HomeMy WebLinkAbout20167446 - Permit (2),,
20 Civic Center Plaza (M-19), sarla ni\cnszzoz Electrical
l nspection Req uests: (7 1 4) 667 -27 38 l nspector Section: (7 1 41 647 -5853
City of Santa Ana
Permit Counter: (714) 647-5800
Permit #: 201gl 49
Pin #: 73346
Project Address: 1113 N Sheffield St
Assessor's Parcel 100.456-33 Lot: 62
U nit:
Block: NA
Bldg:
ftacl:2464
Address Range:
Historic: No
Suite Range:
Zoning: R'l
q
Owner:
Address:
Rosina Figueroa
1113 N Sheffield St
Santa Ana, CA 927031124
(714) 826-1345
01116002 5160:
01116002 5160C
0'1116002 5160:
Fee Type
Serv Meter
General Plan Update
lssuance
Amount
53.28
22.O4
55.04
Qty
1.00
1.00
1.00
Fee
$53.28
$22.08
$55.04Phone:
Tenant Name:
Contractor
Addressr
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Single Family Dwelling
Miscellaneous
Service Meter
Occupancy:
Constr Type:
Codel
R.3, U
VB
cEc 2016
Planning Condilions;
Planning Approval By;
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permil #:
Dale
,rr'nr,Or,"""51311 11t2012018
Account#
lvlisc. Receipl:
l\risc. Receipl:
Misc. Receipt:
Total
Every permit issued shall become invalid unless lhe work on tho site
authoized by such pefinit is commenced wilhin 180 days aftet ils
issuance ot if the wod< authoized on the site by such permit is suspended
ot abandoned fot a peiod ot 180 days after the time the wo* is
commenced
$22.08
$108.32
$130.40
$0.00
$130.40
Ow ner -Builder
lnspector MID#: 20'18-146988
01 116002 51600
0'1 116002 51603
Fee Total
Paid to Date:
Balance Due:
Phonel
Bn
irf,
l-r
({
/')t1 l2tl1t1qrlsi: 7
Ref+ I
It / 2it/?t|i
tD: NG
1
?l-l t67
l9z3?
11311.1
til
[.1
rll
Vi
(
Fee
Lll llI-l-
3r_lr.["i-
r **t-r.155 Aullr + : ll{
Building Use:
Job Type:
Nature of Work:
Notes: Hand out given. Auth on file.
ELE INSPECTOR RECORD
EN ,APPROVALS ID/SIG.coM
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER /-23-/9 (2i",
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rough
Ceilings (T-Bar Rough)
Rough
Service lrleter
FINAL
2t O -/a-la,.-ITTI H
Notes, Remarks, Etc
Z
OWNER BUILDER DELCARATION
I h6cby afiim und6 pdahy of pcjury rhat I m 6mpl 6on lh. Contracbn Lic.nse t w lor lhc iollowio8 rffit (S4 79 1.5
Businss d Pmldion cod.): Any Cily or County qhich requtG 0 p6mir Io co6rtucl, dna, imprcv., &tulbb "r Ep.n e)
srru.lua Fior lo ils tsua., abo r.qun6 lhc atpli.Mt lor such penil lo lilc . siso.d slalcmol thdt h. or 3h. b licdscn pu$aflt
ro th. pmvisiore olthe Conr,crori Lic.ns.d l-aw (Chlptd 9. ConnocinB sith Srlbn 7000 ol Divisio.I ofrh. BBins and
Proa.sDns Cod.) oi tb h. or sh. i! cx.mpt th6efto,n md ilE b6is lor th. all.s€d crdoiod An, riolttionofsc.lion?0115 bye}
applicaot tor a p..nit subjtrrs lh€ ryplicanrlo scililplnahyofnor ftorc rhm n!. hun&.d dollds ($500).
-1.
d o$ nd of Uc pNn ny, o. my .,nploy6 rilh w.g6 s th.ir $1. comFr,lion. f,ill do thc wolt ed th. sflclr a nol
i a&d or ofld.d aor eL (Se.7014. ltuinG sd Prcfsions Cod.: The coitacroas Licn* t w dod not apply lo M ow.q of
thcfllpsry vho builds or i,nplov6 lhsen. od who do6 $ch *o* hinsell or hdlf o. dmuSh nis or hd o*r cnplorc,
provid.d thrr strch inrmr6@E e nol iniqr&l or oru.d aor e]. lt ho*a6. ih. hrildnB or m!rc\mt is $ld wirlii o.. tr
oacompkliotr rhe (x n6 Buildg will hav. ltE hrdo ofl'orins lha hc or dt did nor buikr or improv. $. pt psry tor lt. purpos ol
-l.
6 ovnq ofrhe pmpdy. d qcluiv.ly cont cri.g wnh [.ds.d coflra.toE lo consrucl
'h.
p(j6l {S< 7044, BNms
md Rrtssion Cod.: I'h. Conrr.croi s Li..nsc Law do6 not apply ro u o{.a of proFr, who blilds or nnprovcs lh6.on.
aod who .o d.ls lor such projers$ h. Conhcro(s) lic6$d pu6wl lo the Co mdd.'sI
l n r\rm un $ Sc.ru -1c(c\
DECIASAIIO!
I h.rcb, afllrm und6 p.n.l'y ot Fjury one ofltc follovin8 deleariore
I harc sd vill minrain s Cglifical. oicoMl ro Sclf.InsuE aor worl.ts conrp.nsolioo, s prcvid.d for by Sdlio. 1700 oarh.
kbor Code lor lh. psfonmcc ofrhc wo* for *,hich lh. pdn i,s Gucd.
! have and vill maintain workert .ompo6alio. iBurd.q s requt.d by Sdiotr 1700 ol lhe llbor Cod.. aor lh. Pofo,rrEce of
lh€ work lor which this pdit is is.I My workec coftp.@rion isurmc€ cffiid ud policy nu'nhd e.:
-l
ccnif, thd inrhc pofomanc€ oflhe{ork for which this p6mit is issu.d.I shall nol oploy yFMn inlnymdog
s 6 to hdomc ubjd lo lhc wo*4' comp.Nlion l.ws of Cauloiia. ed rSr fi, if I should b<oh. subid lo rh.
*ork6'conFMlionFovisioBolselion3?O0ofthcljboiCodolsltsll,fonhwilhco,nplywiththoFpovisioE.
WARNINC: Failur.lo sue *oie6' coDFelioo .or.m8c is onlawtul. od shall subjd a. mplorc io oiminal pqEhi6 Md
c'",1 l''n* up r. onc hrd.J rl'ousd dolltrs r$100,00u1,ion rth€ cosl ofconpdErioi,
56lion 1076 ofrhc L,sbor Codq Er6d edanor.ey s
^![clSlarla!
I h*by artrrn uodcr peBlty oa psjury that I @ licotsqi undd Fovision of ( h.gc a (co
of th. BusinN and PmftssioN Cod.. dd my lictrc is in futl lorcr od crld
rvirh Sdrion 70001ofOivision l
co!flalclloll,DlDtNc"acElcr
I hs€br affrm unds pcmhy of pdjury lhd $6e i! a cooltuclion hndinB .g.ncy for thc p6fomu.. of th. sol aor shich this Fnnn is
irq,.drse louT an ar,a>,r.,i"u-.
A8TI.ICAILTECIABAIIO!
I bdrby.rm rnd6 pa.hy ofpsjlry onc olthe lollowins dalaalioB:
D.nolirio. P.rmirs Astct6 Norilicarion F.ddl Rc3uldions ('litlc40. Pa.r6)
-R.qutcd
t lldof Nolifrcaliofl
-t
c.rrify lhal rhc l.dcral rcsllariom (strdins ab.sros rdnolal m nor applicabl€ lo lhis pojal
-l
cdify rhal I 6avc rdd rhh appli.didn md st e rhrt de ,bv. inaonnalion is corccl. l trtd ro comply sith dl Cny and Counly
odinancs and Slalc ln*s Elatiix rize rerrsei arn 6 o l rhis City ed County to .ntr upon llE
al,\. ndrion d popdy for
(::to'
\ppli.tr r n,',\tr rSiA rl
a
Cr --{
{L
DATE
Meter Release
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PolicyNumbs: Erpn6:-
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L€nd.r s AddrB
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