HomeMy WebLinkAbout20167069 - Permit (2)City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Electrical
lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Project Address: 2115 N Broadway
Assessor'sParcel: 399-102-26 Lol: 10 THRU 17
Unit:
Block: NA
Bldg: Address Range:
Tract: E. M. SMILEY'S SuElistoric: No
Suite Range:
Zoning: P
et
Owner:
Address
Phone:
Tenant Name:
Contractor:
Address:
01 1 16002
011 16002
011 16002
011 16002
01'1 16002
011 16002
011 16002
51603
s1603
51603
51603
51603
51600
51603
Fee Type
125 Volt Receptacle
Light Switches, Occ. Se
Light Fixtures
Air Conditioner
Dedicated Circuit
General Plan Update
lssuance,
Fl': I,1 -
ir{t-!i',a
Amount
1 .45
1 .58
1.05
96.90
24.79
22.O8
55:91,,,., ,,t,t,
Broadway Building Group, L
4590 MacArthur Blvd. Suite
Newport Beach, CA 92660
(949) 335-7183
Qty
1 .00
1 .00
3.00
1 .00
2.OO
1 .00
1?P
Fee
$'1.45
$r .58
$3.15
$96.90
$49.58
$22.08
$55.04
Phone
Slate Lic #: 1005485
Lic Type: B
Bus. Lic #: 370469
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #r 9142275-18
Expires: 10/05/2019
'on9i:19
Reti I
1t/1/2fi18
n lJpdote Fee
I 6 rjr Lt 00tr -
IoLql
1d ine 6roupr l-L (:
2r-11i
17112
Occupancy:
Constr Type
Code:
B
V A, SPK
cEc 2016
i3lir-t(r-
r-1rl?321
Notes: lnstallation of (2) new exterior ATM'S.
Building Use:
Job Type:
Nature of Work
Planning Conditions
Planning Approval By
Plan Checked By
Permit lssued By
Subject to Field:
Commercial
Tenant lmprovement
Exterior ATM
Date
Date
Date
lvlisc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Amsden, Julie
Buirdins Permit #: - 10197925
Every permit issued shall become invalid uhless the wotu on lhe site
aulhotized by such pefinit is cohmenced within 180 days aftet its
issuance, ot if the work authorized on the site by such pemil is suspended
or abandoned fot a peiod o1180 days aftet the time the wo* is
commonced
'11tolt2018
Account#
lnspector MID#: 2018-143286
01116002 51600
01 1 16002 51603
Fee Total:
Paid to Date:
Balance Due:
Permit #: 20{67069
Pin #: 79477
Schools First FCU
2115 N Broadway
Santa Ana, CA 927062613
(714) 466-8665
Schools First Federal Credit Union
$229.78
$0.00
$229.78
$22.08
$207 .70
COMMENTSAPPROVALSDATEto/stG.
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
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouoh
Ceilinos (T-Bar Rouqh)
Ivleter Release
Rouqh llqt\1^*
Service Meter
FINAL Ztllri z
"(dqa)Notes, Remarks, Etc I
I
ELECTRICAL.INSPECTOR RECORD
OWNER BUILDER DELCARATION
I hq.b, ailm und6 Fnalty or pdjnry rhd I @ .renfl fmm thc Conri.ro6' Li..ns ljs aot lh. followins Ilen (sd 7011 5
Rsi6s and Proasio. Codc)r Any City or Counl) *hich r.qutr6 a p.rnit lo conslrucl. ahq, imrrovc. .lano[sn or rcPair my -
srtu rm, pflor to ir3 issuec€. also r.quiB lhc .ppli.d for su.h rnni lo frlc a sisn.d slalflol fid h. or sh. b lic sed pumiul
,
lo thc rolisiotu of th. Contractoi! t,icensd Law (Chapld I, Co@edcin8 with Sdion 7C00 ol Divisi.n I oalhc Ausincss d
Prof*ions Cod.) or rfiat h. or shc t .rmpr rhactom @d rh. bdis lor thc allcs.d cxdprion. Any violalion ol Salioo 701 L5 by Eny
applica for a p6mil subj..ls rh. aptli.d r. a nvil p.mhy oa not
'norc
thd fiv. huididl dollm (t500)
-1,
4 orir oalh. FoFny. or my mdo,6 vith wt!6 6 lh.t el. m,nFsrion, will do lh€ s!& tnd th. edE€ n nol
intad€d or offcrcd for sle (S( ?044, BGin6 md Pmf6ioN code Thc Co.tdol! Lic@ k* do6 nol apply to d o*n.r of
rh. Inopdy $1a) bdl& or impovelh@n. dd Bho (l.6 sch $!rk hitr.ltot hdscllot tbrcush his or hd own mplo,6.
prcvided that such ioFov@.rs d. nol idad.d or o,I6.d for sl. I I no*qE rh. hrilding or inpovonol is Fld wnhin on. )@
olcomplcriotr thc Orvns Buildr will h!!. $c hrd@ of provinS lhal h. or sh. did ml hrild or ingrolc lne pmpqly for lhe purl,* oa
-!.
6 oM6 olrh. ,ropdy, o .rclGiv.ly conlractins wilh li.os.d co'nDdo6 6 oNhd ltc Fojc.l (St. 7044, BGrns
.nd Pl!f6i- Co&: Thc Conri.cror's Lic@ tiv do6 nor ,pt,l, to e o$nd o I propcny {ho hoilds or inpro!6 thdd..
d {ho contrrds for luct Fojds with a Co.lr.cto(s) licm.d puu@r lo lh. Conltlclols Lic.6c Low).
-l
m.re'.pr und6 s*rhn .1,. & l'.C. tur dlis '@$n
uo85li45:(out8xl trq!
D[gaaAlIAN
I h6eby a,lirn undd pcrahy of p6jry on. of thc aollos ios d<ldalio6:
lhav.rndwillnai.roinaCcniicatcorCoNdrlostla-lcur.for\rork6tcon,pen&rion,d!rcvid.dforbyS..lion1700oflh.
Labor (ird€, a.r lh. pdfommcc o alhc worl for whi.h lhe p6n b bsmd.
-l
hav. and willoaimain pork.ru' cor.pcNstion iNurancc. s requt€d b! setio.1700 ollh€ libor Code. foi th. pdiomncc ot
lhb Fmh is isu.d My vork
e
lnAl, tl7 qgq
-l
cdilythar i.lhc psfoflnanc. orlh€ Nork aorwhich rhisp.ann is issu.d.l shallnol dpby any pd$n in 5ny nrdno
s 6 to b4rm. subj€cl lo lhc wort6' compeBdion laws of (-alitomi.. trd asr* lhdt if I snouB be.o'nc subiEl to lhe
rort6' comp@lion prcvtioE of Sc<lion 1700 oaln. Latrr Code. I dEll. lonhs i$ comply siin rhos PmvisioN
W RNINC: Flilur. ro sue $ork6' .omp.Ntion ovms€ s u.lawfol, and sh.ll subjd an @ployd ro rnniml p.nahis ud
civil fin.!uproon hundr.d rnousd dou6 it100.000). in addilion ro rhc co! olcomp€nerio.. dma&s a provid.d lnlh€
Cddq inrer.sl d allorney
D};TL$AIIA.J
I hftby omm undd poaly of ptjury rhd I m li.6..d undd pmvision ofchlpid 9 (.omdcins Eilh S6lion 7000) of Dnision l
of lhe BEins md Pml*ioN Cod.. ad ny Ii.eM is in full forc dd cff(r.
./1f)
/y';ro,?.2J)t "t
c.oNu3r(1r0.r_Ll:lutll,ii1iItrlr
I hocby alfim und6 p.raly of pojury 0t,l lhe is a consld.tion kndins ,ga.y lor th. Faoll@c. oflh. worL 6r $'l*h thb Fmil is
issued (Sd.1097, Civ. C.)
AIIUCANLDECI.ASA:I,IO!
I he4 amd uoder paa[y ofpdjrry on. ofthe follovifls d(ldalions:
D.Dolirion Pmils-Asbelos Norificdion F.deral R.Bulalions (Tille 40. Pa16)
-R.quircd
L.rts of Noi6oaion
I .diry thar lh. fcd.r.! r.sulllios rcsading abdot tmral d. nol spplictblc lo lhis prcjdr'
I .6lify lfial I havc rad lhir ,ppli.tlioi ai 3tar. tha! th. ahov. i.folmlion ie corc.l. I .grc ro .omply vhh .ll Cny ard Countt
ordin.n.s .l srd. La\s.eiatulo lu ildins co6rtucl i, . dll authort.'cprcmmn6 ol
::';'1"**'-
.lJlt!
Lcnder'r Name
-
Lend.' \ AddrN
-
abov€ mdlioncd prcp.ny aor nsp.rtion
Applicrnr or A,lctr( Sig..rure
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