HomeMy WebLinkAbout20170928 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #:2tJ17lJ92E
Pin #: 3O39O
Project Address: 650 E Dyer Rd unit:MTRO1
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
ZoningAssessor's Parcel: 411-141-12 Lot:
Owner:
Address:
Shea Properties
130 Vantis Dr. #200
Aliso Viejo, CA 92656
(949) 389-7295
Fee Type
01 '1 16002 51603 Temporary Electric
01 1 16002 51600 General Plan Update
01 1 16002 57770 Microfilm Records
Amount
253.66
22.95
3.91
Qty
1.00
0.00
0.00
Fee
$2s3.66
$0.00
$0.00Phone:
Tenant Name:
Contractor:
Address:
Phone:
Pacific Construction Group
'17895 Skypark Circle #K
lrvine, CA 92614
(949) 748-1500
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State Lic #: 742676
Lic Type: B
Bus. Lic #; 347876
Workers' Compensation lnsurance:Carrier: Everest National lnsurance Company
Policy #: 7600014602191
Expires: O3lO1l2O20
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Building Use:
Job Type:
Nature of Work
lndustrial Occupancy:
Miscellaneous Constr Type
30-day temp Elec. Bldg. #2 Code:
B, S-2
IIIB, SPK
cEc 2019 Notes: 30 day temp electrical. Bond posted on M-74235.
Bldg. #2
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Chavez. Dave a7o'
Date:
Date:
Date:03/03/2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
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:
$2s3.66
$0.00
$2s3.66
lnspector MID#: 2020-158183
0'l'116002 51603 $253.66
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DATE ID/SIG.COMMENTSAPPROVALS
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueinq
Sub-Panels
Air Condltioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rough
Ceilinqs (T-Bar Rough)
Meter Release
Rouqh
Service Meter Avw)FINAL c-10-20
Notes, Remarks, Etc.
ELECTRICAL-INSPECTOR RECORD
I hcrcby aflrm uuler pcnalty of perjury thal I dtr cxcmpt frcnl lhc CbntracloN' Lic.Nc bw for thc following rcasn (So:.7031.5
Business and Prolesrion Code): Any City or County which rcquircs a [Ermil lo construct, alter, improve. dcmlish or rcpair any
struclurc, prilr to its issuance. rlso rcquiEs thc applicail for such lEmit b fih s si8rcd slatcmnt lhal hc or strc is liccMd pulsanl
to thc pmvisions of thc Contractor's l,iccnscd law (Chaptcr 9. Commencing with Scction 7000 of Division 3 o[ the Busincss od
Prof€ssions Cqre) or that lE or she is excnrpt therefiom and tlE b6is for tlE alle8ed exenption. Ary violalion of S4lion 7031.5 by any
applicant for a pcf,nit subj(t$ lhc applicant lo a civil pcmlty oI not mre than fivc hundred doll.m ($5uJ).
_1. es ownca ol lhc prelEny. or my crnployces wilh wages as thcir solc compcnsdion, will do the wtrk and tha stm@ is mt
intcrxlcd or offercd for salc (Se.7044. Busincss and Prclessions Codc: Thc Conlraclor's Liccns Law docs not apply lo ah ownc! of
thepNtEny wlnhuil&orimJtroveslhiamuardwlDd(BsrchwotkhimelforlEr*lforlhrcughhisorherowlemployes,
providcd that such imptr)vcrrcnts [c mt iilcndcd or olTcred for eb. Il. howcvq, 0E building or itrprovcrEnt is sld wilhin orc ycd
ofconpblk)n, $c Owrcr Builtr will have thc bqrden of prcving that he or shc did mt boill or irpmvc thc pmp<ry for thc purpow of
sb).
_1. as owncr of the pmpefly. um cxclusilcly contracting with liccn*d conlaaclors to construcl lha prcFct (Ss. 7{X4. Busirc$
aill P[)tessimCode:TheContmchr'sLicenseLawdoesnotapplytoanownerofprope(ywhobuildsorimproveslhereon.
and who cootracls for such projccts with a G)nlretor(s) IiccGEd pursutut to (hc Conuactor's Lice[se Law).
-l
urexempt under Sectiul-, B. & P.C. for this reason.
WOI{XI.lRS' COM PI)NsATl0N
DECLARATION
I hcrchy alfirm undcr pcnally of pcrjury onc of lhc l'ollowing dccluatiotrs:
_lhavcanlwill nuintairaCcnilicatcofconsenttoSclllnsurcforworkcts'compemation,as prcvidcdforbyScction3T00ofthc
l.rhor Codc. for the pcrfoflMrce ofthc work lbr which lhc pctrnit is issucd.
_lhavearrdwillnraintainworkcrs'collpcrNati()ninsurancc,as rcquiredbySetion3T00ofthehborCodc,forlhcpcrfomH[eof
thc work for wlich lhis Frnlit is issucd. My workcrs' compcNation insurecc cmicr a&l F)lky number oc:it c d
l'olicy 2
_l ccnify that iu thc lErli)rnuncc ol'thc work for whicll this permit is issucd, I shall not cmploy ury pcr$n in a[y nranncr
$ aslobccoDrcsubjccttolhcworkcrs'coillpcnsdionlawsofcalifomia.andagrccthatiflslnuldbccoresuhjecttothc
workers' conrpensalior provisiotrs of Sectiotr 37U) of thc Labor Code, I slull, fonhwilh cornply wilh lho* provisions..
WARNING: Failure 1o rccure workers'compensation covcBgc is unlawful. and shall an emploler to oiminal panaltiqs and
rivil t'ucs up lo orc lundrcd thousand dollars ($100.000). ir additi(nr n) thc danugcs as provided fi)r lhe';:'{5rryr**dd iltorrcy's fek
LICENSED CONTRACTOR
I'I]CLARATION
I hcrcby affrm under lEnalr), of pcrjury rlut I anr licen*d under pruvision of Chapter I (comnEn(in8 with Scction 7000)
ol' the Buriness and l'rofessions Code. nnd rnv liccnsc is ir lull force und effect.
Liccnsc NuDrbcr:6"b
CONSTRUCTION LENDINC AGENCY
I hcrcby al llrm undcr Fnalty of pcrjury that thcrc is a construction hnding agcrcy for thc perlormarce o[thc work lbr which lhis ltrmit is
issued (Scc. 3097, Civ. C.).
Lcndcr's Nanle. _
Irtrdc) s A,l,lre.':
@NpEc!.AB .UAN
I lucby aftirnr undcr 1*-naly of pc{ury onc of thc li)llowing dccluations:
Dcnx)lition Pcrnrits-Asbcskls Notification l'tdcral RcSulrtions ('I itlc 40, Pm6)
_Rcquircd Lcttcr of Notificati)n
_l cenili thal thc fcdcral rcgulAtions regilding asbcsbs rcmrval uc nol applicablc lo this projcct.
@l ccnify rtrot I havc rtad tlus apphcation ild state tlut llE atrvc informatiou is co[ecl. t e8lce to comply
ordinmccs dd Stalc Laws rclatinS k) huildinS constructhn, and hcrcby authorire rcprc$nutivcs ofthis City
with all City and County
and County h cnlcr
above nEntioned propcny for inspcction
ADpli(strl or Agol
Hev.08-07-2015
Pcmrilcc ndnlc
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