HomeMy WebLinkAbout20170931 - PermitCity 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 #:20170931
Pin #: 8,4887
Project Address: 642 E Dyer Rd
Assessor's Parcel: 41'l-14'l-12 Lot:
Unit:
Block: NA
Btdg:
Tract: NA
Address Range: 640-690 E
Dyer
Historic: No
Suite Range:
Zoning
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone
Shea Properties
130 Vantis Dr. #200
Aliso Viejo, CA 92656
(949) 38e-7295
Pacific Construction Group
17895 Skypark Circle #K
lrvine, CA 92614
(949) 748-1500
Fee Type
01116002 51603 Temporary Electric
01'116002 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
State Lic #: 742676
Lic Type: B
Bus. Lic #: 347876
Workers' Compensation lnsurance:Carrier: Everest National lnsurance Company
Policy #: 7600014602191
Expires: 0310112020
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. #4
Occupancy:
Constr Type:
Code:
B, S-2
IIIB, SPK
cEc 2019 30 day temp electrical. Bond posted on M-74235.
Bldg. #4
Chavez, Dave
Date:
Date:
Date:03t03t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes
Fee Total:
Paid to Date:
Balance Due:
a?
$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
issuance, or if the work authorized on the site by such permit,s suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2020-158186
01 1 16002 51603 $253.66
ELECTRICAL.INSPECTOR RECORD
v. 08-07-201
DATE ID/S!G COMMENTSAPPROVALS
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
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinos (Hard & Soffit Rouqh
Ceilinos (T-Bar Rouqh)
It/eter Release
Rouqh AService lVleter
*,w\0)F!NAL 6-10-7,0
Notes Remarks Etc.
OWNIiR BIJII,DIiR I)T]I,CARATION
I hercby affirnr lDder pcrulty of perjury thal I iln cxenrpt from thc Contrrclos Liccnse Law for thc following r.apn (S(.70J1.5
Busincss ard Prolcssion Codc): Any Cil), or County which rcquircs a [Emit to construct. allcr, improvc. demlish or rcpair my
struclure, prior () ils issuarce. aLso requires the applicaill tor such pcmil b filc a sigDed slatcmnl that lE or she is liccDsd pursuanl
ro rhc provisions ofthc Contrnctor's Liccnscd Iaw (Chaptcr 9. Commcncing with Scction 7Ux) ol Division 3 ofthc Busincss and
ProfessionsCodc)orthx(hcorsheisexenuttherefionrand(lcbasisfortlNallegedex.nrptiul. Ailyviolationofseclion?03l.5byaDy
ipplicnntforapcrmi!subjectsthc npplicanttoacivilpentrltyofnotrmrethunfivehundreddollars($5(n).
_1, as owncr ol'thc proJrny, or nry crnployccs with wagcs as thcir $le compcnsation, will do thc work ard thc stMtw is mt
iDteBlcd or olTerad for sle (Sr_.7(X4. Business anrl Profcssions Codc: Thc Conlraclor's Liccnsc law des not apply Io m owncr of
tlrc prcpeny wlxr builds or inproves therqnl drd wle does such work himself or lErself or thruugh his or her owo enuloy€es,
providcd lhat such impmvcrmnts ec mt inlcrdcd or ollcrcd for slc. Il. howcvtr, 0rc buiHing or irprorcmnt is sld within ore yca
ofconpleli(nr, the Owncr Buildcr will havc the burden ofprcvinS lhat hc or shc rlid not build or impmvc 0rc prcpaty for the purpo* of
ele).
_1. as owncr ofthe prop€iy, am cxclusiyely contractin8 with licc[*d conlrac(os to construct thc pmjcct (Scc. 7O{4. Businc$
ard PE)ltssbnCodci'lheContrack,r'sLiceuseLawdoesndapplytranownerofpropenywhobuildsorinrprovesthereon.
and who contads lor such projccts with a Cortraclo(s) licc[ed pursuMl to thc Conrador's Licensc llv).
-l
anrexenrpt under Sectioil , B. & P.C. lbr tlis rea$[.
WORI(I'RS' COMPU,NSATION
DECLARATION
I lrcrcby alllrrn undcr pcnalty ofncrjury onc oflhc li)llowing dccltralions:
_lhavemdwillnraintairaCenilicatcofconsentrcSclf-lrNurcforworkcrs'conrpcnsation,as pmvid€dforbyScctionST0Oofthe
libor Codc, for fic Jrcrfornurcc of the work for which thc perdt is issucd.
_l have anrl will nrauilrnr wotkers coDrpensilltm insurxnec. as by Seclion 3700 of lhc bbor Code, for tlr lErfomuree of
thc work rhis is My cuicr nxl policy outrtrut
rp Q*CL c
Policy
4o I/tt
_l ccrify tlut i[ thc Frfornuncc of lhc work for which tlris pcrmil is issucd, I shall nd cnploy ily Frson in any manncr
s as to becorrc subjccl lo thc workcrs' conrpcnsation laws of Califomia. and agrcc that if I slnuld bccorc subjrcl to thc
*orkers' cotrpcnrution provirioDs of Secrion 1700 of the Labor Codc, I shall, fonhwilh comply wilh thoE provisions..
WARNINC: Failurc lo surc workcrs'corrpcnsation covcruge is unlawful, and shall subjcct m cmploycr lo Fiminal pcmltics and
civil l'iiles ul) k) one hundred thousand dollars ($100.0!0). in ^%.,compensation, danuSes as provided for thc
t
Lahor Codc.l)o inlcrcsl and allork-y's lccs.
LICENSED CONTRACTOR
DECI"ARATION
I hercby affirm under pcDolty of perjury that I anr lic.nsed under pruvision ofChapt.r 9 (connrcocing with S{tion ?000) of Divisi-n J
of thc Business and Pmfcssi<rrs Codc. ard mv licensc is in full fore ard cffect.
LicenNe
tl
CONSTRUCTION LENDING AGENCY
I hcrcby all'irm undcr pcnalty ot pcrjury rhat thcrc is a construction lending aBcrcy for thc perlbrmance ofthc work ltrr which lhis pcrmit is
issued (Src. 3097. Civ. C.).
[.n,ler's Nanrc:
Lrndcr's Addres\:
APPI,ICANT DECI,ARATION
I lmtry irffrnr unclcr 1-.nalty of pcrjury one of thc foll(,wing declilati(,ns:
Dcnplition Pcrnlits-Ashcst)s Ndification Fcdcral Rcgulations (Titlc 40, PM6)
-Rcquircd
Lrttcr of No(ifi cation
_l cdily (hat lhc lcdcral rcgulations rcgdding $bcshs rcrmval uc not applicable to this projlEt.
6 mify tut t trr" rcad this application ard statc tlut inlirnEti(xl i5 coficct I agre rc conrply with all City and County
ordinanccs and Statc liws rclalin8 k) buildinB
abovc rrcntioncd prcpcny for inspcction
Applicstrt or Agml
CI'cmitcc nanrc
hcrcb), authorizc rcprcscntativcs ofthis City and
)
ent r upon thc
/D-