HomeMy WebLinkAbout20165788 - Permit (2)City of Santa Ana
Permit Counler: (7 1 41 647 -5800
20 Civic Center Plaza (M-'19), Santa Ana, C492702 Electrical Permit #: 20{65788
Pin #: 436,70lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 3904 S Flower St Unil: H
Block: NA
Bldgl
Tract: NA
AddressRange: 3800-3928
Historic: No
Suite Range:
Zoning: R4
q
Assessor'sParcel: 410-291-02 Lot: NA
Owner:
Address
Prime & South Coast L P
50 California St 920
San Francisco, CA 941114606
Amount
23.87
21 .25
52.98
Qty
2.OO
100
1.00
Fee
$47 .7 4
$21.25
$52.98
Tenant Name:
Western Plumbing Services
1810 N. Linwood Ave.
Santa Ana, CA 92705
(714) 492-5490Phone
State Lic #: 1O211O1
Lic Type: C-36
Bus. Lic #: 364095
Workers' Compensation lnsurance:Carrier: State Farm Fire and Casualty Company
Policy #: 90C6X6879
Expires: OBl24l2O18
t,eet ern PIufib irrs Servi(e:
Generol Plon updote F '?Err1 1 I 6002- ii160(r(r(fl:r-
E le,:tr icsi
irll16tr(r?- 51603tr00-
lloster Cqrd
CC+ 3 *x*r*iir*I**ii823
Building Use:
Job Type:
Nature of Work:
Multi-Family (5 or more uni Occupancy:
Alteration Constr TyPe:
Washer/dryer Code:
R-2
VB
cEc 2015
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Zuniga, Allissa Y 05t07t2018
Account#
Misc. Receipt:
Misc. Receipt:
N,lisc. Receipt:
Total
Every pemit issued shall become invalid unloss the wo* on the site
authoized by such permit is commanced within180 days aftet ils
issuance or if the wo* authoized on lhe sito by such permit is suspended
ot abandoned for a peiod of180 days afiet lhe time lhe wo* is
commenced
9121 .97
$0.00
$121.97
01 1 16002 51600
01 116002 51603
$21.25
$100 72
Phone:
Contractor:
Address:
Fee Type
011'16002 5160: Dedicated Circuit
01116002 5160C General Plan Update
01116002 51603 lssuance
Botchi:43635 - 1/7/2u|g IDr CCUELLAft
olfice3 CTYH '[rons+: 2? 1? of ]Accti: Refi: 2r116i788
ftcpt,+3(2258744 - 1/7/2tt!& 11!4? Al1
Iransqct ion Totol t1,??0.1t4
$ 1r2?t-t.l
Auth+ r u?6692
$ ll_iri . i
Notes: lnstall a washer & dryer in an existing closet.
Date:
Date:
Date:
Fee Total
Paid to Date:
Balance Due:
lnspector MID#: 2018-143173
ELECTRICAL.INSPECTOR RECORD
ID/SIG.COMMENTS OWNER BUILDEX DEI,CANATiON
I hcrchy lffinn !.der pcnalry of perjDry rhm l d.xcnFr ftom rh. Conrmclou Ltcnsc L.w lo,lhe follo*in8 tcr$.lsft?0.115
Blsinc* lnd Prof.sion Codc) Any Ciry or Couniy which r.qurcs tr Frnrir lo conntoct. alrc.. inuruv.. d.frnnh or ml'n atry
srru.{urc, pior ro ns is\u,tr(, also Equneslhc alplicnnl tb. su.h pcrnrillo l-rlc ! siEmd rrd.@ni rhd rror shc h liccnscd puBua
lo lhe nrolisions ofthc Coirachr\ l.i..nsd Llw (Chapr.r 9. ConnBn.ing Bnh Scdion ?O0O ol Divhion:l of rhe Blsinc* rod
Pmlcssion\ Codc) or thar hc or shc i!.xcmpr rhcrcftom and rh. l[rh Lr rh. allcecd cxcmplion. Any violalion.lScdi.n 70115 byrny
appli.n turnlBr. rrubjc.B(h. .pplicanl ro acivilprnollyoa,or nrrcrhan nvc hundrcd dour\ (S50or
_1, N owtur ofrh.ItroFdy. rn ny cnplo)es wirh w.gcs rs rh.t slc.onrlcn$tion. qilldo rhc *ork and rhc ilmlm ir mt
iniclt.il oroficod for srlc (Se 704,4. Busincssn Prcfcsions Codc: 1hc ConrEcroi s l.i.ensc lis docs n.r trpply h an owmr of
rhcpmFny *h. bnilds or in{n)v6 th.6r. rhd wls dtui ruch $(lrk hnnsclfor hcr$lfor lhrough hh or hcr o{n.n9loy.cs.
nrovidcd rhor such inrmrcmnr @ mr inrcndcd or ollcrd for {k ll h.qch', rh. buildin8 .r inlpNEmnr is n)U *ilhin onc }ur
or.o.{lcr!,1$r own$ auiilf willh.rc r hunlcn ofoovi.s tnat iEor\hcdU no' l,!ih or iqmw rh. tmFny for E purtDcol
-1.
a\owtrcr olrhc nropcny. uorcxcllsivcly(o rrcrirswirhliccnscd.oitnr.^ro.otr{dcrrhcrrcj.tl(Scc.?O{r.Bunne$
lnJ h.f6qionC.dc lh.G)ntrctn s Liccn\c Low do.s nor rtpllfu owncrofp()!crly$hohuildsornnpi.!.\lhfic.n.
.nd sho.onrmckforsuchpmjccrswirnoConrrocrons)liccNdlru6uMrrorh.contrdofrLicnschs).
-lomeremDt
undc. S(rion- B &PC io,rhi\tr$.
}ABXEES.!!}MfjNTAIIA!
DEqI,AEAUAN
I hcrcbyafiirn undcr p.nallrof pcrjuryoncof rhc lollowins dcclararioos:
I haw ,nd w ill flinl{in a Ccnifrclr€ of Consnr lo S.lf ltr\!rc f., *ort6 6n9en*rion, a povidcd lor by Sdi6i 3700 6r rrt
tjh,r Codc, for rh. FrromN ofltu wo* for which lh. lcrmil is issud.
-l
hor ond will mainroin *ortciF conp€nsarion ioiuraee, {s Eillied bt selion 3700 of lh. t bor C.dc. {or lhe pcrro.Mc ol
M,sorkc( c. rFnui,n, i surxf.c.rnicr xl Nli.y nunrhqnrc
/w1
z
-l
ccnilyihar ir rh.I)crLrnuNc ofrhe *or[ for whichrht pcrn,ir i\ isucd.l shdlltror cnr/oyany Pcron insnl 'nrnnsd a1ii, hL{otu \ubjc.r k, rtur workcs conDctrs{totr l0vs ofCrlilnnia. nnd lgB rMr ifl rhuuld b.com subJcr ro lnc
wolkciJ rc p.nsnriotrF)visionsolScdion-U([)ofthcL,tnrCodc.I\hru.fonhwnhconrtly*ilhtho$pmlhions.
WARNINC F,ilurd r. r.urc workcr co |xnsiriotr covcnSc is unlartul. and \hxll rubicr an crDl.)tr k, ni riml IEnahis lnd
cilil finc\ ull n' otu huftlr.d rhousnd dollars ($lu).fiD,, i..dditmn tn. drnu!.s rs !'rovidcd tu rnc
Sc.ri{)r l{)76 ol rhd l]hn :lx 'H"v
DECI,AAAI]ON
I h.dby 6mrnund& t,.Mlry of pcriury lhal I am liansn undcr Fnvisi.n orChnpro 9 (omm*in8 *nh Sc.lion ?0()1)) olDivisn,n 3
of rhc Businc\r and P6r.$nrns co&, an my lkcnsc is in tull lors lrd cfIal
L5 Ioz oz )tol'+/
colulllcuoN.LElDlNc-AaENcr
I hcrcny rn]fln undcr pcnrlrrotr.rjury lhnr rhcrc isa.ons clionhndinSoscncylorrhepcrf.rtunccolrhcworklorwhichlhhlErmith
hsucd lscc 1097, Civ. C.)
AIIIIIANLITESIdBA:NAN
I lElhy lllm under p€nrhy oipcrjuryonc.fthc lolbsing dc.ldalions:
Dcnnnnion Pcflnils-Astcslos Noriliclrion Fcdc.al Rcgxhn,n\ (Tirlt.lo. Pd6)
-Rcquircd
Lcucr ol NorifHtbn
-l
ccnilyitur Ihc ltdcral r.lrrlarionr rcg.rding rsb. osrcmvdlurcmtot tatklorhisrojccl
l(.nirydfu I hrvc rc l rhisn|tli.rln arxlslrldlr llh.{n,vc ii,lnnnxri(r n corfrr I aErN ro .omfly Birh ill Ciry od A'ody
rcprc{ninrivcrof rhisCny. Coutrlyhcnrcr uIx,nllrf'dnrn..\xf,lSr rI x*\ 'chr U n)
rh.rc DEnidrn nmpcny in
.," 51'It,\ppli.ani.r laol Signolu
D4 V.\Vl&ea+!ar
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Salety /Low Voltaqe
Fire Alarm / Dampers
Building
Under Slab / Floor
Bondinq / Groundinq i UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Rool Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouoh
Ceilings (T-Bar Rouqh)
Ivleter Release
Rough 5-v-tK W.$dt
Service Meter
FINAL lo/a/r*€rrarn /o2--
Notes, Remarks, Etc.
APPROVALS DATE
Communications Cable
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L.ndcis Addresr:
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