HomeMy WebLinkAbout20170936 - PermitProject Address: 662 E Dyer Rd
Assessor's Parcel: 411-141-12 Lot:
unit: MTRO1
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning
City 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 #:20170936
Pin #: 28O3O
Owner:
Address:
Phone
Shea Properties
130 Vantis Dr. t200
Aliso Viejo, CA 92656
(949) 389-729s
Fee Type
01 1 16002 5'1603 Temporary Electric
01116002 51600 General Plan Update
01116002 57770 Microfilm Records
Amount
253.66
22.95
3.91
Qty
1.00
0.00
0.00
Fee
$253.66
$0 00
$0.00
Tenant Name:
Contractor: Pacific Construction Group
Address: 17895 Skypark Circle #K
lrvine, CA 92614
Phone: (949) 748-1500 _,-.
State Lic #: 742676 '/
Lic Type: B
Bus. Lic #: 347876
Workers' Compensation lnsurance:Carrier: Everest National lnsurance Company
Policy #: 7600014602191
Expires: O3lO1l2O20
Eotch*:54o5? - 3u'3r2t-t20[fi igg; r.TYH Trons*: 11Accti: triet'* :
Rcpt*rr-r2?r.r7010 - 3i3i2itLit
TrsnEoct ion Totnl
IUi T.L.ULLLAh
13 st' .i
2017r_ri36
1r-r:25 All
t13r5ri5. ii$
Fsc r I ic i:onsLruci isri 6rcrup
EIectr i cal
tl1 1 16trtr2- Sl6LrSrrtrLr-
I(:L i.herk u02i 101+3 $:1. .i r lii
Building 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. Bldg. #6
Occupancy:
Constr Type:
Code:
B, S-2
IIIB, SPK
cEc 2019
Notes: 30 day temp electrical. Bond posted on M-74235.
Bldg. #6
Chavez, Dave
Date
Date
Date 03t03t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Totalvar
01 1 16002 51603 $253.66 Fee Total:
Paid to Date:
Balance Due
$253.66
$0.00
$253.66
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
lssuance, or if the work authorized on the site by such permit is suspended
or abandoned tor a period of 360 days after the time the work is
commenced.
lnspector MID#: 2020-158206
, r..
ELECTRICAL.INSPECTOR RECORD
I hcr€by affinr uilcr p€nahy of pcrjury that I tuD cxenpt [roD lhc Cbnt.aclo6' Liccnse kw for thc following Gaen (Sdc.7031.5
Busincss ard Proltssion C{xlc): Any Cily or County which rcquircs a lrcrmit to construc(, altcr, irnprovc. demlish or rcpair any
slructure, prior 0 ils issuatrce. also requircs lhe applicilil ti)r such pcnrrit k) fih a sigDcd stalctrEnl lhat IE or shc is liccled nur$ant
to thc pmvixions of llE Conlrachr's Liccnscd lrw (Chafler 9. Commcncing wilh Scction 7000 ol Division 3 of thc Busincss and
Profcssions Code) or that hc or slE is exeDrpl thercfrom and tlE baris tor the alleged exemption. fuiy violatiu of Secti(D 703 L5 by aDy
npplicant lbr a pernit subjccts the applicunt to n civil pennltv of nol ,mre than five hundred dollars ($500).
_1. as owncr ol llr proFny, or my crnphyccs wilh wagcs as thcir solc compcnsdion, will do the work and thc structwc is ml
irlerxlcd orofTeredforslc(Se.TlX4.BusincssanrlPrcfcssionsCod.:ThcContraclor'sLiccnsclawrlcsnolapplytoanowncrof
the tmpeny who tNilds or improvcs tlErdrl and who does such work himself or lEr$elf or tkough his or her owD enlployees,
providcd lhat such improvcmnts ilc mt inlcndcd or ollcrcd Io, salc. Il: howcvci tlrc building or irDprovcrrcnt ir skl within onc ycd
ofconpletinr, the owrer Builler will luve thc burden ofprcvirf thd lE or shc did Nt buill or inprcvc thc prcpdly for th. purpos of
uh).
-1.
o owner of thc profEny, om cxclusilely contrscting with liccnsd contraclos lo conslruct t[E preFct (Scc. ?O14, Businc$
and hofbssionCode:TheContrack,r'sLicenseLawdoesnotapplyklanownerofpropcnywhobuildsorinrprovesthereon.
and who conlracts for such p(tj('cts wilh a Contracto(s) liccNd pursumt to lhc Contraclor's Licc[e Llw).
Dale:_
woRKEt(s' c()M Pr,NsA'It0N
DECLARATION
I hdrcby allirnl uilder pcnalty of pcrjury one of thc l(ilk)wing dccltuations:
_lhavearxlwill truinlainaCenilirateofConsenlloSelf-lnsureforworkersicomJtosation,as providcdforbyScctionJT00ofthe
Latrr Codc. for thc pcrforiluncc ofthc work for which tlrc pcrnit is issued.
_l have ud will nrainlain workem con[ensalion insuftncc, as required by Scclion 3700 ofrhe labor Code, for thc lErfornLilrce of
llrc work lhis is policY numhcr mc:
0CJ^4 (q tQ_
Policy o
_l ccnily llDt in thc Frli)rnuncc ol thc wo* for which tlris Frmil is isrucd, I shall not cnuloy uy Frson in any manncr
so as to becorft subjccl lo lhc workers' conlpcnsation laws of Califomia, and atrce that if I slnuld becom subjcct to thc
workcrs' cotrrpensdtion provi5ions of Section 3700 of the Labor Codc, I shall, fofrhwith con)ply wilh thos provisions..
-lanlexemilundet,Sccti()[-'B,&P,C.liilthisreason.
WARNINGi Failurc to sccurc workcrs'compensation covcroge
civil Iiues up to onc hundred thousand dollars ($100.000). in
Section oI intcrcst md dtorrcy s fccs.
I,ICENST]D CON'IRACToR
I)I](]I,ARA'I'IoN
I hercby affirnr undcr Fnnlty of perjury that I am liccnsd uDdcr povision ofChaprer 9 (conurEncinB with Scdtion 7000) of
rry':i,fl ,il,il:':f ',i:"T#,1fi 5'nil:
Q €1€
aWP
of the
Liccnsc
Busincss and Prcfcssions Codc. and nly lrcen\e is in lull forcc and ellcct-
9 )
W
I hcrcby afhrm undcr pcnahy ofpcrjury that thcrc is a construction lcnding agcrcy fo, thc pcilormarcc oflhe work lbr which this pcrmir is
issucd (Scc. 1097, Civ. C.).
kn,lcr's Nam:
[rndcr's Addrcss:
APPLICANT DECT,ARATION
I M)y aflim undcr Fnahy of pcrjlry orc of thc folk wing deldalilns:
Dcnx,litioo Pcrmits-Asbcsk)s Notification Federal ReSulati(,ns (Titlc 40, Pd6)
_Requircd [*(cr of Notificatioo
_l ccnily lhal thc fcdcral rcgulations rc8{ding asbcslos rcrmval uc not applicablc to this proj€t.
(!l ccnify that I luvc rcad rlus application ax.l state lhal lhc ah)vc intirmEtion is corcct. I agre to conDly with all Cily and County
ordinances md Stalc [a$s rclating to building atxl hcrcby autlnria rcprcsntativcs oflhis Ciry ild thu
dbovc lrentioned propcdy for inspcction
Applicant or ASst
Pcmrilcc nanrc
DATEAPPROVALS ID/SIG.COMMENTS
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (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 (Rouoh)
Ceilings (Hard & Soffit Rough
Ceilings (T-Bar Rough)
lVleter Release
Rouqh
Service lVeter l
FINAL to-l0rA tr"\L\[)
Notes, Remarks, Etc.
,'Q,^.
Rev.08-07-2015