HomeMy WebLinkAbout20170926 - 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 #:2lJ17lJ926
Pin #: E,8297
Project Address: 640 E Dyer Rd unrt:MTR01
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
0'l 1'16002 51603 Temporary Electric
01 1 16002 51600 General Plan Update
011'16002 57770 Microfilm Records
Amount
253 66
22.95
391
Qty
1.00
000
000
Fee
$253.66
$0.00
$0.00Phone
Tenant Name:
Contractor
Address:
Pacific Construction Group
17895 Skypark Circle #K
lrvine, CA 92614
(949) 748-1s00Phone
State Lic #: 742676
Lic Type: B
Bus. Lic #: 347876
Workers' Compensation lnsurance:Carrier: Everest National lnsurance Company
Policy #: 2600014602191
Expires: 0310112020
Building Use:
Job Type:
Nature of Work
lndustrial
Miscellaneous
30-day temp Elec.Bldg #1
Occupancy:
Constr Type
Code:
B, S-2
IIIB, SPK
cEc 2019 Notes: 30 day temp electrical. Bond posted on M-74235
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Chavez, Dave
Date:
Date:
Date:03t03t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total9+"
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced wnhin 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:
$253.66
$0.00
$253.66
lnspector MID#: 2O2O-158180
01 1 16002 51603 $253 66
ELECTRICAL.INSPECTOR RECORD
Bev.08-07-2015
APPROVALS DATE ID/SIG.COMMENTS OWNER BUII,DER DUI,CARATION
I hcrcby afltrnr uDdcr p€nalry of Frjury that I m excnpt fioft thc Cbolra.loB' Liccnsc liw for thc followinS rcen (Scc.7031.5
Busincss and Prolbssion Codc): Any Cily or County which rcquircs . pcrmit to construct, alts, irnprove. dcmlish or rcpair my
structurc, prior to ils issuancc. Erlso rcquircs thc applicilil for such lEmut lo lile a sigrcd statcmil lhat ha or stE is liccred pusudl
to lh( pmvisions of thc Conlracbr's l,iccnscd law (Chapter 9. Co,nmencinS wilh Scction 7000 of Division J of the Busine$ md
PrcfessionsCode)orthatltorsheiscxenrptthe.efromandthebasisfortltallegedexenrptbn. ADyviolalionofSeclionT03l.5byany
applicnnt for a pcmit subjects the {pplicunt to a civil pcnalty of not mrc than fivc hundred dollars ($500).
_1. o owncr olthc proFrcny, or my cmployecs with wagcs as thcir solc coml*nsation, will do thc work and thc sttudm is mt
iDterr.l,al or oflcrad for $lc (S6.7(X4. Business and Prcfcssions Codc: The Contractor's Liccn* bw d@s nol apply lo e owrcr of
the profuly wlF builds or itrprovus lhermn, and wlm d@s such work hiNelf or lErself or throuBh his or her own enrployes.
provided that such improwrcnts re mt iilcnded or olle[{ for slc. lt, howcver, 0E buiHitrg or itrprewmil is $H within orc ,ed
ofcomplclio[ lhc Owmr Builder will luve thc bunlen ofpmving tha hc or shc did fttr buill or irpNvc fr pntpdly for lhc purpo* of
sde).
_1, as owner ofthe prpefly, am exclusivcly conlracting with licensed conlraclors to conslruct lhc project (Scc. 7(X4. Business
ad f'rctssboCode:TheContrachr'sLicenseLawdcsilolapplytoailownerofpropcnywhobuildsorimproveslhereon.
and who conuacts for such projccls with a Conlractor(s) liccNd pursuMl to thc Contraclor's Liccnsc trw).
-l
mrcxemp( und{ S.crion-, B. & P.C. for this ENn.
Dsac:-
WORKT]RS' COM I'f,,NSATION
PEC!,ABAUgN
I hercby aftirm undcr pcnalty ofpcrjury onc oftlrc fdlowing dccl&atio6:
_lhavatrdwill nDintainuCenilicatcofconscnttoSclf-l[sureforworkcrs'coDrpensation,as pmvid€dforbyScction3T0Oofth€
Labor Code, for thc lrrfonurcc of thc work for which thc petmit is issucd.
_l havc atrd will nEintain workcrs' conlpcrsation insurance, as rcquircd by Sation 3700 of lhc libor Codc, for lhc fErfomurcc of
the work for which lhis Frnut is issued. My workers' corp!'nsation insutscc cmicr afil policy rumbcr ue:
cmicr: Et€tt$f vvA-l(d,r/4 ( (NS r/lLANc€ co
'7 bO OO tq @2 MPolicy _lixpircs:
_l ccflili that in thc lErfornunce ol'rhc work for which this pcrmi! is issucd, I shall not cnrploy my 1rcrun rn any manncr
s astobccotrEsuhjccttolhcworkch'coilrpcnsationlawsofcalifonlia,anda8rccthatiflshouldbecorrcsubjecttothc
sorkers' compensatioD prolisiotrs of Section 3700 of the l-abor Code, I shall, fonhwith corilply with thos provi$ions..
WARNING: Failurc to scurc workcrs'mmpensation covcfrg. is unlawful, md $hall subjcct m crplorcr to oiminal pcmltics und
civil titrcs up b one hundred thousand rlollars ($100.01J0). iI addition to the ol cornpensatiul, danuges as l)rovided tbr the
lccs.
I
I hcrcby affrrl undcr penalty of pcrjury that I anr liccnsl undcr prcvision of Chaplc] 9 (conlrcreing with Scctbn ?000) ofDivision 3
of thc Busincss and Pmfcssions Codc, anl mv licens is in full forcc a8l effcct.
'Z 67e I
Liccose
zo,
W
I hcrcby al lirm undcr ff,nalty of pcrjury lh^t thcrc is a construction bnding agcrcy frrr thc pcrl-oflnarcc of thc work lt r which lhis pcrmit is
issued (Scc. :1097. Civ. ('.).
Lcnder's Nadrc:
lrndcr's Addrcss:
APPI,ICANT DECI,ARATION
I hrebyaflimr undcL pcDalty ofpcrjury onc ofthc tbllowif,g dcclrations:
DenDlition Pcrnrits-Ashcsk)s Nolification Fcderal Rcgulutions (Titlc 40, Pm6)
_Rcquircd kttcr of Notification
-l
cdily lhd thc federal reguhtions rcguding abcstos rcmval rc not applicable lo lhis pmirt.rsL_lLl cdify tlut I luvc rcad this applicalion dd state tlut lhc above informtion is coffi. I aSreto @nply with aU Cily End County
ordinmces md Statc llws rela(in8 kr building construction, and hcrehy authorizc rcprcscntalivcs oI this City and County to
rbovc mcntioncd pmpc(y for
Applic{nt 0r Agent
I'cmilcc nonrc
purF)ses.
upon thc
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / 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)
N/eter Release
Rouqh
Service lVleter /\
FINAL 6'10.ll t+"t4-l[,)
Notes, Remarks, Etc.