HomeMy WebLinkAbout20166771 - PermitCity of Santa Ana
Permit Counter; (714), 647-5800
20 Civic Center Plaza (M-19), Santa Ana CA92702 Electrical Permit #: 2lJ166771
Pin #: 31263lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 2424 N Tustin Ave Unit:
Block: A
Bldg: 24-F Address Range:
Tract: A.B. CHAPMAN Historic; No
Suite Range: Unit F-11
Zoning: R4
q
Assessor'sParcelr 396-261-55 Lot: 8
Owner:
Address
The Bascom Group, lnc
26 Corporate Park Drive, Suite 200
lrvine, CA 92606
(949) 955-0888
01'116002
01'116002
01 1 16002
0't 1 16002
011'16002
51603
51603
51603
51600
51603
Fee Type
'125 Volt Receptacle
Light Switches, Occ. Se
Light Fixtures
General Plan Update
lssuance
Amount
1 .45
1 .58
1.05
22.O8
55.04
Qty
5.00
12.O0
4.00
1.00
1.00
Fee
$7 .25
$18.96
$4.20
$22.08
$55.04Tenant Name
Contractor
Address:
Katerra Renovations, LLc
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-1065
State Lic #: 1009989
Lic Type: B
Bus. Lic #: 366547
Workers' Compensation lnsurance:Carrier: Midwest Employer's Casually Company
Policy #: BNUWCoi39070
Expires: OllO1l2O19
GOPY
Multi-Family (5 or more uni Occupancy:
Alteration Constr TyPe
Fixture change outs (unit llcodel
R-2
VB
cEc 2016
Planning Conditions
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Faeld:
Building Permit #:
Chavez. Dave
Datel
Date:
Date:09lo4t201a
Account#
Every petnit issued shall become invalid unless the work or, lhe site
authorized by such pemit is commenced within 180 days after its
issuance ot if the wo* authorized on the site by such pemit is suspended
otabandoned fot a peiod of 180 days afler the lime the work is
lnspector MID#: 2018-145649
011 16002 51600
01'116002 51603
$22.08
$85.4s
Fee Totai:
Paid to Date
Balance Due
Phonel
Phone:
Building Use:
Job Type:
Nature of Work:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Fixture change outs (unit 11)
$107.53
$0.00
$ 107.53
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE tD/srG.COMMENTS
Site-Work
Pole Bases
S S Pool, Fountains
Life Safety /Low Volta ge
Fire Alarm / Dam
Communications Cable
Buildinq
Under Slab / Floor
/ UFER
Transformers
Sub-Panels
Roof To ut ment
Facto Wired Unit
Conduit
hWallsRo
Ceilin hSHard & Soffit Rou
Ceilin S T-Bar Ro
Meter Release
Rou h
Service Meter
FINAL 0-flp/tz 5DtrT
Notes, Remarks Etc
OWNER BUILDER DDLCARATION
I h6.by amm u.der F.ahy of pdjury thi I d crcmpr ah:n rhc co.r,.roB Liccns. rj$, ror rhc tolowins r@n (se ?0L j
au.in6s and Prcfsion Codc): Any Cnr o. Counry which rcqutd ! pdftil ro con$ruct. atl6. inprov., ddnolish or r€r,.n my
slrctm, prior ro ils issumc., also icquirs lh. .ppli.dl for su.h [mn to frL a sign.d stalomr th.l hc or sh. i! li.mcd p6uat l
lo rb. provisioE of th. Conhcrd s Licens.d ll{ (Chapts 9, Com.n ins wnh SNlior TI]OO oa Divisio. I otthc BsiDs md
FYoacsions Codc) or tbar lt or shc is cxcmrl lhdcftoin od $. besis aor rhe sltcS.d croplion Any viohiionofs..lion 703t.5 byany
applicantforapmnsubjslstt€applic&rloacivilpcnal(tornortoor.lnm6v.bundr.Jdole($joo).
-I.
$ ownq olth. prop.dr, or ny .mploy6 with \Eg6 as th€n sL compcns.tion, *,ill do $c work tud lh. srruclq. 6 mr
inlad.d or offrcd fo! elc (Sd ?044, B6ins ed ProfBioG Codq 'rhc ConrEciois LicGc L,w do6 mr apply to m oMo of
lhcpDp.ny $ho buil.h or iqmv6lh6on. &d *ho do6 such Bo* hnBcror hGcttorthouSh his or hn o"nnptoyc6.
provid.d rhot such i,nprovonaa e not odcd or olldel lor sL. tt howM. rhe buildn8 or iol[).ovmor is eld wirh,n on. ,uroaconpklion. th€ OM.r Btilda wiu hare lh. hido orFovins dd h. or shc dt nor build or inwlvc thc prlFiy for $. porpoe of
l. a osro ol rh. prop€tn m ci.lsilcly cont ding \ith licos€d sonrdou b s.eru.l lhc prcjct (Sd 7044, aEnB
6nd Eolisin Cod.: Th. cont.clois Licm. Law do6 ror applylo d owo6 ofpropBly who buil& or inprovd thaon.and who co mds tor such p(j(lsrin a Conracro(s) licc.rcd pu*ler io rh. Cdnrmclofs t_ico* Law).
I e .x.npt undd Setio
\\ ORI<ERS' COIII PENSA'TION
DECT,ARA1'ION
I hreby amnn undd p.nally ot psjury one olthc follosins deldarioB
-l
h,v. md will iai.lain a Ccit ificarc of Co6dl lo S.la-IBUrc for vorkdt @npensario\ s ,yovidcd tor by Sdrion l7O0 of th.
bbor Cod., for th. p6fomdc. or ih. @it for which lh. tEtn b isu€d.
I havc and will
'nrintai.
workdi cohpcmatio. inuranc€. 6 r.quir.d by sdion ITOO of rhc Labor Cod., ao. th. Ftumdc. of
rh. w6r! lor rvhich lhir pmnit is i!su.d. My wo,ksr .ooposalion ireurmc. ffir &d policy nunbs scl
-l.cnify
thal nr nrc !.rlomdc. oftheNolk for rhi.h rhis rnrnir is issued. l shitlnor o.pto,.ny pdson in any tom.d$ a to b..oie sbj6l lo lhr rodm' cotup.e! ion lass of Catitomia. d as!€e rhar ifr rholld b€ome subi..l lolhc
tr "116' comF.ner on p o' sroB of Sd'cn 1r0O or rh. tjh.' Cnde. I nutt. ,onhn trn co'npt, *
'r
h r h.R pr o\ ijrons
WARNINC: Failur. ro BW vork6' compdelior covmBe is olasful od shatl subjer m dploF lo oihinat FElrks edcilil li.ca up to on. hmdrcd thousud dollEs ($loo.(]Oo). in addilio. ro th..osr orcompeNlion. dona!.s 6 piovid.d ior the
ser'on 10,6 otrh.l abor Cod.. mi(d ed lnorm s tG
^ppllont: _
LICFNSI,D CONTRACTOR
DECI.ABAIIAX
I h.r.by amm und.r p.nalr, ol pajury lhal I m liccB.d unds pmvisio. of Chrflo 9 (comfrocins rviln Sarion TI]OO) ot Division Iof rh. Buins md Poleions Cod€. ad my li.Gc is in tutl foR ed.Itdr
(.ONSTRUCTION I FNDING ACENCY
I hmby aitnn mdcr pdaltyofpejurythd th6c h3 coGlrucri.n ladins aracy torthc pdfom ccofrh.rvo 6r which this pdtn i!
issucd (Sd 109?. Civ C )
APPLICANT DT.'I ARATION
I hotSy rtrm n.ds p.flahy oI pcjury on. ol thc fouowing ddl@lioB:
Dmolirio. Pcmirs-Asbdros Notifi.alion F-€ddal R.gulalions (Tilt.40, P0n6)
R.qun€d klld of Notifi$rion
-l
c6lif, Er lh. fed.rl r.sulaiions rcsddins 6b6ros rdnoul e. nor apticabte lo rhis pol.(1
-I
cdily $ar I h,v. rcrd thi! appli.arion dd slarc rn.r lh. abov. inaomation is cord r dsr* to @mpl, with all City a.d County
ordinancd ed Srat€ liws Ehliru to blildins coNiruclion. ad hacby aulhorize r.?.Miari!6 otthis Cny dd Coulryro dr6 rpoo th€
abov. noriond pmp.rry f.. isp<rion pulos.
Appllcr orAgotslgn.tuft: Drt.:
Underground
Light Standards
Signs (monument)
Bonding / Groundinq
Torqueing
Air Conditioners
Walls (
h)
Poli.t N,mbs_ ErDir: _