HomeMy WebLinkAbout20169495 - Permit (3)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Electrical Permit #:20{69495
Pin #: 47482</
Project Address: 200'! S lUlain St
Assessor's Parcel: 403-164-01 Lot: 1, '17, POR 2
Unit:
Block: B
Bldg:
Tract: 284
Address Range: 2001
Historic: No
Suite Range:
Zoning: C1
Owner.
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Bank of America
200 E Randolph Dr
Chicago, lL 60601
(508) s22-686s
Bank of America
Orange Electrical Contracto
448 S Montgomery Way
Orange, CA 92868
(7141 771-2814
01 1 16002 51603
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
Fee Type
Light Fixtures
Min Fee Adj
General Plan Update
I ssuance
Amount
1 .09
58.82
22 95
57.20
Qty
16.00
1.00
1.00
100
Fee
$17 44
$58 82
$22 es
$s7.20
State Lic #. 834083
Lic Type: C-10
Bus. Lic #: 373167
Workers' Compensation I nsurance:Carrier: INSURANCE COMPANY OF THE WEST
Policy #: WSDS03209103
Expires: 0110112020
Bstch+:51621 g,t??/?fl19 ID: LI10SALES
Off i ce: CTYH Trnns*: 57 I of 1Acct*: Ref*: 2ut 6? 4?1
Rcpt+:1t27241146 8/22/2019 lrr:57 Al1
Tronsoct ion Totol t156.41
0rnnse Electr icol (:ontrnctors
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial
Miscellaneous
Security Lighting
Pezeshkpour, Ali
Zuniga, Allissa
Genernl Plnn Update FeE
01 t 16tuJ2- 5l6rr[01rCI-
Electr i c0l
Lr1 1 16002- 51 61130110-
Uiso
u p g ra deqnafffi t l$ltfr(f. * * 7 7 1 4
i22. ?5
$133 .+6
tt56.4l
Authi:(rl9416
Occupancy:
Constr Type.
Code:
B
VB
cEc 2016 Notes:
Date:
)
Date.
Date:
08122t2019
08t22t2019
Account#
Misc. Receipt:
Misc. Recerpt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 51603
$22 9s
$1 33 46
Fee Total
Paid to Date:
Balance Due:
$156 41
$0.00
$156.41
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Permitee MtD#'. 2019-153848
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUII-DER DELCARATION
I hcrchy aflirm undcr pcnalty of pcrjury that I am cxcmpt frnn thc Coolraclors' Liccnrc kw for thc following ro$n (Ss.?0.11.5
Busincss and Profcssion Codc): Any Cily or County which rcquircs a lErmil k) cotrslrucl. allo. irnprove. {cmlRh or rcpair any
struclurc. prior to ils issuancc. oho rcquircs lhc applicant for such lrcrmit to filc a signcd slalcmnl lhat hc or shc is liccnscd Ftripanl
to lhc prcvisions of thc Contraclor's Liccned Law (Chaptcr 9. Conrncncing with Scclion ?fix) of Division 3 of thc Buslncss and
Profcssiors Code) or lhal hc or shc is cxcmpl lhcrefron and thc b{sis firr thc allcged cxcmplion, Any violution of Setion 70-1 I .5 by any
rpplicnnr for r pcrmit subjects thc applicont to a civil pcndlty of nol morc than five hundrcd dollars ($500).
_1. as owncr of thc pro1rcrty. or rny ctnployces with wagcs as lhcir solc cornpcnsalion. will do thc work and thc structure is not
intendcd or oftered for salc (Scc.7044. Busincss and Protbssions Crdc: The Contractor's Liccnsc Law tklcs not apply to an owncr of
the property who builds or itnprovcs thcrcrrn. and who <locs such work hirnsclf or hcrself or through his or her own cmployecs.
;trovidcd that such irnprovenrcnts arc not intcndcd or offcrcd firr sah. lf. hou'cvcr. thc buildirtg or intprovctltctll is sold within onc ),cilr
of corrrplction. thc Owncr Buildcr u'ill have thc burdcn of proving that hc or shc did not build or im;rrovc thc propcrty for thc purp)sc of
sulc).
_1. as owncr of the proprty. am cxclusivcly contracting with licenscd contraclors lo conslrucl lhc projccl (Sec. 7M4. Busincss
and Profcssion Code: Thc Contractor's License Law docs nol apply to an owner of propcrty who builds or improves lhcreon.
and who contracts for such projccts with a Contractor(s) liccnscd pursuant to the Conlractor's License l-aw).
-lanrcxcnlDtundcrScction-.B.&P.C.lbrtlrisrcason.Dale: Owner:-
WORKF' RS' CONT PENSATION
DECLARATION
I hcrcby affirm undcr pnalty of pcrjury one of thc following dcrlarations:
_l havcandwill maintainaCcrtificatcofConsentloSelf'-lnsurcforworkcrs'compcnsalion.as providcdtbrbySeclion.lTfi)ofthc
I;rbor Codc. for lhc Jrcrformancc of thc work for which thc pcrntit is issucd.
-l
lravc and will rttainlain workcrs' cotnpctlsation insuriutcc. ils hy Section -17(X) of tlrc Labor Codc. lbr thc pcrforntancc of
carricr and policy nuntbcr are:lhc work firr which this pcrntit is workcrs'
Policy
_t ccrtily that in thc pcrtirrrruncc of thc work for which this Jrcrrnit is issucd. I shall not cmploy any person in any nlanncr
so ls to bcconrc sub.|cct to thc workcrs'compcnsalion laws of Calilirrnia. and agrcc that if I should hcconrc suhject to thc
workcrs' conrpensalion provisiolrs o[scctiorr 37fi) of thc Lahrr (ixlc. I shull. ltrrthrvith corrrply r.r'ith thosc provisions..
IVARNING: Failurc l() sccurc workcrs' conrpcnsation c()vcrtgc is urthwl'ul. and shall suh.icct urt cnrpl<lycr to criminal Jrcnaltics altd
tion. darnages as proviclct fur tnccivil lirrcs u1l to orrc hurtclrccl tlrousand dollars (SlU).(XX)). in ntl<l lo thc of-."t'j:[Tq*inlcrcsl artd
I hcrchy allirrn undcr Jrcnalty of pcrjury that I am liccnscd undcr provision of Chapter 9 (conrmencing with Scction 7Un) of Division 3
of thc Busincss and Pr<lfessions Codc. and my licensc is in f'ull frlrcc and cffect.
l-iccrrsc L
r,",. zB')}..[?
cONS'l'RLl("1'l( )N L!:N I)lN(; AG !.NCl'
I hcruby affirm undcr lrcnnlty of pcrjury that thc]e is a construcliil lcnding agcncy for thc tErfortrnncc of lhc work for shich lhis FYmit is
issucd (.Scc. 3097. Civ. C.).
[.cndcr's Namc:
APPI ICAN'I DECLARATION
I lrcrcby aflinn under pcnalty of pcrjury one of the fbllowing dcclarations:
f)cmolitiorr Permits-Asbcstos Notification Federal Regulations ('l'itlc 40. Part(r)
-Required
lrtter of Notilicatiotr
_l ccrtify that thc fcdcral rcgulations rcgarding asbeslos rcrtxrval arc nol applicable to this projcct.
_l ccrtify that t havc rcad this applic:ation and statc that the ahrvc inlirrrnaliorr is correct. I agrcc lo cortrply with all City and (--ounly
ordirranccs ancl Statc Laws rclalirtg to ard hcrchy aulhorizc rcprcserrlativcs oI this Clity and County lo cntcr ugrn lhc
lbovc rncrttioncd propcfly frlr
Applicant or Agent
lft.rrnilct llanle ( ;rrint ):
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under SIab / Floor
Bondinq I Groundinq / UFER
Transformers
Torqueinct
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Nleter Release
Rough
Service NIeter
FINAL t 7lfi lt4 b*firlc L+ b?
Notes, Remarks, Etc t t,
t() t-t7 Dni H
ExPires:
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