HomeMy WebLinkAbout20170356 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:20170356
Pin #: 80897
Proiect Address: 3610 S Bristol St-a -
Assessor's Parcel: 412-131-12 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range: 3600-3798
Historic: No
Suite Range:
Zoning: C2
Owner.
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Metro Town Center
3610 S Bristol St
Santa Ana, CA 92704
(s4e) e2e-8805
Landon Construction
23272 Vista Grande #A
Laguna Hills, CA 92653
(7021 610-980s
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01116002 5777C
Fee Type
Special Event
General Plan Update
I ssuance
Microfilm Records
Bqbch*:53348 I2/9/201? ID: CCUEI.LAF
Off i ce: CTYH Trqnsl: 130 1 nfl ?Accti: Refi: 2017U356
Rcpti:(f2831796 I2/9/2019 4|32 Pl1
Trsnsoct i on Totol t52?.5?
Amount
1 66.53
22.95
57 20
3.91
Qty
1.00
1 .00
1 .00
100
Fee
$1 66 s3
$22. es
$57 20
$3 e1
,} nr1 rlEP.t{"( , 7 rt
$223.73
13.?1
$529.5?
State Lic #: 432136
Lic Type: B
Bus. Lic #: 374565
Workers' Compensation lnsurance:r Carrier: Exempt
Policy #.
Expires:
Lnndon ConEtruct i on
Genernl PInn Updnte Fee
0l I 16LtLt2- 5160t:ttt0t"t-
Electr i col
0l I 160tt2- 516031rtr0-
l',l icrof i lm & Documents
0 1 1 1 60112- 1777tr0lrlr-
I CL (:hecll tttt77l.4
.'; v
Building Use:
Job Type.
Nature of Work:
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #.
Other
Miscellaneous
Christmas Tree Lot
Graham, Jeffery
Occupancy:
Constr Type:
Code.
Date:
Date:
Date:
N/A
N/A
cEc 2016
Notes: Special Event LUC2019-106/Hand out given. Dates are
from Nov. 29- Dec.24,2019. Contact:Jeffry Keena
949-929-8805
Zuniga,A[*v
12t0912019
12t09t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
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 sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01116002 51600
01116002 51603
01 1 16002 57770
$22 9s
$223 73
$3 e1
Fee Total
Paid to Date.
Balance Due:
$250.5e
$0 00
$2s0.se
lnspector MID#: 2019-156062
a
ELECTRICAL.I NSPECTOR RECORD
n0 n7 1n -! fr,
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hocby alfm undr pcralty of pctjury th8t I m exmpt from thc Conlraclos' Licme [:w for the following rcmtr (Se.7031.5
Buincs ad Prcfcssion Codc): Any City or County which rcquirc a pcrmit to costruct, altq. improvc. &nolish or repair uy
structw. prior to its issuacc, also rcquirc thc sl,plicmt for such pcmit lo lilc a signcd statmot thd hc or sh€ b licds€d p|met
lo the provisiom of thc Contractor's Liccnscd law (Chaptq 9. Commcncitrg ivith SctioD 7000 of Division 3 of thc Busin* ild
Profsions Code) or that hc or shc is cxcmpt thqefrom ed the b6is for thc allcged cxmpion. Any violation of Scclion 7011.5 by any
applicantforapanitsubjetsthc applicsnttoacivilpenaltyofnotmorelhofivehundreddollus($500).
_1. 6 oms ofthc propcrty. or my mployG with wag6 6 thcir mlc compwtion. willdo th€ work ard thc stnrtrc is not
intodcd or oftcrcd for slc (Sc.7044, B6ines ud Prcfwions Codq The Contractor's Lico* Irw doc not apply to an ownE of
thc propcrty who builds or imprcvc thcm1 ild who dG such wr* himsclf or hmclf or thrcugh his or ha om cmployc.
providcd that such impmvamts rc not intadcd or offrod for slc. I[, howd6. thc building or imprcvmot is pld wthin onc ]q
of complaion. the o\rnq BuiLds will havc thc burdqr of proving thd hc or shc did rct build or imprcrc thc popo'ty for thc purpo*of
$lc).
_.1. as owner of the property. am exclusively contracting u'ith licensed contractors lo construct the project (Sec. 7044. Business
and Profession Code: The Contractor's License Larv does not apply to an owner of propo'ty u'ho builds or improves therctrn.
and who contracls for such projects with a Contracto(s) licensed pursuant to the Contractor's License [arv).
-l
am exempt under Section-. B. & P.C. for this reason.
Dnte:_Owner:_
WORKERS' COMPENSATION
DECLARATION
I hereby affirm under p€nalty of perjury onc ofthe following declarations:
_l have and will maintain a Certificatc of Consent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
Labor Code, for the performance of the work for which the po'mit is issued.
_l have and will maintain workers' compensation insurance, as requird by Section 3700 of the labor Code. for the performance of
the u'ork for u'hich this
Policy _Expires:
_l certify that in the performancc of the work which this pernrit is issued. I shall not ernploy any person in any manner
if I should be.come subiect to the
comply rvith those prouirionr.. Iso as to become subiect to the workers' cornpensation laws of California. and agree that
rvorkers' compensation provisions of Section 3700 of the Labor Code. I shall. forrhrvith
WARNING: Failure to secure workers' compensation coverage is unlawful. and shall and
civil fines up to one hundred thousand dollars ($in addition the
Section 3076 of the interes andL
I hereby affirm under penalty of perjury that I am provision of Chapter 9 (commencing rvith Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
)
Number:
Ll /36
License
I hereby afTirm under penalty of perjury that there is a lctrding pei'formance of the rvork for s'hich this permit b
issued (Sec. 3097. Civ. C.).
Lender's Name:
I.cnder's Address:
APPLICANT DECLATIATION
I hereby affrrm under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
-Required
Letter of Notification
_l certi$ that the lHeral regulations regarding asbestos removal are not applicable to this project.
_l certi& that I have read this application and state that the above information is correct. I agre to comply with all City and County
ordinances and State Law's
above mentioned property for
Applicnnt or Agent r
l'crrrrilec
authorize representatives of this City and County to the
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm I Dampers
Communications Cable
Buildins
Under Slab / Floor
Bonding I Grounding / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soffit Rouoh
Ceilinss (T-Bar Rouqh)
Meter Release trYDIE )En
r--.
Rough nFn tn ?fnn
Service Meter l)^4,
F!NAL (\il\MG6.{,O,n l,cfi,wI
Etc.
is issued. My rvorkers' compensation insurance carrier and policy number are:
t
1
Dale:
\,\?