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Home My WebLink About20162299 - Permitcity of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853 Electrical Permit#:2lJ16,2299 Pin #: I 683$ Proiect Address: 2603 S Main Sta - Assessor'sParcel: 016-052-08 Lot: 5-12, PORS 4 & 1 Unit: Block: NA Btdg: Tract: 159 Address Range: 2601-2607 Historic: No Suite Range: Zoning. C2 Owner: Address: Phone: Tenant Name: Contractor Address: Phone: Gardena Holdings LLC 10240 Geary St Santa Fe Springs, CA 90670 (562) 903-1436 T L M Petro Labor Force lnc 909 N Alameda St Compton, CA 90220 13101 639-2227 01 1 16002 51603 0't 1 16002 5't 603 01 1 16002 53601 01 1 1 6002 51 600 01 1 1 6002 51 603 Fee Type Light Std w/ 1 fixture Add'l Fixt, same pole Ptc - 65% General Plan Update lssuance Amount 23.88 0.00 0.65 21.25 52.98 Qty 8.00 4.00 184.80 1.00 1.00 Fee $191 .04 $0.00 $120.12 $21.25 $52.98 State Lic #: 761755 Lic Type: B, A, HAZ, C-10 Bus. Lic #: 364698 Workers' Compensation I nsurance:Carrier: State Fund Policy #: 1541 1 50 Expires: O1lO1l2O18 Building Use: Job Type: Nature of Work Commercial Miscellaneous Light Standards Occupancy: Constr Type: Code: U VB cEc 2013 PAID Planning Conditions: Planning Approval By: Date: Misc. Receipt: 69014 Plan Checked By: Davis, Scott Date: 0512412017 Misc. Receipt: Permit lssued By: {8 U"rnrndez, Kathy Date: 11t01t2017 Misc. Receipt: Subject to Field: Account# Total Buirding Permit#: 10191774 Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 180 days after its lssuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 180 days after the time the work is commenced. Notes: fee pd on M-70226 Fee Total: Paid to Date: Balance Due: NO\/ 0 1 7011 $ City of Santa Ana $385.39 $385.39 $0.00 lnspector MID#: 2015-119845 N/A - No Balance ELECTRICAL.INSPECTOR RECORD APPROVALS DATE ID/SIG COMMENTS OWNER BUILI)ER DEI,(:ARATION Ihoebya[firmundopenaltyofpojurythatIanexemplfromtheContraclo6 LicffscLawforthefollowingre6on(Sec.70-1L5 Businas md Prof6sion Code): Any City or County which rcquile a ponit to constmct, aho, improve. deprolish or rqrir ryry slruclure. prior lo ils issuance, also requirG lhe applicant for such pennil lo file a signed statmml that he or she is licssed pursuant to lhe provisions ofthe Conlraclor's l.icensed hrv (Chaplq 9, Comntencing wilh Seclion 7000 ofDivision 3 oflhe Business and : ProfessionsCode)orlhatheorsheisexemptthsefiomandtheb6isfortheallegedexonption. AnyviolationofS(lionT0.ll.5byany applicant for a pmrit subjects lhe applicant to a civil penalty ofnet more than five hundred dollms ($500). I. o orvner of lhe proFrfly, or my ernployG with rvaga r their mle compmation. rvill do the work md lhc studue is nol intoded oroffsedforslc(Se.7044.BusincsandProfesionsCode:ThcContractor'sLicmeLawdo6nolapplyloeotrntrof lheproperty whobuildsorimprovsthqsn,@dwhodo6suchworthimselforheselforthroughhisorherownemployes. provided that such improvanfits m not intmded orollsed for sle. l[ horvo'q. the building or improvenmt is vrld uithin one 1w ofcomple,tion. the Orns Buildq will have the hrdm ofproving that he or she did not build or improve the rtropqty for thc puryn* of gle). , _1. a ownr ofthe poperty. an exclusively contracting with licmsed conlraclore to construct the Froject (Sec. 7M4. Busins and ProftssionCode:'lhcContractor'sLicenseLalvdo6notapplyloanorvnsofproJmtyrvhobuildsorimprovolhtrsn. anrl who contracls for such prcjets rvith a Conlracto(s) licoscd pursuant to the Contractor's Liccnse Larv). I an €xempl unds Setion-, B. & P.C. for this rrcon. Date:_- _,Osner: lVORKERS' CONIPENSATION DECLARATION I hcreby allirm undo penalty ofpojury one ofthe follorving delarations: lhaveildwillmaintainaCenificateofConsmltoSclf-lnsureforrvorkss'compqrsation,o providedforbySKtion3T00ofthe t,abor Code. for the pofonnance ofthc work for which the pmnit is issued. Ihaveandrvillmaintain*orkm'compcroalioninsurance.6 requiredbySetion3700oftheLaborCode.forthepsfonnanceof the \rcrk for which this pmnit is issued. My rvorkm' compmsalion imurancc cmio md policy numbo re: Caris:- Policy Number:-Expires: I cffiry lhat in the perlbrmance ofthe rvork for which this permit is issuetl. I shall nol employ any pqson in any milner o m to become subjat to the work6' cornpeNalion laws of Califomia. md agre that if I should becorne subjat to the workqs' cornpsation provisions of Sction -1700 of lhe Labor Code. I shall. fonhwith comply with thos provisions.. WARNINC: Failure to wure rvorkers'conrpmxtion covenlic is unlawful. and shall subjct m mployo to oiminal peraltis and civil fins up to one hundred thosand dollds ($100.000). in addition k' tk cost ofcompensation. damages as provided for Ihe :";-x[Lr-TT:'f\nnou0, .lt-"ffi**I hereby aflirm under pmalty ofpqjury that I an licosed undo govision ofChaplfl 9 (commencing with Se.tion 7000) otDivisbn 3 of the Businss md Profesiom Codc. md my license is in full force md effecl. l-icense Class: *.. Iil,IJ Nurnbcr: (-onlraclor: (.0NS I'RUC'TION LIiNDINC ACi:N('Y issucd (Sa. 3097. Civ. C.). lrndo s Narne: _ Ltrdtr s Addrsr _ APPLICAN'I DECLARATION I hecby affmn undo penalty ofperjury one of the following decla ations: Itmolition Pmits-Asb6tos Notification Fedaal Rcgulations ( l itle 40. Pd6) _-Required tdttr of Notification I cerlify lhat the fcderal regulalions regading asbetos ronoval ue nol applicable lo lhis projecl. I ccrtity lhat I have rcad this application md statc thal the atnve iilfomati(rn is cor(l- I agre to comply : reprdcntatives oflhis City wilh all Cily and ('ounly and (bunly to ents upon theordinances aDd Slate Laws rclaling to atnve menlioned prop€rly for inspetion Applicsnt or Agent I'crtrlilce ilatrrc (l,rinl): constructfu n. and hcreby aulhorizc -*,",llzl t) Site-Work Underqround Pole Bases Liqht Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bondinq / Groundinq / UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilinqs (Hard & Soffit Rouqh Ceilings (T-Bar Rough) Meter Release Rough Service Meter /A. FINAL \-1,-r "7n x){fN\ Notes, Remarks, Etc.