cofsdd rhc trojcd (Ss. ?(I44. Bu$nc$
md holt$irn Cixlu:'l h. G'nrr&ttr s t-i..n\c Lna docs n.r at)fly tu rn owncr oinropcnysho huilds nr i,npn,v.s thcr.oi.
,trd wlr co n.k for such pm].cts sirh a Conracto(s) liccnscd lunurnr ro rhc Conr&rois l-i.rn{ Irw )
I turcby alirjn n.dcr pcnlhy ol pcrjlry onc ollhc,nlh$ing dcclaralion\:
I hrvc rndwill mdintain . Ccnrficdc ol Consnt toS.lf.ln(urc lor worker' compcnsd n& a\ pmvincd fr, byS.\lion 1700 ollhc
ljhtr('dlc- forrhcpcrlontun.corrh. work for qhrhthc !.nnit h hsucd.
-l
halc rnd {ill mri air wortcr conlncnsaiion insumncc. rs rcquncd hyS..rior]7mollhc b6or C(\lc. nnrnc p.rnn'rir.,ir
Ihc work hr *hicn rhis lcrnrir is issucd Mysorkc^ .unprn\ nnr ii rnr.c.,nicr and lolicy nnnrtcr c:
ad,;ffi .n,tl,,y rny ncr{'n i', my rr trci
\houllh..oN nrhlcd ro rhc
$orkc6 comFn\arn)n F,vi$ons ofs.rri(r 17ft)ofrhe Lrlx, Codc.I rhlll. tunhwirh c.nrtly w,rh rl$$,rovisi(rr
WARNING: Failurc to ccurc workcr coarEnsrrion..tcrryc is uihstul. rnd \hrll sohitr .n cmploy.r ro dinriNl ncnrllics and
civil hrcs uf t0 onc hunnrcd I
:._' lahf
I h.rby rllt'nunJ.r Ixnalryofprjtry tld I rtrt licutrwl uddcr of ChrDIcr'J (.onnncn.i',8 *irh
ol Ihc Blsimss.nd Pofcsn,nsCodc. a nry licci{ h in iullrt
IONSIf,IJCIION.LENDINCSCINCT
I hcreby affirnundcr pcnalryorrcrj!ry rhnl !hd. iq,.oNrru.tbn hnding.Scmy hrlhc pcrforron.c of'hc worx for whkh rhk rsmir is
ksucd (Se 1097. Civ. C.)
AIIUCANLDECI.ABAII!]N
I hcrr,y otrmr und$ p.nlhy ofpcrjuryoN of lhe followin8 dslaErions:
D.mlirion P.rmirlAsb.rros Norifi.ation ftdcrrl Rc8ulat ions Oirlc 4.0. Pan6)
Rcqun.{ L.tt r of Nolil_Etion
ltr1,J
ilrrlBr rhc fcdcral rcsUl ionsRgard,n! an{io\ rcnk,vrl rc mr rt'flcrblc lolhi\ nnr.rr
lh!l I hrvc r.ad rhisrplli.rri(u dilnr rhrr rhc rb.vc nrfornDrion ircorar I asrd r. cor'rly wnh dll Cny ali Co
.nntrtr0..\ rnn SrrrrI xs\ rIri'€t) hui i']!
rhovc nrnrioN Doj^-ny lnr insfd.rtr,,!trrfli
t,rizc rcprcscnn ik\ orrh
ADpli..nl or t6l Si,tnnlurc
Pemite nrm. (prirl ):
't'i,")j
/D
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq / Groundinq i UFER
Translormers
Torqueing
Air Conditioners
Rool Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouoh
Ceilings (T-Bar Bough)
lVleter Release
Flough
/l
FINAL L OL fl K#\81
Notes, Remarks, Etc.-t
DATE
Sub-Panels
Servrce lvleler
;:uli)
Irnd as Ad.lrc<\
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