HomeMy WebLinkAbout20167407 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
lnspection Requests: (7 1 4) 667 -27 38 I nspector Section: (7'l 4) 647 -5853
Permit #: 2lD1fi7407
Pin #: 42250
Project Address: 3610 S Bristol St
Assessor's Parcel: 412-131-12 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range: 3600-3298
Historic. No
Suite Range:
Zoning: C2
Owner:
Address:
Phone:
Tenant Name:
Metro Town Square
3610 S Bristol St
Santa Ana, CA 927040000
Pumpkin City's Christmas Trees
Owner-Builder
Fee Type
01 1 16002 51603 Specia! Event
01 1 16002 51600 General Plan Update
01 1 16002 51603 lssuance
Amount
160.25
22.08
55.04
Qty
1.00
1.00
1.00
Fee
$160.25
$22.08
$ss.04
Contractor:
Address:
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation ! nsurance:
Carrier:
Policy #:
Expires:
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Building Use:
Job Type:
Nature of Work:
Other
Miscellaneous
Christmas Tree Lot
Julie
Planning Conditions:
Planning Approval By: Arabe, Jill
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
N/A
N/A
cEc 2016
11t09t2018
11t14t2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
Special Even LUC 2018-'l24lhandout given. Dates are
from November 23 through December 24,2018.
Contact is Jeffry Keena @ 949-929€805.
$237.37
$0.00
$237.37
01 1 16002 51600
01 1 16002 51603
$22.08
$215.29Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 180 days after the time the work is
commenced.
lnspector MID#: 201 8-147568
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ELECTRIGAL.I NSPECTOR RECORD
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APPROVALS DATE ID/S!G.COMMENTS OWNER BUILDER DELCARATION
I h6cby affum unda pcnalty of pajury thar I m cxcmpt from thc ContrscloB' Liccnrc kw for thc following rmn (Sc.7031.5
Bwine and Prcfeion Codc): Any City or County which rcquim a pornh to construct. slt6. imprcvc, &mlish or rcpair uy
structuq prbr to its iswcc. also rcquiB thc applicet for such pqrdt to fil€ a signcd ststmmt tha hc or shc b licarcd pwmt
to thc provisiom of thc Contractor'! Lienscd Lrw (Chapta 9. Commcing with Sction 7000 of Division 3 of the Busin$ md
PrcfsioroCodc)orthathcorshcbqcmptth@fromedthcbosisforthcallegcdcr@p(ion. AnyvioldiooofS€lbr703l.5bymy
appliciltforapcntritsubjetsthc applicuttoacivilpcraltyofnotmrcthefivchundrcddollus($500).
_1. s ome of thc Fopcny. or my cmplo)6 with wag6I thcir mlc comFrution. will do tlrc work ed thc gnrlrc b rct
intodod or olfscd for slc (Sc.7044. BEitrs md Profcssiore Codc: Thc Contrsctor's LiccB Law do6 not apply to 4 omq of
thcpropqty whobuildsorimpovstho@n,ildwhodoBschwrthimsclforhcrclforthrcughhisorhaomcmploye.
providcd that such imFovffits rc rct intad.d or oIftred for slc. tf. howffi, thc buiHing or imFoffit is sld wthin one yw
of complction. thc Ownq Builds will havc thc fudo of Foving thd hc or shc did not buiH or imprcw thc Fopdly for thc purpos of
slc).
_1. I oM6 of the prepaty, m cxclusivcly contmcting with licqNcd contractoB to conslruct thc prejer (Se. 7044, Buins
ud Proftssion Code: The Conlrsclor's Liccrc Law do6 not apply to e ownq ofprcpcrty who builds or imprcvs th6@r,
md who contncts for swh prcjccls with a Contracto(s) licoscd pmuant to thc Contraclor's Liccre Law).
-[
m cxcmpt undq Sction-. B. & P.C. forthis rcen-
I)olo'
WORKERS' CONTPENSATION
DECLARATION
I hereby affrnn under penalty of po'jury one of thc ficllorving declarations:
_l have and rvill maintain a Certilicate of Consent to Self-lnsure for workers' conlpensalion, as provided for by Section 3700 of the
I-abor Code. for the poformance of the work for which the permit is issued.
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have and u'ill maintain workers' compensation insurance. as required by Section -1700 of the labor Code. for the performance of
the work for which this pennit is issued. My workers' compensalion insurance carier and policy number are:
Policy Number: Expires:
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ccnifythat in the pqfomecc of thc work for which this pmit is issued, I shall not mploy any pqson in any ma
s a to beomc subjet to thc wo*6' composation laws of Califomia, ed agrc that if I should b€comc aubjst to thc
wo*s' compffition prcvisioro of Scaion 3700 of the l^abor Codq I stull, forthwith omply with thos prcvisioB..
WARNINC: Failurc to sw workm' compcnsation cov@ge is unlawful. ud shall subjet m oployo to qimiml pqnltie ed
civil fmes up to onc hundrcd thosd dollm ($100.000), in addition to the cost of compcMtion, damage r provided for thc
Sation 3076 of thc l6bor Codc itrt66t and anorney's fe.
I)o to.
LTCENSED CONTITACTOR
DECI.ARATION
I hereby affirm under penalty of pcrjury that I am liccnsd under provision of Chapter 9 (commencing with Ser-tion 7000) of Division 3
of the Business and Professions Code. and my licerse is in full force and effect.
License Class: License Number:
fl.rto.
W
I hreby alfum undr pcmlty of psjury thar thqc is a construclion loding agocy for thc pofomcc of thc rcrk for which this pcmit b
issued (Se. 3097, Civ. C.).
Lender's Name:
Lender's Address:
APPLICAI\T DECLARATION
I hereb}, affirm undcr penalty of perjury onc of thc following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Tille 40, Part6)
-Required
Later of Notification
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certify that the federalrcgulations rcgarding asbe$os removal are not applicable to this projed.
_l cerri& that I have read this application and state that the above information is correct. I agre to comply rvith all City and County
and County to entef, upon theordinances and State laws relating to building authorize representatives of this City
,. Pernritee
for inspection
construclion.
?-.--
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Site-Work
Underground
Pole Bases
Light Standards
Spas, Poo!, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire AIarm lDampers
Communications Cable
Buildinq
Under SIab / Floor
Bonding I Grounding / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilings (Hard & Soffit Roush
Ceilinqs (T-Bar Rouqh)
Meter Release EXPIT lFn
Rough nFc tll ztn
Service Meter .-1
F!NAL ,AMU A1C, Zt o, 506, 067 =NW{Notes, Remarks, Etc.(./u V
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