HomeMy WebLinkAbout20166016 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
l nspection Requests: (7 1 41 667 -27 38 l nspector Section: (71 4) 647-5853
Electrical Permit #: 20{66016
Pin #: 44344
Proiect Address: 2705 N Bristol St
Assessor'sParcel: 232-051-12 Lot: POR 14
Unit:
Block: NA
Bldg: Address Range: 27Og.27Os
Tract: POTTS, BORDEN &Hlistoric: No
Suite Range:
Zoning: Cl
q
Owner:
Address
Phone:
Tenant Name
Contractor:
Address:
Fee Type
01116002 51603 FWU
01116002 51600 General Plan Update
01116002 5'1603 lssuance
Amount
23.87
21 .25
52.98
Fee
$23.87
$21.25
$52.98
Qty
100
1 .00
1 .00
LAYAO
Owner-Builder
Phone
Stale Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #;
Other
Miscellaneous
Fireworks Stand
Occupancy:
Constr Type
Code:Notes: Handout given/fees pd in full on M-71057
Date:
Datel
Date:
Misc. Receipt: 71057
Misc. Receipt:
Misc. Receipt:
Total
Amsden, Julie
Every pemit issued shall become invalid unless the wo* on lhe site
authoized by such permit is cofimenced within180 days aftet its
issuance ot I the wo* authoized on the site by such pernit is suspended
ot abandonod for a peiod of180 days aftet the time lhe wor* is
commenced.
06/04/20't8
Accou nt#
$98.10
$98.10
$0.00
lnspector MID#: 2018-143655
N/A - No Balance Fee Total:
Paid to Date:
Balance Due
Floral Park Promenade Llc
PO BOX 11964
Santa Ana, CA 927111964
N/A
N/A
cEc 2016
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE lD/srG.COMMENTS
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Sions (monument)
Life Satety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouoh
Ceilinos (T-Bar Rouoh)
Meter Release
Rouqh
Service lVleter tn tv /iA,n.1
FINAL fiq /
Note e S E
Lt."Lll 6- NAT br.Ar
OIlNER AUILDER DI]LCARATION
I hcrctr, uriirm undcr pcnohy oi pcrjury lho' I oD crc'nB no'n nrc CoffackF Ltrtrs L3$ ror rhc foln,$ins rcxy,n (sLr?0ll5
Busincs trlxi Prolcs ,n Cslc) Any Cir, or Counry {hi.h rcqlirc\ r If,rnlir n, ..n{rucr, rlrcr, nnptuvc, d.nDl$h or r.nar ,try
sru.ror., |tri(rt, ih ii\uamc, also i.quirc\ rh.q,Ilkn iu \!chljcnnirrJ lllca rign.d slatcmnr rhar tEorshc is licc.scd tusu t
ro rhc pmvtions ofltr Conlmcror's l-iccnscd ttrv (Choptcr 9. Comrcncnrs wilh Sccrion 7O0O ot Division:l oi rh. Busilc$ and
Porcsrion\Codc)o,rhar tf, or shc is€rerur rhcrcfronand lhc basis fu rhc nllcsd cr.mrrn,n Anyvn ari{,norscri.nT0ll5byrny
itpli.nnr f(r a p.mrir suhjdrs the dmli.nm ro a .ivil Fnilry of nor frrc rhm fivc lrndrcd dours ($500).
-1,
!s o*ncr of rhc pnrEdy, or my employss airh wa8c\ a\ lhcn sb Fn{an\ar ioo. will do rhc lqk ail rh. iturm ir mr
inr.fth, oroficnd for slc (Se.7O4.l. Busincs d Pmfc\sionr Codcr Thc C.nkF&tr\ La.ns trw docs not Errrl,to anosmr of
rhc pml*ny w,n hilds or irym6 lh.pn. uxl wh. des un wn( him\clf or herclf or rhmlBh ht or tcr D*n .nfloyc.r.
ptulidd rh.r such inobrm s m m( inrc icn oi offcrn fo, {h. lf. tsw.r( rh. britlin8 or irproBmnr i. sld whhin om )rr
o,qlllllbli.n.rhcOwmrBuil:lswillhawrhcturdcno{Droliryrh.rhcor\hcdid,rlaiBorinrmwdctqdyfoitr!uq.{or
I.r\owicrolrh.pn|xny,r'ncrclu\ivclycontr.rin8rnhli.cn\cJconh.nn\hcondtu.rrhcpn'j..r(Sd.704l.Auencs
0rkl Prr&sh. Codc: Thc Conlrlcror's Liccnsc Lrw docs nor.rply h atr owncr ofI'loncny who
rnJ sho c.nrn '\ ltir \uclrrujrcr\*ilhr Co.ercdl \ r li.ctrscd ptrr\urnrbrhrc(rirrc
DESdAAIIAN
I hcrchylltnmu sp.nrllyoipcrjuryomofthctullowinsJc.lnmtn,ns
Ih.vcddvillmainr.itr.C.niicarcofConrcnlroscl nsur. r(r rukcra .omFnsd ion, us pmlidcd lor by Seclion l7(r oi rhc
titxrr codc, fitr rh. pdrfnrncc of rhc *ork i(r which rh. pcrmir i\ hsucd
_l havc axl{illnui rin *orkcr' conDcnsarion insuraNc, as rcquircd $y Sccrn,n :r7ul ol rhc Labor codc. fff rhc
'ltrroIr11mc
or
rhc *ork tur khich rhi\Frmil is ksu.d MtworlcF .omnens!,i,nr insuflrc Qrio dd F,li.! nu'nh.r ml
l!.niftrhrr i rh. t^-^rformn( (,f rhcwo lnr tr h(h rhn Frrnir ir r\trc . I drll Dor cmdoy rtry
$ rs
'o
hrsm subjd to thc rcrtcts'onrlEtrsition llws of Cllifomia. md rsN lhol if I shoold
workds mnlr..elion lrovisions of Scclio, l',0o of rhc t2bor Codc, I shall. fonh*irh coq)l
WARNIN(;: I:!ilurc lo c.urc $orlc^ .r'npcn\rrim c.vcrrsd is unh$rul. rnd \
*: a'i'i'r
-'*r:l1l l:l](x).lxxr). i| rddr
DECI,ASAIION
I hcrchy uffirm hder ocnulty ol Frj!ry rhar I an liensd unacr pDrision olChsfl( 9 ((,hnrncinS wirh Scdion 7000) oioivision 3
o, lhc susincsr Md Profe$ions Codc. and mr liccnsc is nr full n,R und clltcl
b FAV
COXIIf,IJI]rcII.BDIIGAGEICI
I hcEhy afim undcr tEnalty of frjury 'Ia'
rhft n a coisrocrion lcndins ascfty for rtr FrrolrMcc of th. work for whth thn lrmil k
issred (s(.109?. civ c.).
AIzuCAILII&CLAAAIION
I hdrny fllmr und.r p.nrtry of p.rrury orc of rhc foliowine ddlr t,ns
D!nmlirion Pcrnrirr A\hcsl6s Norificrri(,. Fcdcr!l Rcstlalt,ns flirlc,(), Pan6)
_R.quircd Irncr of Norili.utn,n
-l
ccnilylhd lhc rcncrd rquhtions resudin8 ashcslos rc
l..nifyrhrr lhrvc ru rhi\ m I ure lo conDly qnh all Cnyrnd Counly
o'dtrr .cs rtrd sorc l-rw! rcldiriBro huiknrg ncs.flhn Citynnd Counrr ro
rb(rvc tr{nti(nrJ pn)pc'ry l(r i',!If,cr
.\pDlnMt o. ,rletrr Si*nHltrr.
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