HomeMy WebLinkAbout20164692 - Permit (2)@ City of Santa Ana 20 civlc center Plaza (M-19), Santa Ana, cA 92702 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (7141667-2738 lnspector Section: (714) 647-5853
Permit #: 2lJ164692
Pin #: 27299
Project Address: 1921 E Carnegie Ave
Assessor's Parcel: 430-222-12 Lot: NA
Unit: G
Block: NA
Bldg:
Tract: NA
Address Range: l90t-192'l'
Historic: No
Suite Range:
Zoning: Mi
Owner:
Address
Phone:
Tenant Name:
Contractor
Address:
01116002 51603
01 1 16002 51603
01 116002 51603
01116002 5'1603
01116002 51603
01 1 '16002 53601
01 1 16002 51600
01116002 51603
lvy Geng
1921 Carngie
Santa Ana, CA 92705
(9491 445-2435
UM Media
Owner-Builder
Fee Type Amount
'125 Volt Receptacle 1.40
Light Switches, Occ. Se 1.52
Light Fixtures 1.01
Air Conditioner 93.28
Serv Meter 51 .29
Ptc - 65% 0.65
General Plan Update 21.25
lssuance 52.98
Qty
56.00
14.00
61.00
'1.00
2.00
357.80
1.00
1.00
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires;
8nt,:h+.436?g -0ll ice: Cl YH
,lcct+;
tirp t+ 3 0:?59?91
fron€flct ion To
Tt'
]vv G€ng
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By
Commercial Occupancy:
Addition Constr TYPe
Addn/TURoof Mtd EquipmenCode:
Date
Date
Date
6en Erol Flnn Updrrt r
t:t1 I 16!"1fl 2- I 1 Jrl{BLI-r-
Ele,:tr i,-nl
'-1
I I 1 611!_r?- 51 Jn:Ir:[.rt'-
l./ i so
C(:+: xI*r;Ir*IrrrU,i
U isn
CC+: r****rrrrtrl:,l
Notes
Teri
12t1412017
051o7t2018
Account#
Misc. Receipt: 70303
Misc. Receipt:
Misc. Receipt:
Total
93944
Every pe fiit issued shall become invalid unlass the wo* on the site
authoized by such permit is cofimenced within180 days after its
issuance, ot il tho wo* aulhoized on the site by such permit is suspended
ot abandoned for a period o1180 days aftet the lime lhe work is
comfienced.
$663.95
$232.57
$431.38
L
,lvlar
lnspector MID#: 2017-138228
01116002 51600
011y)tuz 51603
$21.25
$410.13
Fee Total:
Paid to Dalel
Balance Oue
\
Fee
$78.40
$21 .28
$61.61
$93.28
$102.58
$232.s7
$21.25
$52.98
Phone:
j...l,-) ; LliiDs^Ar,E:
M.491
ir Ftl
*41r-'.1
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
B, S-1
VB
cEc 2016
g';.'i'rf-r
A.,r.l i ; r,,7.r11:/j' i4ti,
h.!r. | :! ittTnft?r.
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Lile Salety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq A
Under Slab / Floor lo - ld- lV v^ut{)
Bondinq / Groundinq / UFEFI
Transformers
Torqueing
Sub-Panels
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
ryNM-Walls (Rough)tt ":l*1 2b.)
Ceilinqs (Hard & Soffit Rouoh v\
,}At a-l)UCeilings (T-Bar Rough)l:2.,till8 -r .zn)
Meter Release ,/
Rough
Service lvleter
7 rfia4a|tFINAL 'e./
Notes, Remarks, Etc a t
OWNER AUILDER DELCAIATION
I h.rcby .lfifln ulx|cr p.nally oI p.rj!ry thrl I m crcmpl lrcm lhc ContractoN Licen* h* fo, lh. followins dasn (S.c 701 1 5
Businc$ rnd Pof.sion Codc): Any City or Counly whi.h rcquircs ! |Emil lo onsltucl. lttcr iryrolc. demohh or Epdir' dy
(Ecrurc. prior ro irs issunncc. aho rcquircs rhc appliconr lor suchFnnir ro filcaskncd srarcmnr rhar hcorshc t lic.scd pn6uMr
t. lhd pbrirbn\ ol rh. Conhror'r Li.lns.il lrw (Cbuprc.9. C.mkming wnh Secrion ?fiI) oi Division I ofrhe Businc$ 8nd
Pmfcsions Codc) or fill lE or shc k crcn t
'h€rfron
dnd lhc bdis lor ltr alk8cd crcnfln n Atry riohrn n ofSccri,n 70:l I 5 h, an,
dmlicanrlurpcrorirslhjahrhcappli.inrn,acivilll.uhyolnormocrhxnfivchnodrcddolld*(1500)
-1,rs
owncroilhcpolEny.or y cmDloFcs $irh r'.Bcs rs Ihcn sb comncr\rr ioo. *ill do rhc aok dxl thc r rucrm i\ nor
inrcndcd or oitcrcd tur {lc (S( 70,rj- Bu\ines and llolis\ion\ Cdc, Thc Coikr.tr's LitM Ltrw docs tror rpDly lo anowncr ol
rhc D$IEny wlhtuild\.r ilr{xnq rllmn.ond wtx) (lcssu.h *brt hnnscllor her*lforlhn'ughhnorhcr.wncnpl,,y.c\,
pmridci rhrr skh nnpnr.Erhr. i cndol or.flia ri,r elc lt lr,*c!ci rh. t ihinE or nr{rorrmnt h oU *nhinorc )!s
oI c.ry'!:rion. rtE Osrcr lruildcr will h0vc $c nu.dcn ot prcrins rhlr lE or chc dil nol hiki or impo( thc pmFly ror rh purlDe ol
l. N.srrotrhc pnrFny, amcxclosiv.ly.ontacrinE qirh licei{dd.onrrh$ tr.otrifl.' rh. pn,F.!' {Scc. ?04.1. Du\inc$
rlxl Pnlcssion Codc: Thc Conrd.rs Licc.sc Li* d{r\ norrpplyro !nosrcrol'popcnywh,) blild(or impn,v.s rhcr.on.
rnd trho ont!.r \ f.tr \kh pr+.h Nirh a G,nta.n,rl9 ltctrsd lrBumr t, rh. ConlDdoll Li.cnsc ti* ).
".t
';/7lls
I hc..by rllntrrtndcr r^-nJlry of p.rj1,
-l
havc ud will nuin[in a Cenifictrrc of Cnirc hSclllnsureiorworkcB.onlc.\.rn,n,r [ovidLd rorbyScction3T0ooithc
L.bor Codc. l'or lhe rrfonmncc of rhc *ork for which rhc pcrnril is hslcd
I havc and sill tuinrain w.rkcs comtf nsarion insututrc., a\ rcrtuind by Sccr ion 3100 of lhc r:b.r Codc. ao, th. Frfonuftc ol
rhc work ror whi.h ihi\ pci,bn i( tsucd. My worlcn comFnsorion insumNc .aFicr ud policy rumhcr dc
-l
ccnifythar inrhc rcrhrm0acc otthc *o,k i.. shththisFrnir h is$cd- Ishrll or cmrk,yanyr.^.i 'n,nyn'anrct$ (, ti.o.r sxbJccrb rh. rorkdl .onrNnsdrion lrw\ ofcalifdtu{ rnd isrcc rhd ifI should hcmm subjccr lo rhc
workc^ c.mpcns0rii,i provisiotraofSc.rnrn:lTmofrh.lih.r C.d..l shall.lonhsilh comply wilh thosc pmvnions.
WARNINGT F,ilurc tu sur. $orkcrj conD.Nrlion ovcn8c t unldwtul. lnd shall subj.rl .n cmpbFr t, sidinal FMha\ u'd
ci!'l finc! ut k, onc hDidrcd rhrtr\nnd dollr\loo.Ulo, rn ddiiiotr k) rhc cosl of conDcnsnrio.- dlrmgc\ a\ pn,!id.d i, rh.
)/t /,Y
ll[(f,rlA.rlrl)N
I hcrby nfiliflundcr p.trdltyol !crjury llr u(cr pmvhio. ofCh.plcr 9(mmtrtmina wirh s&rion xlro) ol Divhion I
ol rl'. tiu\i'r$ r Porr$i(ni\ ( ()dc. nnd niy li..d\c n i', iiill nmo r,rl.l1..r
Liensc NumlEr:
Afluci TNTDECLAtrAIDN
I lrn$y rfmundfi p.nohy oipcrjury om ofthe lollnwin8 dccltrariotrs:
Ixnmlirtun P.rnrir+Ash.{os Norifi c0rion Fcdcml Rcgularrns (TirL 40. PM6)
-Rcqlncd
brrcr ol Noliliarion
orc nor a,,plicahle io rhhpmjccr
romution is c.r.cl I aeN to coq'ly wirh all Ciry and Counry
ond (ininrlro ctrr.r trFr r,r
Icn"irc"'th*fr , nn A*,^-l
*"' c/1J4
ELECTRICAL-INSPECTOR RECORD
Air Conditioners
IAXSIBICTANIEIDINC-&C.ENCI
I hercl,y affird!.dcr FnolryotFrj!ry rh rhcr.iraonsrtucrionhndingrg.ncyror$cpcrfordnccolthc*orktushichlhisFermin
issucd (Scc 1097, Civ. C.).
lxnd.i\ Nrnr
lxtrJca! ddrc\.