HomeMy WebLinkAbout20166178 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
l nspection Req uests: (7 1 4) 667 -27 38 l nspector Section: (7'l 41 647 -5853
Electrical Permit #: 2O16617E
Pin #: 82650
Project Address: 1701 N Main St
Assessor'sParcel: 003-143-32 Lot: I THRU 14, POR
Unit:
Block: B
Bldg: Address Range:
Tract: WILEY ADO. Historic: No
Suite Range:
Zoning: Cl
q
Contractor:
Address:
HUU N PHAM
3 VIA BURRONE
Newport Coast, CA 92657'1407
Orange County Educational Arts Assoc
Owner-Builder
Fee Type
01 1 '16002 51603 FWU
01'116002 51600 General Plan Update
01116002 51603 lssuance
Amount
23.87
21.25
52.98
Fee
$23.87
$21.25
$52.98
Qty
1.00
1.00
1.00Phone
Tenant Name
Phone
State Lic #:
Lic Type:
Bus. Lic #:
workers' Compensalion lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Sub.iect to Field:
Building Permit #:
Other
Miacellaneous
Fireworks Stand
N/A
N/A
cEc 2016
Occupancy:
Conslr Type
Code:Notes: Handout given/fees pd in full on M-71110
Date
Date
Date
Misc. Receipt: 71110
Misc. Receipt:
Misc. Receipt:
Total
Link, Patricia
Every pemil issued shall become invalid unless the worr( oD ahe sile
authorized by such pennit is commenced within 1 80 days aftet its
issuance, or if lhe wo* authodzed on the site by such permil is suspended
ot abandoned fot a peiod of180 days after the time the work is
conmenced-
o6t13t2014
Account#
$98.10
$98.10
$0.00
lnspector MID#: 2018-143990
N/A - No Balance Fee Tolal:
Paid to Date:
Balance Due:
\40
Owner:
Address:
ELECTRICAL.INSPECTOR RECOHD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby !fiirm undcr Fnah, of pcrjury rhar I am cxcmfl frcm thc ContadoF Liccnsc ljw for rh. fdk,win8 ,c!{,d ($c 70.11 5
Bu\iness nl Profcssion Gdc): Aiy Cir, or Counry which rqute\ a le.mir lo co.(dcr. trlrs. id\rovc. d.mlilh Dr d!,t any
{ru.rur.. tmr ro ir! ilsuancc. dl$ r.quner rhc amlkanr fo, ruch lcmn lo fih a \igmd {rtcftor thr tr or sh. i\ li.cnsd puKuanr
ro rhc provhions olltE Conlrrclois Liccnscd Lap (Ch.rlcr 9. Commncnr8 with Scclion 70Ol).f Divhion:l ofrhc Bo*inc* lnd
Pmttssbns Codc ) or rhd ltorrhc h.rcmtr rhd.from and rhc l,n\is fdr rhc alhBcd .k(prion. AnyvioldionofS.crion?0:ll5byrny
/Fndn,fl rcr a nc n \uhj(crhc.ml.crnrrotrcrrllcnJk)nln.'nmmrhrnlnchundreddollus'S!D,.
fi\llJ,**.,,*,-*"y.u,n)rn{,rnrc\qi,h*asesas,hcns.comp€ns,n,n.* d,,,tEwo.kux,,h.{turmn*,,
/'{.rifu * "r""!t r," *t rsc 7(t -1, Buvft* rnJ P6fe*tun\ Codc Thc Conoa.rofs Li..n\c tj* (n).i..r alply ro an osE of
rh.fmFfly qh, huilds or iryrorcs rh.ren. md rh. nas sch e* hinscll or hcr$ l{ or rtnuen nh or hcr o*n cmrk,yces.
prolidd lilt \uch imrmEmnls m mt inrqrlcd oror.crd for slc.ll h.sctr. rhc tdildin8 o. iinovcmnr iseldvirlinorc }Ir
ofompLlion. th owmr suii:hr will ho€ tE huni.. ofrruvinS rhr hc.r shr dil id t iU or in{,mw lhc In,lcny aor llE ru,Inr of
-1.
as owncr ol rhe prupcny, { r cxclusircly conracring wirh li{ned coMador ro on(rud rlE Imjct (Sc 7ol.t, Buiinc\\
anl Pofcssin C6dc: Thc Contr.ktr s Lic.is. tjw docs mr aptly k, an owncr ofpr.pcnt wh. huildr or impmvcs rfurcon.
and who €onrrlcts for suci projccls with a Contncrons) li.cnsd pursunr ro Ihe Conlra.rois l,tcnrc ljs).
I hUdhy rlli'mutricr t,crr !y.r |.,itrrvonc.r rl'. k'll(NiDr
-l
hrlc ondsill mrinr0in 0CcnificarcofConscnr ro Sclf-lnsurclor qor[eN compensation. os pmvidcd for byscc'i.i.]7(n.frhc
hhorCodc, torrhc pclorm!trccof lhc workl'or wnich rhctcnnil i isstrcd.
_l h t ,nd sill nrinuh s.r[c6 co'nrcnsur ion nFurorcc. 0s rcquted b, Ssr ion :]7no oi rhc ubor CoJ.. in
'hc
p.rronnn.c ol
lhc work lor which lhis!.nnil is hsucd. Myworkcri <rpcnstion nrurunccc icr ud F,lty nonrhcr uc
PolicvNumtcr: L:xpne
/Mfu,,,",,..-",,*"".,,,. h,h^nf,mrF,..u.r,\h.,,nu,v L,f^ ro *ou*.ut'6cr r" rrc "orta. smFn{rDn lJtr, ol t rlrtnmr.'. .rd rtEc rhd rfl
.ntloy dny Fmn in ony.nanrct
shou[ lEcnnE suhj€cr ro rlt
wolkcls ..n{..\altun !fuvisn,trs of Sccl ion l7m ol rhc btrr C'dlc. I shrll. fonhsith d,mply * irn lhor peyninn!
WARNINC: r2ilurc ro surc workcis'
*::'Urytr
con cnsnnr mtsagc t utrhwful, 0nd shall subFl an cmnLrcr ro simhA,/\,
r rtrrsrrr uhr rrY.rtion
Dr!r l1rA rx,\
I hcrby anrDlndcr pcmlryorFrjoiy ihar I an liccn{d lodcr p(,!nion ofChrfld 9 t.onfticing wirh s.crion 7fix)) olDivisi{,r 1
ol rhc Busincs lnd Pft,fcsn'ns Codc- ! nry li.cn{c h in full |ore and cilccl
l-icc \.Cl s: l-iccrsc Nr rhlr:
Dalel
CANflf,.IJEIIONIINDINJJ.AGINII
I hcruhy rffirm und$ lcNlty. f l. uryrhd lhcfu isa.orntucrirrn lcndingrgch.y lorlhc|. onnlncc oflhc $ori lnrrhirh rhi\ rf,m,ir i\
i$ucd (Scc :109?. Civ C )
+tn;;;
fcdcrJlrc8oLrnnr ftSddi'rE r\h((o\ r.nxralrrc nor llplicrblc r, rhis |n,jccr
rrd rhis dmli.rti.n rftl sd. rhar rhc rh.v. i.f(mrarmtr iscon(r.l agr ro co Dply *rh lllCiry rnJ (innn!
Ci'ylndCounrtr, cnrcr tr n rh.*s r.lrl,n8 b huiltlinA con cr io.. ,kl hcrcby lurhornc rclIc{ntalircs
ultnc nrnii{,n.J pn)p.ny nn i'r9r.ri(nr
Appliunl or Agetrt Siln{n'r(
P(mit( mmc lp.inl):6 "...,1r]qk
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Salety /Low Voltaqe
Fire Alarm / Dam pers
Communicalions Cable
Building
Bondinq i Groundino / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soflit Rouqh
Ceilings (T-Bar Rouoh)
Meter Release
Rou gh I
Service Meter ll t (/
FINAL u ntln A
Notes, Remarks Etc.
Under Slab / Floor
(,t{
AIPIICANLDECIJAA.ITAN
I no.6y !frm lndcr penalry oa pcrjury oic oflht followin8 d(ltrarion\:
t)cmolilion PrnrnsAstrslos Notilicltion rtdcrul Rc8ulal ions (Titlc .10. Pon6)
-R.!uiFd
Lcrt.r of No{ificariotr