HomeMy WebLinkAbout20153546 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:20/153546
Pin #: 63853
Project Address: 2130 N Grand Ave Unit:
Assessor's Parcel: 396-19144 Lot: POR G.L. RUSSE Block: A
Bldg: Address Range:
Tract:A.B. CHAPMAN Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Phone:
Alliance Church of Orange
2130 N Grand Avenue
Santa Ana, CA 92705
(7141542-0777
Alliance Church of Orange
Fee Type Amount
125 Volt Receptacle 1.28
Light Switches, Occ. Se 1.39
Light Fixtures 0.92
Air Conditioner 85.42
Dedicated Circuit 21.86
Low Voltage/Comm 29.86
Add'l Devices/Low Volt 2.82
Subpanel 46.97
Time Clock 10.66
Over 50-100 HP, KW or 92.51
Ptc - 65% 0.6s
GeneralPlan Update 19.46
lssuance 48.52
Qty
90.00
27.00
171 .00
10.00
'12.00
1.00
20.00
4.00
2.O0
1.00
1,728.93
1.00
1.00
Fee
$115.20
$37.53
$157.32
$854.20
$262.32
$29.86
$56.40
$187.88
$21.32
$92.51
$1,123.80
$19.46
$48.52
State Lic #: 966844
Lic Type: B
Bus. Lic #: 346862
Workers' Compensation lnsurance:Carrier: Benchmark
Policy #: CSTS00491i
Expires: 0211912015
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
other occupancy:
New ConstrType:
New Church/Roof Mtd EquipCode:
,N
Davis, Scott
Hernandez, Kathy
07t15t2014
10t02t20'14
Account#
Misc. Receipt: 61837
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
Date:
Date:
Date:
Building Permit #: 10180945
Every permitissued shall become invalid unless the work
on the site authoized 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
d 180 days after the time the wotu is commenced.
01 1 16002 51600
01 1 't 6002 51 603
01 1 16002 53601
$19.46
$1,863.06
$234.23
$3,006.32
$889.s7
$2,116.75
lnspector MID#: 2014-113352
Contractor:
Address:
Rindtek
1440 E 28th Street
Signal Hill, CA 90755
(310) 695-8271
01116002 51603
01 1 16002 51603
01 1 16002 51603
01116002 51603
01116002 51603
01 1 16002 51603
01116002 51603
01116002 51603
01 1 16002 51603
01 1 16002 51603
01116002 53601
01116002 51600
01116002 51603
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i11160rJ2- 536ii1
ELECTRICAL.I NSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS owncr-BuildcrDcclararion
--
I hereby affirm under penalty ofperjury that I am exempt form the Contractors' License Law for the following resson (sec 701 L5 Busincss.
and Prof6sion Codc): Any Cily or County which rcquire a pcmil to coNtruct. 8hcr, improvc. dcmolish or rcpair any struclwc. prior to its
issuancc,alsorcquirothcspplicsntforsuchpemitlofilcasigncdslstcment thathcorshcislicc$cd puEumttothcpmvisio$ofthc
Contraclor's Lrcensed LEw (Chapter 9, Conrmencing with Section ?000 of Division 3 of lhe Busin6s and Professiom Code) or that hc or
shc is excmpt thcrefrom and th€ basis for thc allcged cxcmption .Any violation of Scction 701 L5 by any applicant for a pemil subjecrs lhc
applicant to a civil pcnalty ofnot more the fivc hundrcd dollan ($500).
_1. 6 ownc, of the propcny. or my cmployccs with wagc as thcir solc compcnsation. will do thc work and thc strucluc is nol inlfldcd
or offered for ssle ( S@ 7044. Business and Ptofessions Code: The Contractor's License Law does nol apply to an owner ofthe propeny
who builds or improves thcrcon. ed who docs such work himsclfor hcnclfor through his or hcr owo employccs, providcd that such
irnprovcmcnts arc not intcndcd or offercd for salc. lf. howcvcr, the building or irnprovcmcnt is sold wilhin onc ycar ofcomplction. thc
Owncr-Buildo will havc thc burdcn ofproving thal hc or shc not build or improvc for thc purposc ofsale).
_1. s owncr of lhc propcny. am cxclusivcly contracting wilh liccNcd contraclors to coEtruct thc projcct ( Scc. 7044. Busincss md
Prof.ssion Codcr Thc Contractor's Licans. t{w do.s not apply to an owner ofprope(y who builds or improves thereon , 6nd who
contracts for such projecls with a Cootractor(s) licensed pursuant to lhc Contractor's Licensc [Aw.)
_l an cxempt uoder Scclion & P.C. for lhis reason.
Datc:Owner:
WORXERS COMPENSATION DECLARATION
I hcrcby amm undo pcnalty ofpcrjury onc ofthc following dcclamtio$:
_l havc and will maintain s Ccfiificatc of Co6cnt to Sclf-tNure for workers' compeNtion, as provided for by S6tion 37oo of the
kbor Codc. for thc pcrfomecc of thc work for which thc p6mh is isucd.
-l
have and will maintain workers' @mp.nsation insurance, as required by Section 3700 ofthe Lsbor Codq for the performncc ofthc
work for which this pcmit is issued. My workers' @mpcn$tion iruursnce erricr and policy numbcr are:
Cuiq:
Policy Numbcr:_Expircs:
(This srction nccd not be complctcd ifthe pcrmit is for (hc hundrcd dollan {$100j or less)
I cc(ify lhal in lhc performance ofthc work for which this permil is issued. I shall nol employ any in any manncr so 6 lo
became subject lo the workers ' compensation laws of California, and aSree thAt if I should to thc workers'
;:I#;* i"':?
""""'"Labor Code. I shall.
Applicanl
WARNING Farlure lo secure workers'
tin6 up to onc hundred thousand dollam
compensation
($l 00.000).in
coverage is unlarvful. and shall an cmployer to crirninal penallies and civil
.ddition to thc cost of damages as providcd for thc Scction 1076 of
thc Labor Codc. itrtfiet ud attorney's fe6
LICENSED CONTRACTORS DECLARATION
I hqcby arlirm undcr pcmlty of pcrjury thst I m liccnscd undcr provision of Chaptcr 9 (comcncing with Section 7000) of Division 3 of
lhc Bwincss and Prof6sions Codc. and mv liceroe is in full force and cffet.s.tqLiccnsc Class:_76
[)ate:
I hqcby affm undcr pcn.lty ofpqjury that thcrc
issucd (Scc. 3097. Civ. C.).
Lcnder's Name:
a conslruction lcnding agcncy for lhe pcrfomance ofthe work for which this pcnnit is
[rcnder's Address: _
APPLICANT'S DECLARATION
Dcmolition P.mits-Asbcstos Notification Fcd@l RcgulatioB (Titlc 40. P8n 6)
_ Requircd lrtro ofNolification
2l cenify rhat thc fedcral rcgulations regarding asbestos rcmoval arc not applicablc to this prcjcct.
_ I ccniry that I have rcad Ihis applicstion and ststc lhat thc abovc infomation i! corect. I agrcc to comply with all Cily and County
ordinancG and Slatc Laws r€lating to building coNtruction.authorizc rcprcsentalivcs oflhis City and County to enter upon lhc
atx)\'e menlioned propeny
Applicsd or aBent sig.
Pcrmitlce name (print)l
o
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Com.munications Cable
Building
Under Slab / Floor
Bonding / Grounding / 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
Rough
Service Meter
FINAL 'il*ol/L:=B/rt r,n lrlt1/VV Y"Notes, Remarks, Etc.
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