HomeMy WebLinkAbout20166079 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702 Electrical Permit #: 2O166079
Pin #: 3O2{3lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 541 E Gentral Ave Unit:
Block: 2
Address Range: 541-545
Historic: No
Suite Range:
Zoning: R2
E
Assessor'sParcel: 015-090-20 Lotr 2, POR 'l
Owner:
Address:
Roman Catholic Bishop Of Orange
541 E Central Ave
Santa Ana, CA 927073503
(714) s40-0902
Our Lady of Guadalupe
Fee Type
01'116002 5'1603 Special Event
01116002 5'1600 General Plan Update
Amount
154.26
21 .25
Qty
1.00
0.00
Fee
$154.26
$0.00
Phone.
Tenant Name:
Contractor
Address:
Jack's Electric
5706 Pennswood Avenue
Lakewood, CA 907'12
(562) 588-7080
B6t(h+:44174 - A/A/zf-ttg I0; orttoroleslioflice: CTYH Tron5+r :9 I sf 1Ac.t+: Fi..ifi: ?Lll66t-r79
R':pt+:0??89185 - d,r6./2trlg 1r1/ Pt1
fnqnsoct ion Totol $1t4.26
Phone
.Jock's Electr i,:
Electr ic0t
El ll60rl?- i16r:rJ[f r]-
Coch
Chonse
9154 .:.4
i16r-1.0r1t.r1,:4't
Building Use:
Job Type:
Nature of Work
Other
Miscellaneous
Special Event
Occupancy:
Constr Type
Code:
N/A
N/A
cEc 2016 Notes: Carnival June 8-10, 2019. Handout given.
Planning Conditions: LUC 2018-59
Date:
Date:
Date:
l\4isc. Receipt:
lvlisc. Receipt:
Misc. Receipt:
Total
Plan Checked By
Permit lssued By:
Subject to Field:
Building Permit #:
B 06/06/2018
Account#
Every permit issued valid unless the wofu on the site
$154.26
$0.00
s154.26authoized by such permit is commenced within 180 days after its
issuance, or if the v,to* authoized on the site by such peftnit is suspended
or abandoned for a penod of 180 days aftet lhe time the work is
comfienced
lnspector MID#: 20'18-143092
01 '1'16002 51603 $154 26 Fee Total:
Paid to Datei
Balance Due:
Bldg:
Tract: 39
State Lic #: 591173
Lic Type: C-10
Bus. Lic #: 3,f4853
Workers' Compensation lnsurance:Carrier: exempt
Policy #:
Expires:
Planning Approvai By:
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Lile Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding / Grounding i UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Solfit Rouqh
Ceilings (T-Bar Rouqh)
lvleter Release
Rough
Service Ir/eter
FINAL /c'9- /O ^.UzldA /av)
Notes, Remarks, Etc
OWNER AUILDER I'ELCARATION
I hcrcby nfltn nrdfi pcoalty ol pcrjnry rhr! I d.renfl rmnr rhr G,nr,do^ Lrrtr{ tjf, lor rh. lnllo*rnp reron (scc.70ll.5
aurtr'c\ Mil Pro,c{mn rod.r AnyCtr, or c.unD chf,h rqu'r. L Fmr h mn{rulr. alrcr, rmnro\c. drm[\h or Npar 0n]
strucrurc,rmrtons issuatre. alw rcquircsrhc 0odicanr lor suchpcflnirto filcastnci srlrc'ftnr rhar heorrh. ir li..6scd llmanr
ro lh. pmvisions ofrtx cotrlracrols Lic.trscd Law (Ch,Icr 9. conlmcNing 'iih Sccrion 7000 ol Divhion 3 ol rh. Blsines ,nd
Protesions Codc) or th.i hc or shc n cxcnll)t thercfrom and lhe bnsh lor lh. allcscd cxcmplk,n Anyliolarion.tScdi.i 7011.5 hylny
!ptli.d, for a pc,mn subjecls rhc arulica ro acivilrnalryofnor morcrion fivc hlnd,cd d.llur ($5()o) '
-1,
as o*ncr of lh. propcny. or nry c'nployes qith r08cs as thcn sE .ompcnselion. $ill do ltE emk u'd dt Morc i\frn
inrc.ddl or ofi.,rd for $ic (SL!.7044. BNituss rnd Ptuf.*k,tu Cod.: Tt Conrmto. s Liccn* uw docs ,or amly io an ow.ci of
rhc pmFny *ho tnikrs or inpmks tlrtun. and wlrl dG s.h trd( himsclfo! heMlf .r rhmu8h hn or turown cmflloycc\.
Fovidcn rhal surh in{'mvcmtu N ml intcndcn or .frcEn for eh ll ho*cvci th€ ttrildinE or iqmEE n eB {irhin onc ycar
oi co,raklion. rhc O. mr BuiHs will hovc ltr burdcn of lmvin8 thar hc or shc dil ml bliki or tnpht tnc pmrqiy iot rrt puF{ or
l.rrowtr.r.lrl[pn,p.ny.Nrcr.lusiv.lr.oftnnngsirhli.ctr{dc.iri.ro6rocrnnru.rlhcpr.j.$r(Scc7ll14.Bulnc\r
und i\ofcsirn Codc: 'l hc Conrrrlors l-iccn\c l-ae docr nolulrrly ro an osncr otrmpcdt *ho huild\ or inDrovc\ lhri.on,
nnd who co acrs for \trch pn,jcch wiih a G,ntacbn n liccn\cd pu^unnrhrhdContr.rofs Liccnsc ljw)
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d crempt u.d6 S*rion- B & P C. to. rhis rcason
Drl.r O*m.
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I hcrcby a0nh uMcr p.nalryofFrrur) oft.t rhc followirB delnrdt \:
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hnle !.d will mioruin a Cenificurc ot Co.enr ro Scltlnsurc lor sorkdi coop.nkrion, s{ rrovidcd tu by S.rlion 3lLU of dc
tit r Codc, for lhc FriornEmc ofihc wort for whi.h lhc rcflnil t issucd.
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hrk rDd *ill 'rainrrin worlcri conlcnsdion insurrm.. N rcqui(dhyS.dn,n.lT0OofrhcLrhn,C..lc,forrhcpcnnnrftc.f
rh. work for whichrhir prnnir is is\xrd My sork.d.6nrp. \rrnrn ir\uran ccMicr,rl pol'.y,runrb.rrc:
/a l rcn i l) rhar rn rhc t'filorroncc of rhr * ork lor which lhis pcirtrx ( hsucd. I shall nor cnploy an, pc^o. in any mtrmr
' q, s\ x, bG.n r \dhFr L i rhc * rlsi .onpcnqrmn la*i ot Crliadni,. 'nd agn. rhd if I snouh h..om slbjd ro rh.
sorkcn.\,np.nsario.poli\i.nrorSdrion1700orthcl-lt{iCodc.!sh0ll.fonhwirh€nrrlywirhlhospmvhions..
WARNINC t.ilurc Io w!rc ro.kcs'compcnsa .ovctuAc n unh*1irl. md shJll suhirr Jn cn,lloycr b .ri inrl o.tuI'ic\ i ,i
civil lines ut lo o* hundrcd I
Scc'ion]076 oalhc Lanr Codc.
00.1xx)r. ir iddirtnr h rh. corr ol con,pctr\riion. drtrusc\ r\ ptuviJcd f{tr thc
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I hcrchy.lrirr undcr pcnalr, ofpcrru.y I rm liccia\l undcr prcvnion.lChrprcr 9lconnrrncing *irh S.cri(r 7{n0) ofDivi\nr 3
of lhc Ausinccs ntul Profc$iurs Codc. and my iiccns ir ir tull ,irEc $d cliacr
I hcrhy nfiirm ondc! Iroalt, oa pcrjlr, rhlr
issucd (SN. :ltr97. civ. C )
ru.rion bndirg agcicy f,n rhc pcrfornrn.c ofrhc work lor*hich rht Fanii is
APPI ICANT DECLAR,ATION
I hs$y !trm und.r F.rlt, ol Frjury onc of lhc folloving d..lrd iotrs
D.mlirion P.rnirsAsb.rlos N.rificlrhn F.dcBl R.e!ldlhnr (Tnb rr0, PM6)
R.quircd b!r$ of Nolilicarion
ldr ,.
'cal rhi\ lltli.ari(,rruxlinicrh r rl[rh,r. inntridir)n is.onccr lrFrctucomply$irhnllCiryindConnry
I rtr\ ftlrri,rg k) builthtr!.o {tu.rnni.JJd h.'rhJ rurhnn,. rrm$nhr'v.r ofrhr C'ry md Counry rocnrc' uIInrtr
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Ldcrnl rcsulrrion\ rcEurdins lshc\r.s rcm.vrl ffc nol q,plic,hlc n,lhi\ !ri,jd
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