HomeMy WebLinkAbout20170377 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:20170377
Pin #: 68933
Proiect Address: 3605 S Bristol Sta
Assessor's Parcel: 410-30141 Lot: NA
Unit: D
Block: NA
Bldg:
Tract: NA
Address Range. 3003-3611
Historic. No
Suite Range:
Zoning: C2
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Athena Property Management
730 El Camino Way, #2OO
Tustin, CA 92780
(e4e) 3e8-8750
Chicken Maison
lcon Pacific
21143 Hawthorne Blvd #408
Torrance, CA 90503
(310) 538-ss38
01 1 16002 51603
01 1 16002 5160C
01 1 16002 5160;^
01 1 16002 5777C
Fee Type
Signs & Neon
General Plan Update
lssuance
Microfilm Records
Amount
80 95
23.79
59 30
4.05
Qty
100
100
100
1 .00
Fee
$80 95
$23 7e
$se 30
$4.05
Phone:
State Lic #: 866714
Lic Type: C45
Bus. Lic #: 321423
Workers' Compensation I nsurance:Carrier: Exempt
Policy #:
Expires:
Commercial
Signs
Sign-illuminated
Occupancy:
Constr Type:
Code:
Date:
Date:
Date.
A-2
VB
cEc 2016
r-rl1t6r"rr_rZ- :i16u
I'l ii rsf i ltrt & Do,
r-r11161u:r2- ?_,77 7
I (:L (:he':[l I
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Notes: lnstall (1) led-illuminated channel letter wall sign for
"Chicken Maison"
$ Hernan dez,Kathy 10121t2020
Account#
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
Total
Buirdins Permit #: 10110251 3
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.
01 1 16002 51600
01 1 16002 51603
01116002 57770
$23 79
$140 25
$4.05
Fee Total
Paid to Date:
Balance Due:
$168.09
$0 00
$168.09
r_rl I
Ele
lnspector MID#: 2019-156344
fLtlrl-
3I
t-
._t
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNE,R BUII,DER DIiI,CARATION
I hereby aflrrnr under penalty of prjury that I anr exenlpt fronr the Contractoru'License l-aw for the following reason (Sec.7031.5
Busincss and Prot'ession Code): Any City or County which requircs a pcrmit to construcl, alter, irnprove, demolish or rcpair any
structure, prior to its issuance. also requires the a;rplicant for such pernit to file a signed slatement that lre or she is licerrsed pursuant
to thc provisions of thc Contractor's Liccnscd kw (Chapter 9. Commcncing with Section 7fi)() of Division 3 of thc Business and
Professions Code) or that he or she is exen4rt therefrom and the basis for tlrc alleged exenption. Any violation of Section 7031.5 by any
applicant for a gxnnit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001.
_1. as owncr ol'thc. property. or my crnployces with wagcs as thcir solc compensation, will do the wcnk and the structure ls rnt
intoxletl or offered for salc (Sec.7044. Busincss anrl Profcssions Crxlc: Thc Contractor's Licensc l-aw tlocs not apply to an owner of
the property wlxr btrilds or inqrroves lhereon, arxl wlro does such work hinself or lrerself or through his or her own employees,
providcd that such improvemcnts arc not intcrxlcd or ollered for salc. Il, howcver, thc building or funproverncnt is sold within onc ytar
of completiotl the Owner Builder will have the burden of proving that he or she did not build or improve the properry for the purpose of
sale).
_1, as owner of the property, am exclusivcly contracting with liccnscd conlractoni to construct the projcct (Sec, 7044. Busincss
and Profession Code: The Contractor's License Law does not apply lo an owner of property who builds or improves thereon.
and who contracts for such projccts wilh a Contractor(s) licenscd pursuant to thc Contraclor's Liccnse hw).
-l
anrexempt under Section-, B. & P.C. lbrtltis reason.
WORKI'ILS' COM PIiNSATION
DECLARATION
I hcrcby afl'irnr undcr pcnalty of Srcrjury onc of tlrc tbllowing dcclarations:
_I have arxl wilt nraintain a Certilicate of Consent to Self-ln"sure for workers'cornpensation. as provided for by Se,ction 3700 of the
labor Codc, for the Jrerformance o[ the work lbr which the prrnit is issued.
_l have arrd will maintain workers' conrpen.sation insurance, as required by Section 3700 of lhe [-abor Code, for lhe grcrfornunce of
the work tbr which this pernrit is issucd. My workcrs' comJrcnsation insurance can'icr arxl Jxrlicy nuntbcr are:
Policy Nunrber: Expires:
_l ccrtify that in the pcrfornurnce of thc work for which this Jrcrmit is issucd, I shall not cnrploy any pcrson in any manncr
so as to bccornc subject to thc workcrs' compensation laws of California. and agree that if I stnuld bcconp subjcct to thc
workers' c<lnrpensation provisions of Section 3700 of the labor Cotle, I stull, forthwith conrply with thosc provisions..
WARNING: Failure lo secure workers'compensation coverage is unhwful, and shall subject an cmployer to criminal grnalties and
civil tines up to one hundred thousand dollars ($100.000t. in addition to tlrc cost of competusation, danrages as provided ftrr the
Scction 3076 of the l-abor Code, intcrcst and attorrrcy's fces.h)
I hercby affinn under ;rcnalty of perjury that I anr licensetl under of Chapter 9 (cornnrncing with Section 70m) of Division 3
of the Business and Professions Code. antl tny license is in lull forcc antl effect.
License
n^r^.hn
I hcrcby al'tirrn undcr penalty of pcrjury that thcrc is a construction lending agency for the perl'ormance of the work lbr which this pcrmit is
issued (Sec. 3097. Civ. C.).
lrnder's Nanrc:
lrnder's Address:
APPI,ICANT DECI,ARATION
I hxcby allirnr undcr pnalty of pcrjury onc o[ thc following decliuations:
Dcmolition Pcrnrits-Asbcstos Noification Fcdcral Regulations (Titlc 40, Part6)
_Rctlu ircd [.r:ttcr of Notification
_l ceaily that thc fcderal rcgulations rcgarding asbcstos rcmoval arc not applicablc to this projcct.
_l certity tlral I havc rcad this applicalion aml statc thal thc atxrvc infornulion is corrcct. I agrrc to conrply
rrcprescntativcs of this city
with all City and County
and County to enter upon theordinanccs and Statc [:ws relating to construction, and hcrcby authorize
above mcntioned property for
Applicant or Agcnt
Pcrmitcc nnnre
I^')r,ite, l0^Ll-Lo)c)
Site-Work
Underoround
Pole Bases
Lioht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safetv /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under SIab / Floor
Bondinq / Groundins I UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilinqs (Hard & Soffit Rouqh
Ceilinos [-Bar Rouqh)
lVleter Release
Rough
Service N/eter
F!NAL /z-?,2O /> c-r:rJua> "Aq
Notes, Remarks, Etc.
Rev. 08-07-2015