HomeMy WebLinkAbout20169913 - 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 #: 2lJ1699{ 3
Pin #: 55033$
Project Address: 2301 N Tustin Ave
Assessor'sParcel: 396-141-01 Lot: NA
Unit:
Block: NA
Bldg: Address Range:
Tract: A.B. CHAPMAN Historic: No
Suite Range:
Zoning: C5
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
The Rego Group
P O Box 1493
Tustin, CA 92780
(7021217-7900
Starbucks Coffee
Superior Electrical Advertisi
1700 W Anaheim St
Long Beach, CA 90813
(800) 995-9099
Fee Type
01 1 16002 51603 Slgns & Neon
01116002 51600 General Plan Update
01 1 16002 51603 lssuance
Amount
78.08
22.95
57.20
Qty
1.00
1.00
1.00
Fee
$78.08
$22 95
$57.20
State Lic #: 27'1598
Lic Type: C45
Bus. Lic #: 117521
Workers' Compensalion lnsurance:Carrier: Travelers Property Casualty Co of America
Policy #: U8SK094655
Expires: O4lO1l2O2O
Building Use:
Job Type:
Nature of Work:
Commercial
Signs
Order Board
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
N/A
N/A
cEc 2016 Notes: (1) llluminated order board 32 " x 68" /bond posted on
M-73629.
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Amsden, Julie
Subject to Field:
Buirdins Permit #: 101101519
1011412019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01116002 51603
$22.95
$135.28
Fee Total:
Paid to Date:
Balance Due:
$158.23
$0.00
$158.23
Every permit issued shall become invalid unless lhe work on the site
authorized by such permit is commenced within360 days after its
rssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2017-139816
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUII,DER DELCARATION
I hcrcby allirm undcr pcnalty of pcrjury thal I m cxemll lionl thc Contrack)E' Liccn* hw ti)r llr lbllowinS rcas)n (SR...70]1.5
Busincss ttil Pr()ttssion Cqle): Any City or County which rcquircs a fErnlit to constnlcl. allcr. improvc, dcnrllish or rcpair any
structurc. pri()r to its issuancc. also rcquires thc applicant lilr such lErnlil t) file a signcd statemcnl that he or shc is liccn*d pursuant
k) thc Fovisi()ns ot thc Conlraclor's Liccnscd ljw (Chaplcr 9. Connrcncing wilh Sccli()n 7(X)0 ol Division -J of tlr Busincss and
Pro|ssionsCodc)orthatlaorshciscrcmptthcrelromandthcbasisti)rlhcallcgcdcxcmplion. Anyvi()lationolScclionT0.ll.5byany
applicxntli)rapcrmitsuhjcctsthc alplicanttorcivilpcnallyofnotrnorcthdiltivchundrcddollus(S5fi)).
_1. as owncr of the proFrty. or my cmployccs wi(h wages ds lheir solc compcnsation. will do thc work drd thc stmtw is nd
intcndcd orotl'credlirrulc(Se.?044,BusincssandPrufassionsC(rlc:ThcContrack)r'sl-iccnsLawd(Esnotapplyk]mowncrof
thcpn)Fny whobuilds()rimpruvcslhcmn,iurlwlDdessuchworkhimsell'orhersclfotthruughhi\orhcrowncmployccs.
providcd that such irnprovemnts dc not if,tcndcd r)rollLrcd li)r salc. ll. howcvcr. the huilding or improvcnrcnl is sold within urc ycil
r)fcomplctiur. lhc Owncr Builder will havc the burdcn of proving tlut hc or shc did not build or intprovc thc prufrcny li)r thc purF)sc of
sah).
_1. ds owner ofthc propcrty. am cxclusively ()ntracting wIh liccnscd r(nilracl(ln t) constnlct thc p().iccl (Sec. 7044, Busircss
and PR)ltss([Codc:'l'hcConlraclor'sLiccnscl-awdoesnotapplyk)xnowncroflropcrtywhohuildsorimlrovcsthcrcon.
and who conlrarts li,r silch projccts with a Corilracb(s) liccnscd pursudnt to thc Conlrlclor's l-iccnsc Law).
llmcxcmDtunJcrsect(,n-.B,&P.C.1brthisrcason'
Dsle:-
]Y!B6E&I-g9TITENSA]IAN
DECLARATION
I hcrcby ullirm undcr l^.-nalty of pcrjury onc of lhc lilllowi[g dcclarations:
_l havc arl will rruiilain a Ccrtilicatc of Conscnt lo SelLlnsurc tbr workcrs' compcnsalion, as provitlctl for hy Scction 1700 of the
tlbor Gxlc, lilr thc pcrli)rmancc ol' lhc work fi)r which thc Pcrnrit is issucd.
_lhaveandwillmairtainworkcrs compensali([insurancc,as rcquircdhySection]7(nofthcLahorCodc,fbrlhcpcrt(xmanccof
thc w(,rk li)r which this pcrmit is issrcJ. My workcrs compcnsltion insurancc cuicr iukl fDlicy numbcr tre:
e ("olzrt
Policy
.L
_l ccdili that in thc l--rfornuncc of thc work li)r which lhi( pcrnlil is issilcd, I shall n(il cmpkry any pcrson in any manncr
so as lo hccore subjccl k) thc workcrs' compcnsat ion laws of Calilomia, and agrcc that if I should hccomc suhjccl to lhc
workers'conlpcnsali([provisionsol'Sccti(]n-17(X)oflhcLrh)rCodc,lshrll,fi)rthwilhcomplywilhthoscp(]visi(rls..
WARNTNG: Failurc k) *curc workcrs'comlEnsation covcragc is and shall suhjcct m cmplrrycr to uiminal lrcnahrcs ud
civil IiDcs !p k) onc thousatrd dollilr{ (Sl0t}.UX)). tn addit()n thc cost of compensation. damxges as providcd ti)r the
Scct()n.1(17(,Codc, intcrcst And alt)rncy s ftcs.
q
Applicrnl
I hcrchy allirm undcr pcnalty of pcrjury lhat I am liccnrc,l umlcr pnrvisioil ofChapter 9 (comrcncing with Section 7(X[) of Divistrn ]
ol lhe Busincss and Pnrfcssions Ctxlc, arxl my liccnsc is in lull t'or@ iurl cffccl.
Liccnsc
-L{z1( t-f 6
o I
CONSTRUCTION LENDING AGENCY
I hcrcby allirm undcr frnal(y of Frjury that lhcrc is a construclion hnding rgerrcy firr thc ltrfomrmce of lhc work tirr which lhis lEmit is
issucd (Scc. 1097, Civ. C.).
Ilnrlcr's Nrnrc:
lahder's Address:
APPLICANT DECLARATION
I lErchy atlimr undcr pcnalty oi pcrjury one of thc li)li)wing dccluations:
Dcmolitir)n Pcrmils-Aslrsk)s Notillcalion Fcdcrrl Rcgulations ('lillc 40, Pd6)
_Requircd [.tlcr ol Notiliertion
_l ccrlily lhat Ihc lillcral rcgulali()ns usbestos rcn$val arc not applicahlc lo lhis prujcct.
_t ccnily thal I havc rcad this thc rhrvc inlinmrtion is corccl. I aSre k) comply with all City and
ordinaor('s rnd Stalc I-xws rchlirrg l()
afx)vc mnli(trlcd propcrty li)r inspccli(,n
Appli(anl or Agena
I'cniriteo n{De (
urd hcrchy rcprcscnlalivcs {)f lhis City aod
rL tt
thc
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof.Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouoh)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
Rough
Service Meter
FINAL olfr/ n ,\l<- v-r A Sxltt)
Notes, Remarks, Etc
.a
iu.r.r-[ ,n