HomeMy WebLinkAbout20166142 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (l\4-19), Santa Ana, CA92702
lnspection Requests: (714) 667-2738 lnspector Sectionr (714) 647-5853
Electrical Permit #: 2lJ16,6142
Pin #: 53031
Project Address: 3301 S Bristol St
Assessor'sParcel: 410-222-25 Lot: NA
Unit:
Block: NA
Btdg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning: CR
q
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
Brisplaz Co Llc
PO BOX 4900
Scottsdale, Az 852614900
Jaguar Dtamond Booster club
Owner-Builder
Fe€ Type
01116002 51603 FWU
0'1 116002 51600 General Plan Update
0'1 116002 51603 lssuance
Amount
23.87
21 .25
52.98
Fee
$23.87
$21 .25
$s2.98
Qty
1 .00
1.00
1.00
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit Issued By:
Subject to Field:
Building Permit #:
Other
Miscellaneous
Fireworks Stand
N/A
N/A
cEc 2016 Notes: Handout given/fees pd in full on M-71 110
Misc. Receipt: 7'1110
Misc. Receipt:
Misc. Receipt:
Total
Link, Patricia
Every pemit issued shall becohe invalid unless the wotu on lhe sile
aulhorizod by such pe nit is commenced within 180 days after lts
issuance. or if the wot* authoized on the site by such permil is suspended
or abandoned lor a period of180 days aftet the time the wo* is
cofifienced
06/13/2018
Account#
$98.10
$98.10
$0.00
lnspector MID#: 20'18-143951
N/A - No Balance Fee Total:
Paid to Date:
Balance Due:
Building Use:
Job Type:
Nature of Work:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
ELECTRICAL.INSPECTOR RECORD
ID/SIG.COMMENTS
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Bonding / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Condrtioners
Rool Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soflit Rouqh
Ceilinqs (T-Bar Rouqh)
l\,4eter Release
Rough
Service lvleter ri
FINAL 'D0a tq
Notes, Remarks , Etc.ll
OWNER AUILDER DELCARATION
I h$ch, ,,Inn un&r pcMlry of rcrjlr, rhll I m.xcnpt fmm Ihc C nrr&x,6 l-k.ns ljw ror rhc following rcNotr (S(.r031 5
Busincrq dnd Protc*i{}d Cnde): Any Ciry or C.unry whi.h ftqut8 tr pdmir ro conslDcl. rll.r. improvc. dcmlhh o! Ep.n atry
slruciurc. Frbr r. ih issnaft.. rho rcquircs rh..prli.ad lor sx.h Fmir to fika rigrcd sletcmnl thd hcorshc n liansed pur$anl
io rh€ proririons ol rlf Co.rracrtr r Li.e.*d Lzw (Chaprc, 9, Conncn.ing wnh S.cttun 7000 of Division I of thc Business .nd
PrcIcsions Codc) orlhal hc or shc iseicnDl rh.rcfon and lhc blsis lor rhc allcscd crcmprinn Any !n drio. orscdion T0rl 5 by.ny
Ailrc0r f.r0trfr \uhJ(h rhc 0pnltrrnr rn acrv'lNntrlrynfnar nnnc rhon li!c hundnn dollor\,9100,
Z[t-*,.,*
".*r.
n mycmnr.y(\ r h*aEc,.\r\ci, s. con'Fn\J,tr'n. v,,tdn,hr].rr d,h. {tr,m ^ tu,
i[.,]& nr "r".a to, .t" (s* 7(x4 Bu\ms and Pr,tcssioB crdc] Th. contftr.r'r Lkdnsc Ilw des nor apply ro !n owrcr of
rhc tmp.ny who hdild! or iny,ows trNn. dd who dos such rc& hinNclf or heMlf or thou8h hh or hcr own e'qloyces,
pmvidcd (hor such i,rymrcmnrs m nor ir cndcd or oftcrcrl tu slc lf. ho*cv6. thc huilding or i'nprov.ftni is $kl wirhi. o.c Far
ot m.Ul€rt tr lhc Owns Buildcr will haE tlE budcn of pmviry lh,l hc or shc di1 mr build or inlnok $c ptr,Fty ror rl* purF{ or
LasowncrofrhcI'openy.!mcxclusivclrconrlaclin8riihliccnrd.ontrcr.rst,.on\trucrrh.pmp.rlscc7044.Busrrcs
and PnniJsbn codc: Thc G,nha.ior's Liccnsc Law d.cs nol,Inly lo an owm. ofpropcny who builds o, imp(trcr rhercon.
und who oniruch lor such nrcirts wirh a ConlEkr(\r lkcn*d nunumr ro rhc C.nr.a.ror'r l-i.cn* tjw).
_l _.8
I hcrcby 0fltDUnd& !.nih, orD.rjurtonc.f rhc lolhqi.S dcclarations
_lhaveaBlwillm0inrlnr!Ccninclrc.IConscorroScllrlnsurcfor*orkcn conrpcnsrri{u. rs providcd nrbySccliotr]7m.frho
L{hor Cqle.li,rlhc pcd'ornnncc olrhe wo lnr *hich thc n rnil h nsucd
I havc nnd will minrrih work \' conln.nsrr ion inrutui... as rcqund hy Scct ion 17IX) of lhc Lahor atdc. lbr rhc lr.rLrro'trc ol
rhd sork for*ii.hihh Fr.rir is nshd. Mywork.* co.rlrhsdri.i insur.i.c .dfticr r Folicy numher orc:
lkyNlmb€r:Jxp@s
ofthc w.rk for whi.hlhisltnnir is i$ucd.l shull trol cnI,loyonyl)cnotr in riynuincr
c^ compcnsation luwsofCaliforni{- adrsrcc rhlr irl \hould h..onE subl..t !otlE
)f scrio! :1700 ol rhc lih, codc, I lhnll, nflhRirh.onrdy wirh rh)s pm!ision\..cou!.osarion pDvNrnr(
WARNIN(; t-Jilu.c x, {cu.. *orkc conrFnsxrbn covcrrgc i\ D ln*lu. md shnll sulrlr(r r cnll'loycr 1o (rimi
:*.-',uffitl#
llJ'\ (S100.(Ix)r. in rddiiirr
I hcFbyaritalundcr D.n0llyol rcriurylhli I rn lienqlundcr n ol Chryrrr 9 (.ontrmmi'rg wirh
of rh. Businc$ rnd Pofcssions Codc. dt my ltctrs n ir tull forcc.ndcthcr
IAISIBICfl9NIENDIIGIC.EN(.I
I hcrcby rrfirm Dndcr pcn,lryofFrjlry rhar rhrrc is r.onirucrion Lndins,Bcn.y for rhc Frrbirmncc ofihc uork for *hkh rhis Frmi n
hrucd(S( 1097. Civ. C )
AIILICANLDECLIAATON
t tmfi, aninn hdcr p€nsllyofp€rjuryonc of lhe followii8 drcl{arionsi
Dcnblition P.rmih-Ash.sros Notifi.alion a{dcrilRe8ulations(1irlc40. Pun6)
R.quiEd L(.r or Ndiff, dbn
n
-lccnilr
rhr rhc lcdcrJlrcsultrl,l----JLI ccn'ryrh. l hnlc rcrJ rh^Jmlv.^lrnrnr...trJ 5r, c tiw\ rlar,ng 'n
rtuns E!rding asb. (o\ r.n,Hl J c norlpflic hlc t) rh'\ ttii)ic.r
i.arioritrd{ lclhdrlErlivc irrfnnnllln hcotrccr. Ir$eioconrlywirhrllCiryand
rhtriz.r sfirn!\ olihi\ Ciry atrJ C.
I
xtr,v.nrnri,rni p'on dyi(tri',\nrcri{n,
/1poli.nnl or ]\grnl Siamturc U 6 H"
I
I,IAIYIZI
APPROVALS DATE
Under Slab / Floor
Lic.nrc Cl.s:-Lic.nsc Numhcr:
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