HomeMy WebLinkAbout20166206 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (Nl-19), Santa Ana, C492702 Electrical Permit#:20{66206 }1,
lnspection Requests: 1714\ 667-2738 lnspector Section: (714) 647-5853 Pin #: 747fi6
unit: MTR02
Block: A
Bldg: Address Range:
Tract: S.A. GRAND AV Historic: NoAssessor'sParcel: 396-201-04
Owner:
Address:
Santa Ana United Methodist Church
2121 N Grand Avenue
Santa Ana, CA 92705
(714) 647-5800
Fee Type
01116002 51603 Serv l\4eter
01116002 51600 General Plan Update
01116002 5'1603 lssuance
Amount
139.86
21.25
52.98
Qty
'1.00
1.00
'1.00
Fee
$139.86
$21.25
$52.98Phone
Tenant Name:
Contractor
Address:
New Space Construction
11740 112 E. 106th Street
Artesia, CA 90701
(7r4) 555.s714
Ir)
Phone rflnsi:I- 6/t4
State Lic #: 960438
Lic Type: B
Bus. Lic #: 368395
Workers' Compensation lnsurance:
Carrier: State Compensation lnsurance Fund
Policy #: 9202917
Expjres: O1lO7l2O19
ri lotnl
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Building Use:
Job Type:
Nature of Work
Commercial
Miscellaneous
Service meter
Occupancy:
Constr Type
Code:
A-3, E
VB
cEc 2016 Notes: Service meter for school
Planning Conditions:
Planning Approval By
Plan Checked By:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Permit lssued By:/
t
Subject to Field: '
Amsden, Julie
Building Permit #;
Every pemit issued shall become invalid unless the work on the sile
authoi2ed by such pormit is conmenced within 180 days aftar its
issuance, or if the wo* authorized on the site by such permit is suspended
or abandoned for a peiod of180 days after the time the wo* is
lnspector
01 1 16002 51600
01 r 16002 51603
$21.2s
$192.84
Fee Total:
Paid to Date:
Balance Due:
$214.09
$0.00
s214.09
Proiect Address: 2121 N Grand Ave
Lot SEE COMMENTS
Suite Range:
Zoning: Rl
,1flers I F
1116082-
1e,:Lr irs
i11600?-
r50
-ft: *Iri iiulhi:l
Date:
Date;
Date:06t14t2018
Account#
MID#: 2018-144071
EL RICAL.INSPECTOR RECORD
APPHOVALS DATE COMMENTSID/SIG.
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountarns
Siqns (monument)
Life Salety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Groundinq / UFER t ),nfc loz
Transformers
Torqueino t lo llI fi.c b't
Sub-Panels
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouoh
Ceilinqs (T-Bar Rouqh)
lt/eter Release bhol rc fst* k)1
Rough
Service firleter 4 9l,ttd 1.,3
FINAL C lro I r9 Cl b\
Notes, Remarks Etc.1
rYrrrf.J,^t D*rr..
I I
\/r"r-Upha^. -2^\
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OWNER AUILDUR DELCARATION
I krcby affirfr undd F..alry or tujury rhar L'n crcmpr fb'n rhc Conlra.roN Liccns. Law for rhc follosins r.rv,n rsc. Toil :
Busi,rcss a.d Phf.sion Codc) ny Cil, or County which rcluncs a [En.il k' .oidtucr- olr(, inpbvc, dcnml$ .r ePan My'
$rudurc, rio! to irs issu!rcc. also rcquirc\ rhe lpplicmr ttr such Fnnir ro filcd \ign.d sarcnrm rhd h.or shc h liccoscd lurstrnr .
ro thc tmvnn,ns or lhc 6nrmclors Liccnsd bw (Chlptcr 9, Connncncins qilh Sccrnnr ?O{D of Divhion .l or rhc Busnrs\ .nd
Pn,Icssn,s Gdc) or thar tE or stu kcr. lprrhercfto stul rhc basi\ tu'rhc trllcgcd cx.m/ion. Anyliohrionofs(lionT0.ll5hytrny'
rrflicanr ror rpcnnn suhjen rhc aFllicrtrr to.civil pcnahyofnol nstc rhnn iivc tundEd doll6 ($500)
_l- ar oencr oi rhc pmpcn y, ,r my cmpk,y.es wirh *a$r n\ rh.n s,k L$m|].nsarion. will do lh. work rnd lhc n nde i\ ior
inrcnlcd or ofr.rcd for {L (Sft 1014. Busincsc md Pr.fcsn.ns Cdlc: Tlc Conr0clois Lietrsc L!* d€s ml alpl, to r. owtr( of
rhc l)R)pcny wtu brilds or imnl)B rhcmn. a,n who des se-h q!* hinNcllor hc6clfor rhn,ugh bi\.r h.r own cnfhyc.s.
pn,vnl(l rhar such inrprn*nEnrs c mr inrcnd.i or oLcRi fq elc lU h,kk,, rtr h! ilti.g or iflpnrRnrnr k sld wirhin.m ]qtr
ol'complcrion. rh.Opncr lhildq uillhnvc rhe i rdciofpnvinsrhd h.orsir dil mr t tlo, i',{m!c rh. pDFiy rbr rh.,u4nkor
_1. rs.wmrofrhe pnDrnr. nncr.lxsikly.unrrcring *irh li..nfd cDnrraclon to ronstrucrrhc lro]ccr(se 7044. Burinc$
ond PtolLasbn Codc: l hc Co.lracrofs Liccnsc Law d€s nor lptly ro otr owncr olpropeny *ho huild\.r inprorcs ihcr.on.
and *ho d,nrrucls fn slch pr+c( sirh { Cod@cx,(, liccn\cd purenr ro rh. c.trktr ttr\ Lk.nr tjw)
Ianr.rc,flundcrSNii( .4 &PC li,.rhi\rcaron
Dol.: Ownei
woRt(ERs coMPflls 1!()N
DECLAM]IO!
I htrchy altum undcr pcMlryoiFrrtrryoic oirhc lollosin8 dalaralt,nq:
-llrvcsn{illnEinroinrCcnilrdrcofConsnrroScliltrsurclbr*orlcd..nvcnsarbn..spmvidcdfubySccln,nS?00.llhcLln)r Codc, ior lh. pdloflIft. of rhc work lor qhicn lhc ,cmil is ksucd.
_l haE rnd willMinkin ru[c!! .on]Ftr\ar i(h in\urakc. i\ rquncd hySo.riotr:l?U)ol rhc tibor(odc.lorrhc pc o.nnn.cof
rhc *ork i{n *hich rhhlEnnir is is\ucd Mrworkcrr comp.nstiin in{trancc .ari$ dd NIi.y nnnlbcr trc:c*t ?+(Tt? aiw1.
""""""
l."niryrh,t i.ihcFh,**., rh. w.rk r.. sh'.hrhnr."n rtrru.d.I.h0lltrorcmlln)rnyncr..nrtrnym n,
sasroh&!msubirrrorhcsorke$com!.ns$nrnhwsofcililorni!-$drsNrhdiflikiuldhecom{bjeclb'hc./
uoricrs' comp.ns ion pmvnions oI Sdion 3?00 of thc Llbor Codc. I shall- rodnwnh cotPly wi'h rho$ Frvhions
S.criin,.rl)76olrl,c lrfitr Cixt., i' crc( dd rnonry \
;f^*.,.,";X4d r+rzlaA h^
DECIdBAI]O!
I hcrcbylffirm undcr lEn,hyofpcqury lhll I am lienxn undcr J,mvisn,n ofChrpru 9 (.ommncnrC wilh Sdion ?000) olDilhion l
or rI1c Busincs mJ Pofcssbns Codc, ard rny liccn{ is in full lora nd cl'lar
b*'$aqar4t d ,J e awgirr+n{,
I icrchy slltmufftq p.nllrrof!.rjury rhd rhm h a..n$tu.rion lcMing d8cmy for lhc pcrformamc oflic *ork aff whkh rhis r.mir is
tsucd (Se.1097, Civ C.)
AITLIIANI.DECIAAAIION
I1m.1,, animrndcr pcna!ry ofpdjury un ofrh. folbwint dNlrarnns:
DcnDlirnnr Pcrn rs Asbc{os Norilictrri(,n Fcdcrdl Rcguhti{Jn\ (Tnh 40. Pd6)
-Rcqnncd
Gtrcr ol NolifElrion
_ lrsrifyrl,ar I hav. r.rn rhis,'ntli(rri(m nd {nrc rhxrrhcrh,r rf,n [r n is.orccl I ngre h.onply sirh nll cityntrd ( otrnly
o',li',rD.cl rtr,lSrrrc l.rs\ rchring n' huil,litr!..nn \c irnc\.1'lhn Cny 3nd A,unry t, o r(uI! rlt
abovc nrnrioned pm0cny for insocdionl)u
'\pDlir nl or,\sr.l Si!Dnrurr ho ft
,"'"$ra1r{:or/
Air Conditioners
lo
If,nJ.ir Addrfl(
-
_l ccnity thar rhc {cdcral rcExlarnrns Eldding ish.s.sfum)vrlftc no',a'dErblc to lhh pmrccr