HomeMy WebLinkAbout20170922 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853 nq
Permit #:2ll17lJ922
Pin #: 41122
Project Address: 726 S Center St
Assessor'sParcel: 407-071-23 Lot: '15
Unit:
Block: NA
Bldg: Address Range: 7,18-9OO
Tract: SANTA ANA ACRE$listoric: No
Suite Range:
Zoning: O
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
City Of Santa Ana
600 W SANTA ANA BLVD 115
Santa Ana, CA 927014577
(562) 688-7080
Paul Maurer Shows
Jack's Electric
5706 Pennswood Avenue
Lakewood, CA 90712
(562) 868-1605
Fee Type
01 1 16002 51603 Special Event
01116002 51600 GeneralPlan Update
01116002 57770 Microfilm Records
Amount
166 53
22 95
3.91
Qty
1.00
0.00
1.00
Fee
$166.s3
$0.00
$3.91
Phone:
State Lic #: 591 173
Lic Type: C-10
Bus. Lic #: 344853
Workers' Compensation I nsurance:Carrier: exempt
Policy #:
Expires:
gsl6hi:54632 - 3/2/2tJ2tt ID: amorole,;1i0ffice: CTYH Trans+: 1?3 1 of 1Acct*: Rel*: 2ttL7lt922
Rcpti:tr29r16741 - 3/2/2fi2(t 12:25 F'n
Tronsncb ion Totql tl7n.4+
Jncll's Electr i c
Electr i cql
01116002- 51603000-
Ilicrofilm & Oocurents
Lrl I 160112- 5777(r0ULr-
tl 66. 53
Building Use:
Job Type:
Nature of Work:
City
Miscellaneous
Special Event
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
N/A
N/A
cEc 2019 Notes:
$3.91
t7tt,44
c,.-t I
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit
Every permit issued invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
,ssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
'eri 03102t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
li i :in 1i
Generatg[ {e*rpgelfll fyfn*SE{{arch fl&fr$ :1o.2Pi
$170.44
$0.00
$170.44
01 1 16002 5't603
01116002 57770
$166.53
$3.91
Fee Total:
Paid to Date:
Balance Due:
lnspector MID#: 2019-153404
ELECTRICAL.!NSPECTOR RECORD
Hev.08-07-2015
APPROVALS DATE ID/S!G.COMMENTS
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinss (Hard & Soffit Rough
Ceilinqs (T-Bar Rough)
lvleter Release
Rouoh
Service [Vleter nt- lz-a \rWl!FINAL
Notes, Remarks, Etc
OWNIiR BI.]II,DI]R I)EI,CARATTON
I lrercby affrnr undcr pcualry of perjury that I iln crcnrpt frunr thc Conraclo6' Lic.rM Law fot thc following rcasn (Sd.7011.5
Busincss ard Paol'cssion Codc): Any City or Counly which rcquircs a pcmit to construct, alt6, irnprovc. dcmlish or rcpair any
structurc, prior rc its issuance, also rcquires the applicuil for such Fmil to file a sigrtd slatcntnl lhat lE or shc is liccn$d pursuaill
to the provisions o[ th.' Contractor's l,icenscd Irw (Chaptcr 9, Cohhcncing wilh Scc(ion 70(x) of Division 3 of thc Business and
ProfessionsCodc,orthathcorsheisexeripttherefronildtlEbasisfortlEallesedeienrption. AnyviolationofseclionT03l.5byaoy
npplicrnl for a pennil subjects the dpplicant to il civil pemlty oI nol more than five hundrcd dollors ($500).
_1. a\ owncr ol lhc p(rJrny, or nry crnployecs wilh wagcs as thct solc compcnsilion, will do tlrc work ad lhe stffiue b nol
iDlcrxlcd or offcrcd for slc (Sa.7tN4, Business anr.l Prcfcssions Codc: Thc Contraclor's Liccnsc Law docs not spply to m owncr of
thepmFny wlrctoildsorinqrrovestlH@LildwlEdmssuchworkhimselforlErselforthroushhisorh€rowneoDloyecs,
providcd rhat such irnJrovcrrcnts ac mt incrdcd or ollcrcd for sab. ll: hosevq, thc boilding or irpmvcmnl is $k wihin om ,ca
ofcoophlioil, thc Owrtr Buikler will have the borrlcn of poving tha hc or she did mt build or irprcvc tlrc pmpdly for tlE purpos ot
sale).
_1. as owncr of thc pmpcny, am cxclusiycly contractinS with liccnsd conkactoE to onshct lhc prcjcct (Sd. 7(X4, Busircs
anl ProltsbnCode: Th€Contractor'sLicensekwd&snotapplytodowrerofpropcfrywhobuildsorimproveslhereo[
and who contracts for such prejccts with a Contrack)(s) Iiccn*d pu.sumt to thc Contractor's License lrw).
-l
amcxempt under Sectiur-, B. & P.C. fbr this reason.
WORKDR^S' COMPENSATION
DECIdMIJAN
I hercby allirm urdcr pcmlly ofpcrjury ore ofthc lbllowing dcclaratiom:
_IhavcardwillnuinlahsCcnilicateofCoNenttoSclf-lnsurcforworkqs'$rnltnsdion,as JrevidcdforbySdtion3T00ofthe
tibor Codc, for the JErforrMftc ofthe work l'or which the pcrmit ir issued.
_l have ald will nraintrirr workers insuratrcc, as rcquiled by Section 3700 ofthc tibot Codc, for thc pcrfonruNe of
thc work tbr which this ltrnril ii workcrs' conrpctrsaliorr insurmcc cMicr axl lrulicy Dunrr(r ilc:
Policy
'ccnify thal i[ lhc Fr|rnuncc o[thc work for which this Frnril is issucd, I shall not cn4rloy any pcrson in any manncr
$ 6 to bccorE suhjcct to thc workcrs' cornpenstion laws of Califomia, and agrce (hat if I slnuld bccorc subjcct to lhe
wori(crs'cotrrlxnsalionprcvisioNofSectionlT0OofthekborCodc,lslull,fonhwithcrnplywilhlho*prcvisio$.-
WARNING: Failurc to *curc workcrs'compensalion covcraSa is unlawful, and shall subjcct il cmploycr lo oiminal penaltics anrl
civil fiocsuproonchuDdrcdthousanddollars($100.UJ0).iradditiontotlrccostofcom[rc$alion,danEgcs6providcdforlhc
Section 3076 of thc t2k,r Codc. intercst ild ltcs.
I hercby affrnr undcr pnxlty of perjury that I anr liccnxd undcr povision ofchaptcr 9 (comntncinS with Section 7000) of Division l
of thc Busincss and Pmlcssions Codc. ard my liccnsc is in [ull forc und cffcct.
License Number:
I hcrcby allirm undcr F.*nalty ol pcrjury that
issued (Sec. 3097, Civ. C.).
isa lcnding agcrcy for thc pcrlormamc ofthc work lbr which lhis pc.mit is
[rnder's Nanrc.
-
kndcr's Addrcss:
@NUE!&I!9N
I hocby aflimr undt'r Jrnalty of pcrjury onc of (hc following d(ldatioos:
Dcnrclition Pcrnrits-Ash(skrs Notification Fedcral i(tnr ('titlc 40, Pd6)
_Rcquircd I"cltcr ol Notilierli(,n
_t rcgulations regading asbcshs rcrnoval &e not applicablc to this pmjcct.
rlul I luvc thir applicatiul urd stalc llHl lhc atx)vc infoflnatiul is corccl. I a8rcc b conrply wilh all City and County
rclating k)oflhis City ild County lo cnlq upon thc
Applicant or
Pemilcc n!mc
for
constructir)n, and hcrcby authorize