HomeMy WebLinkAbout20170721 - PermitCity of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA92702 Electrical Permit #: 2lJ17lJ721
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Sectionr (714) 647-5853 Pin #:85905
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Project Address: 904 N Louise St U nit:
Block: NA
Bldg: Address Range;
Tract: LOURIES SUB. Historic; No
Suite Range:
Zoningr RlAssessor'sParcel: 405-262-'11
Owner:
Address
Alton Hitchcock
904 N Louise St
Santa Ana, CA 92703
1.714}775-0779
Fee Type
01116002 51603 Serv Meter
011 '16002 51600 General Plan Update
011 16002 51603 lssuance
011 16002 57770 Nlicrofilm Records
Amount
55.37
22.95
57.20
3.91
Qty
1 .00
L00
1 .00
1 .00
Fee
$5s.37
$22.95
$57.20
$3.91
Phone
Tenant Name:
Contractor
Address:
Vermette Electric
10524 58th St
Mira Loma, CA 91752
(95',t].255-7711
State Lic #: 7049'13
Lic Type: C-10
Bus. Lic #: 349810
Workers' Compensation lnsuranceCarrier: Exempt
Policy #:
Expires:Genernl Plqn Updqte Fee
01116r1t12- 515nt-t0t1(-llicrol i I6 t Docu6ents
tr1I I6002- 5777rlr:r-lrl -
Electr i.:(l1Building Use:
Job Type:
Nature of Work
Single Family Dwelling
Miscellaneous
Service meter
Occupancy:
Constr Type
Code:
R-3, U
VB
cEc 2019 Notes:une.dll I $6M3;,f, J&H'*'ttbut giu"n
CC+ r rrrixrrrrrrriiB9 Authi: li-r;1:i
Planning Conditions
Planning Approval By Date
Date
Date
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Amsden, Julie
Every permit issued shall become invalid unlessthe work on tho site
authonzed by such pemit is commenced wilhin360 days aftet its
issuance, ot if tho work authorized on the site by such pemit is suspended
ot abandoned for a period of 360 days after the time lhe work is
cofimenced.
$139.43
$0.00
$139.43
lnspector MID#: 2020-'157522
01 1 16002 51600
01 1 16002 51603
01116002 57770
$22.95
$112.57
$3.91
Fee Total:
Paid to Date:
Balance Due:
Lot: NA
Phone:
Bstchi:5,1222 - 2/4/2n2t I0l nnorolaslS
off icer CTYH Trnns+: 27 ! of 2Acct+: Refi: 2017{|721
Rcpbi.$28976L2 - 2/4/2O2t) ,?41 Al1
TrBnsoct ion Tot(l ,142.43FHB Controct oP
Veroette E lectr ic
$22.91
$3,91
t112.57
$442.43
021o3t2020
Account#
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE tD/srG.COMMENTS O'WNER BUILDER DELCARATION
I h6.by ailrm unds F.alty oa psjury lhal I m dofl &om rhc ConbadoB Lic€m bw for lh. lollowi4 r.en (SE.70l L5
Dusin6s ed Ptuf*ion Codc) Any Ciry or Coumy which rcqunG a larnn to coNtrud. dlld. i6!rov.. d@olish or r+6n My
sttuctue p.ior to irs isuuce, also r.qun6 rhc applicd lor su p.f,hil to filc 6 signd slatmnl thd tc or $hc b licclts.d pNdl
to thc provsioB oat Co.tacrors Li.ms.d Ijw (ChaF6 9, Conmocins vith Srlion 7000 oa Division I oflhe BEire ed
Proacsions Codc) or th.l h. o! sh. is crmpt lhdcliom and lhc basis for lh. all.s.d crdFio., A.y violtlion ofs€.lioD 7011.5 hy any
applicd tor a pdnn subtcts lhc aDplicul ro a .ivil p.mny ot not nor. thu fivc hundrcd doll&s ($500)
L 6 owns oflhc prcprry. or ny enployd wnn wa8e a lhcn st comp.nsalion. sill do lh€ uo,L dd rhe $!cr@ is @t
i.lodo.t or ofiged lor slc (Sd 7044. B*in6s dd Prol6iom Cod. 'ft. Controclois LicN t2w do6 nor appl, to & oMd ol
rh. DtuDdy wto toilds o. n prcvB lhqan. ad sho do6 such wo* hims.laor hNlaor rhou3h his or hs o*n 6ployt6.
Fovid.d thal such imFor@rs e mr inrsxloJ orolr6.d aor sL. Il holsq,lh. hiuins or iryrold11d t ed *nhin oft,a
oaco,npl.tion, llE o\,nd &rild6 will lEvc thc hlrdm ol prcvi.s lha hc or sh. dA nol bnild or nnprclc tn. Flpsly for thc puloe of
.1, aow.6oirhe pmldy, dn exclusivclyconrmcrinr sirh liccni€d co.tracrouro coftrtu.l tic projrt (S( 7044, Auin6
dd Asasion Codc: Thc Conlrd.rois Liccns. Las do6 oot applylo anoNnd oipror.ny who buildr or imp.ovB thd.or.
a.d lho contmds for such prej4lswilh a Coor,lcto(s) licda.d luBUMi to rh. Conlraclo.s Licas La*)
lrne\.rn trnd.r SRl,on . R & l)C nnrh* r.asod
Dnrc otrnr.:
laaEEll!:c9lltflsArlo.r
DICIJAAIIO!
I hcrcbyaflim undd poralry olpojuryonc of$c lollowin8 dclsalios:
-l
h!!c and q ill naibrain a Cdificatc oacomd lo Scla-16urc for work6 N'npdsnion, a F.vi.led aor b, sdio. 3700 o f lh.
I-abor Cod., aor rh. pdfomtu.e o f rhc "od for rnich lhc pqmil is issucd
I htrv.andwill mainlain worl6 .ohp.Narioo iBurd.c,6 r.quned b, Salion 1700 oflh€ Labor Cod.. tor lh. Ffof]@cc ol
lhc Mrk aor *fiich rhb !.mi is ic$.d My qorh6 onpaMlion i@e.. 6iq 0d policy numbq e.:
I
r& llt ..n'rr rur
'n
rt. por.mancc oirh. -or[ ror which rhis p.mn h issu€d, I shallnor.mployaoy D.&n in any 66nd
e a lo b<onc aubjd' lo rh. \rcrta' .onpdsation laB of Califomia. and as@ rhd il I slDuld b<om. subjel lo rh.
world'comp.NrionpmlisioBofSElion1700olrhcLahorCodc,Ishall fonhwithcomply wilh thospmvisions..
WARNINC: F,ilur. io su. vork6' conlPoetion cove,asc s mlawful. ,id thall stbjd m 6plo,€r lo oiminal FEtts ed
.ivil fin6 up to on. hundrcd lhousdd dollm (1100.000). ih rddni.n b th. cost of comp€nsation, darEscs N ptovid.d for lhc
Sdion t076.frh.l ahn Code mro6r
T,,lut^tL^.,r(
LtcllsEa.caNraacpB
DECIdEAIIAN
I hqtby afm undd p.adty ofFjury $ar I m U6ed undo p.ovitior of Cht 16 9 i@mdcing wht S*tior 7000) ol Division I
ol rhc BBid* md PEfNiod Codq and,ny lic6F is in tull lore dd cltcr
,"*."*, O-to I i...{.Ntr,nIE -7otl cttl
12 Aoze ."^,,."r,Xldo,--
COXEIAIGIIQN.LIUDINGICENCI
I h@by afllm uidd Fnah, oa pdjory $d th@ is a codoclk'n l€mlins 6sdcy for lh. pofomMc. oalh. wort fot shich thls Fnit b
isucd(S(.1097, Ci!. C )
L.nddi \m.
ABLICAUDECIdEATqT
I hdtby a&r ondd p..olry of pdjury o.. oa th. aollowing ddldal ions:
D.molirion PmirvAsb6td Norifi..rion Fcd@l R.gulali.N Onl.40. Pan6)
-
Rcquiicd lclto olNotindio.
I(di6 rharrh. f.ddd r.!uhioB Exsdins dbBros rmordle r o! appl'. ablc ro r hi, pmjdr
\dY'U *,,t*,*l,* apprratrnnud narcrh $cabo!. inromiion iscotr.d.I o!,a ro comply wnh arl cny dd counry
ordi@.6 Md starc bws r.Lring ro building coErruclio^ ad hdcby allhorir r.FMialivB ollhis Cny od Cou.ty lo dl6 uDo. lhc
alsre mmrioncd propeny for inspd t-
4
,,,", kJ. I 2ozo
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Sians (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communicalions Cable
Building
Under Slab / Floor \
Bonding / Groundinq / UFER ?-.-luzd )r#\?,
Transformers
Torqueing
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
Ir,4eter Release Z-G-Z VWlLi,
U
Rouqh
Service [Ieter z-g'v0 J
FINAL 7-,-5.21
Notes, Remarks, Etc.
Rev. 08-07-2015
Sub-Panels
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Applionl or Aeetrt Sign.lure
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