HomeMy WebLinkAbout20166167 - PermitCity of Santa Ana
Permit Counter: (714\ 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Electrical Permit #: 20{ 66{ 67
Pin #: 73341
Proiect Address: 216 E Warner Ave
Assessor'sParcel: 016-031-50 Lot: NA
Unit:
Block: A
Bldg: Address Range: 210.216
Tract: SOUTH SANTA ANA|istoric: No
Suite Range:
Zoning: Cl
q
Owner:
Address:
Phone:
Tenant Name;
Contractor
Address:
KYONG LEE
4 NARBONNE
Newport Beach, cA 926606823
Victory Outreach
Owner.Builder
Fee Type
01116002 51603 FWU
01116002 51600 General Plan Update
01'116002 51603 lssuance
Amount
23.87
21 .25
52.98
Qty
1.00
1.00
1.00
Fee
$23.87
$21 .25
$s2.98
Phone
Planning Conditions:
Other
Miscellaneous
Fireworks Stand
N/A
N/A
cEc 2016 Notes: Handout given/tees pd in full on M-7lll0
Date:
Date:
Date;
Misc. Receipt: 71110
Misc. Receipt:
Misc. Receipt:
Total
Link, Patricia
Every pemit issued shall become invalid unless the h/o* on the sile
authoized by such pemit is cafimenced within 180 days after its
issuance, or if the wo* authotized on the site by such permit is suspended
or abandoned for a period of180 days aftet the time the work is
commenced.
o6t13t2014
Account#
$98.10
$98.10
$0.00
lnspector MID#: 2018-143979
N/A - No Balance Fee Total:
Paid to Date:
Balance Due:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature ot Work:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Occupancy:
Constr Type:
Code:
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.OWNER BUILT'IR DELCAR-ATION
I h$.b, airr,h undcr pc.ahy or Frjury rhar I m cxcmpl nom rhc Conrraclos' Ltens li* for rh€ follo*ins easn (sm 70.1 I 5
Buiincs lnd Prof.sn'n Codc): Any City or Counly whi.h (qriEs a ldnil t' .onstru.r. dt.r. impnnc. &nDlth or Np3t My
srdclurc. pr6r to ns issuamc. alo rcquir$lhc rrtli.anr ffi ru.h F.nrir ro fiLr sigkd sarcm t rh, hcor sh. ii li.en$d lu uair
lo lhc pmvisi.ns or0r. Conkr.rois Li.cnsM Law (Chlprcr 9. Conmcncinr *irh S€crioo 7000 ol DivtnJn .l orihu Busines and
Pofcsi.ns CodcJ or lhar h. .. shc k cxcmpr rh.errcn and rhc harir ad rh. alhgcd .x.nprirn. Any violalion of Sdio. 70:l I J b, My
Mffi ffi Jffi#;'','*ffi ffiffi--;iilff:,*", ",rhc poltny sno builds or in{mrcs rllcm[ ! *ho des shh u,* hinMlf or hcsclf o. thmu8h hh or hcr own cmrloyecs.
povidcd rhor such i.pmEm.rr ft nor i.rundcd or ofrcRrd ror $h lt ho*cvcr, r huilding or iqmvcmnt is sold *irtin om yca
ofcoir0Lrio.. th. Owncr Buiun rLll hrv. rtr bnrdc. ol pmving rilr hc or she dA mt hrild or in'Ilmk rhc ImFiy for rhc purIIN ol
-!.rsowncrollhc!mp.ny,oDrcxclusivclycont..rhrgsirhli.cicdc.fii.krsro..n(ructrh.pft!..r(Se.1014.llunN$and PDltsbn Codcr Thc Conrrrcroas l.iccnsc L!* docs nol ltply ro i" own.r oiproll.ny wh. builds or improus lturcon.
aM sho .onr(( ror su.h ln,j..h *irh , Conrfrckn(s) licc.\ed punr r k, rhc C.nrn tr'l Lien* Lrw)
I hcrchy aflnn undcr lcrrllyolrcrjuryorc otrhc i.lrowirB de
-l
havc uld will nEinlain a C.n if8lL of Conscnt lo Sclll,Nur. ror uor*cr' ollln.mll,otr. as omvidcd lbr by Sd ion :1700 ol rhc
Labor Codc. lor lnc pslormmc of rhc wort for (hi.h th. ldnir is isrucd.
Ihrlcud*illnrtrirhinworkcrrconDosrrioninsunncc.rsicqutcJ$ySccrionlT(x)ofrhcL.horCodc,(,rh.nrr.n,umcot
rh. iqk,nr which rhG p.lnil is hslct M,trclkcr compcn{rion i.summccmhr dpolicynumh.r&:
aiil.*ntr'runcofrlt sork for which rl,i\ pcnnir i\is\u.d,l shrll nor .mtloy any l.n.n in rny nm,fr
nnd rBE lhd if I should tE{om subjd lo rlr
slllll hnh*ithcomply wilh ltrs psvisions.
r,rc worlcH omp.nsltrtr lows otCrlifomin
sorkem conrpcnsatiotr pmvnions ofSccrion lT0Ooltic tihr ci,lc.I
urhtifl
.otrrNn\rri, .or!rxA. i\ tr rq,nl xn,l ntrl \u1+.ntbyd Li drnmrl l}-mlri$ dtrd
doll \ ($l(D.(XXIr. ii ad iotr. ddrMscs as prov cd l.r rhc
I h.r.hy llnf, trnJcr prDrliyolP(irl thrl I xn lic.trscd i,r,.l{ hrJ,r.' ! l$nnn.n.i'r! Birh
or rhc Buim$a Pdassins Codc, und my licctrsc ir ir fu
CAN,SIBIJEUANIDNDINC.AGINCI
I b.rby afllrn undd Fnrhyorpcriuryrhd rhm ic r..n{tucrt,n lcndins ae.ey ror rhc p.rroinrftc olrhc w6rk l'or shich dis p.rni is
hsucd (Sc. :1097. Civ C ).
AIPIICANLIECI.ABAIIIJN
I lrl*,y afimundcr r.nalry of ffrjury one of lhc f.lk,ein8 dElaarions:
Demlirion Pcrnik-Asbcsr.s Nolinc io. trdcol Rcsulations(lirlc,l0. Pan6)
_Rcq0itud Lrr!er of Norilralbn
l.cnirv lhrr rl'. lidci,l r.puldi'ntr
df.",,,'n,',,",",",,0,n,.,"",'.",,,,
i,du,fu..! dnd sr . tjtrrrcLrnF ru huil
rcsardinB osbcslos ,cmldl arc nor alflicoble lo lhis I,oF:l
n lnd sratdhor the lhove inlnmtion is comcr.I asN bsmp l)-$irhrll ciryiid cou ry
y rtrd Couoly ni cnrcr trF,r llLconsltu.rion. ad h.rcby aulhrizc rcjrcsnllrivcs ollhk Cil
ahov.
'nctr1i,nrcd I'n'!cny tur insp(ri(,,
,\pdicrnl or,\!rnl Si{nit'r(
Pemile. ntrmc llrint ):
*"blnltb
Site-Work
Underground
Pole Bases
Light Standards
rqpas, Pool, Fountains
Signs (monument)
Llfe Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Bonding / Grounding / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Rool Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Bouoh
Ceilings (T-Bar Rough)
Ivleter Release
Rough
Service lvleter )\
FINAL 6t1b {utdbl
Notes Remarks , EtC I IV
COMMENTS
Under Slab / Floor
;:
Lrcnlc ('lx\! l.iccnsc Nonil{r:
Duk. ('i'nrr n,