HomeMy WebLinkAbout20166813 - PermitCify of Santa Ana
Permit Counter: (71 4) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
I nspection Requests: (7 1 4) 667 -27 38 lnspector Section: (7 1 4) 647 -5853
Permit #: 2fl1668{ 3
Pin #: {8552
\rl
Proiect Address i 3124 S Main St
Assessor'sParcel: 410-231-02 Lot: 83
Unit:
Block: NA
AddressRange: 3100-3260
Historic: No
Suite Range:
Zoning: CR
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Decron Properties Corp
6222 Wilshire Blvd t1400
Los Angeles, CA 90048
(323) ss6-6600
J - Squared General Contra(
1780 E McFadden, #112
Santa Ana, CA 92705
(714) 8844590
Fee Type
01'l'16002 51603 Swim Pools
01116002 51603 Spas
01116002 5'1600 General Plan Update
01 1 16002 51603 lssuance
Amount
121.09
121 .09
22.08
55.04
Qty
1.00
1.00
1.00
1.00
Fee
$121 .09
$121 .09
$22.08
$55.04
State Lic #: 918485
Lic Type: B
Bus. Lic #: 344727
Workers' Compensation lnsurance:Carrier: Everest Nat'l lns Co
Policy #: 7500015996
Expires: 0210112019
LllI
HL
f.:cr
/2+/2t111
'crrrs+: 49
Reli:- t/24/2lt1t
A4
VB
cEc 2016
ltq I
lpdote Fee
Lltl0tl-
r_r0r:l
ir *iili54
rJrlu736
Building Use:
Job Type:
Nature of Work:
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial Occupancy:
Tenant lmprovemenl Constr TYPe:
Fitness/Clubhouse Pool PgnCode:
Julie
Date:
Date:
Date:
1 01 97558
01t24t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total.
Paid to Date:
Balance Due:
01 1 16002 51600
01 1 16002 51603
$22.08
$297.22
$319.30
$0.00
$319.30
Every permit issued shall become invalid unless the work on the site
authoized by such permit is commenced within 180 days after its
lssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 180 days after the time the work is
commenced.
lnspector MID#: 2017-135549
Bldg:
Tract: 7408
n;:r'n I (.ontr
ELECTRICAL.!NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hereby atfirm undq penalty ofperjury that I m excmpt fiom lhe Conlractore' l.icense LaN for thc following rea.gon (Se.70-]1.5
Busines ad Profsion Codc): Any Cily or County which requirs a pmnit lo construct, alto, improve, donolish or repair my
slructue. prior to its issumce, also requir$ the applicanl for such pmit to file a signed statemmt that he or she is lictrsed pusumt
lo thc prcvisioN of the Contractor's Licensed larv (Chapts 9. Cormencing rvilh Setion 7000 of Division 3 of the BusinN ild
Profe$ions Code) or that he or she is exempt thsefrom and the basis for the alleged ermption. Any violalion oisdion 70-11.5 by any
applicantforapf,nitsubjststhc applicanttoacivilpenaltyofnotmorethmfivehuodreddollus($500).
_1. a omo of the prcp€ny. or my employc with wag6 s their sle compenstion, will do lhc wo* dd the structuc is nol
intqded or olTered for sle (Sa.7044, Businos md ProfmioN Code: The Contraclor's Licflse lnw do6 not apply to d oMs of
lhe prcpdy who builds or irnprove th@tr od who do6 such wrk hirnself or htrself or lfuough his or ho om employca.
provided lhat such improvmots ffi not inlodcd or off6cd for sle. If. howoo. the building or improvemdt is rcld within one ]q
ofcompletion. the Ownq Builds rvill have thc budm ofproving thd he or shc did not build or imFrovc the prcpsty for the puposof
sle).
_1. a owno of the propqty. m cxclusively contraclin8 with licmed contractoE lo connruct thc projecl (Se. 7044, B6ins
and ftofsionCode:ThcContraclor'sLiccnscLawdoqnotapplytoaownoofpropenywhobuildsorimproveslhq@n,
and who contracts for such prcjecls wilh a Contmcto(s) liceacd pureumt to the Contractor's t,icse Law).
I m exempt ud6 Sstion-. B. & P.C. for this r6of,.
Owner:_
WORKERS' COIIIPENSATION
DECLARATION
I hercby affirm unde pcnslty ofpsjury onc ofthe folkrwing dcclrralions:
_l have and will maintain a Ccrtificate of Comol to Self-lmure for workers' compensalion, 6 provided for by Setion 3700 of lhe
Labor Codc, for the psfonnace of the work for which thc tmit is isued.
_l have and will maintain workers' comp€nsalion imurmce 6 required by Sstion -3700 of lhe Labor Code. for the psfonnilcc of
the u'ork for which this pmit is isued My workos' compruation insurilcc cmio and policy numbe re:
\-. o^^(a
Itlicy 0t{?a3 2- t-ll
_l ce(ify lhat in the perfonnance of the rvork for rvhich this permit is issued. I shall not enploy any person in any moner
m clobecomesubjattolheu'ork6s'compeflsationla*sofCalifomia.ilda8rethalifIshouldbecomesubjettothc
workqs' compeNation provisions ofStrtion 3700 ofthc Labor Code. I shall, fonhwilh cornply with thos provisions..
WARNINCT Failure to wue work6'cornpenslion covqage is unlarvful. md shall subj4t m onployo to siminal tEEltics md
civil lines up to one hundred thousmd dollm ($100,000), in addition lo the cost of compemation, dmages 6 provided for the
Section 3076 ofthe Labor Code. intset dd altorney's [ee.
-1-
I h6eby afftrm undfr poalty of perjury that I m licosed undo provision of Chaptq 9 (comqcing wilh S(tion 7000) of Division 3
of the Busine md Profmions Code. md my licmc is in full force ad effat.
l-iccnse Numtrcr:413 ( 8r
n"r", 1-3 \ - L0 con,""",.., J- 50.-ralcd
CONSTRUCTION LENDINC ACENCY
I hoeby affirm under poalty of pedury that th6e is a construction loding agency for thc pofonnilce ofthe work for which this permit is
issucd (Sa. .1097, Civ. C.).
Lender's Name
Lender's Addrs:
APPLICANT DFCI,ARATION
I hslby affim undq pqa lt y o f pcrjury one o f the follow ing dr luat ions:
Dcmolition Pmits-Asb6tos Notification Fcdqal Rcgulations (Tille 40. Pafl6)
-Required
Lats of Notificaliof,
-l
cstify that the fedaal regulatiom rcgrding abetos rmoval ae not applicable to this prcject.
l4!cqti& rhat I havc rad lhis application ild state that the above infomalion is conecl. I sgrc lo comply with all City and County
ordinancc ad State laws rclating to building constructioo, md hseby authorizc reprGotative of this City ud County to mtq upon th€
abovc mmtioned property for
Applican( or Agent
Permitee n6me (print):t4
_-Lr( -l al
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondinq / 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)
Meter Release
Rouqh
Service Meter
FINAL ?-LO-?,0 fr< ln
Notes, Remarks, Etc.
(