HomeMy WebLinkAbout20167390 - Permit (2)City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Electrical Permit #: 20{67390
Pin #: 4O45N
Proiect Address: 3904 S Flower St
Assessor'sParcel: 410-291-02 Lot: NA
Unit: C
Block: NA
Bldg:
Tract: NA
AddressRange: 3800-3928
Historic: No
Suite Range:
Zoning: R4
Owner:
Address
Contractor
Address:
Phone
Tenant Name
Prime & South Coast L P
50 California St 920
San Francisco, CA 9411'14606
(714) 556-7960
Western Plumbing Services
1810 N. Linwood Ave.
Santa Ana, CA 92705
(714) 492-5490
01 1 16002 51603
01 1 16002 5'1603
01 116002 51600
01 1 16002 51603
Amount
24.79
23.80
22.O8
55.04
Fee
$49.58
$23.80
$22.08
$55.04
Fee Type
Dedicated Circuit
Fee Exempt
General Plan Update
lssuance
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A
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l,lState Lic #: 1O211O1
Lic Type: C-36
Bus. Lic #: 364095
Workers' Compensation lnsurance:Carrier: State Farm Fire and Casualty Company
Policy #: 90C6X6879
Expires: 0A12412019
ul
11
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By
Multi-Family (5 or more uni Occupancy:
Alteration Constr TYPe
Washer/Dryer Code:
Date
Date
Date
R-2
VB
cEc 2016 Notes: lnstall a washer & dryer in an existing closet.
11t13t2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
eri
Every pemit issued shal become invalid unless the wotu on the site
authoized by such pemit is commenced within180 days after its
issuance, or ifthe wotu authoizod on the site by such permit is suspended
or abdndoned lor a period of180 days after the time the work is
commetrced.
MID#: 2O18-147623
01 1 16002 51600
0'1 1 16002 51603
$22.08
$128.42
Fee Total:
Paid to Date:
Balance Due
Qty
2.00
1.00
1.00
'1.00
t./ 1.1/2t:riti ID: N1;A:,
({ll5r i {.t -
Rel+ | ? I:116;r.t "
.l 1,i l.l/lr:rtrj 3:.11l i1'3:;r,.::iPhone:
. :,erv l':eE
Llqt ri Fee
lti..
i . t-rii
l/53 Auth+ I 11
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:$'r s0.50
$0.00
$150.50
lnspector
ELECTRICAL.INSPECTOR RECORD
DATE ID/SIG.COMMENTS
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
F actory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouoh
Ceilings (T-Bar Rough)
Meter Release
Ro ugh u-/?-/9 .//.tt/d d ltt Fkl /oz-
Service lr4eter
n^,.^-rraFINALLl(lz,- i {zc )
Notes, Remarks Etc
OWNER BUILDER DELCARATION
I h6eby amm unds p€nahy of Frjury thar I m €xcmrn from Ihc conlric'o6' Li.ens trs tur rh. followidg l@n {Se 70ll.s
Bus$€s ad Prcf6rn Code): Any cn, or Co!6ry which r.9un6 a p.nnt 10 .oBrtu.r. ah6. improvc, domlish or Epon uy
slrudu( Fior to irs isu&c.. aho ,equiB rhc .pplicd for s(b Fnni ro f € a si-lncd sGrnd th.l he or sh. i. licd*d p6udr
ro rh. pmvlrioft of lh. Conlriclo.s Li@fls.d Ltw (Chaprd 9. Comnr.ncins wnh Sdlion 7000 of Divisio, I ollhc BNinN ad
PBlsions Cod€) or thal lE or sh. is cx€npt th6.from md rh. hasir lo.lhc allqcd cxmplion Aoy violarion ol S.dtu. T0ll.5 by M,
gpplicant lor a p6mit subj(Is rhc applica lo a cilil p.Mhy o I nor mor€ lh& fiv. hu.dred dolld ($500).
l. s o*n.r oath. proFdr. or ny .nploy6 wnh {as6 6 $cn $E coDpssation. vill do rh. m ad th€ slru.lu. i' nor
itrrodd or offs€d for Flc (SE 704{. Busins ed ltolsioN Code 'l he Conkrcro.'s Lic.e tiw do6 nor aptly lo m osnd of
th. pmFl, s ho b{ilds or imlxlve ilEorq rnd who <!06 Mh NA hi,ns.lf or h#lf or lhmu3h his or hd oM.mployc6.
provided thal such imFo\tMts e Dl htdd.d or ofrdrd lor el.. ll ho{66. tk hriBins or impmEnsn is *ld winin on. )e
6rco,npldion, thc Ownq lruitas vill hnvc rh. bordn oapronns thd hc or shc did nor build or improre $e prcpdy lor lht $r!oF of
-1,
d o\vnff o l th€ p.opqly. dexclusivelycoflrra.t'ns w,th liccc.{j coitacroBro.06r d rhc proj.c( (Sc. 704,4. ltNins
anl Pmlision aod.: TheConlracloas Liccm. Law do6 nor apply ro e.wnd oaproFny sho builds o! improvdlhscon.
.nd qho co.b,cts aorsu.h prcjdts wnh a conl6clo(, licffcd pus@r rorhc conthclors Li.d* tjR)
lanercnrpt onde, SL{rion .I].&PC for lhisr.soo
Drle: O*re.:
1tatrs!:!8(auE!ratr0xp[cL!8 uqr
I lrrcby aliirm und.r p.naltroapcjorron.oathc follo$in! !(1trdiotrl
l ha\c md sillma'nram a Cqlifi.areofCo6cnl b selr l6urc ror $o nr conrpensarion, a pio\ided aorbySationlT00olthe
bUr Code, tu rhe lErfomMcc or rhe vork for \shich rhc psoil ii isu€d.
I har. 6d qill mainrai. work..r conpeNalioi iroruc., 6 rcqrnal by Sdlion 3 700 oarhc tibor (.odc. fot the prfolfucc ol
th. work aor whi.h rhi! pmil i! i3!u.d. My rcrl4 comFerion itrurece cei6 ed policy numbd e.:
Policy N@bs:_Erpn6:
-l
c€ni8 lhal in lhc p.rfomrnc€ oflhc worl for Nhich thG p6mn is issu€d. I shall not drloy aoy D.6on in uy me.d
e a lo b..orb. iubj<t to lh. work6 .o6F@rion la$ oacalilooia. and agre rhd ia l should b..of,E subjet io ltE
*ori6.onpasolio.provisioBoasdtionl?00ofth.bh.rCod.Ish"ll,fonhwitficohplywirhlhospovisioB..
WARNINC railurc kr scur€ work6'coEsdsalhn is unL\ !1. and shlll srbje( m mplorq ro siminal p..ahi6 and
civil ,ines ur lo oru hundEd lhoNand dollm ($l
Scrion 1076 oflh.t borCodc.ir s6t and lorEy s
lhdcb! xfinhu rpenalr)olpdJuryrh.r I dr lic.nse! u (.ohm6cinB $ith Sdlion 7000)olDivision l
of ihc Uusinss md ftofssnrnsCodc d mvlicms. is in
LitcBe( l.ss l,ic
D.lr: ( otr(rr.lor
N
I hc'cb) ,llirn undr p.n.lrrofp.'jtrD rh.r Ih6. ts a (onen,cron lu f.r nE pdfonM.cc of lh. lvork for trhichlhis rE.il G
issucd (S(.1097, Civ. C.)
AIII.ICANLDICTAAAIION
I hdey .ftm unds p6.lly of p6juy onc of thc followins dRlmlioG:
D.nolnio. PmilgAshc(N Nolificalion F.d.€l ReSuhions Onk 40, Prn6)
-Rquncd
lrtd of NotifidioD
I cdliry $a/hc fcddal rcsularioB cea.d,.s sbcros rdoval e @l applicabL lo thb poj.cr
on is conal I aErE to conrply{nh allCnyad Counly
riz€ r.p.shrn 6 of this Ciry and Cou.ry ro ord uF. toldinaNs ard Sr.le ljqs reLlin3
.b.rc rdl iod.n propdl lor
pplicrnl or Agetrt Signrlure
Pemil@ nim. (prinl):
ionmd stale thal Eabo\c nrionn3li
I
APPROVALS
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