HomeMy WebLinkAbout20170932 - 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 #:211170932
Pin #: 16274
Project Address: 642 E Dyer Rd
Assessor's Parcel: 411-141-12 Lot:
unit: MTRO1
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning
Owner:
Address:
Phone:
Tenant Name:
Phone:
Shea Properties
130 Vantis Dr. #200
Aliso Viejo, CA 92656
(949) 389-7295
Pacific Construction Group
17895 Skypark Circle #K
lrvine, CA 92614
(949) 748-1500
Fee Type
01 116002 51603 Temporary Electric
01116002 51600 General Plan Update
01116002 57770 Microfilm Records
Qty
1.00
0.00
0.00
Fee
$253.66
$0.00
$0.00
lLC. L.t ln
LLt.
rt*:tri?t"r76l
nngctct t crr
:ii ic i.otrst
UI
'
LLI
rtiil: -
L.lrELli
'/
li-rlLr
ll9? r
nc
3/3i2t
J LlLrLr -
rrr_r2l i r-r143
IUi L.L.IJE T-L9oi
2Lr1/tii3?
{.-.. rir hll(l r l!r H,,
t13r5ti5.iit
$.r
lL
State Lic #: 742676
Lic Type: B
Bus. Lic #: 347876
Workers' Compensation lnsurance:Carrier: Everest National lnsurance Company
Policy #: 7600014602191
Expires: O3l01l2O2Of
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
lndustrial OccuPancY:
Miscellaneous Constr Type
30-day temp Elec. Bldg. #4 Code:
Chavez Davv-V-
Date:
Date:
Date:
B, S-2
IIIB, SPK
cEc 2019 Notes: 30 day temp electracal. Bond posted on M-74235.
Bldg. tt4
03103t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Fee Total:
Paid to Date:
Balance Due:
$253.66
$0.00
$2s3.66
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 ls suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2020-158205
0't116002 51603 $253.66
Contraclor:
Address:
Amount
253.66
22.95
3.91
c.l.cL
ELECTR!CAL.INSPECTOR RECORD
Rev.08-07-2015
APPROVALS DATE ID/S!G.COMMENTS ()WNT'R BUII,DER I)1]I,CARATION
I hcrcby affrnr under pcnahy of pcrjury that I dtr exenpt fronr lhe CbntmctoN' Licensc Law for thc following caetr (Sft.7031.5
Busincss and Profcssion Codc): Any City or County which rcquircs a pcmit to construct, altq, improve. demlish or rcpair my
struclurc, prior to ils issuancc. also rcquires thc applicnil for sucl ltnril k) fik a siSned statarftnl that lr or she is licco*d pursu{rl
lo th( pmvisions of thc Contraclor's Liccnscd lrw (Chaptcr 9, Comrncncing with Section 7fiyJ ot Division 3 of thc Busincss and
PrcfessionsCode)orthatlEorsheiscxcmpttherefronraildtlEbasisfortheitllegedexemiliotr. AnyviolationofS{licn703l.5byany
appliconrforapeflnitsubjectsthe cpplicxnttodcivilpcnaltyofnolmreth&nfivchundrcddollars($500).
_1. &\ owncr ol the prolrny, or my ernployces with wagcs as their solc compensalion, willdo thc work and thc stNft is mt
interklcd or offarad tor sala (Sd.7(N4. Busincss and Pmfcssions Codc: Th€ Conllactor's Liccn* Law d@s not apply lo flr owrcr of
tlE lmp€ny wlD hoildi or irwoEs llH$& uxl wlD d(ur such work himself ot lErself or throuSh his or her own enployces,
provided that such improvcrmnts ec not iilcndcd or ollcrcd for salc. ll, howcvs, OE tuilding or ftprovcmnt is sld within orc )r{
of conlplctiol (he Owrer Buik-ler will havc the bonlcn of pnrving tha hc o( s]E di.l mt buil.l or ifipmvc thc pmpqty for thc puq[s of
sale).
_1, as owncr of the prcpeny, um cxclusivcly contrac(ing wilh liccfisd conhcloB to construcl th. prcFct (Scc. 7044. Businc$
and Prolisur Code: The Contrackrr's LiceDse Law dcs not apply lo an owDer of propcny who builds or improvcs lhereon.
atrd who contracls for such prejccts wilh a Coilmcto(s) licenscd pursuet to thc Contrador's LiceNe [lw).
-l
mr erenlt under Section-, B. & P.C. tbr tbis reason.
Dale:-
lYoRKI.;RS' Col\l l'HNSA'r'lON
DI:CLAR,\TION
I hcrcby affirm undcr pcndlly ofpcrjury onc oflhc l'ollowitrg dccl4atios:
_l have md will nuinlair a Cefliticalc of CoDsent m Self-lnsurc for workcrs' conrpensation, as prcvided for by Scction 3700 of thc
Latx)r Codc, for thc trcrfoilMmc oflhc uork lor which lhe pcrDil ir issucd.
_l have an{l will nrairilail workers cotrrpensali()n insurarce. as requircd hy Secti<m 3700 oflh€ tik)r Codc, for the lErf()rDurrc of
thc work lbr wlrich this lrcrnit rs i\suc(l. Mj comfEBation irrsur@c cuicr arxl lDlicy numher dc:
C d.1/.t (/11 cl
ZZr/Policy
_l cc(ili thar i[ thc Frlinnancc ol thc work for vhich this ]rcrnil is issucd, I slrall not cnrploy any pcrson in any manncr
m astobccorrcsubjcctlothcworkcrs'conpcnsrtioDlawsoICalifornix.andaSrccthatiflslnuldbccorrcsubjccttothc
workers' conucnsalion provisions of Section 1700 of th. tnbor Code, I shall, fonhwith conlply with thos prcvisiorN..
WARNING: Failur. to scure workcrs'
civil lines up k) onc huDdred thousand
compcnsation covcrdgc
dollars ($100.000). iD r
is unlawful. and shall subjcct an amployer to crhninsl pcnaltics
Iaddition to lhe cost of danrages as providcd for
a(orrcy's fccs.x
I)I]CI.ARA TION
I hcrcby affirnr unrJcr petralty of perjury thal I anr licensd under prcvision ofChapter 9 (cotrrmencinS with Section 7U)0) of Division l
of lhe Busincss aDd Professions Code. and my license is in lull forcc and effect.
License
7V2 6?b
2o
CONSTRUCTION LENDING AGENCY
I hcrcby allirm undcr pcnaky of pcrjury that thdc is a construc(ion lending agercy for thc IErformmc of(hc work lbr which this pcrmit is
issucd (Scc. 3097. Cir'. C.).
lrndcr's Nanrc:
[rndcr's Atldrcss:
ruNLpEe!&UtlN
I lmby aJt'imrundcr pcnalty of pcrjury onc of lhe following delarations:
Dcnnlition Pcrmits-AstEskts Notification Fcderal Rcgulations (Titlc 40, Pd6)
-Rcquircd
Lcttcr of Mlificalion
_l cc(ify lhd lhc fcdcral regulalions rc8ddins asbcstos rcmoval de not applicablc to this projet.
B-l cmify rUr t tuvc rcrd this applicalior axl stalc tlul the abovc infornulion is corcct. I a8rc to conrply with all City and County
ordinanccs and Statc laws rclating h building hcrcby authorize rcprcsntativcs ofthis Cily and County to cnts uF)n thc
alxrve mentioned prrpe(y for inspectt)n
Applicant or A[ctrl
I'cmilcc nsnrc t ^,",2/r/ao
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm i Dampers
Communications Cable
Building
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
Meter Release
Rouqh
Service lVleter
F!NAL 6-10 -za },\fl-)0
Notes Remarks Etc.I
I