HomeMy WebLinkAbout20167409 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702 Electrical Permit #: 2lJ1674lJ9
Pin #: 59439lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 2414N Tustin Ave Unit:
Block: A
Bldg: 14-B Address Range:
Tract: A.B. CHAPMAN Historic: No
E
Assessor'sParcel: 396-251-55 Lot: 8
Owner:
Address:
The Bascom Group, LLC
26 Corporate Park Drive, #200
lrvine, CA 92606
(949) 955-0888
01 I 16002
01 1 16002
01 't 16002
0'1 1 16002
01 1 16002
51603
51603
51603
51600
51603
Fee Type Amount
125 Volt Receptacle 1.45
Light Switches, Occ. Se 1.58
Light Fixtures 1.05
General Plan Update 22.08
lssuance 55.04
Fee
$7.25
$1 1.06
$4.20
$22.08
$55.04
Phone
Tenant Name:
Contractor
Address:
Kalerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-1065
:L/ LtJ/2tJtt
ir0n9+: :1
Ref+:
11/15/t01
ul
Phone '21-l
State Lic #: 1009989
Lic Type: B
Bus. Lic #: 366547
Workers' Compensation lnsurance:Carrier: Midwest Employe/s Casualty Company
Policy #: BNUWCo139070
Expires: 0l/01/2019
l.r n5r I L(
jr-lLru-
DD3rJ76
Bualding Use:
Job Type:
Nature of Work
Multl-Family (5 or more uni Occupancy:
Alteration Constr TyPe
Fixture change outs (unit 5) Code:
R.2
VB
cEc 2016 Notes: Fixture change outs (unit 5)
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Chavez, Dave 11t15t2018
Account#
lvlisc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every pemit issued shall become invalid unless the h/o* on lhe site
authoized by such pemit is commenced within 180 days afiet its
issuance, or if the wod< authotized on the site by such permit is suspended
or abandoned lor a period of 180 days 1ftet the time the wotu is
commenced.
$99.63
$0.00
$99.63
lnspector MID#: 20'18-'147691
$22.08
$77.55
Fee Total:
Paid to Date:
Balance Due:
Suite Rangei Unit 14 B.5
Zoning: R4
Qty
5.00
7.00
4.00
1.00
1.00
Fdote fee
ul-ll"tLt-
xxrUEg4 Aulh +
Date:
Date:
Date:
01 1 16002 51600
011'16002 51603
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDER DI'LCARATION
I hd.by.mrm und6 pd.lty ol pdjury rhar I &n .rcmpt liom rh€ Conhcror' Li.ens. ta* tor rhe lollowinu r.Mn (Se 7trll.5
B6in6s ..d Pmfaqion Cod.): A.), cny or cou.ry whi.h equn6 a tEmn to .onirud. dh6. imp.ov.. dd,oli'h or r.p{t y
struclure pior lo il3 i$uanc.. als rcquiG lhc applica lor strch p€mit ro filc a signcd srarotral rhat hc o! sh. ii licaEcd pcudr
ro thc pmvisioB oa rh. Conlrlcrors Lic.ns.d Latr (Chapn 9- Com.hci.! sio Serion 7000 oa Dnision I old. Busincs d
Prof.sions Cod.) or $ar he or sh. is .xmpr fi@tos dd rn bara lor lhc rlleSed .mnplion. An, violation ol S€clion 701 Lt by any
applicanl for a pcnnit srbjrclslh€ appliconl lo acivilp€Mtyoanor lnoretho fivchundrcddollss($500)
_1. as owrcrolrhe pmpeny, or my.,nplorG sirh wagcs6lhet $le compmatbn. willdo th. wo,k md tlE struclE is nol
i oded oroifd.d aor el. (Sd.7014, DBinN d Pr.asirns Codd Thc (o.'lroclois Licos,js doc nol applylo d o$,s of
th. pmlh) who boilds or nryrov* $@., dd $hd do6 su.h *o* hnns.lfor h6.lior rhrcugh his orfir o*n oploy6,
provided that such imlrov@rs ft nor inlod.d or ottold lor eL ll ho\ard. rh. buildins oi nntiovmmr i $B wnhin ',ne )w
of conDldion, th. Osr( Builda "ill havc the hIds ofprovins thd h. or sl'. dii nol tnild or impre\ c 6. I'spsry aor lh. purpos ol
-1.6o{nrof
th. Iropsly, d dclusiv.lyconlrftring virh lics.d conlra.roBlo cda'tud tbc Fljd (s(. 7044. aueins
md Plol66.code: Th. Cotrtraclois Liccns. Law do6 nor apply to eownr ol prop€ny rvho builds o. nnprov6 $d&n,
and *ho contmcrs lor such pojdrs wilh a Con!6clo(, ltc6.d puGudr ro rh. ('onlra.lols Li..N tr{)
lamerempl u qs.{rion ,Lt &PC lorthisrcGon
.!roaxEr!r:co!!tErs6!!9!
D&CIANAIIO!
I h6€t'y afiirm und6 p€n.hyotpsiuryoncoilhc lbllowin,r dNlaralioN:
I hflv€ ed rvill roinl.i. a Ccnificare ol Coredr ro ScllJ6urc tor workBa @nD.nsri(,r, 6 p.ovid.d ior by Selion 1700 of th€
tibor Codc for rne pdaoflnMc. o f thc \nt for whicn d. Fni b bx€d.
_l havcandwrlllnaintain *orkers conpcBarion iBurdoce. $ reqlned hy s&rion 1700 oarh. tibor (td.. for the pgiomecc ol
a! iieucd. My worltd!- conpq&lio. i*l@.c .&nd ad poli., numb6 ee
lat 4
L////./71/
I cenilylhat io Ihe pcrloflnanceollhework for s[ich lhis pdm]t h issu.d. I shall nol cnrploy any p.6on in any 6e.d
s s to b..on. subjsr ro rhc mrts comF.elion l.ss ofcalilomia d arr rh,l if I shnuld h.r6n. subj.{i t) th.
woIkm comp.nsalio.povisionsofSeclionl?00oflh.tibo!Cod..lshall.lonhsirhco'nply$irhlho*psvisioru
wARIINC: r{ilme ro suc workm' comp.nsarion covGase is unl.waul. dd shall nrbjccl an mplors lo Fninil
'j.nahie
and
civil fm6 up Io onc hun&.d lhousd doll6 (t100.000), in addirion lo rhe con or&np.Nlioo.d,ruE stJ,rolid.d ro! th.
Sdion 1076 olnrc bbor Codc, intresl and lrtorE) s rs
,",+l0y f5l0l8-
DI]CIJsATIAN
I h@by am,n u.d6 F.alty of Fjury rhd I m licds.d und6 Folisio. ofchrpl€ 9 (.om,Mcin8 with Selion 7000) ol Dilision 3
ol lhe B6in6 sd PrclsioB Cod.. ud my lic.N is in tull forcc ad c,Id.
D /e"2??0.o?
*"ll0vjj20tg c.n(r'.,.r ^<-
(olutrllcrloNtllDllc-acENcr
I hd.6, rlIri u.d6 Fnahy of rrjury 'h, thd. ie r co.nodion Lnding r*dcy aor $. Ffomde ofrh. $o.k for snich lhn pdnir b
i$ucd (Sd.3097. Civ. C.)
AIIIICAILDECIASAIIQN
I b.dy amm uidd poalry oaFjlry on. of th. followins d6l@rio6:
D€moliion Pgmils'Asb6tos Nolilic ion Fcdoal Rcsulalions (lirl.40, Pan6)
R€ut€d Inrs of Notifrcalion
-l
cdifythd rhe fcdsal r.gulariom rcBddins Nhcros rdovaluc nor applicablc ro rhis prcjEr
k*t-"x:tI h.verdd rh6 rrplicrrion ed.rar.$.r lhcdbovc iniodatn,n ir.o l I aBrc ro .omply wnh all Cny snd Couory
rro I a\s rrLxri,i! ro bu'1dtr,3 consru(otr. and aurhonz. rolrMrativ6 oarhk ciry md Cou.tylo ql6 upon lhc
abve menttrn€d prop€ny lor inspalion
,{pDlic!nl or ,\lcnl Signtrlure
Pem'il€e ninre (prnrl):
,ll0V 1 ! 2P1g
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
To rq ue rng
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roug h)
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rouqh)
Rough //-lc 1e,.4e..2:
Service Meter
FINAL llt tr/l't >u6t
:ZA : t.l;
It4eter Release
Notes, Remarks, Etc.