HomeMy WebLinkAbout20170942 - PermitCitV of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:2017o942
Pin #: 76o.27
Proiect Address: 709 E Alton Ave unit: MTR01
Block: NA
Bldg
Tract:
Address Range:
Historic: No
Suite Range:
Zoning: M2Assessor's Parcel: 411-141-12 Lot:
Owner
Address.
Shea Properties
130 Vantis Dr. #200
Aliso Viejo, CA 92656
(949) 389-7295
Fee Type
01116002 51603 Temporary Electric
01116002 51600 GeneralPlan Update
01116002 57770 Microfilm Records
Amount
253.66
22.95
3.91
Qty
100
0.00
0.00
Fee
$253.66
$0.00
$0.00Phone:
Tenant Name:
Contractor:
Address:
Phone:
Pacific Construction Group
17895 Skypark Circle #K
lrvine, CA 92614
(949) 748-1500
State Lic #: 742676
Lic Type: B
Bus. Lic #: 347876
Workers' Compensation lnsurance:Carrier: Everest National lnsurance Company
#'7600014602191
03t01t2020
ing Use lndustrial
Miscellaneous
3o-day temp Etec. B4L!t'i
Occupancy:
Constr Type:
Code:
B, S-2
III B, SPK
cEc 2019
Job Type:
Nature of Work:
Notes: 30 day temp electrical. Bond posted on M-74235
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Sub.iect to Field:
Building Permit #:
Chavez, Dave
Date:
Date:
Date:03t03t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total9!.
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced wtthin 360 days after its
issuance, or if the work authorized on the site by such permit ls suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Fee Total:
Paid to Date:
Balance Due
$2s3.66
$0.00
$2s3.66
lnspector MID#: 2020-158209
01 1 16002 51603 $253 66
ELECTRICAL.INSPECTOR RECORD
ID/SIG.COMMENTSAPPROVALSDATE
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Sions (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rough
Ceilings (T-Bar Rough)
Meter Release
Rouqh
Service l\tleter
FINAL 0-7)V{-rr
Etc.
-+
OWNER BUILDER DIX,CARATION
I hcrehy affirD) undcr penalty of pcrJtrry thal I anl cx€nDl fronr rhe CbntracloN' Liccnsc l:w for thc following rcaen (Scc.70Jt.5
Busincss and Prolcssirln C'odc): Any Cily or County which rquircs a pcfinil to construct, altcr, irnprovc. dermlish or rupair any
slructure. pri()r t) ils issuatrce. dso requires the applicant for such lEnrit b file a siBDed slatetEnt thal lE or shc is licened pusuant
to thc prcvisions o[ thc Contraclor's l,iccnscd liw (Chaptcr 9. Comrncncing with Scction 70/\X) ol Division 3 of thc Busincss and
ProltssionsCode)orthatleorshcisexeilrptlhereliomandtlEbasisforll*allegederenrption. AryviolalionofSectionT03l.5byany
applicant for 0 pctrnit subjecls the npplicaDt to il civil penalty oI not rmre lhun fivc hundrcd dollars ($500).
_1. as owncr ol'thc proJrcnv. or rny crnployccs wilh wagcs as thcir slc comlEnsation, willdo thc work ard thc stMuc is mt
iitcfrlcd or offered ft)r sala (Se.7044. Business and Prcfcssions C<xlc: Thc Contractor's Liccnsc Law docs nol apply lo an owner of
the pR)tEdy wlx) huilds or in{rroves llErHnL url wls d(Es such cr}rk himself or lErslf or ihruuglr his or her own enployees.
providcd that such imprcvcrrents trc ml intcndcd or olTcrcd lbr sat. Il, howevs, thc building or irprovcrrcnl is $ld wilhin onc yctr
ofconrplelk)n, tlE OwrEr Buikler will havc lhe bsrden ofpR)viru lhat he or she did xil boild or imprcve tlrc pmpany for lhc purF)€ of
slc).
_1, as owncr ofthe propeiy, !m exclusi!ely contracting wilh liiankrl contraclos to construcl lhc project (Scc. 7044. Business
and PnrtlssirnCode:TheContrack)r'sLiccDseLawdoesnotal)plytoanowDerofpropenywhobuildsorinrprovc$theEofl.
and who cootracls for such proi'cts wilh a Contrachr(s) liccnsd pursuml to lhc Conuaclor's Liccnsc kw).
-lanrexcn4nundersccti(trl-,B.&P.C,lbrthisreasotr.
WORKI]RS' COMPENSATION
DECLARATION
I hcrcby allirm utrdcr pcnalty of perjury onc of lhc lolk)win8 dccltrations:
_l have md will nuintaiD u Cenificate of Consent b Self-lnsurc for workcrs'conlpehsalion, as providcd for hy Scction 3700 of the
[3tDr Codc, for lhc Frrfonrurcc ofthc work for which thc permi( is issucd.
_lhavcandwillnrarntainworkers conrpcnsnti(ninsurancc,as raquircdbySeclion3T00ofthaLahorC:ode,forllre[ErforDurreof
thc work for which this lErnlit is issucd. My workers' conrpcnsation insurillcc wicr uxl Jxrlicy nunrbcr ue:
a
-t c-€/r\(q
Policy
o
_l ccnify lhat in thc pcrtirrnlancc of thc work for which this lcrnlil is issucd, I shall not colploy aoy Nrson in any manncr
so rs to becorrc suhjcc I lo t hc workr'rs' conrlrcnsation laws o f Cali forn ia, and agrcc that i f I shou ld becom subjccl to t hc
workers'coDrpensa(ionpru!iJioDsofSeclionlT00ofthcljborCbde,lslull,fonhwilhcorrrplywilhtlp*provisioN..
WARNING: Failura lo scura workcrs'compcnsalion covcrogc is unlawful,subjcct sn nod
civil tiilcs up k) oile huildred thousrnd dolhrs ($100.000). in additi('n rhe
atktrncy s ltcs.
DECLARATION
I hereby affirmunder penalty of perjury that I nnl licensd under prcvision ofChalrter 9 (comnEncin8 with Scction 7000) ofDivision 3
of thc Business and Profcssions Code. anl my liccn* is in full fore aftJ cffcct.
67€
Liccnsc
CONSTRUCTION LENDING AGENCY
I hcrcby all'irm under ltnalt)i of pcrjury lhal thcrc is a construction lcnding agcrcy for thc pcrlbrmarcc ofthe work lor which this pcrmit is
issucd (Sec. 3097. Cir. C.).
l:ndcr's Addro.:
APPI,ICAYT I)ECI,ARATION
I hfrty afirnrundq ltnalty ofpcrjury onc of thc folklwing dccluations:
DcnDlition Pcrnlils-Asbcst)s Notificiltion Fedcral Rcgulaliols (Titlc 4{), Pd6)
_Rcquircd trllcr of Nolificrtion
_l ccltili lhal thc fcdcral regulations rcgadin8 asbcslos remval &c not applicable lo this proi{t.
f9t.*ify tt rt I luvc rcad this applicalion ard state tlut lhc ah)ve inforDuliotr is corcd. I agre to conrply with all City and County
ordinanccs and Statc Laws rclntinS b buildinS construction. ul hcrcby authorizc rcprcscnhtivcs ofthis City and Counly to cnter
abovc rrchtioncd propcny for inspcction purpo$s.
Applicant or Agflt
l'cmritc( trrnr(
*5
tl*
Hev.08-07-2015
/r-\
,
kndcr's Namc:
-
CGO
City 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 #:2O170942
Pin #: 76,o.27
Project Addres@ 7n C lt-TzJuHit: MTR01
Assessor's Parcel: 41'l-14'l-'12 Lot: Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Shea Properties
130 Vantis Dr. #200
Aliso Viejo, CA 92656
(949) 389-729s
Pacific Construction Group
'17895 Skypark Circle #K
lrvine, CA 92614
(949) 748-1500
Fee Type
01116002 51603 Temporary Electric
01 1 16002 51600 General Plan Update
01116002 57770 Microfilm Records
Amount
253 66
22.95
3.91
Qty
1.00
0.00
0.00
Fee
$2s3.66
$0.00
$0.00
But,chi: i,40I? -
0lf ire: i.TYH
HLLLT.
ftrp u+:0:i tr;'6:i
lror,SBCt, lorr lgLti
Fcrcif ic (:onstr'uq-
Electr r csl
tt11i60tt2- 5lot tJttt
I(:L (:hecir Ut'
Jf iIU
State Lic #: 742676
Lic Type: B
Bus. Lic #: 347876
Workers' Compensation lnsurance:Carrier: Everest National lnsurance Company
Policy #. 7600014602191
Ilxpires: O3tO1l2O2O
duilding Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
lndustrial
Miscellaneous
30-day temp Elec.
Occupancy:
Constr Type:
Code:
Date:
Dale:
Date:
B, S-2
III B, SPK
cEc 2019 Notes: 30 day temp electrical. Bond posted on M-74235
03t03t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Chavez, Dave
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the site by such permit ls suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Fee Total:
Paid to Date:
Balance Due:
$253.66
$0.00
$253.66
lnspector MrD#. 2020-158200
01 1 16002 51603 $253 66
ELECTRICAL.INSPECTOR RECOBD
Rev.08-07-2015
DATE ID/SIG.COMMENTSAPPROVALS
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Sions (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rough
Ceilings (T-Bar Rough)
Nrleter Release
Rouqh
Service [Meter
F!NAL
Notes, Remarks, Etc.
A.x
I hcrcby aflrnr undcr pcnalty of per.jury that I an cxcnrpl froD lhc C:on(GctoN' liccnse bw for thc followint Een (Soc.7031.5
Busincss aM Prolcssion Codc): Any City or County which rcquircs a pcrmit to construct, ollcr. irnprovc. dem)lish or rcpair my
struclure, prior to ils issuance. also rcquircs thc applicail for such fEnrrit to filc a sigrcd slalcmnl lhd ha or slE is lice[Ed pur$ilt
to thc provisions of th!' Contractor's l,icenscd law (Chaptcr 9. Commcncing with Scclion TUXJ of Division J of thc Business and
Professious Code) or thrr lE or she is ctcmli therefron aod tlE b6is fbr th€ alleged exery{ion. Any violatioo ofsetioD 7031.5 by sry
.pplicdntlorapeilnitsubject$the.pplicantloacivilp.naltyofnotmorethanllvchundrcddollars($5uJ).
_1. as owner ol lhc profEny. or nry cmployces wilh wages as (hcir solc cornpensalion, willdo thc wtrk and thc structwe is not
intcrxlcd or offercd for sle (S6.7(N4. Business and Pnrfcssions Codc: The Contractot's Liccn* ljw d€s not apply lo m owner of
the pR4rny wlxr builds or inrproves tlrrBnr, ud wlrc does such work himselt or lErslf or through his oa her own enDloyecs,
providcd that such impi()vcrrcnts dc nol intcndcd rlr ollcrcd tor slc. Il: howcvq. thc building or improvcmnt is mb within onc yca
ofcorqrlcli)[ llE Owrcr Builler will have tlr burdcn ofprcving lhat h. or she did mt boil,l or imprcve thc prepdty for th. purpoc of
stL).
_1, ru owner ofthe prr)peny, ilm exclusively conlracting with licensed conlractors lo conslruct lhc prcjcct (Sec. 7044. Busincss
arrl hofe\siilCode:ThcCotrtrlc()r'sLicenseLawdNsnotapplytosnownerofprolrnywkrbuildsorimprovesthereon.
and who contracts for such proiccts with a Contracbr(s) liccnscd pursuilt to thc Contractor's Licensc Law).
-l
anlexempt ulder Section-, B. & P.C. tbr tlils reasoo.
WORKER!' COMPENSATION
D&qI.ABAIIQN
I hcrcby aftirm under penalty ofpcrjury onc ofthc lbllowing decltrations:
_l havc atrd will nEiorai! a Cenilicate of Conscnt to S.lf-lnsure for workas' mmpcnsation, as prcvid.d for by Scction 3?00 of thc
tabo. Codc, for thc perfofl)ffic of lhc work lbr which thc pcrtril is issucd.
_l havc atrd will nraintain workers' coDrpc[salion insurance, as requircd by Selion 3700 of lhc tibor Codc, for thc fErfomwc of
thc work tbr which this is coicr uxl
v€v{
Policy C)qt
_l ccnili thal iD lhc lErf()rnuncc ol'thc work for which (his Frmil is issucd, I shall not cnrploy any lrcrson in any manncr
s astobccorrcsubjcct(othcworkcrs'cornlrcnsationlawsofcrlifomia.andagreethatiflshouldbccorrcsubjccltothc
uukers' con4EnsrtioD proviliotrs of S€ction l7U) of lhe Labor Code, I slull, fo(hwilh corply with thos provisious..
WARNING: Failurc to securc workcrs'compensation covcraee is unlawful, md shall subjccl an employcr to rirninal pcilics and
civil tincs !p k) oue lrutrdred thousand dollars (S100,000). in additiur compcnsation. danugcs o providcd fi)r the
::^T :kY;Z inlercst and a(torrcy's fces.
I hercby affrnr under Fnalry of perjury that I anr liccn*J under prcvision ofChrptcr 9 (cotrrnrcocing with Scction 7fi)0) of Division 3
ol the Business nnd ltoltssi(nrs Code. arxl mv liccnse rs in lull torce and elfect.J €1€
LiceDsc )
>c7
W
I hcrcby alfirm undcr F-nalty ol pcrjury (hd there is a conslruction lcnding agercy for the pcrformarce of the work lor which this pcrmit i\
issuctl (Scc. 3097. Civ. C.).
kndcr's Name:-
[rndcr's Address:
AIEUEANLDEELABdI!qN
I lmhy allimr undcr pcnalty ol pc{ury onc o[ thc litllowing dcrluations:
Dcnx)litioo Pcrnits-Astf,'stos Notification f'cdcral Rcgulations (Titlc 40, Pd6)
_Rcquircd txtrcr of Noliication
_l cc(ili thal lhc ltdcral rcSulations rcguding utrcskrs rcrmvalsc not applicablc to this projcrcl.
_l cc(ili lhat I luvc rcad thir application {xl stalc lhal llrc abovc inlo'nHlion is corcct. I agre lo ontply with all City ilnd Coulty
ordinanccs and Statc [is's rclalin8 k) buildiog hcrcby authorizc reprcsntativcs o[this Cily md County to ent6 upon thc
abovc nEnlioned propc(y for inspcclion
Apllicant or A8$l
l'cmrilcc tranrc
b/>o