HomeMy WebLinkAbout20167800 - Permita
City of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA927O2 Electrical
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (7'14)647-5853
Permit #:20167800
Pin #: 25132
Proiect Address: 307 E First Sta
Assessor's Parcel: 398-516-16 Lot: PORS 1,2,3,4,10
Unit: 1-A
Block: 1
Bldg: Address Range: 301-3Oz
Tract: BLEE'S ADD Historic: No
Suite Range:
Zoning: SD84
Phone:
Tenant Name: Jugos Acapulco with Wings
Owner:
Address:
Contractor:
Address:
Phone:
Santa Ana Downtown Plaza
315 E First St
Santa Ana, CA 92701
Bullseye Builders lnc
960 N Tustin St #379
Orange, CA 92867
(7141 202-454s
01 1 16002 51603
01 1 16002 s1603
01 1 16002 s1603
01 1 16002 5160.'
01 1 16002 5160C
01 1 16002 5160;'
Fee Type Amount
125 Volt Receptacle 1.51
Light Switches, Occ. Se 1.O4
Light Fixtures 1 .09
Serv Meter 55.37
General Plan Update 22.95
lssuance 57 .20
Qty
24.00
12.00
26 00
100
1.00
100
Fee
$36.24
$19 68
$28.34
$55.37
$22.95
$57 20
State Lic #: 1015600
Lic Type: B
Bus. Lic #: 372419
Workers' Compensation lnsurance.Carrier: State Compensation lnsurance Fund
Policy #: 922524418
Expires: 0113112020
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Commercial
Tenant lmprovement
Tl/Change of Occupancy
Occupancy:
Constr Type:
Code.
A-2
VB
cEc 2016
Zuniga,
Date:
Date:
Date:nrrissaffi 09124t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Electrical for Tl/Change of occupancy
Fee Total
Paid to Date:
Balance Due:
Buildins Permit #: 10198910
Every permit issued 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 fhe site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MtD#'. 2018-148042
01 1 16002 51600
01 1 16002 51603
$22 9s
$1e6 83
$2t 9 78
$0 00
$219.78
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER EUTLDER DELCARATION
I hcrchy atlirm undcr Fnalty of lcrjury that I m excmpl lrum thc ContrackrB' Liccns law tbr lhc fbllowing ltam (Se.70J1.5 -
Busincss and Professhn Cule): Any Cily or County which rcquircs a JEmrit kr rrnslruct. aller. in{rruvc. dcmolish or rcpair anL
struclffc, pri(rr to ils issuancc. aL$ rcquircs the applicanl lirr such lrcrmit to filc a signed s(atcnEnt that hc or shc is lienscrl pusuarlT
to thc provisions of the Contractor's Liccnsd Law (Chaptcr 9. Commencing with Secti(rn 7(Xl0 of Diviskln J of thc Busincsr,lnd '
ProlcssionsCulc)orthalheorshciscrcmplthercliomandthchnsistirrthcallcgcdcxcmption. Anyviolationofsftti(tn70.11'.5byany
applicanl ftrr a Jrmil subjccts lhc applicant to a civil pcnalty ofnot nDrc lhan five hundrcd dollds (S500).
_1. as owner of'thc pn)pcrly. or my cmployces wilh wagcs as thcir sole compnsation. will do lhc work aftt thc struclurc ls not
ilttcndcd or ofi'ered tbr salc (Scrc.7M4, Busincss and Pr<ltbssions Crx.le: 'l'he Contractor's Liccnse Law docs not apply lo an owncr ol'.
thc pnlJray wlxr builds or impnrvcs thcrcon, and wlxr dtrcs such work himsclf or hcrsclf or through his or her own cmployecs.
providcd that such impnrvcrncnts arc not furtendcd or ol'tcrcd tilr salc. Il, howevcr, thc huikling or improvcrncnt is sold within onc ycar
of complctkrn, thc Owner Buiklcr will havc thc burdcn of proving lhat hc or she did rurt build or improvc the prupcrry tbr thc purJxrsc of
sah).
_1, as owner ol'lhc pnlpcrty, am exclusively contracting with liccnsctl contraclors to conslruct thc projcct (Sec. 7(X4, Busincss
and Pnrtbsskrn Codc: Thc Contraclor's Liccnsc Law docs not apply to an owncr <lf property wlto huikls ttr intproves thercon.
anrl who conlracts lbr such projccts with a Conlractor(s) liccnscd pursuant to thc Conlractor's Licensc Law).
-lantcxcntptuttdcrScctitln-.I}'&P'C.tilrlltisrcasrln.
Dale : Owner:
}V O RK EI(S' CON I PF:NSATIO N
DECI,ARATION
I hcrcby atl'irnr undcr Jrcnalty ol'Jrcrjury onc o[ thc lirllowing dcclarations:
_l havc antl will maintain a Ccrtificatc of Consent to Scll'-lnsurc lbr workcrs' comlrcnsalion, as providcd tilr by Section 1700 of thc
Latxrr Codc, tbr the lrcrlirrmancc of thc work tilr which thc Jrcrmit is issucd.
_l havc and will nraintain workcrs' comJrcnsation insuralrcc, as rcquired by Scction J700 of the Labor Codc, lilr thc pcrlorntancc of
thc wrlrk lirr which this Jrermit is issucd. My workcrs' conrpcnsalion insurance carricr antl pllicy number arc:
Policy at,/=l ) /'oile( -'r
_l ccrtily that in thc perklrmancc of thc work ftlr which this Jrcrmit is issucd, I shall not empk)y any [rcrson in any manner
so as to bccome subjcct to the wrlrkcrs' contJrcnsation laws ol'Calilirrnia, and ilgtce lhat if I should hccomc suhjcct to lhe
workcrs' comlrcnsation pnlvisions of Scctirln J700 of thc [-ahlr Ctxlc, I shall. lirrthwith comply with thosc pnrvisions..
WARNING: Failure to sccurc workcrs' conrpcnsation covcragc is unlawlul. antl shall sub.jcct an cmpktycr t() criminal pcnalties and
civil lincs up lo onc hundred thousand dollars in addition to thc cost of cttmgrcnsation,as provirlcd tirqthc
Scclirxr 107(r ol'thc Latxrr Crxlc, inlcrcst and t'ces.
oot
I hcrcby allirm under Jrcnalty ol'pcrjury that I am liccnrcd under pnrvision of Chaptcr 9 (commcncing with Scction 70m) of Division 3
of thc Business and Prol'cssions Codc, arul nry license is in full lirrce aml efl'cct.
Liccnsc Numhcr:\o (sEce
Dil", pa/?< J4
CONSTRUCTION LENDING AGENCY
I hcrcby allfum undcr Jrcmlty of Jrcrjury rhar rhcrc is a c$nstructk n bnding agcrey lbr thc trrli)mr&! of thc Mlrk hlr which lhis JEmit Ls
issucd (Scc. 1097, Civ. C.).
[rnder's Name:
[rntlcr's Adtlress:
APPLICANT DECLARATION
I trcrehy alfrm unrler pcnalty of prjury one of thc following declarations:
Dcnxrlition Pcrmits-Ashcstos Notification Fcdcral Regulations (f itle 40, Parl6)
_Rcqu ircd lrt tcr ol' Notilication
_l certity that lhc lbdcral rcgulations rcgiuding asbcstos rcnxrval arc not applicahlc to this pntjcct.
_l ccrtily lhal I have rcad this application and statc that thc ahrvc inlirrmation is corrcct. I agree to comply with all City and County
ordinancc's and Statc Laws rclating to hcreby autlxlrizc rcprcscntativcs ot'this City and County t() entcr uSxrn the
alrovc nrcntioncd pnrJrcrly lirr )
Applicant or Agent
Penrritrc nnnre
conslntcl
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding I Grounding I UFER
Transformers
Torqueinq - ,a7
Sub-Panels -24412r.)
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)a
)n1'b ,\ a/,)/
Walls (Rouqh)/\n- 2 wnfrry
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
Rough
Service Meter A
FINAL b--61 *7a ult+-l[,1
Etc.
na n7 1fl.i x
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