HomeMy WebLinkAbout20161868 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ar:a , CA 92702 Electrical Permit #: 20161868
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 inspector Section: (714) 647-5853 Pin#: 97268
Project Address: 2121 N Grand Ave
Assessor's Parcel:
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
State Lie#:
Lie Type:
Bus. Lie#:
396-201-04 Lot SEE COMMENTS
Santa Ana United Methodist Church
2121 N Grand Ave
Santa Ana, CA 927057021
(714) 542-2219
River Springs Charter School
Owner-Builder
Workers' Compensation Insurance:
Carrier:
Policy#:
Expires :
Building Use: Other Occupancy:
Job Type: Alteration Constr Type:
Unit:
Block: A
N/A
N/A
Bldg : Address Range : Suite Range :
Tract S.A. GRAND AV Historic: No Zoning : R1
Fee Type Amount Qty Fee
01116002 51603 Air Conditioner 90.25 12.00 $1 ,083.00
01116002 51603 Subpanel 49.63 1.00 $49.63
01116002 53601 P/C -65% 0 .65 1,132.63 $736.21
01116002 51600 General Plan Update 20.56 1.00 $20.56
01116002 51603 Issuance 51.26 1.00 $51.26
Nature of Work: Roof Mtd Equip/Screening Code: CEC 2013 Notes: Install (12) new roof mounted HVAC systems on 2-rear
buildings for school. Per contract price. Auth on file.
Planning Conditions: Paint metal to match stucco
Planning Approval By: Date:
Plan Checked By:
Permit Issued By :
Davis, Scott ~ / Date:
Zuniga, Allissa ~ Date:
11/22/2016
12/19/2016
Subject to Field:
Building Permit#: 10189069
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of180 days after the time the work is
commenced.
Inspector MID#: 2016-128374
Account#
01116002 51600
01116002 51603
01116002 53601
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
$20.56
$1,183.89
$32.26
68763
Fee T otal :
Paid to Date:
Balance Due:
$1,940.66
$703.95
$1,236.71
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG. COMMENTS O WN ER llUILDElt DliLCA RATION .
I hereby affirm un der penally of perjury that I am e.,empt fro m the Contrn ctors· License Law for the following n!ason {Scc.7v.H .5
Site-Work Business and Professi on C'o<le): Any Cily or Co un ty which req uires a pc:,,,nit to constnu.:t. altc:r. imp rtwc. dem olish or repair any -st111 cturc. prio r to its issuance. also requires the a pplicant fo r s uch permi t 10 file a s igned statement that he or she is licensed purs"..<Zri t
Underground !/v ll-17 f lt, {.,,.;i, /41& __,/ to the provisions of the C'ontrnctor·s Licensed Law l Clrnpter 9. Commencing with Scc1ion 7000 of Division 3 of the Businc'ss and
Pole Bases z;<,/ A ✓/1,,J-,,,,,? ( If.ta..., Professions Code) or that he or she is ext::mpl therdrnm ,md lht": b;tSis for 1hc alleged c:mnption. Any violation of Section 7031 .5 by any
applicant for .i pcnn it subjects the ap pl icant to a ci vil penalty of not more than fi ve hundred dC'l llms ($500).
Light Standards nY }A f,:;_-.,J_ ~ ,J _I, ,15 owner of the prope11y, or my employees with wages n5 their_ le compensation. will do the work and the slnKture is not
~
Spas , Pool, Fountains intended or offered for sa le (Sec. 7044. Busi ness and Professions Code: he Contractor's License Law does not ;1 pply to an owner of
the propt.-rly who bu ilds or impmves tht,,-re<.111. ;md who does such work hin ·elf or herself or throl1g_h his or her own employees.
Signs (monument) provided that such improvements are not inlcndcd or olTert.'d for sale. If. ho ·ever. the bui lding or im provement is sold within one year
of compld ion. the Owner Builder will have the burden of proving that he or sh did not build or improve the proper1y for the purpose of
sale).
Life Safety /Low Voltage _I. as owner of th e property. run exclusively contracting wilh licensed contrncto to cons1ruct the project (Sec. 70-l4. l3usim.-ss
and Profession Code: The Co111rnctor"s License Law does t apply to an owner o properly who bu ilds or improves thereon.
Fire Alarm / Dampers and who conlrads fo r such prnjects with a Contractor ) h ·ensed pursuant to th Contract or·s Ucc11sc La\\').
Communications Cable _I on,J/97/cct ion I B. & P.C. for this rcaso
Ih le: I { . 'It. o~'k '«i,_ -----Building t I ,_,. WORKERS' COMPEN SAT IO N
D ECL A RATION
Under S lab I Fl oor
I hereby affirm under penalty or p(ijury one or the fo llowing declarat io ns:
Bonding / Grounding / UFER _I ha ve and will mai nta in a Ce11ifica1e or Co nsent to Sclr-lnsure for workers · compensmion. as provided fo r by Scc1iM .HOO o r the
Labor Code. for the perfonnance or the wOl'k for wl,ich the permit is issued.
Transformers _I hm·e rmd will ma intain workers· compe nsat io n insuran ce , as required by Section 3700 oftl1e Labo r Code. fo r the perfonnance of
T orq ueing the work for which this pen11it is issued. My workers· co mpensatio n insuranc e cm,·ier and po licy number arc:
Sub-Pane ls Call'icr:
Air Conditioners Policy Number; E:~pires:
Roof Top Equipment _1 ccrt iry that in t he per forman ce of the work for whic h 1his permit is i sued. I sha ll not emp loy any person in any maim er
Factory Wired Unit so as to become subject to the workers' co mpe nsat ion laws ofCalifomia. a 1d agree that if! shou ld become subject to 1hc
work ers' compensation provisions of Section 3 700 of the Labor Code. I sh II. forthw ith comply with those provisions ..
Wa ll s (Conduit) '""'""' ,.;, ... '" _,_, .. .,-, mm,-;..,t. """"" ' ~ '"" .. ,., "" """'~" rn,.;m, -·~ '" W a ll s (Rough) civil fi nes U(J lo o ne hun dred thousand dollars ($109-, 0). in ilddition to ,c cost of compensat ion. dam<1ges as provided for the
Ceilinqs (Hard & Soffit Rough Section .107~ of:7 L:;;C~dc, interest and alt o ncxfs cs. t?;
Cei lin qs (T-B ar Rouqh) Date: .J / -Z.. '/ 'f// I Appl\, t: I I -· IC ENS ED C O NTRACT OR
Meter Release DECLA RATION
I hereby affirm un der penally o f pe1jury that I am licensed under prnvision o f Chapter g (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in ful l fo rce :md effect.
Rough
License Class: License Number:
Service Meter • I
l~/X/17 ~ . Date: Contra ctor ; FINAL ..... .,;::w '\
Notes , Remarks , Etc.
, C -..... C O NS TRUCTION I.ENDI NG AGENCY
I here by anirm under pena lt y o f perjury that there is a constniction lending a£cncy for th e performance of the work for which this permit is
issued (Sec. 3097. Civ. C.).
Lender's Name:
\ Lende r·s Address:
I A PPLI CANT llEC I.AIU T ION
I hereby affinn undt.·:r penalty of perjury one of t he fo llo\ing declarations:
Dcmoli1 ion Permits-Asbestos No1ificatio11 Federa l Reg liations lTitle 40. P~u16)
_Required Len er of Not ification
_I Ct,,'rlify that the federa l regulations gar ing asbcst s remova l arc not app licable to th is pl'Cljcct.
_I certify thm I ha ve read this ap pli , li on and state that th · above inform ati on is co1Tect. 1 agree to co mply wit h all City and County
ordinam:es and Stale Laws relating to . uilding constmcti on.: ":"''"'""~""'""""';=•':"'"':~-above mentioned prope1ty fo';i.tio rnrposcs.
Appli cant or Agent Sigm,ll 1 c: --· -Dale:_l _ { {(
Pc-rm it ce nam e (pri,11 ): I
{._1,..,,, PO r ~ ( 17 'J \ I.I.