HomeMy WebLinkAbout20367443 - Permit (2)Proiect Address: 1920 E Seventeenth St
Assessor'sParcel: 400-011-03 Lot: 3
unir 120
Block: NA
Bldg:
Tract 6313
Address Range:
Historic: No
Suite Range:
Zoning: C5
20 Civic Center Plaza (M-19), Santa Ana, C492702
lnspection Requestsr (7 1 4) 667-27 38 lnspector Section: (7 1 41 647 -5853
Electrical Permit#:203674/3
Pin #: 196261\
City of Santa Ana
Permit Counter: (714) 647-5800
Owner:
Address:
Contractor
Address:
Alex G Gladkov Dental Corp
6818 S La Cienega Blvd #203
lnglewood, CA 90302
01116002 51603
01116002 5160:
01'1 16002 5160(
01116002 5160:
Amount
1 .58
70.22
22.O8
55.04
Fee Type
Light Switches, Occ. Se
Min Fee Adj
General Plan Update
lssuance
Qty
2.00
1.00
100
100
Fee
$3.16
$70.22
$22.08
$55.04
Phone:
Tenant Name: Orthodontic Center ot Orange County
vcD&soNStNc
526 S Ross Street
Santa Ana, CA 92701
(714) 801-7604
r/l?,/201E, l
ons+: 116
Eefi I. |t/19 /2itt1
Phone
,d8t e F
r000-
30011-
**r6935
e
Building Use:
Job Type:
Nature of Work:
Commercial
Tenant lmprovement
TI
Occupancy:
Constr Type
Code:
Planning Approval By:
Plan Checked By:
Permit lssued By: zuniga, Allissa
Subject to Field:
Buildins Permit #: 10396696
B
VB
cEc 2016
1'1t1912018
Account#
01116002 51600
01116002 51603
Fee Tolal
Paid to Date:
Balance Due:
Legalize unpermitted work - new partition walls to
create dental rooms, xray, office;(2) new restrooms;
new exterior door; demo patio cover.
$150.50
$0.00
$150.s0
Notes
v Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
NIisc. Receipti
Total
$22.08
$128.42Every pe.mit issued shall become invalid unless the wo* on the site
authoized by such pormit is comnenced withinlS0days after ils
issuanca, or if the wotu aulhoized on the site by such pennit is suspended
ot abandoned fot a period ofl80 days after the time the work is
commonced.
lnspector MID#: 20'18-143892
0t
State Lic #j 596135
Lic Type: B
Bus. Lic #: 3a42
Workers' Compensation lnsurance:Carrier: State Compensation lnsurance Fund
Policy #: 1877843
Expires: 1110112019
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Planning Conditions:
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE COMMENTSID/SIG.
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
Rough :,//l/t/ I ,Loufv /
Service lrrleter
FINAL *ll41tlt fl",llt {Dc{ \k{/rJ
Notes, Remarks, Etc.
OWNER BUILDDR DEITARATION
I hd€by arlid uodd ,.nalr, of pdjury th, I m .ra$t 6on lh. Co.hcto* Lic.ns. tiv for lhc lollowio-q r@n (Sc 701 I t
B*in6s rnd Prut.ison Cod.): Any Cily o! Coualy which r€qut6 a !6nn to co6truct, .1t6, inptov.. dmolth ur Epin tny
shcrm. prior ro ns nsumcc. aho rcqutE tb. applic&l lor such pdmn ro nl. . siSncd slalmdl tha hc 6r stE G liccB.d psudl
ro rhr p@vBions 6alhe Conlrrclor 3 l,iccn*d Llw (Charn€r 9. Comd.ncing *tn S<tion 7000 of Division I ofrh. Busines ed
Prcfsions Cod.) or thar hc or shc * dcdpr th6cn6n od th. bsis for rn€ allcx€d cxanBion An, viol.tionofs.<1ion7031.5 by any
applica for a ponn subjdts rn arplicant lo acivilp€nally.fnot noethd n!. hu r.ddoum(tt00)
!. 6 o*n6 ofth. piopglx or my cnDlo'6 wirh sasB d lhet elc comp.6alion. Nill do rhe qort ed 6. sllltlrc i! nol
i adcd or ofiqcd Inr eL (56.7014. Bui.e md Prcl6sioN Cod€ Tt€ conhrctor 3 Li..m Lav do6 nol apply lo d ostd oi
rh. FDFny *no builds o. im|'ove rtc@( @d wh. do6 s(h r6rk hiNclaor hcrlr or rhouEh his ot hd own cnploy.6.
povidcd lfiar slch inFormaB e nol n od.d or or6si aor eb. l( hosdd. rlE buildins or improvdcd i! $H vhhin onc t@
ot co,npldiotr thc O$-nd tsuildd will ha( $. hrda oapro!$g th, lE or sh. dil ml hlild or itg,ovc 6. poFly for lh€ purpor ol
-1,
6 o*nd ohh. p'!pdy. dn crchsivcly contra.linr *'ilh licff.d conradoB ro .onsrrucl lh. prej€d (Sd 7044, acm6
rnd hofsion Codc: , hc cdnradoa s Licos. Las do6 .or applr lo s o*n6 o rprot dy *ho bxilds or imptove lh.ron
and *ho cont6.8 for sxch proj.ds wilh a Conl6.lo(s) licc6.d pu6uant lolh. Conr6.ror's l-icde tr$)
_l a'nc\ctrrpr u ddsc.ri.n .ll &l'( nnlh'src6on
Drrc Orn..
lloar[f,ltcourElsallg!
DECI4EAIIO!
I hd.by ammuide pdntyofpcjuryon€ oftt foUowiig d.deio6l
-I
hav. r.d wiu mintain a Csrifid. olconsl lo SclfiE@ aor sorl6' mnrpd3.lion, s prova.d ior by Scdon 1700 of thc
t!bo, Codc lor rh. p€fomec. oflh. wort for which lhc pdf,it i! ilsucd.
_l h,v. and $ ill mridain workda .oop.caio. iB$a.c.. s rcqun.d by S€lion 3700 of lh. Llbot Cod., for lh. pqfomdc. ot
lh. "ork for $hrch tnis Dmil 6 e.d M\ wo st com!.M'od rNuMcc cMiq sd Fl'\y numbd m
.*. gfa..f€ F-un Alz ll I ->ot 1
I cdify thar in th. ecrfomancc of rh. {ork for uhi.h rhis pdmn is i$ued, I shall nor cdpl.}.ny p.Mn in any dd.d
so d $ b.cofr. subjdr rd rh. worl6 compc.slion hws ol Calilomia. ed !8r.. $d if I slFuld bcco'n! tubjd to the
$ort6' compensarion prorisioB ot S€clion lr00 ollhc lrbor Code. I slbll. fonh$ nn comply sirh lhoe ptuvGio6..
WARNINO railu,e lo F@ {0&6'.omt trarioo co\mle B
civil fincs up to o.e hundicd rhoused dollm (11010.000). h addi
Sdion 1076 otrhc Lohor Code inl66r &d0normy'r am.
t \.
DECI,ASAIIA!
I hftby afim und6 p.nalry ol pdj!ry thal I m lic.ns.d undd porieiofl of Ch!flo 9 (conmdcinB vilh S.tlion 7000) oI Divisio. I
oa th. Busins &d Pmf6io6 Codc, and By licftc b in aull aorc. dd .rdl.
44 "-o
I h.'$y afinn trndd pdrlty o f pdjury that Ih6e lfrdinsr!c.c, lorlhcp onnan.. olrhc*olk lor trIichrhs penm L\
6sued (sc :1097, civ c)
ATIUCANLDES.AAAIION
I nd!,tyaffimurdn pcnalr, ofFjury on ollh. followifls d6l@lions:
D.oolitio, P(nits-Asb6td Nolincalion F.ddd R.eularions ( lnk 40.lan6)
-RcquiEd
LerrqoiNorincrion
-l
co1iry thar rh. fetld, rcrularios r€e6din8 6b6los rono\ al ar. nol applicabl. ro this plo.Jd
I ccn,ly rhar I h.ve rc.d rhis amlicarillr dJ fonndion is coral I agla lo comply rvnh aU Cny.nd Cortrly
ord nanc6 and Siatc lj\s Bpr6dr iv6 of lhiscirymd Counlyto
rh.rc,nmthn d propdy
,\l,plicitrl or
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