HomeMy WebLinkAbout20166015 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Electrical Permit #: 20{660{5
Pin #: 34329
Bldg;
Tract: MABURY
Address Range: 1311-'1601
Historic: No
Suite Range:
Zoning: C2
qProiect Address: 1601 W Seventeenth St
Assessor'sParcel: 399-121-38 Lot: 12
Unit;
Block: PM
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
Ggf Bristol Llc
100 W Broadway 950
Glendale, CA 912101209
Gold Coast xtreme Boys Soccer Club
Owner-Builder
Fee Type
01116002 5'1603 FWU
011'16002 51600 General Plan Updale
01116002 51603 lssuance
Amount
23.87
21.25
52.98
Qry
1 .00
1 .00
1 .00
Fee
$23.87
$21 .25
$52.98
Phone
Planning Conditions
Planning Approval By
Plan Checked By:
Permil lssued By:
Subject to Field:
Building Permit #:
Other
Miscellaneous
Fireworks Stand
N/A
N/A
cEc 2016
Occupancy:
Constr Type
Code:
Notes: Handout given/fees pd in full on M-71057
06/04/2018
Account#
Misc. Receipt: 71057
Misc. Receipt:
Misc. Receipt:
Total
Amsden. Julie
Every petnit issued shall become invalid unless the work on the site
authotized by such permit is commenced within180 days aflet its
issuance, or if the wotk authoized on the site by such permit is suspended
ot abandonad lor a period of180 days aftet the time the work is
commenced.
$98.10
$98.10
s0.00
lnspector MID#: 2018-143654
N/A - No Balance Fee Total:
Paid to Date:
Balance Due:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work;
Date:
Date;
Date:
ELECTRICAL.INSPECTOR RECORD
DATE ID/SIG.COMMENTS (,WNER BUII.DER DELCABATION
I hcrhy affirm ond.r prdslry ol Frrury rhd I m cx.nDi rmnr rhe Conr{im Liccnsc Liw for lhe followins rc&a. (Ss.7011.5
Busincss rM Profc$ion Codc): An, Cily or Counlt which rcqunA o pcrnrir ro consltucr. !lrd, imFovq dcnEli.h or nprt {ny
srrucrurc. Friorro irs hsuurcc. lho rcauircs rhc amlic{nr for suct rEnnit ro lile a siso.d $rar.'rcnr rhd tror shc is li.cn$d purulnl
b (hc F,visbns of rhc Conrrucror's Li.cn*d ljw lchapr.r L comcncin8 vilh SNtion 7m0 ol Divhion 3 oflhc Brsinc* dnd
Pr.r.sionsCi.)orrhartrorshciscx.m rnrcfromlndrhcbasisli,rlhcsllcSe(cxcmplion AnyviolalionolsarionT0ll5hyaoy
lpDlicant lor 0 ,tcrnil suhjalslhe {rlic.nrlor.i!ilpenaltyorootnnrcthlnfivchundrcddoll*!(S50o).
l. ns owncr ofrhc po,rnr, or my cmployccs wirh wagcs n lhcn st ompcnkrion. willdo rlt vo.t and rl'c dftr@ i\ ftn
inre cn or oficrcd for rlle (S( 7ltl4. Burires lod ftof€ssions Codc Thc Conhcroa s Liccn* tiw docs nor apply lo an oanc, of
lh. pmrxdy wtr, builds or int mRs rhmn. ed who dmx such wr hrmrclforhcrscllorlhmu8tfihorhcrowncoll.yccs.
providcd rhor su.h impn,rmnr( m (, idcnl.d or olliBl lor ek li h,Mhi rtl hoikling oi i'ntmvcmnr is q,kl wirhin orc J{(
ofco.llllc'ion. fi. o,rrcr Bui[cr willharc ItE hodcn ofrovinS lhar hc or snc dn mr l{ih o. irnpDft lnc polxny ror th pu{rk or
rhc Drorcny. ncxclu\ivclycontrrcrinswirhlic.n{dcontucr,At,conrtu.ritr|tr(iLrr(s..7{}:l,1,lrurinc$
,dc: Thc Cont .ttr\ Li.cnsc Lrw docs tror.Ftilyk, in.wncr oftr(,lEny$ho huildror i'npn)vds rh.rco..
lnr6 ,n, \uch pojccr \ *irh r (irnt rtrni 9 licctrsd pur\utrr n) rhc
P('
DECIATAIION
I hcrchy llinmudcr pcmllyoipc.juryonc otrtf, nnhwin8 dcclmrion\:
-l
hlvc en will minrain ! Cen ilrolc of Cotrsir ro Sllll trsurc for *ortcn comj{.s ion, d rovidcd for ty Selion l?00 of lh.
kh.r O,lc, forlhc p..lornDftc of$c so for whth rh. Fnnn is nsucd.
-l
hrvc rnd will mrinrli', *orkcrs com!.n\rrtn, insrra'r., a\ rquimd hyS..rioi lTUlolrhc LnborCoJc. tur rhc !crl.rnun!.ol
rfu work lar shich rhistcnnn i\ is\ucrl. Mywurk.^ cu rpcnsdror r\ufuncc crricrnnifl,li.ynunrhcr ecl
Poli.yNumb.r: Eirtc\:
-l
ccnily rhll in rhc pcrtornrncc ofrhc work n, shich rhis r.rmir i\ isiucd. I shrll nor cmtloy atry pcretr in nny munrct
sr dr ro h.(oft subj.cr t, rh. workc^ comlrtrslio lnws ofcaliforni{. rnd i8rcc lhul il'l sh.uld b..oft suhjer t, rh.
wo*.n.oq,cnetionflovisionsolScclion]?00ofrh.trborCodc,Ishall.iorrhuirhcomply*nhrbs
WARNIN(;: liilurc b $.nr. sorkcr comptn\Jrion.ovcBlc i\ unlJ*lnl. r'xl (hill
civil ir.s up ro onc hundrcd rhou\anJ dolh^ (Sl(X).( O). in rddirion
S(ri.n lltr76 ofl,lc Ixlo, CodUmcrc{ and dt
*"' r hflT *,
DICI,I.8AIIAN
I hcEby lafim un'ler p€nalryolpcrjnry rhnr I !d li$n$n under lrornn orch.picr9(.o mEmi
of $c BusiRss lrd PmlessiorNCodc. o,n nrylkcns is in aull loR. ard criacl
Q I
C(INS'TRUCTIoN LENDING AGI'NCY
I hcrcby rlltnr undcr IEMlly of pcrjlry lhar rhcrc h u snNlru€thn hndins ulcn y ror rhc pdldnmftc ofrhc vork ior whichlhis lcimil h
isucd (S...l0)7.Civ. C ).
AIIIIqANIDECITIAAII!)N
I h.r$y rninn urdcr pcndlly ol pcrjury onc oilhe lhllowing dshrorions
Deffnirn,. Perhn\ Ash{or N.rifi.arion Fcdcrrl R.laldrioos (Tirl.rto, P0n6l
_Rcqun d Ldrcr of MriLarion
I ccdilyrhd thclcdcrdrcguhrt,ns rcsoftlin8 lshc{oseflnulsrc nor$plic!$lctu rhis F!..r
_l ccnilyrhrr I have rodrhis rpplicrrinmJ {rlcihrr rhr*iv. nna fr{r I n8rcc b.onDly wirh trllCiryand Counry
odin.nrcs ind Srolc L.ws.cblirr k,
.bvc nrnriomd lmpcny for i,rpccl
Appliotrlor&mlsi8MluE
-Peni,t.Nn ryna,,, j(1_Lel?_L >/1 ::.:LLH
Site-Work
Underground
Liqht Standards
Spas, Pool, Fountains
Signs (monument)
Life Satety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER
Translormers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soflit Rouoh
Ceilings (T-Bar Bouoh)
Meter Release
Rouqh
Service lvleter 1 I
FINAL ^hbn7 twwl
Notes, Remarks, Etc.I \)/ /
APPROVALS
Pole Bases
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