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Home My WebLink About20164458 - Permit1 City of Santa Ana Permit Counter: (714) 647-5800 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 }J Permit #:2lJ164458 Pin #: 12726t Proiect Addressi 4518 Westminster Ave Assessor'sParcel: 100-190-36 Lot: NA Unil: A Block:NA Bldg: Tract: NA Address Range: Historic: No Suite Range: Zoning'. C2 Phone: Tenant Name: Smog Test Only Center Owner: Address: Contractor Address: Phone: MK&SONS 4518 WESTMINSTER AVE Santa Ana, CA 927031221 T&KConstructionCo. 17660 Newhope Street, #B Fountain Valley, CA 92708 (7141875-6877 01 I 16002 51603 01 1 16002 51603 01 1 16002 51600 01 1 16002 51603 Fee Type 125 Volt Receptacle Min Fee Adj General Plan Update lssuance Amount 1.40 65.04 21.25 52.98 Qty 4.00 1.00 1.00 1.00 Fee $5.60 $65.04 $21.2s $52.98 State Lic #: 793124 Lic Type: B, C-10, C-39, C-15, C-46 Bus. Lic #: 310345 Workers' Compensation lnsurance: Carrier: State Compensation lnsurance Fund Policy #: 9092246 Expires: 11l0gl2017 Building Use: Job Type: Nature of Work Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: \A ,",r,"ndez, Kathy Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Notes: Fee Total: Paid to Date: Balance Due: Commercial Miscellaneous Outlets Occupancy: Constr Type Code: Date: Date: Date: F-1 VB cEc 2016 10t26t2017 Account# 01116002 51600 01 1 16002 51603 $21.25 $123.62 $144.87 $0.00 $144.87 Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 1 80 days after its lssuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 180 days after the time the work is commenced. lnspector MID#: 2017-139538 ELECTRICAL.I NSPECTOR RECORD APPROVALS DATE ID/SIG.COMMENTS ()\\'NFtR BtJIl.I)!tR Dl].( ARA.l l()N I haeby aflim undo penalty of psjury lhat I an exempt fiom lhe ContracloE' Licmse lzrv for the follorving ree)n (Ss.]031.5 llusincs ad Profeion Codc): Any Cily or County rvhich requirs a ponit lo coNlruct. allq. imdrove. dem,.lldr or rcp,,r any slruclure. prior lo its isuance. also reauirG lhe applicanl for such pmit to file a si8ned stalmfit thal'he or shc is lilensed p. ;11 ,nt to rhe provisions of the Conlraclor's l-icenscd ljw (Chapltr 9, Commencing wilh Section 7000 of Division 3 of thc Businefand Profesions Code) or that he or she is exempl thseliom md th€ b6is for the allcged ermplion. Any violalion of Seclion 70-l 1.5 hy any applicantforapmitsubjectsthe applicantloacivilpenallyofnotmorethanfivehundrcddollils($500). I _1, ru orvner of the prop€ny. or my employecs rvilh wage c their sole compensalion. will do the work md the strxclrlr is nol intmdsl or of[sed for sale (Se.7M4. Business od Profesions Code: The Contraclor's l,icense Law does not apply to an owner of thcprepqly whobuildsorirnp(rvslhqen.mdwhodo6suchrvorkhimselforhoselforthroughhisorherownemployed. provtled that such improvqnols de not intmded or offqed for ele. If. howwq. the trrilding or improvment is old rvithin one )qrr ofconrpletion. the (hvner Uuildo uill have the burdm ofpreving that he or she did not build or irnprove the propsty for the purB)se of sle). _.1, 6 os,nq of the propay. an exclusively contracting wfuh licmcd contradom lo comtrud lhe lrojed (S{. 7044. B6ins md ProftsionCode:TheContractor'sLicenseLawdo6notapplytomownqoIpropcrlywhobuildsorirnproveslhermn. and rvho contmcts for such projels with a Contrado(s) licfised puEuill lo lhe Contraclor's Licsse Las ). _l en exempt unde 56lion B. & P.C. for this re6on. O*ner:_ WORKERS'COMPENSATION DECLARA'I'ION I haeby aflirm undo penalty ofpojury one ofthe following dalarations: lhavemdwillmaintainaCerlificateofconsmltoSelfJNureforworkss'conrpensation.6 providedforbySslion3T00ofthc Labor Code. for the pqfonnmce oflhe work for which the p6mit is isued. . lhaveandwillmaintainwork6 cornp€nsationisura.ce.6 rcquircdbySdlion.lT00oftheLaborCode.forlhepofonnarlceof the rork for rvhich this pemit is isucd. My works' compensdion iNurmce cmier md policy numbo ae: Policy Numbq:- -Expires:I ce(ily that in the pertrrnrancc oflhe work for $hich this pernrit is issucd. I shall not ernpk)y any person in an),manner so ns b beconre subjecl k) the workq s' compcnsation las,s of Cali fornia. anrl agre that i f I should become subiel lo thc workq's' compensalion provisions ofScclion 3700 ofthe Labor Codc. I shall. forthrvilh cornply wilh lhose provisions.. WARNINC: Failure to wurc workers'compensation covemge is unlarvful. md shall subi(t an mployo to fitninal p6.llis and civil finesuptoonehundredthousanddollars($100.000).inadditionlolhccoslofcompensation.damagesasprovidcdforthc Setion 3076 of the Labor Code. inltrd md dlomey's fs. o,,u,4i-2L2tl') Dlt( 1.,\R.tiloN I hoeby affirm unda porahy of perjury that I m licens€d undtr provision ofChapto 9 lcommmcinS with S(tion 7000) of l)ilisior l of the Busines and Profcsions Codc. od my licmse is in full force ad effect. Li."nr.Ctu"r, R/L -License Numbcr:14,2_ I hreby affim undo petrahy of perjury that thse is a coNruclion lmding agmcy for lhe psfommcc of thc work for which lhis pqrnit b issued (Se. 3097. Civ. C.). Lendq's Nme: l-ends's Addr*: APPLICANT DECLARAl'ION I heeby affnn unde pmalty of perjury one ofthe follorving declaations: Dcmolition Pnnits-Asbestos Notillcation Fedqal Regulations (Title 40, PadO) - Required [,etter ofNotificalion I cerlify thal lhe federal regulations regrding asbeslos renroval ac nol applicablc lo lhis prcjecl. I cdiry lhat I hare read this application od slale that the above infonnalion is cor@t. I agre lo comply with all City and County r reprsqlativB of this City ed Counly lo otq uB)n lheordinancs md State [aws relating lo comtruction. od hqeby autkrrize above nrmtioned propeny for ircpecl Applicsnl or Agcnt Signa(trrel Date: Cr(: J r. I l.Permt(e nsme (prino, To \r t\)r*1glJ -2-L+%f Site-Work Underqround Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Buildinq Under Slab / Floor Bonding / Grounding / UFER Transformers Torqueinq Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilinqs (Hard & Soffit Rouqh Ceilings (T-Bar Rouqh) lvleter Release Rouqh tolzt ll7 .,oq4/t D Service ltleter I FINAL I I - /{,17 m/<_/q .>^./ O,,itnj',ilV Notes, Remarks, Etc.I Cmiq: o"", \ (I 2-L f 2.al} contractor: X @