HomeMy WebLinkAbout20165992 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (N4-19), Santa Ana, CA 92702 Electrical Permit #: 20{65992
Pin #: 17733lnspection Requests: (714\ 667 -2738 lnspector Section: 1714) 647-5853
Proiect Address: 2424 N Tustin Ave Unit:
Block: A
Bldg: 24-C Address Range:
TTact: A.B. CHAPMAN HistoTic: No
Suite Range: 2
Zoning: R4Assessor'sParcel: 396-261-55 Lot.8
Ownerl
Address:
The Bascom Group, lnc
26 Corporate Park Drive, Suite 200
lrvine, CA 92606
(949) 955-0888
01 1 16002
01 1 16002
01 1 16002
0'1 116002
01 116002
51603
51603
51603
51600
51603
Fee Type Amount
'125 Volt Receptacle 1.40
Light Switches, Occ. Se 1.52
Light Fixtures 1.01
General Plan Update 21.25
lssuance 52.98
Qty
5.00
7.00
4.00
1 .00
1.00
Fee
$7.00
$10.64
$4.04
$21.25
$52.98
Phone
Tenant Name:
Contractor
Address:
Katerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-1065Phone
Slate Lic #: 1009989
Lic Type: '. B
Bus. Lic #: 366547
Workers' Compensation lnsurance:Carrier: Midrvest Employe/s Casualty Company
Policy #: BNUWCo139070
Expires: O1lOll2O19
Building Use:
Job Type:
Nature of Work
Multi-Family (5 or more uni Occupancy:
Alteration Constr Type
Fixture change outs (Unit 2)Code:
R-2
VB
cEc 2016 Notes: Fixture change outs (unit 2)
Planning Cdnditions:
Chavez, Dave
Date
Date
Date 06111t2018
Account#
Misc. Receipt:
Misc. Receipt;
Misc. Receipt:
Total
Every pemit issued shall become invalid unlessthe wotu on the site
authorized by such pemit is commenced within 180 days aftet its
Esuance ot if the work authoized on the site by such pemit is suspended
or abandoned fota peiod of 180 days aftet the time the wok is
commenced
$95 91
$0.00
$95.91
lnspector MID#: 20'1E-143630
01 1 16002 51600
0'1 1 't6002 51603
$21 25
$74 66
Fee Total:
Paid lo Date:
Balance Due
q
uI
Planning Approval Byl
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATrcN
I hcrchy afirm uidcr pcndry of p.rjury rhd I m cx.f,pl fnm rh. (t,nrn loN Ltcnsc L!8 nrr rhc ftrlowihg rca$. (s{?031.5
Brsin * rnd Profcsion Cdl)r Any Cily or Couniy $hth rcquiEs n Fanrit x' .on\rruL1, {116. iftriow. dc'mlnh or rctllt atry
sruciuc. prior ro ns issuoncc, olw rcquncs lhe amliclnr lor uch pc,nir b tilc a ligmd tul.m lhal h.or shc h liccnsd purMnl
ro rhc rb!(ions orlh. coita.rols Liccnscd tjw lch.plcr 9. ComnEncins wirh Se.lion TOOO of Divhbn I ol dc Busincss a.d
PmtcsionsCod.)orrhalhcorshckcxcmplrhc.clmnandlhcl8shforlhcalkEdqcnnrbn.AnyviollrionofSccthn7011.5bylny
lpnlicrtrr ior a lcrmir subccrsrhe applicani t, a.i!ilpc.alrror,or tu,Efid 6v. hundRal dolles ($Jm).
-1.
x\ owmr or rh€ rroFny. or my cntloFrr wilh wtrc$ as rh.n sb .ompcnsotion. q'ill do rh. worl ud rhc crmhm k mi
inr.toL{ or offcrcd roi sh (sN ?()44. Businc$ and Pmfc$ions Codcr Thc Conrracxtr r Li.cn* tiw do.s nor lpplt lo an owrct of
rhc pmleny qho hu ilds or inDows lhcpn, urd sho d@s skh wd( htnsclr or hc6cla.r rhmu8h ht or ,Er o*n employds.
Fovidcd th0r such i.DoEmnraEmt i.rcrd.d orotrcrcd rorsh ll.lrscw( Ih. hildin8 or impmwrnr is eld *ithinok ru
olcon{,lcri4 rhc owncr auini will harc rhc hor'lo of noviry th.l hc or shc dil mr build or i'ionNc f pbIcny ror rh. purJrs or
I. iso*..r ollh. !mp.ny, mcxclusivcl, contructins wilh li$nfd conrra(ni^ h, str{dcr rtr l)rcjNt (Sa. ?1i14. Bu\inc\\
nlxl thril\bn Codc Tlr Conrrcrols Licen\c LaB doe! nor aff,|, ro !n own.r or rrol.ny Rho builds or imrovcs thcrs,n,
nnd who .untrc(lnr su.h pmrcBwfha Conrmroi s) liccnsd pnnurnt k' rhc Conrraclor's Liccn{ Ijw)
-l
amcxcmpt undcr Satio
t!!4tr[&r:g]Mf[NliarpN
D[CL n u(}!
I lErchy rmrm undcr lEnollyolpcrjuryoic orrttr r(,lk'wtrg d..l&ii{trs:
Ihsvcnideillmirtrin!CcnifrcotcofConsenrroSelllns!rc,o,sorkoi.rf,p.nerkr,rspDvid.dlorhyScctn,nITOOdrrh.
Ltrhor C.dc. ru rh. r.rroamncc ofrhc aork lor which rhc pcrni is nsucd.
I hrvcrnd willnrinlsin wortcrr compcns ion inslratre. f,\ rcqlied b, s(r bn 1700 oi lhc Llbor Codc- {(tr rht porornBn.c of
h nsucd My *orkcs' conEnsln'n nNurdcc .dicr &i polty nutrlhcr dc
(
5
I ccniftrh ir thc |x lornmncc ollhcw.rk l *hichlhi\ nermir ir isu.d.l \hnllnor c,nPloyrny Pcrson inany manmr
so sro hcconE suhjcd ri, rhc workcG co'np.n\arn,n h*s.rCnlil.nriJ. Md l8ndhlt iil \hould hcorc \rbrc.r hrlr
workcr' compcn\lrion lr.vnion\ of Scd n,. .l7m of rhd bbr Gxlc. I shall. i)nhwilh .onrply wirh rho* pxrvi\ions
\YARNIN(: tilurc r. rcurc aorkcn compcnrariotr covc&Se is unlowtul, ad shall \ublc.r rn cmtlo)cr ro rininrl Fnalricl md
:.:iilill'1".il.il'uffi.llll,;i:
l(x).UxD, in oddnion lo rhc.o( or.ddures rs rrovidcJ fttr rhc
IECI.d8dIx)N
I hcrcby ofirD undcr lcnohrolpcrjury Uur I sn lie.$rl udc l,r,lision orch4rcr 9 (onmrcio-q wilh Sccrtrn Ttxxr) orDivhion 3
of rhc Busircss and Polcssions Codc. {d my licc,sc t in 6ill forc aBl cfl.cr
\oo11 oo1
""" JUN t
COISIAIJCIION.LENIIING.{AENCI
I hcrcby!flirnru&r Fnalry orr*.jury rh thd. h!coiiruc'iotr lcndins oScmy for lh. por.r@nN of'hcwork lor which rhir lcrdil ir
nslcd (Scc.:lO9?, Civ. C.).
APEI.ICANLDECI,ABAUON
I hcrcby ofum udq pcnolr, oapcrjury onc otrhc rou.wine dcclddions:
Dcmrilion Pcrnih'Asbcstos Nori6carion Fcdclal RcE!htions (Tirlc 40. Pan6r
-Rcquncd
Lxltcr ol Noli,icalion
_l ccaiiy rhDr rhc r.dcr,l rcgulrtnrns rcgddin8 asb.srosrcmvd!rc not atfltar,h ro rhn pmi.r
-l]?cnify rhor I h,vc rcad rhls applk,rion.nd iarc lh,l lhc atrrc info,nulion is.orfur I nlre lo conply qnh all Ciry un Colnry
ordinde\ a.d Sralc Liw{ rclsring ro huildinS construcrion. !.d hcrcbyruthorjzc rcrcrnrdiks 6frhir Ciryadd Counlylo cnrs upon rhe
!h.ve rrnliord ptr,pcny ftn invd i{,n turyr,\c\
Appli.anl or AEent Signnlurc:
zr>4./r,,"\1 2018
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Sions (monument)
Life Salety /Low Voltaqe
Fire Alarm / Dampers
Building
Under Slab / Floor
Bondinq / Groundino / UFEFI
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soflit Rouqh
Ceilinqs (T-Bar Rouoh)
lvleter Release
Rouqh tt/l?tlq <,\ tft
Service ltleter
FINAL t/zt/,c ,b8g
Notes, Remarks, Etc
Communications Cable
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