HomeMy WebLinkAbout20164821 - Permit (2)20 Civic Center Plaza (M-19), Santa Ana, CA 92702
lnspection Requests: (714) 667-?738 lnspector Section: (714\ 647-5853
ElectricalCity of Santa Ana
Permit Counter: (714) 647-5800
Address Range: 100-230 *
Historic: No
Suite Range:
Zoning: SP2
qProject Address:100 N Ha or Blvd
Assessor'sParcelr 198-061-17
Un : C-1
Block: NA
Bldg:
Tract: NA
Owner:
Address
Contractorl
Address:
Tenant Name:
01 't 16002
01 1 16002
01 1 16002
01 1 16002
01 1 16002
01 1 16002
51603
51603
5'1603
51603
51600
51603
Qty
30.00
6.00
30.00
3.00
1.00
1.00
Fee
$42.00
$9.12
$30.30
$34.95
$52.98
Fee Type Amount
125 Volt Receplacle 1.40
Light Switches, Occ. Se 1.52
Lighl Fixtures '1.01
Photo Cell 11.65
General Plan Updale 21.25
lssuance 52.98
Phone
State Lic #: 374153
Lic Type: B, C-39
Bus. Lic #: 366882
Workers' Compensation lnsurance:Carrier: State Fund
Policy #: 9038073
Expires: 0110112019
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:,. t +: Rea+: 20164pLi:O2269142 - l/22l2(r18 5: r:t1
.rns(lrt lofl Totql *1',54r-l
tflerql Plon Updnte Fee
tl16002- 516[tru[(-le(tr i':n1
t 116tr02- F l6r.13110rl-I Chec]r fttr3281
Building Use:
Job Type:
Nature of Work
Planning Conditions;
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Commercial
Tenant lmprovement
TI
Chavez,Dave
Date
Date
Date.-74'ost22t2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
B
VB
cEc 2016
Notes.
Buildins Permit #: I 0195042
Every permil issued shall become invalid unless the work on the site
authonzed by such pefinit is commencod within 180 days after its
issuance, ot il the wotu authorized on lhe sile by such permit is suspended
or abandoned fot a period of 180 days aftet the time the wotu is
commenced.
$190.60
$0.00
$190.60
lnspector MID#: 2017-140384
0'1 'l 16002 51600
01 1 16002 51603
$21.25
$169.35
Fee Total:
Paid to Date:
Balance Due:
Permit #: 2l!164421
Pin #: 9{659
Lotr NA
Phone:
GARFIELD BEACH CVS LLC
1545 W 17TH ST
Santa Ana, CA 927063300
Federal Building
15870 Curtis Ave
Fontana, CA 92336
(909) 428-8007
Fcderol ftu i 1d ins
Occupancy:
Constr Type:
Code:
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Lile Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Rool Top Equipment
Factory Wired Unit
Walls (Conduit)/r\
Walls (Rough)9-',t^,K N"\L471,
Ceilinqs (Hard & Soffit Rouoh
Ceilinqs (T-Bar Rouqh)
It/eter Release
Rough
Service l\ileter
FINAL sA
Notes Remarks, Etc
-..,
OWNER AUILDER DELCARATION
! h€rcby rflirm un<lcr pcnllry of pcrjury rhar I an .rcnpr lion hc Conra.roN Licctrrc tiw rb, rhc fouowing mrsn (S(.7o1 L5
Blsincs .tuj Pn rcrb. CoJc)r ny Cily or Coxnry which rcquncs o Fmrir ro onrr ct- ah.. if,fuvc, dcmolish or EPrt 6.y
slfl.turc. rir ro ns hsu.ncc. dso rcquiEs lhe aplli.unt for slch Fn.it ro fih a \i8n.d sarcm tnar nc or shc t li..i{d rurual ;
r. rhe pdvirion ortu C.nh.rols Lions\l llw (Chapr.i 9. Crnmcmins ,ilt Scction 7(Xx) of Diviion 3 ofrh. Irusincs rnd
Pmr.esn,ns Codc) or lhnl h. or shc is cxcn{,1lncrcfron'and lh€ tEsn lor lhc lllcscd cxcmflion. Any vblalhnofSsri,n70115 br rny
q,llicd lou pcrmi subj.ru rh. aptlic!trr ro a civil pcnolry ol nol 'mr.
rhn fiw hu.drcd dollom ($50)
-r.,s
osrcrolrhc nrortny. o. mycmtbrcs rilh wag$ as rhcir elc c.nFn\olion, willdo rlt rbA,nd rtr sME i\ fr
i cnlcd or oficrcd ror sk (Se.7014, Busircss .nd Pmfcssions Cn c: thc ConrBcrois LicnE bw docs ml aml, ro !n owncr of
rhc pmFny *ho buih\ or inlpmha rh.Gr. dd wlb dc\ skh mrk him!.lror hc^ell or lhmu8h his or hcr own.mployc.s.
providcd rhar su.h inlpmftctrh m nor hr.nd.{ or olf.Eri ld $k. l( ho$rwr. rhc huildins or impmwntnr is s,kl wirhin nnc ,Ltr
ol con{,htion. thc Owmr Buiklcr uill hnE Ih burdcn of pmvlr8 rhnr lr or rhc dit d huild or nqtow lhc pmFny tor thc pulF)s of
L r\ .wrcr .fihc Iop.dy, rm.rclusivcly contmdirS pirh liccn$rl conrracb^ t, con{tucr rtf, r4ftr (se 704-1. RuvEss
ern Pmfc\si,. Codc: Thc Conlrrlols l,i.ensc li* docs nol aprly kr Nowndr olpropcrl, {ho nuiBs or imlnlcs rh*.on.
lnd *ho conh.i\ror such p6.ids r,lh r Co.lr!.ror1, liccned pusuotrl lothcConrra.ttr\ t-i.cns. tf,w).
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imcxcmpl unds Sccri(
Ovn.r:
]]OBf,&BII1;OIIIENSAIION
IEILAAA.IION
I hcrchyrifirorundcrlEnrhyolpcrjuq.m.lrh.tulL,$'insJ..lax nnN:
I havc onl v'll ,miN rJClnilj.rr.olCotr{nrloScll'ltr{trcti)rno'[c cunrFn\dridr.,spmrdcJli,rhyScclidr.17(xIolrhe
ItrtnrCodc, turhcFnnrmrtuc.f rh. work fr whi.h rh.Frmir i( tsucd
I havc !.d eillmJintlir workcrl coflrpctrsoli nNunrn.c. $ rcquircd bySccrion.lT00ofrh. L.hor Codc. l'or lnc 0crforoErcc ol
rhc work lor wlrich rhi. p.rmir is issEd. M y wortcG con!,cnsolion insulancc crfti.r drd |blicy numbcr mSln# l,,,to
5
I.cniry rhar in rh. lcrrormRc oI thc *ork lor which Ihh |x nir is issucd,I shrlt nor .'nnloy iiy !.non itr m! m0nnc!
q) a. ro hcmm suhFcr ro
'h. "ort(s\' .onncns,r nr n h*s.rCaliromin, oM rBrc hlr ifl should l[sm sul,j.d kr rr.
w.rlcB conrpcnsarion ,r,vkbns of Sc.tion l?lDofrhc L$or Codc.l sh.ll.lonhsirh ootly qirh rhos pmvhkn$..
WA|INING: Fuilurc r. s.urc $orkc6 conrpcnuriur ..vctugc k u.lawrxl. rnd sholl suhjccl utr cmfLrlr ro aitunrl lctuxi.s dnd
civil nrcs up lo onc hundrcd lhousand dolluh ($l00,ilo0), n[ddkion to lhc cosr oi conlcnelioa. damgc\ ai Porid.d tr rh.
Sc.r'on lu76 ol rhc LJI!tr Cndc. mrcrc.l ond ah{rE)\ fN.
nnn.."lit*r;kss
DECIJEAIION
I hcrcby amrh unj.r p.nalry or pcrlurr lh,l I e,n licn*rl und$ pmvision o( Chor s 9 (onrftking *nh Sccrion ?000) of Divhion 3
of lhc Busincss ad Pmfcssions Codc- lrd ny ltcne is io lull r.rc. ,,xl cficcl.
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i*u.d (S...:l(n7, Civ. C )
APPIISIINLIIECLASAIIA!
I lIR'$y nmnn undcr |Enrhyofpcr.juryone ollhc hlhwins dc.ludn,ns
Dcn)lirion Pcntrik sb.nos Noritl.dnrn [cdcrrl RCBUlnti.ns (l illc 40. l'ado
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l.cnirythd lhc ttdcrilrcr!lllt,n{r.BUdiigrsb.skNrcii,v l c..rimli.!blc rorhis proj.cr
e,..nrdy wirh illCiryrnd ('onnry
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ID/SIG.COMMENTS
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