HomeMy WebLinkAbout20170453 - Permitcity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAq27O2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (7'l4l667-2738 lnspector Section: (714) 647-5853
Permit #: 2lJ17o453
Pin #: 7544lJ
Project Address: 3230 S Standard Ave
Assessor's Parcel: 41'l-152-06 Lot: POR 3 & POR 4
Bldg: Address Range: 3220-32so
Tract: SECCOMBE Historic: No
Unit:
Block: NA
Suite Range:
Zoning: M1
Owner:
Address:
Phone:
Tenanl Name:
Darin Gilchriese
673 E Young Street
Santa Ana, CA 92705
(714) 5s6-0408
Tesla Motors
Lakevierv Construction lnc (
10505 Corporate Dr #200
Pleasant Prairie, Wl 53158
(850) 699-04s9
Fee Type
01116002 53601 Revision
01'116002 5'1600 General Plan Updale
01116002 57770 Microfilm Records
Amount
230.87
22.95
3.91
Qty
2.OO
0.00
0.00
Fe€
$461.74
$0.00
$0.00
Contractor
Address:
Bntch+:53986 - Ll!4/?tt2lit JDr (:(:lJELLAti
offire: CTYH Trons+: 12 I ol 4Ac.t+: Eefi: 2t11711.1r:;3
Rcpti:(12965394 - 1/L1/7O2tt 2.73 Pll
Tnon scct ion Totfll i7t1,r1Phone
State Lic #; 671201
Lic Type: B
Bus. Lic #: 7722
Workers' Compensation lnsurance:Carrier: National Union Fire lnsurance Company of Pitts
Policy #: 50829/15268
Expires: 0910'll2O2O
Lokev ielr (:onstruct ion 1n( dba
P/C Electr i.
(r1116002- 536010r:r(r-ItL Check ?00[12?6
Cnsh
Chanse
$715.1i?
$tl'?i;
( $rl. ?rt )
$23r:i. il;7
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Commercial
Revision
Revision
B, S-1
VB
cEc 2016
Occupancy:
Constr Type
Code:Notes: Revision to 20169046. lnstall washer/dryer.
efl
Dale:
Date:
Dale:
0110212020
01114t2020
Account#
Every pemit issued shall becoma invalid unloss the wok on the site
authorized by such pemit is commonced within360 days aftet its
issuance, ot if the work authorized on the sile by such pemtt is suspended
ot abancloned fot a peiod of 360 days after the time lhe wotu is
commenced.
lnspector MtD#. 2019-152449
01 100549 01116002 53601 5a6ffiZD
Fee Total:
Paid to Date:
Balance Due:
$461.74
$230.87
$230.87
Misc. Receipt: 73937
Misc. Receipt:
Misc. Receipt:
Total
ELECTRICAL-INSPECTOR RECORD
O\YNER BUILDER DELCARATION
I hneby .016 u.dd pcnali, ol pdjury 0',l I cxmp( hn rh. Conhdo^' LicG tiw for lh. aouoeins rcNr tsx 1n] L5
Businds 3nd Prof*ion Codc): A.y Cily or Cou , which r€qut6 a p6rnn lo connrud, !lls. irprov€, donolish or Epatr 4y
srrudurc, rrior ro irs srudce. also rcquir6 rhc applic&t fo. such Fmi to lil. 3 siSn d slalmal thrt hc o! sh. b licmsd pusumr
ro th. FovieioB of $e Co.lra.lors Lic.,s.n Liw (cnagd 9, Comncncins with Sation 7000 of Division I ollhc Bsin.s ed
Prcfsions Cod.) or thar h. o! snc is (cmpl thqciion od thc bsis lor $c all.s.d cxd0ion. An, liolalion of s<rio. 7011 5 by e,
lppltoi aor 6 p6ni subjGu the rpplicdr ro r civil p..ahy ol nor Dore tlr fiv. fiutrdr€n dolles ($t00)
.1, s ownd olrhc popcny. or rny ctoplo)s wilh {ag6 6 rheir elc conpnsdion, wil & lh. woi{ ed th€ nrudu€ is nol
i 6dcd or ollded for elc (5*.?044, Ausin6s ed P.ol6sio.s ( od.: Th. conlraclols Licm lne do6 nol aply to M oM6 oa
theI,D!6ry who bilds or ihpro!6 rhd6q and s,bo do6 such srk hiis.lf or h.*lf or ihmlAh his ot hd own cf,plorrB.
provid.n lh.r such improvoMls e mt inro&d or ofts.d for ele li hosdq, rh. buildiry or inprovdmr b $Li wnhin on. ,a
of coBplction, rhc o\Itrd Build6 vill hr{ th! hndo oatovinS rhd h. or sh. dil mt toild or i,qovc ln. pDFty lor lh. prpG€ ot
l, 6 ows olthc Ilropsry. mexclusivcly contEcrins wirh licc6rd .oitad66 ro codttud rh. FojN (s€c. 7044. BusinN
d Phrsion Codc: Th. Coma.ror's l-io.ns. Law do6 nor 4plrro d o*no ofpropdy vho builds or nnprovG th66n.
and who contmcrs lor such prcjccls wirh a Coarado(,licmsd pu6u tiorhcCo rador'rLicm.Ijw)
-l
m.x€npl utrds S6lion-. B. & P.C. forlhts r.&n.
tloBK![t_coMPratallaN
DECIdAAIIO!
I hd.by afiim und.r Fdty 6i p-jury otu orrh. lollowin8 deldarioGl
I have d willnunnlin a Ce.lifical€ oicotror to Scl nrur. aor rvorke compoMion. a prolidGl lor by Salion 1700 oafi.
l,abor Cod€. fqlhe prrom ccoflhcwo* aor q'hich lh€ p.rn( G issu.d
-l
ha\ c &d u ill ,nainmin { 0116 cotuposarion itrurec.. s r.qun€d by S€clion 1700 ollhc L!b., Code, lor lhc pofomdc. of
\fi. \rcrk lo! uhrch rh6 pmir is irsu.d. Mr trorlm' compGrron Nurrcc cm'o aid rEl() nrmbo m
)opa ,o t)F;rc lPst,rc.+.,cC (ar../
toztq+{abT
t ccniry lhal in lhe psfo,mac€ ofth€ pork for *hichlhis p6nn is i$uol, I shall not mplot ony paso. in any mMn r
$ 6 lo bdo@ slbj(l ro ihc Mrk6' comp.nsrio. laws o f Califomia, ed asr thar if I should bcomc subjrl lo thc
"ort6 onpq$l ion pmvisioN of Salion 1700 oilhc L,b.r Cod.. I shall. aonhwilh compl, sih tnos ptovisioN..
!|ARNINC: f-ailur€ ro su€ Nork6 comp€Mrioo cov@sc is unlastul, ad shall subjdt o onployd lo diminal !.ndhi6 Md
civil nn€s up lo onc huldred thoumd dollus ($l in add(io. ro rrc.ost oacomp.Narion, dunag.s a provdcd for rhc
"",",
r/iq lloao A 0
I hftbt rmrm unds lrn.liyolpcrjury rnar I m licss.d provsion of Chapt6 9 (cooncn.ins wnh Sdlion 7000) olDivisi.n l
ol rhe Ausn6s md ltolsiore Cod., and my licas is in lnll lorce ad .fic1.
B 1(C.o(
I h@by a,Imn undd F.ally of psjury lhal
i$md (sa. 3097, Civ. C.)
Ladd s Nmc:
I€nding aBdcy f6r rh. Ffomd.c oafic wort tur whi.h rhi, pqnh n
ASTLICANLDECIAAAIIQ!
I hdtby arm undd pciahy ol psjlry onc oflh. followins d(hialioa:
o.molition Pmils-Asb61@ Notiicarion F.d.rd R.gxlariofl s (Tnk 40, Pan6)
R.quircd L.tlB of Noiificalio{
I cdiry rhat &c lldqal r€gu lat ions csddinr 6b6los rdoval & not arpli.ablc to dis pNjec'.
red rhis application dd strle lhar rh. abovc infomarion is cotr(r I agc lo coq)I, wilh al Cn, and Cou.ry
Laws Elaiis lo buildins coistruclion. dd hdeby ,ulhorn rcprGmlativ6 oafiis Cily d Counly to olq upon lhc
Uri \\ i
APPROVALS DATE ID/SIG.COMMENTS
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Building
Under Slab / Floor
Bondinq i Groundinq i UFER
Transformers
Torqueing
Sub-Panels
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls Rou h
Ceilings (Hard & Soffit Rouoh
Ceilings (T-Bar RouOh)
Meter Release
I I LL r-4
Rough Lltv LU .l,Ar '\Yd ((L4O /
Service Meter I I
v
FINAL 7t rL *6-/
Notes, Remarks, Etc I
'\ll-
Rev.0B-07-2015
C^ t^.\
t l ,qla(JC
Site-Work
Communications Cable
Air Conditioners
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