HomeMy WebLinkAbout20170930 - 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 #:2O17O93O
Pin #: 77OgA
Project Address: 660 E Dyer Rd
Assessor's Parcel: 411-141-12 Lot:
unit: MTR01
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) 389-7295
Pacific Construction Group
17895 Skypark Circle #K
lrvine, CA 92614
(949) 748-1500
Fee Type
01116002 51603 Temporary Electric
01 I 16002 5'1600 General Plan Update
0't 116002 57770 Microfilm Records
Amount
2s3.66
22.95
3.91
Qty
1.00
0.00
0.00
Fee
$253.66
$0.00
$0.00
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State Lic #: 742676
Lic Type: B
Bus. Lic #: 347876
Workers' Compensation lnsurance:Carrier: Everest National Insurance Company
Policy #: 7600014602191
Expires: 0310112020
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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. #3 Code:
Date:
Date:
Date:
B, S.2
ilt B, sPK
cEc 2019 Notes: 30 day temp electrical. Bond posted on M-74235.
Bldg. #3
Chavez. DaveA'"'03t0312020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
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
issuance, 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 MtD#. 2020-158204
01 1 16002 51603 $253.66
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ELECTR!CAL-INSPECTOR RECORD
Bev.08-07-2015
APPROVALS DATE ID/SIG.COMMENTS OWNTiR BUII,DI.]R DI),CARATION
IlErcbyaffirnrundcrp.traltyofperjrrryth0tIilDcxenrptfroDthcC'onractos LiccnsclawforthcfollowingEasn(Sec.70]1.5
Busincss and Pro,tssion Codc): Any Cily or County which rcquircs a prmit to conslrucl, altcr. improvc. dcmlish or rupair ay
structurc. Fi(,r () its issuance. also rcquircs the applicail for such lEmlit to filc a sitsned slatcrrenl that lE or shc is liccilsed pursusnl
to lhc previsions of thc Contractor's l,iccnscd llw (Chaptcr 9, Comrncncing with Scction 7000 of Division 3 of thc llusincss and
ProfessionsCode)orthatlEorsheiseren4rlthcrefionlardtlEbasisfortlEallesederenrplioo- AnyviolatiorofSectionT03l.5byany
applicilntforapennitsubjeclslhe ipplicantloacivilpemltyofnotrrerethunfivehundrcddolltrs($5LU).
_1. a\ owncr ol'thc foJrcny. or my crnployces with wagcs as their mlc mmpcnsation. willdo the work ard lhe stffim is mt
intculcr.l or offcrcd lor slc (Sa.7O1.1. Business and Prcfcssions Code: Thc Conlractor's Liccn* liw d@s not apply to m owncr of
the prulEny wlb builds or inproves tlBrsr! ud who does such work himself or herself or lkough his or her own enrployecs,
providcd that such impmvcrrcnts ec mt inlcftlcd or ofcrcd for eh. ll, howcvq, ttr boiHing or ifiprovcmnt is sld within orc ycu
of conrplclin\ lh Owrcr Buillcr will lmw thc buden ofpmving tlu lE or sh. did mt buill or irprcvc thc propcny for the pur[ps of
srle).
_1. as owrcr of thc propcny, lnl cxclusiycly contracting wilh liacnsed contracloN to conslruct thc prcjcct (Scc. 7(X4. Business
and hufbssiolCode:ThcContracbr'sLicenseLawdoesnotapplytoanownerofproFnywhobuildsorinrprovesthereo[
and who contracts for such projccts wilh a C(rntrack)(s) liccnsd pursumt lo lhc Conrrctor's Liccnsc kw).
-l
anr exenrpl uDder Scctiotr , B. & P.C- tbr this reason.
l)ste:-
WORKERS' COITPENSATTON
DECLARATION
I hereby aflirm undcr pcnalty ofpcrjury onc oflhc li)llowing dccltuations:
_IhavesrdwillnuiilainaCenilicateofConsentloSelf-lDsureforworkers'conrpcnsation,as providcdforbySectionJT00oftlre
lnhor Codc, for the pcrfoflMnce o[ thc work lor which (hc pcrr[it i\ isrucd.
_llEveuMwillnuintailworkers'c(nDpetrsali(trri[sutance,as requiredbySecli(ill3700oflhehborCodc,
thc work lur which this trrnrit ir issuc.l. My workcrs' con{rcnsation insurdrcc cmicr ilxl ltulicy nunficr de:
,,,,,,, Ev€(6 €\ f
^i/lrr
ccsrnt4 | lzttgJ/q,
f()r lhe ltrli,rnuDce of
.4 ee c-o
t /2/tqc 3/Policy t---T---T
_l ccnily thal irr lhc ltrforDancc ol lhc work ftrr which this pcrmil is issucd, I shall nu enrploy any prson irr any mannc,
s as to bcconr subjcct to thc workcrs' cotrlpcnsation laws ol Calilomia. and agrcc thlt if I should bccorrc subjcct to thc
workers' co[lpensation prorisions of Section ]700 of thc Labor Cod€, t slull, fonhwith cornply with tho* prcvisioN..
WARNING: Failure lo {curc workcrs'comlEnsalion covcrdgc is unlawful, and shall subjcct an cmployar lo oirninal pcnaltics and
civil lincsuploorchur)drcdtllrusanddollars($100,m0).iradditiortotlEcostofcompeNalion,danugcsuprovidcdforthc
allorrey's fccs.,
DI'CI,ARATION
I hercby affrnr under lrnalty of pctjury that I anr licen*d undcr prcvision ofChaplcr 9 (conrrEncing wirh Scction ?UJO) ofDi!isiori 3
of lhe tlusiness and Professions Codc. aftl mv license is in full forcc nrd cffcct.
License L Nu 2co7 b
LU
CONSTRUCTION LENDING AGENCY
I hcrcby all'ifln undcr I^.-naky ol pcrjury that thcrc is a conslruclion lcnding agcncy for thc pcrlbrharcc of thc work lbr which this pcrmit is
issucd (Sec. 3097. Civ. C.).
[Jnder's Nanle:
[.nder's Addr.ss:
APPI,ICANT DECI,ARATION
I irrchy u.ftinr undcr l{nally of pcrjury onc of thc li,llowing dcclarations:
Dcnnlitk)n Pcrmits-Asbcst,s Notilicdti(rn Fcdcral Regulations (Titlc 40, Pmf,
_Rcquircd Lctrcr of Notification
_l ccnili that lhc li'dcralrcgulalir)ns .cgilding asbcstos rcrnoval nc not applicablc o rhis projcct.
stalc thal lhe ah)\'c inli)rnulior is corecl. I agre to conrply with ull City and Coutrty
uk)vc nEntioncd prcperty for inspecthn
ADplic&nt 0r Agenl
I'cmrilcc nsnrc
rcprcsntatives of thir City and k) cntcr rlx'
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safetv /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
Meter Release
Rouqh
Service lVleter A\
FINAL 6-[0-20 k.y4)$\
Notes, Remarks, Etc.U