HomeMy WebLinkAbout20161925 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical Permit#: 20161925
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853
Project Address: 3509 W Fifth St
Assessor's Parcel:
Owner:
Address:
Phone :
Tenant Name:
Contractor:
Address:
Phone:
State Lie#:
Lie Type :
Bus. Lie#:
198-171-25
John & Trang Lin
121 Treasure
Irvine, CA 92602
(949) 861-3630
Lot: 105
Do Builder & Design Inc
16912 Gothard St., Unit 0
Huntington Beach, CA 9264
(818) 446-8888
994497
C-36, B, A, C-10, C-20, C-38
348098
Workers' Compensation Insurance:
Carrier: Wesco Insurance Co.
Policy#: WWC3231527
Expires:
Building Use:
10/30/2017
Commercial
Miscellaneous
Occupancy:
Unit: Bldg: Address Range:
Block: NA Tract: 554 Historic: No
Fee Type
01116002 51603 Light Fixtures
01116002 51603 Light Std w/ 1 fixture
01116002 51603 Time Clock
0 111 6002 53601 P/C -65%
01116002 51600 General Plan Update
01116002 51603 Issuance
B
Pin#: 71404
Suite Range :
Zoning : SP2
Amount Qty Fee
0.98 6.00 $5.88
23.10 5 .00 $115 .50
11.27 1.00 $11 .27
0 .65 133.30 $86 .65
20 .56 1.00 $20.56
51 .26 1.00 $51 .26
Job Type :
Nature of Work: Light stds/wall pacs
Constr Type:
Code:
VB, SPK
CEC 2013 Notes: Light standards, wall pacs. No plan check required
per Scott Davis -led lighting.
Planning Conditions:
Planning Approval By: Soboleske, Hally Date:
Plan Checked By: Date:
Permit Issued By: Hernandez, Kathy Date:
Subject to Field:
Building Permit #: 10188322
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
11/03/2016
12/06/2016
Account#
01116002 51600
01116002 51603
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#: 2016-127993
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
T otal
$20.56
$183.91
68790
Fee Total:
Paid to Date:
Balance Due:
$291.12
$86.65
$204.47
APPROVALS
Site-Work
Underground
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-Pane ls
Air Conditioners
Roof Top Equipm e nt
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rough
Ceilings (T-Bar Rouqh)
Meter Relea se
Rouqh
Service Mete r
FINAL
Notes, Remarks , Etc.
DATE ID/SIG.
i l
7/Jo lr'.1-
ELECTRICAL-INSPECTOR RECORD '
O WNER BUILDE R DELCARA TION ~7 COMMENTS I hereby .1ffirm under penalty of pc1jury that I am e.,empl from lhe C'ontractors· License Law fo r the following. re<lson (Sec,703 LS "'•
Business and Professio n Code): J\ny City or Counly which requires a pennit 10 conslruct. ahcr. improve. demolish or repai r any
slructure, prior to its issuance. also requires the ilpplicanl for such pen11i1 to file a signed stntcmcnt that he or she is licensed pursu:mt
to the provisions of the Contractor's Licensed Law {Chapter 9 . Commencing wilh Sectio n 7000 of lJh·ision 3 o f the Blts im:ss and
Pro fessions Code) or that he or slit: is c.,empt therefrom ,md the basis for the alleged cxcmp1icm. Any viol.it ion of Sect ion 703 1.5 by any
applicant for a pcn1 1it subjec ts the applicant to a civi l penalty of not mo re than fi ve hundred do ll ars ($500).
_I. ns owner oft he prope11y. or my emp loyees w ith w.iges n!i I heir sole compensat ion. wi ll do the wad, nm! the structure is not
int ended or olTered for s.i le (Sec. 7044. Business and Professions Code: T he Contractor's License Law does not apply 10 an owner of
the prope11y who builds or improves thereon. and who does such work himself or hersel f or through his or her 0\\-11 employet."S.
prov ided that such imwm·cincnts are not intended or offered for sale. If. ho,,·e\·er. the building or imprnvemeni is sold wit hin one year
of completion, tl1t: Owner Bui lder will have the burden of proving th at he or she did not build or impron: the pro1x.11Y for the purpose of
sale).
_I. as owner of the propei1y. a.i n exclusively c ontract ing with licensed contractors to C'o nstruct th e project (Sec , 70-M, B11si11ess
and Profession Code: The Contrnctor's License Law docs not apply to an owner of prope11y who bui lds or improves thereo n.
and who conlracts for such projec1s with n Contmctor(s) licensed pursuan1 10 the Con1rac1o r·s License Law).
_l am exempt under Section ________ . B. & P .C. for this re11s011 .
O.tle: __________ Owner:_W_O __ R_K_E_ll_S_' _C_O_~_IP-E-◄N_S_A_T_I_O_N ____________ _
llECLARATION
I hereby affirm under penalt y of petjury one o f the fo llowing declarat ions:
_1 have :md w ill m.iint.iin a Cc11 ilic;itc ofCcmsenl lo Self-Insure for workers· co 111 pe115ntion. as pro vided for by Section .''.t?OO o ft he
Labor Code. for t he ptTfon nan cc of the work for which the pt..,,nit is issued.
_1 have a nd w ill main1ain wo rkers' compcns.1t ion in surance. as rc<1uircd by Seel ion 3700 o f the Labor Code. for the pcrfonnnnce of
the work for w hich this pcnnit i s issued . My work (.Ts · co mpensat ion insurance c.:UT icr am.I policy number arc:
C m icr: ___________________________ _
Policy Numbcr: ______________________ Expires: __________ _
_1ce11if)1 1hat in 1he perfo rma nce of the work for wh ich thi s perm it is issued. I shall not emp loy any person in ,rny manner
so as to become subjct:1 to the wor kers' compensation li1ws of Cali forn ia. mu.I agrcc.thm if I should become subject to the
wo rkers· compensat io n pro visions of St-ct io n 3700 of1hc Labor Code, I slmll, fort hwith co mply with I hose provisions ..
WARNING : r:ai lure to secure workers' compens.1tion co\'crage•~1s unlawful. an ,all subject an emp loyer to criminal }X"Tlalties and
civil lines up to one hundred thousand do ll ars ($100.000). in a dit ion to t os~pc,~on. d.1111.igcs as prodded for the
Secti on 3076 oftj e 7aoo/7 do/'ntcrcst an d attorncy·s fec.-s . er-/ ..,;9"".J 1
Date: /? f b/ , Ip) A pplica nt: ~ A"~/
I 1r ,--.-: '"'TR,\rTn....-V
IIEC L ARATIO~
I hereby amrm under pen.i lly ofperjtiry lhrit I am licensed under pro\1is ion of Chapter 9 (commencing with Section 7000) of Division:;
of 1he Business and Prorcssions Co de. and my license is in full force and effect .
License Cl.1ss: ______________ Li cense Numbcr:A t:f ~£1{/_!3_ -;.,..
Date: / '( /t /_LC,. Contrnctor: X ·c_; £1 (/7;~//
CONS'J"R ~C l"l~!lllz.ENCV
I hereby a mn n under pen.illy of pe1jmy tlmt there is a const ruction lendi nb!, agency for the pcrfomi.111ce or the work for which 1his permi t is
issued (Sec. 3097. Civ. C.).
Lender"s Na me: _________________________ _
Lender's Address: _________________________ _
A PPLICANT DEC LARATION
I hereby nllinn under penalty of perjury one of the follow in g dcc larat ions:
Demolition Perm i1s-Asbcstos Notification Federal Regul at ions (Tit le 40. Part6)
_Required LcttcrorNotification
_I cci1ify th at the federal regulations regarding a5bestos removal ore uot applicable to this project.
_I cci1ify that I have read thi s applicilli on and state that th e above infonnatipn is cmTcct. I 1.1grce to co m ply with all City and County
ordmances an d State La\\S relattng lo bu tldtng c0nst111ct1 1n e1;_!)Y autho11ze 1cp1escntattvcs o fthts C1tv and Counly to enter upo n the
abo,c mcnlloncd p,opc,1y rm mspc¥:J" p~s ff / _ / /
Applkant or Agenl Sign,llurc V\_,. -1..J ~---,,,-(,,,/ l}nf c / ~c I It
Pcrm ilce munc(print):_r~ &,/:"',. £. .