HomeMy WebLinkAbout20166302 - PermitBldg: Address Range:
Tract: HENINGER'S ADD Historic: No
Suite Range:
Zoning: SD,lo
qProject Address: 610 S Broadwav
Assessor'sParcelr 010-152-10 Lot: 6
Unit:
Blockr C
City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 9'2702
l n spection Requests: (7'l 41 667 -27 38 l nspector Sectron: (7 1 4\ 647 -5853
Electrical Permit #: 2lJ166'302
Pin #: 28944
Owner:
Address
Contractor
Address:
Belen lbarra
610 S Broadway
Santa Ana, CA 9270'15642
Quality Air Condition and H(
18375 Ventura Blvd #159
Tarzana, CA 91355
(818) 822-0828
Amount
23.87
21 25
52.98
Notes clo
Qty
100
100
1.00
Fee
$23.87
$21.25
$52.98Phone
Tenant Name:
P hone
State Lic #: 903052
Lic Type: C-20
Bus. Lic #: 367385
Workers' Compensation lnsurance;Carrier: State Compensation lnsurance Fund
Policy #: 9103075
Expires: 06/18/2019
Bat,:hi:445t17 - 8/27 /2i18 I0: CCtlEt-l-AF0fticpr (;TYH Trnnsi: 80 1 of lAcct+: Ref+: 2t:1166;lLl:
Rrpti:0?304835 - 6/27 /?tttg 31{t(t Pn
Trqnsocb ion Totol t41.t.49
Qunlitr Ain Condition and Hent
6enerol PIqn Updote Fee
0t 116[02- 516000tr0-
Ele,:tricol
[1116002- 516t:t3(I]Ct-
Viso
(:(:+ 3 rr*r r*r**r* *&1?0
i4l
Authi: (rtr34?,
4
Building Use:
Job Type:
Nature of Work
Occupancy:
Constr Type
Code:
Single Family Dwelling
Miscellaneous
FWU
Planning Conditions:
Planning Approval By: Mar, Escarlet
Plan Checked By:
Permit lssued By: {fi Hernanoez, Kathy
Subject to Field:
Building Permit #:
o6t27t2018
Account#
01 1 16002 51600
01 1 16002 5'1603
$21 .25
$76.85
Fee Total:
Paid to Date:
Balance Due
Date:
Date:
Date:
06t27t2018 Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
Total
Every pemit issued shall bacome invalid unless the wo* on the sile
authorizod by such pemit ts commenced wilhin180 days after its
$suance, ot if lhe work authorized on the site by such peftnit is suspended
or abandonecl lot a peiod of 180 days after the time the wo* is
commenced
lnspector MID#: 2018-144342
$98.10
$0.00
$98.10
Fee Type
01116002 51603 FWU
01116002 51600 General Plan Update
01 116002 51603 lssuance
2
s
R-3
VB
cEc 2016
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE IDiSIG.COMMENTS
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab i Floor
Bonding / Groundinq / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soffit Bouoh
Ceilings (T-Bar Rough)
lvleler Release
Rough
Service lvleter
FINAL I / rr,/t{)
Notes, Remarks, Etc
- o.'(/
OWNER BUILDER DELCARATION
I tErch, amrn under pculr, of ncrjury rhar I !m cicmrrr fron rh. ConrracbN Li.rtrs. Ijw ro. lhc iollowi.S rcnbn ( Scc.roll.5
Burinc$ dd Dor.$bn Codc) Any Ciry or Counry whi.h rcqxirs ! Fi,nir t, otrnrud. allci nnprolc- dcmlhh or rcn, r ony
slru.rurc. ,rio. ro ik nsudtrc. ,lso mquncs d. lpplhd lor such IErn t) lilc a siSn€n slrlcmnl lial hc or shc h licens.d ,,l^u,ni
h rhe povhn,is olrtr Conrtuttr\ l.iccnscd liw (Chrrrer 9, Conm.n.ing wnh sccLon 7un nf Division 3 ofrh. Busincs and
PmrcsrionsCodc)orrh{rhorshchcxcnlrrhcdiomrndlhcbnsicrorlhcallcBcdcxcnrprion.Anylt,lario.ofSeclionToll5hyany
appliclnl for a pcmir subjcclsrhc atpli.ml to Bcivilpcnaliyolnor m,clhrn lirc hutdrcd doll$ ( S5m)
l. * .wnft or rhc polrdy. or mt .n lorca wirh wngcs as lhcn $k .omp.ns.trn. will do lhc wok and rhc {eh h or
i cndcd oron'crcd for slc (Sa'7(}14. Blsim$ rnd ftofesions nrlc:'l'hc C\trk.tr's La.trE tjr docs norll1ply ro nnowmr oa
rh.Impcny who buildsor inlomrsrheNn, eod wno docs such srl hi'nacll or hcMlf or rhmuBh hir or hq ow. cnrlLyccs.
lri,vilcdrhar such idtoirftnh ft mr inlcdcd droficrd for$L.If. hoscri thc blildin8 or irymrcm n$ndwi.hnoi.,u
oac.q,krion. tL Owmr Bui0d wiu harc lhc hudefl of,,ovinB thrt tr or \hc dil nor r,likl.r i.rpow th. tmFiy ror rlh purins of
_,. !sownerolrh.lmDcny, amqclusivclrco racrinssirhliccnscdconr.lctrsfuL$n$ru.!ihcptuc.rlsc.7t|4-1.aunrcs
nnd Pnrt*i,Cod. Th.Conta.ro.\l-i..ns.L,qdftsnorltnlyro,troR.cr.fl)lot.nywhohuildsorim[ovcslhcrcon,
.nd who onlrmls lor nEh [ojccrs wnh ! Co ruchno licctrsd pusulnr ro rh€ Conlncroi s Liccn\e ll*)
l,ncrcnnr uMcr Sftri(
jll)BKEtsl':ljaMMSA.UAN
DIICLIAAIION
I h.r.hy rfii n undcr !.nnlry ol turury oN ol rh. Llb*ing dNlrdrirnN
Ihtrlrud\illnrinr,inICcnilkrrcof(i rsc hS.l \ur.tuworkcrf.on{cnsrllotr.rslrolidcdI{nh,S(rbn]7fl}ofrhc
litxn Cod.,lu rhc pcrfonnrm. ofrfic work for whirh rhc ltnnn is h{ucd.
_lhrvcondwillnuinllin*orke6comI[.aioiiistnncc-a\rrquiEdhyS..rn:17(Dofrhclib.r('onc.ttrIhc,Erl'onMic.ol
rhc work li)rNhi.h lhis pcn,ir is h\u!l M,worteB conD.isrri{nnNUr d.add rtrd tDlrytrtrtr$cr ru
Ceicr:-
I'.li.yNu rhcr-E(Iircs:
-l
ccnity rhrr in rhc pennrnumc ofrh. N.rk lr shi.h rhi! t rn,ir t n\u&I. I \hrll nor cn\roy rny r$s.tr ir n,ry rnrtrncr
v' x\ t, scconr rubjer ro rhc workc^.otrrpci\rriinr hw\orcalihrnid dod 4N rlrrirl slx'uld tE(rN subicd r,'lhc
$or*c^ comp.n\rrion pmvisi{,ns orSdn,n:170) otrhc l.rtxr Cod.,lshrll, n)dlBirh conply wilh rhosc pmvisioN
WARNINCT Fnilurc ki $.urc *orken .ompcnsdion cov.r.Ac is unl0wlul. 0nd shtrll subrccr !n cmpl('ycr ro di'ninrl p.Mlris utrd
.ivil fincs up ro.nc hnnd(.d thousrtrd dollrs ($lu),UJ0). in {ndnn.lo lhr.osr ofcomtc.\lrion. dtrtugcs as pbvid.d for rh.
S.cr'nh.'u/6,,rrh. tlh{ C.dc. rnicrc{ .'ftI arbrrcy . lNs
lpprionr: V
Llt/E\sEn (oNTRA( T()R
DECI,INAI:IO!
Ihcrbyn,firmund.,Fnalr,olp.rjuryrharIrrlien{durdol]n)vi!i.nofcl[prcr9(conuEncin8wiliSarion7(x{r)orDilhio:1
ol ltc Businc$ a.d Fmlcsions Code. ana my liccns n nr tull rorc. lnd .rdr
x
gairBuqrlrri.LElDAc-f,cEN(I
I hcEl,y omrm under pcnlhy ot lerjury rhar rh€rc is ! onsrrucri.n hndins.see, tor th. p.rrormftc ofthc vork for rhich lhis pcrmil i
issucd (S... 1097. Civ. C.)
AIII.ICAITLDICIAEAUAN
I hnt'y,trran uNl.r p.nilry of pcrjury one orrhc followire dcclrtr0rions
Dcholiri{,nldrmirs Ast{sosNorificdirn Fcd.rdl Rcgulnri.ns(Tirlc40. PM6)
-Rcquned
Lcrrcr of N.rifi Llrid1
-l
aniiy lhal thc fcdcia I rcsu lal ions resndins 0$e$( rcmovulurc nor trPplicrhlc t, rhis pn,jc.r
l.dilirh l hnvc rcrdrhh amli.diotrat s.rcth rh. nt rc iiformrion kcoiiccr I agre to comply sirh nll Ciry aid coumy
orli aic.s n.d srrre llwr rclditrg ro buildin8 .onnfld t 6, md h.ruby aurhori- lcrrcsm ivcsolthirCiryandCouoryk,enrfiulonllf,
i&)vc mnl ioncd tmpcny Lr iny,ccr ion puqrc*s
,rpprienr or egent Stgnrhrr f,
Pedile Nm! (prlnt):
,,lril
Itnd,-'.^Jd',!.