HomeMy WebLinkAbout20144664 - PermitProject Address: 3610 S Bristol St
Assessor's Parcel: 412-131-12 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range: 3600-3798
Historic: No
Suite Range:
Zoning: C2
a
city of santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738
Electrical permit #: 2||144|f;|fi,4
I nspector's Section: (7 1 4) 647-5853
Owner:
Acidress:
Phone.
Tenant Name:
Metro Town Square
3610 S Bristol St
Santa Ana, CA 92704
Pumpkin City 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
148.00
18.00
45.00
Qty
1.00
1.00
1.00
Fee
$148.00
$18.00
$45.00
Contractor:
Address.
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Bab,-lr*:12?11 LZ/t-i/!fi I0: ftICHARD
tjf't'ice: CTYH Trnns*: 1?1 I of' 1
Acct *: Ref *: ?rJl +4-6114
Rcp t* : 0ttIiS0S33 l?/7 l?itItt 4 : ?3 F'H
lr'nnsu.:tit:n Totol $?11.tl[t
Iiet ro Town Squor'e
Gener'ctl F'lnn Updote Fee
tll I I 6uLl2- :i l6lll:lLlt-tt-t--
EJecLrirnl
u1 I 16uu2- 516rJ:]0rlrJ-
(:h e';k 9630
Notes: Special Even LUC 2010-138/handout given
Fee Total:
Paid to Date:
Balance Due:
$ 1g . [r[r
$ 193 . [t[t
$21 I. [t[t
Planning Conditions:
Planning Approval By: Apple, Bill
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Every permit rssued shall become invalid unless fhe work
on the sife authoized by such permit is commenced within
180 days afterifs issuance, or if the work authorized on the
sife by such permif is suspen ded or abandoned for a peiod
d 180 days afterthe time the work is commenced.
lnspector MID#: 2010-94509
Building Use:
Job Type:
Nature of Work:
Other
Miscellaneous
Christmas Tree Lot
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
N/A
N/A
cEc 2007
VI* Hernan dez,Kathy
1210712010
12t07 t2010
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 51603
$18.00
$1e3.00
$211 00
$0.00
$211.00
ELECTRICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS Owner-Bui lder Declaration a
Law for the following rcason (scc.703 1.5 BusinessI hercby affirm under pcnalty of perjury that I am excmpt form the Contractors' License
!d prcfc$ion Co&): Any Ciry or CMry which rcquiro r pm[ ro @trrrucq dt6, improvc, dcmlilh or rcprL my rmctuc, prior to ht
istuucg rlrc rcquircr thJ rpplimt for uch pcmir !o filc r lfrcd lutcmcnt thr hc or th ir liccn*d puruut to tlr prcvirios of thc
Conrrcror'r Lien:cd Ltw (Cheps 9, Cornnqrcing wirh Serion ?o00 ofDivilion , ofthc Butincs ud Profclsioro Codc) or rhrt hc or
th. b dcmpt rbssfrom ud thc bsir br tbc rllcgcd *cmption .Any viol.don of Scctiotr 703 I . 5 by my rpplicrnl for r pmit lubjcs! rhc
rpplicmt o r civil pcndty of not mrc thrn f,vc hundrcd dollu (t500).
_I, u oms of th€ prcpcny, or my cmploye! with wrgc! r! thcir rclc smpcniliot! will do thc work ud thc rnaw ir not inrcndcd
6iifcrcd for ulc ( Si.Zo44, Susini[ rid Frofcrrionr Codc: Thc Coilre'tor'! Lienp Lsw doc! not rpply to e omlr ofthc prcpcrty
who buildt or improv6 rh66q ud who dog mh work himrclf or hadf or through hir or hcr om cmployes, prcvidcd rhet ruch
improvcmcntt & not imcndcd or offcrcd for ulc. tf, howcvs, thc building or imprcvcmcnr ir rcld within onc ycu of@mpldioq thc
Omd-Buildcr will hrw tho budcn ofprcving 0[t hc or lhc not build or improvc for thc purpore of$lc).
_I, I om.r of thc propsty, u qclusivcly coilrscing with liccrocd otrtnctotr !o @ofiruct thr prcjet ( Sc 7044, Budncts ud
Prcfcsioo Codc; Thc Conmaor'r Lienrc Lrw dct trot rpply to m ovmcr of propaty who builds or improvcs thcrcon , ud who
oilrrctt for och prcjcts with r Contn6or(t) licancd prot to thc Cootncor't Liccnr Lsw.).
_I anr exempt under Section for this re8.son.
Date: Owner:
I hercby affrrm under penElty of perjury onc
_I hrvc md will mriDbin r Ccnifiqt! of Corent o Sclf-Iwc for sIkfl' ompcurlioq u providcd for by Scaion 3700 of thc
Lrbor Codc, for thc pcrfomm of thc worh for which thc pcmit ir irucd.
_I hrve and will maintrin worker!' compcn$tion insurance, t!
work for which this permit ic issued. My workcrs' compcnsation
rcquird by Scction 3700 of thc Labor Code, for the perfbrmtncc of the
insurance cErricr and policy numbcr are:
Policy
(This section not bc completcd if the permit is for One hundred dollur ($100) or less)
I certify that in the pcrformancc of the work for which this permit is issued, I shall not employ any person in any manncr so Es to
became subjcct to the workcrs ' compcnsrtion laws of California, and agrec that if I should become subjcct to the workers'
compcnsstion provisions of Section 3700 of the Labor Code,fonhwith comply with those provisions..
WARNING: Failure to rccurc workert' compensation
fines up to one hundred thousrnd dollars ($100,000),in
the Labor Code, interest and Enorncy's fees.
covcrEge is and shall ur cmployer to criminal pcnalties and civil
addition to the cost damagcs as provided for the Section 3076 of
LICENSED CONTRAC'TONS DECI./IRATION
I hscby sfiirm unds pcnrlty of pcrjury thril m liccrcd undcr prcvirion of Chrptcr 9 (omcncing with Sccrion 7000) of Division 3 of
dr Businor md Profasioro Codc, rad my liccn:c is in full forcc ud cffct.
Liccnse
Date:
License Number
l^a-o.-aaa'
@
I hcrcby aftirm unda pcnrlry of pqjury rhrt thcrc ir r co ruction lcnding rScncy for lhc pcrfomcc of thc work for which $is pcrmit ir
issued (Sec. 3097, Civ, C.).
Lender's Name:
APPLICANT' S DECI.ARATTON
Demolition Permits-Asbestos Notification Fedcral Regulations (Title 40, Pan 6)
_ Roquired Lettcr of Notificetion
_I certi$ that thc fcderal regulations rcguding asbestos rcmoval Erc not apPlictblc to this projcct.
_ I ceni$ that I havc rcad thit epplicrtion and Jtstc that thc above informrtion ic correci. I agrec to comply with all City and County
ordinances End State Laws representEtives of this City and County to cnter uPon the
above mentioncd property for
Applicant or agcnt
Permittce name (print):
constructior\ and
1
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding I UFER
Transformers
Torquing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rough
Ceilings (T-Bar Rough)
Meter Release E\'EIIE )EFI
Ei7 la ra
Rough nFn t0 'nv.\l
Service Meter
FINAL SAMU U-4C, Zt v, cDti, oo /etl
Notes,Etc.
t
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