HomeMy WebLinkAbout20170905 - Permitcity of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA 92702
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Electrica!Permit #:2O17O9O5
Pin #: 343291(
Proiect Addressi 38215 Bristol St
Assessor'sParcel: 410-301-18 Lot: NA
Unit:
Block: NA
Btdg:
Tract: NA
Address Range: 3701-3941
Historic: No
Suite Range:
Zoning: CR
Owner:
Address:
Phone:
Contractor:
Address:
Bristol Retail XV, LLC - DE
520 Newport Center Drive
Newport Beach, CA 92660
(714) 336-0359
01 1 16002 51603
01 1 16002 51603
01 1 16002 51600
01 't 16002 51603
01116002 57770
Fee Type
Re-Set Mtr
Subpanel
General Plan Update
lssuance
Microfilm Records
Amount
55.37
55.37
22 95
57.20
3.91
Qty
1.00
1.00
1.00
1.00
1.00
Fee
$s5.37
$5s.37
$22.95
$57.20
$3.91Tenant Name:
Ness Electric
19681 Descartes
Foothill Ranch, CA 92610
Phone:
State Lic #: 637428
Lic Type: C-10
Bus. Lic #: 375234
Workers' Compensation lnsurance:Carrier: lnsurance Company of the West
Policy #: WSA503783102
Expires: 1OlO1l2O2O
BBtch+: I4lg7 - 2/?7 /2t_t?t-t II
0l I i ce ; (:l YH 't r crn si : -g-.+Accti: Ret'*: l
ftcpt+: Lr?9Lr3g1u - ?/27 /?tt?t-t ,
Trsnsnct i on Total t:
t'less Electr i,:
Building Use:
r Job Type:
Nature of Work
B
l[B
cEc 2019 Notes:Meter re-set and subpanel.
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Chavez. Dave .e!.02127t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Commercial OccuPancY:
Miscellaneous Constr Type
Meter Re-set and Subpanel Code:
Date:
Date:
Date:
Every permit issued shall become invalid unless lhe 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 permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51603
01116002 57770
$22.95
$167.94
$3.91
Fee Total:
Paid to Date:
Balance Due:
$194.80
$0.00
$194.80
lnspector MID#: 2020-158124
ELECTRICAL-!NSPECTOR RECORD
v. 08 -2015
DATE ID/SIG.COMMENTSAPPROVALS
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouoh)
Ceilings (Hard & Soffit Rough ACeilings (T-Bar Rough)
Ivleter Release 3'3 -2'h .lu\h
Rouqh
Service lMeter 3-7-20 *,vk*
FINAL 3-z-20 Y.IMh I
Notes, Remarks, Etc.
-+
OWNIiR BUILDER DDLCARATION
I hcr.by affmr under penalty of prjury that I atr cxenrpl ftonr thc ConmctoN' Liccn* law for thc following rcasn (S€c.703t.5
Busincss ard Prolession Codc): Any City or County which requtes a pcrmit to construct, alt6. irnprovc. dcmlish or rcJair my
stNcturc, prior to its issuancc. also rcquircs thc applical for such [tmtrt to filc a si8rcd slalcmnl lhat lE or shc is liccMd pu$ant
ro rhc pmvisions of thc Contractor's l,iccnscd l2w (Chaptcr 9. Commencing with Scction 7u)0 ot Division 3 of thc Busincss md
ProfessionsCode)orthatheorsheisexemptdErefronrandtlEbsisfortlEallegedexcmption. AnyviolationofSeclionT03l.5byany
dpplicrntfornfEnnitsubjEtsthe applic0ntto0civilpenrltyofnotmrethanfivchundreddollars($500).
_1, a\ owncr of the pro[En),. or ilry ernp hyccs with wagc$ as their solc compcnsation, will do thc work and the struduc is not
iilcndcd or olTcred for sle (Se.7tN4. Business and Prcfessions Codc: Thc Conu aclor's Liccnsc Law docs nol apply to an owncr of
thcpl)lrrly whobuildsorinprovestherfrr!drjwlmdessuchworkhimelforltrsel[orthnrughhisorherowneorpk)yees,
providcd lhat such improvcrrcnts dc frx intcndcd or ollcrcd for sale. Il, however tlE building or itr{rrovemnt is sold within onc ycr
ofconpletb[ tlf, Owrer Buikhr will lrvc thc burdcn ofprcvir8 that lt or shc did fril buill or ifipmv. thc pmpetry for thc purpoE of
ele).
_1. &\ owncr of the prcpcny, am cxclusivcly conuactinS wi(h licen$d .ontr&tos to consttucl th. prcixt (Sc. ?044. Busircs
anl Pnrfesim Code: The Contrdctor's Liccuse law das not apply !o m owrcr of lfolEdy who builds or improvcs lhercorL
and who conuacts for such projccts with a Contrelo(s) liceNd pursuul to thd Conusdor's Licc6e kw).
-l
am exempt utrder Section , B. & P.C. tbr (lis rcason.
lhte:-
lvoRKt]Rs' c0MPENSA't r()N
DECLARATION
I hcrchy allirilr undcr pcnalty of pcljury onc ol llN ti'lk)wing dccluations:
_lhaveurdwillnuintairaCt(ilicateofCoDsentbSelf:lnsure forworkers'corlllEnsalion.as prcvidedforbySection3T00oftlE
lntx]r Code, tor {hc pcrlorilEncc of lhc trork f(rr which thc pcrnlil is issucd.
_l havc and will maintain workc6' conrpensali()n insumlcc, as rcquircd by Selion 3?00 of lhc tibor Codc, for lhc pcrfomln."-c of
tlrc work for wlich this Frnrit i3 issucd- My workcrs' conrlrcnsation imuruce coicr urd lnlicy nunrhcr ue:
V)a
Policy
- w<A o g _oL a l0- s -ZaLo
_l ccnily lhat irr thc lrcrfin'nlancc ol thc work for which this pcrnril is issucd, I shall n(tr cn{loy any lrcrson ir any nranncr
so as to bccolrc subjcct to thc workcrs' compcnsation lnws ofCalifomia. and agrcc thal if I should bccorrc subjcct (o thc
workers' conrlrensation provisions of Sectior 3?00 of lhe Lobor Code, I slull, fonhwith coDlply with thos provision!..
WARNING: Failure to secura workcrs' conrpcnsalion unlawful, and shall subjcct an cmploycr to sitninsl pcnaftics dd
civil liDcs up to one hurdred thousaud dollars (to lhe of cdnpe,Lsatidr. danrages as provid.d li)r lhe
Scclion 3076 o[thc litor Cfllc. inte'rcst and
Dere:r a'L1 -L0
I hcrcby affrtu under Fnalty of pcrjury that I anr licensd unrlcr prcvision ofChuptcr 9 (connEncins with Scctbn 7000) of Dilisior!l
of lhe Busincss and Pm[cssions Codc. ad rnv lic€nrc is in full fore und e[[ect.
Liccose a lrt
o
I)e1e;
"-
-L1 7o
W
I hcrcby allirm undcr pcnahyofperju.y that lhcrc ir a conslruclion hnding agcmy for thc pcr,brmarce ofthe work lbr which this Frmit is
issued (Scc. 3097. Civ. C.).
kndcr's Nanre:
kndcr's Address:
@LPEELASA'I.!AN
I llTchyafliro under pcnalty of pcrjury onc oIthc folk)win8 dcchations:
Dcnxrlition Pcrnrils-Ash+sk)s Notificatk'n Ftdcral RcSulalions (Titlc 40, Pd6)
_Rcquircd tJtlu of NNificrtion
_l ccaili thd lhc
{ ccnili rhar 1 lrauc
fcdcral rcgulations rcguding dsbcstos rcmoval ec not applicablc to this projcct.
rcud tlris application lhal lhc atx)vc is corccL l agre b conply wilh all City and County
ordiomccs ud Slatc liws rclating to and rcprcsntativcs ofthis City and County to cntcr upon $c
aboyc !rcntioncd pmpc(y for inspcction
Applicant or ASmt
clq
Dil..2-27-zo
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