HomeMy WebLinkAbout20169873 - PermitfA City of Santa Ana 20 civic center Ptaza (M-19), Santa Ana, cA927oz Electrical,
@ PermitCounter: (114)o4z-5{oo lnspection Requests: (714)607-2738 lnspectorSection: (714)047-s853 JV
Permit #:20169873
Pin #: 45989
Proiect Address: 400 S Grand Ave
Assessor's Parcel: 01 1-313-02 Lot: NA
Unit:
Block: NA
Bldg:
Tract NA
Address Range:
Historic: No
Suite Range:
Zoning: SDl6
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Public Storage
7'l Western Avenue
Glendale, CA 9120'l
(818) 244-8080
Public Storage
lcon ldentity Solutions
1418 Elmhurst Road
ELK GROVE VILLAGE, IL 6(
(847) 531-3207
Fee Type
0'1116002 51603 Signs & Neon
01116002 5160C General Plan Update
01 1 16002 51603 lssuance
Amount
78.08
22.95
57.20
Qty
1.00
1.00
1.00
Fee
$78.08
$22.9s
$57.20
Botchi:5267tr - lLr/?3 /?ltl? I0: o,noruie lS
0f f ice: CTYH llsrnsf : 53 ? of 'rA,:ct+: Ret'*: 2U16?87:i
Rcpt+:112783869 - llt/23/2tt19 3:39 F H
Tnonsact i on Total t7611.45
Icon Ident i tv Solut i onE
State Lic #: 796721
Lic Type: C45
Bus. Lic #: 365906
Workers' Compensation I nsurance:Carrier: Nat'l Fire lns Co of Hartford
Policy #: 605242861
Expires: O3l28l2O2O
Genersl F'lon Updste Fee
Lr I 1 1 6tll12- -11 6Lrlr0lrl:l-
Electr i col
rrl I 16trLt2- 516L]3lrlrr]-
2?,9
35.2
CL Chec(:L Chec
cL (:hec
ll t tit-t 16tlk 05rt161k r-r30498
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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:
\)h ,",nundez, Kathy 10t23120't9
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Other
Signs
Sign-illuminated
Occupancy.
Constr Type:
Code:
Date:
Date:
Date:
N/A
N/A
cEc 2016 Notes: lnstall (1) led-illuminated channel letter wall sign & (2)
non-illuminated signs for "Public Storage", bond
posted on M-73669
Buirdins Permit #: 101101770
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.
01 1 't6002 51600
01 1 't6002 51603
$22.9s
$135.28
Fee Totat
Paid to Date:
Balance Due:
$158.23
$0.00
$158.23
lnspector MID#: 2019-154875
ELECTRICAL{NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUII-DER I'ELCARATION
I hcrchy allirm lndcr pcnalty of pc{ury lhal I m cxcmpt Irom lhc Conlraclors l-iccnsc l,aw li)r lhc li)llowirg rcason (Scc.70-}1.5
Busilcss and Prolission C(x-lc): Any Cily or (ounty whiel rcquilcs a lrrnril l() conslnrel. altcr. improvc. r.lcmrlish or rcpair an1'
slruclu'c.pri()rk)ils issuance.alsorcquircsrhcapplieantfhrsuchJErrnillolilcasilncdslrtcnrcnt thalhcorshcisliccnscd pursuant'
to thc provisi(rls ol'lhc Contraclor's [-iccnscd l-aw (Choplcr 9. Conrnrcncinc with Scclir)n 70ffi of Division .] of lhc Busirlcss anJ
Proli-ssionsCo.lc)orthallrorshcisercmptthcrcliomrndthcbasisli)rlhcallcgcdc\cmltion. AnyviolalionolScctitrnToJl.5hyany
applicant fi)r , pcrmit srhjccts thc apflicant kr a civil pcnally of nol morc lhrn fivc huntlrcrl rlollars ($5fi)).
_1. as owncr of thc prolrcny. ()r my cnlployccs with wages os thcir s(,le compcnsat ion. will do the work and thc structuc is not
intcndcd orollcredlbrsalc(Se.T044,BusincssindProltssionsCrxlc:-fheContractr)r'sLiccnseLlwdocsnotapplytoanowncro[
the pnrfrcny wkr huilds or improvcs thcB)n. ml who d(rcs such work himscll or hcrsclfor through his or hcr own cmployccs,
pr()vidcd that such imp()vemnts m not intcndcd or olltrcd t'or sxlc. If: howcvcr. thc huilding or imprrvemnl is sold within onc ycil
ofcompletinl, tlE Owncr Buildcr will hnvc thc hurdcn ol provurS lhal hc or shc drd Ril huiu or irnprovc thc pn)Faty li)r lhc puqDrc of
salc).
_1, {s owncr ol'thc propcny. anl crchsivcly conlracting wilh liccnscd conlr{ct)rs k) conslnrct thc p(tccl (Scc. 7044, Busincss
and PnrlbssinCodc:'fhcContrack)r's1-icenscl-awdocsnolApplyk)dnowncrofpropcrlywhohuildsorimprovcslhcrcon.
anrl who conlracts li)r such prrjccts wilh a C:ontraelor(s) liccnseil fursurnl k) thc Cirilrack)r's Liccnsc l-aw).
Iamexcmplundcrselxnl-.B,&P,C.fbrlhisrcason'
WORKERS' COTTIPENSATION
DECLARATION
I herchy allirm undcr lrcnally of pcrjury onc of lhc lilllowing .jcclaralions:
_l have anl will maintain a Ccrtificatc of Conscnl to Sclflnsurc tilr w()rkcrs comlrcnsation. as ptuvi.-lc.l tor hy Sccti(,n ]700 of lhc
tibor Codc, lbr thc pcrlomancc of lhc work for which thc pcmlit is issucd.
_lhavcandwillmaintainworkcrs comlrcnsalioninsurancc,as rcquircdhySeclion-lT0OoflhcllborCitdc,forlhepcrli)manccof
lhe work li)r which this pemit is issucd. My workcrs compcnsalion insurancc caricr :md F)licy numhcr ec:
Policv Numbcr: Expires,
-
_l cr'nily thnl in thc pcrlbrmancc oithc work li)r whie h this pcrnril is issucd. I shrll nol crnphy any;rrson in any manncr
so as tr bcconrc suhjcct k) the workcrs'compcnsalion laws ol Califbrnir. ild agrce thnl il I slx)uld hccorc suhiact k) the
wo.kcrs'comfcnsalionprovisi(nrsolScclion-1700oflhcLah)rCodc.lshall.li)rthwithcomplywilhthoscprovisions..
IVARNIN(;: Failurc k) sccutc workcrs'eomlrcnsalion covcra8c is unlawlul, and shall suhjcct rn cmph)ycr lo criminal Fnallics anil
civil tincs up t) onc hundrcd rhousxnd Jolhrs (Slm.(D0). in adilil()n k) lhc cosl of conrlrcnsalion. damagcs as provided ,i)r thc
Scction .1076 of thc l-at$r Codc, intcrcsl nnd dlk)rncy s l-ccs.
oau. lo- Z? .Zet4
DECLARATION
I hcrcby allirm undcr penalty of pcrjury that I nm licen$d undcr pruvision of Chaptcr 9 (conilnencing wilh Scction 7000) of Division l
of thc Busincss {&l P(rltssions Code, anl my liccnsc is m lull tbrcc rurl ellccl.
Liccnsc
Dale:
Numbcr:
/o-?3 -Z a( n --.-
W
I hcrchy al I irm undcr Frcnalty of pcrjury that thcrc is a construction lcndinS dgcncy tor thc pcrlbmancc of thc work li)r which t his permil is
issucd (Scc. -1097, Civ. C.).
kn,lcr's Nime:
Lndcr's Addrcss:
APPLICANT DECLARATION
I lrcrcby allinil undcr pcnalty of pcrjury onc of thc ti)llowing dcclilatio0s:
Dcnxllili()n Pcrmil\-Ashc\los Nolilicati{n Fcdcral RcSulllions (Titlc 40, PM6)
_Rcquircd Lllcr ()I N(nilicxtkln
_l ccnili thal lhc ltdcrrlrcgulalions rcgd{ing ashcsk)s rcmovalarc nol applicahlc b this lrojccl.
_l ccilify that I have rcad this rpplicati(fi dil statc thal lhc rtx,vc iDlhrmrtiiilr is corcct. I a8rcc k) comply with all City and County
ordinanccs tnd Statc Ilws rrlating to building constructi(tr1. illd hcrchy aulhorrc rclrc\cnlrlivc$ of this City and County lo cnter ul)n lhc
xh)vc nNnt(rlcd ropcdy li)r insl-.-clion purF)scs.
Applicsnt or Agent
Pr'rnril(c nntrrr I c
oate, I o-a7 -Zol 4
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq / Grounding / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rough
Ceilinqs (T-Bar Rouqh)
N/leter Release
Rouqh
Service Meter A
FINAL 3-1t-tu v.wlt)
Notes Remarks Etc.
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