HomeMy WebLinkAbout20158345 - PermitCity of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, CA 92702
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Electrical Permit #:20158345
Pin #: 2976,36t
Proiect Address i 2130 N Grand Avea
-
Bldg: Address Range:
Tract: A.B. CHAPMAN Historic: NoAssessor'sParcel: 396-19144 Lot:POR G.L. RUSSE
Unit:
Block: A
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone
Alliance Church of Orange
2130 N Grand Avenue
Santa Ana, CA 92705
1714) 542-0777
Alliance Church of Orange
Rindtek
1440E 28th Street
Signal Hill, CA 90755
(310) 696-8271
01 1 16002 51603
01 1 16002 51603
01 1 16002 53601
01 1 16002 53601
Fee Type Amount Qty Fee
Serv Meter 131.14 1.00 $131.14
Subpanel 48.10 3.00 $144.30
Ptc - 650/o 0.65 275.44 $179.04
Revision 200.53 1.00 $200.53
Botch3:32830 - 2/18/2016 t0: ELIZABETH-Oitice: CTYH fronsi: 31 ? ot 2
Accti: Reff: 20t583{:
Rcpti:01499{21 - 2/t8/2016 l1:20 AH
ironsoct ion Totol t791 '81
R i ndtek
{273.+1
t179.04
t79t . sl
Authi:121242
Notes: Revision to 20153546. Revision to change service
meter.
State Lic #: 966844
Lic Type: B
Bus. Lic #: 346862
Workers' Compensation lnsurance:Carrier: Benchmark
Policy #: CST5004911
Expires: 0211912016
Electr ical
0tu6(E2- 51603000-
P/C Eleclric
0tu6002- 53601000-
V iso
cc+: rrr*;rrrr***9969
Building Use:
Job Type:
Nature of Work:
Other
Revision
Revision
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
A-3
VB
cEc 2013
Planning Conditions:
Planning Approval By:
Plan Checked By: Davis, Scott
Permit lssued By:
Subject to Field:
Zuniga,
02to3t2016
02t18t2016
Account#
Misc. Receipt: 66957
Misc. Receipt:
Misc. Receipt:
Total
Building Permit #: 10180945
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
lssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a peiod of 1 80 days after the time the work is
commenced.
Zi1SY{Fee rotat:$65s.01
$200.53
$4s4.48
01 1 't6002 51603
01116002 53601
9e53r90
Paid to Date:
Balance Due:
lnspector MID#: 2014-113352
$179.04
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDI:R DEL(]ARA'I'ION
Iherebyallirmunderpenaltyofpe{urylhatIanexenrptfromtheConlraclors l,icenseLarvforthefollorvirgre6on(Sec.703lr5
Busin6s md Profession Code): Any City or Couily Nhich requirc a ;mnit to construcl. alto. irnprrrle. donolish or rcpair my
strudure. prior to its issumcc. also require the applicanl for such permil to file a signed statemenl lhat he or she is licensed pursuant
to the provisions o[the Contraclor's Licensed [,aw (Chapter 9. (i)mmencing rvith Section 7000 ofDivision 3 oflhe Busine$ and
ProfsionsCodc)orlhatheorsheiserenrpllhtrerio,nandthebasisfortheallegedexenplion. Any\iolalionofSationT0.ll.5byany
applicantforapennitsubjststhe applicanttoacivilpenallyofnolmorethanfivehtrndreddollars($500).
I. 6 owner of lhe proFny. or nry employG rvith wags o their wle compeNalion. \rill do the work md lhe stnrdue is nd
intmded or offcred for $lc (S(.7M4. Busines and Prcfmsions Code: 'l he Contractors Licmse Lorv does not apply to an owns of
lheprcpeny uhobuil&orimprovsthqon.mdwhodoesuchwrrrkhimselforherselforthnrughhisorherorvnenrployew.
providedlhalsuch impmvqnots[enotinlmrledoroflLrqllirrsle.lf.howcvq.thetnrildingorirnprovementissoldrvilhinone]w
ofcotnphion. the Owmo Buildtr will have the burdo ofproving that he or shc did not build or improvc the p()pqly for the puqnsof
sle).
-1.
a orvno of the prolmy, m exclusilely contracting \r ith Iicensed contractonlo conslrucl the pr(li(t (sec. 7014, Bwins
md hofcsionCode:TheContraclor'sl-icenseLawdo6nolapplyloanoN'nqofpropayrrhobuildsorimproveslhq@n.
and rvho contmcts for such prcjets with a Conlractor(s) licensed pursuant to lhe Contmclor's License Law).
-l
an exqnpt undq S{tion-. B. & P.C. for lhis re6on.
Dsle:_ Owner:__
WORKI]RS' COI\IPENSA'I'ION
DECLARATION
I hacby affrm under pqralty ofpqjury one ofthc follorving dclarations:
I have md rvill rnaintain a Cffillcate ofConsmt to Self-lnsurc for rvorkos'conrpensation. c provided for by Section 3700 ofthc
Labor Code for the perfomance of the rvork for which the pfinil is i$ucd.
-lhaveandrvill rnainlainworkers'compensalioninsumnce.d requiredbySrtion.lT00oftheLahorCode.forthcpqfummceof
the u,ork for rvhich this pennit is issued. My rvorkm' compensalion insurance canio md gxrlicy number oe:
Carrier:
I\rlicy Nunrbcr:Iirpir cs:
I cenify that in the perftrrmance ofthe work for which lhis permil is issued. I shall nol eDploy any person in aly manner
so ro to become subjecl to lhe ['orkss' compensal ion lavs of Calihrmia. and agre that if I should lrecome suhjrct to thc
\rork6' compeosalion provisions of Salion 1700 of the l,atror Codc. I shall. forlh\ ith coilrpl]- \\ ith tlrcs frcvishns..
WARNINC: Failute to sure rvorkm'cornpasalion co\'(age is unlarvful. and shall subjrct an onploy.o tn oirninal penaltie md
civil finesuptoonehundrcdthousanddollars($100.000).inaddiliontolhecostofcornpensalion,darnagesasprovidcdforthe
Seclion 11076 ofthe Labor Code. intdBt 6nd altomev's fees.
LICENSED CON'IRACI'OR
DECLARATION
I hereby affinn undo penahy of perjury thal I m licensal under p(rvision ofChapto 9 (commencing rvilh Section 7000) of Division 3
of the Busines md Profsions Code. md rnv licme is in full force md eff(1.
Lice6e Class;
Daae:_
License Numbor _
( onlrnc(or:
CONS'IRU(:'I'ION LENDING AGENCY
I haeby aflirm undo penaly of pfrjury thal th6e is a construction lcnding agmcy for the pofonnancc ofthe $ork for s'hich this pornil b
issued (S(. 3097. Civ. C.).
Lcnder's Name: _
Lstder's Ad&esr
-APPLICANT DECLARA'I'ION
I hotby alfrm under penalty of p6jury one ofthe following delrations:
Demolition P6mils-Asbcstos Nolification Fedsal Regularions ( l itlc 40. Pd6)
Requfed Lcllq of Notificalion
_l certify thal thc fedoal regulations rcSuding dbeslos removal are not applicable lo lhis prcjecl.
I cqtify that I have read this application dd stalc thst thc atnvc infonnation is cor(t. I agrc to comply wilh all Cily and County
ordinancs and Stale Larvs rclating to buildinB constrnction.
ffi;-^-ffi:.:",:ff'z%_
Pemire nnme (prrn u,&jn r / > >
reprsef,tal iv6 of this ('ity and Counly to ents upon the
Drte: t
and hereby
z-/f-z
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildins
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
Rough
Service Meter {-- r)
FINAL Ub/1t6,Kt )na,l,t hc/
Notes, Remarks, Etc./ a\t
na n7 aAlAt:_r