HomeMy WebLinkAbout20166186 - PermitProiect Address: 230 N Harbor Blvd
Assessor'sParcel. 198-061-17 Lot; NA
U nit:
Block: NA
Address Range: 100-230 -
Historic: No
Suite Range:
Zoning: SP2
q
City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702
lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Electrical Permit #: 20{ 66{ EG
Pin #: 9{926
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
GARFIELD BEACH CVS LLC
1545 W iTTH ST
Santa Ana, CA 927063300
Second Baptist Church of Santa Ana
Owner-Builder
Fee Type
01116002 51603 FWU
01116002 51600 General Plan Update
01116002 51603 lssuance
Amount
23.87
21 .25
52.98
Qty
'1 00
1 .00
'1 .00
Fee
$23.87
$21.25
$52.98
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Other
Miscellaneous
Fireworks Stand
N/A
N/A
cEc 2016 Noles: Handout given/fees pd in full on M-71110
Date
Date
Date
Misc. Receipt: 71110
Misc. Receipt:
Misc. Receipt;
Total
Link, Patricia
lnspector MID#: 2018-143997
06/13/2018
Account#
N/A - No Balance Fee Total:
Paid to Date:
Balance Due:
$98.10
$98.10
s0.00
Eer' lc#-- \1I-U
Bldg;
Tract: NA
Phone:
Occupancy:
Constr Type:
Code:
Every pefinit issued shall become invalid unless fhe wor( o, tha slte
aulhoized by such permit is commenced within180 days after its
issuanco, or if the wok aulhoized on the site by such permit is suspended
or abandoned lot a peiod of 1 80 days aftet the time the work is
cofimenced.
APPROVALS DATE ID/SIG.COMMENTS OWNER BU!LDER DELCARATION
I hcrchy .ifirm undcr p.naxy of lfr.iury lhd I m ex.rli tFd rh. Con(F.ioN Licc.s. tlw ror rh. followin8 rctrsn (S.c 703 1 5
Busincs ,nd Profcssion Codc) Any City or Counry which rcquncs N F rnit lo $nstEct. ,llc( im0rove, dcmlhh or arEir any
srtuclure prbr lo ns hsuotrcc,oho rcqutcs thc arplicanl for su.hpcmi ro nt o siemd st cm lnol hcorshe is liccncd plruur
ro rh.,ftvi1ions orrlt Conka.bfs Li.cns.d Ll* (Chrrrer 9, Commn ing wirh sc.rion 7000 or Dirision 3 of lhe Busincs and
Pmacssions Codc) or rha' lE or shc k cxcnFl th.rcfom Md lh. bast for lhc alhScd cxcmplion. Atry eio,alion ofScdion 7011.5 hy otry
^
smlEanr ir d |(.nrir .uhFcrs lh. lrnlic,nr ln a c.v,l Fnak ) ol nnt mE lhatr lirc hundrd d,,llu .
'
$n0 r
zflLl a. "*ncr or r rrc nmnny. n, my cmrlnles w h s+cs .3 rhcr src .omp.ns i,tr. w,ll do thc sck and rh$rnErE i\ mr
' inrcnJcd .r ollcrcJ fir qk lse T044, Au$.c( snd lrotcsion\ Cods The Conrru.ktr r Licc.s ljq rtr. nor nmly h ar owftr of
rhe pmrcrly aho builds tr inDrorcs lhcE)n. md who doB $ch w,lk hiflselfor h.isclf or lhmusi hh or ner own cnrrloyccs-
[ovidcd rhar such impmwmnls e mr inrcndcn or onarcd for .oh li: ho*crcr. rhc hildin8 or trymwmnl is $ld *irhin otu ,tr
ol complcrk'n. rhc Oencr Builds wiu hlve lhc burdcn of Imvin! rhd h. or shc did mr hoild or irrmE lh. pmFny lor lh. pu4Dc of
l.n\ow crorrh. nmFnr. rmcklu\ivclr.onrracrins sirh liccn\rd conrr.tn t, .onntucr rhcti(id (s.. 101,1. Btr\irf,s\
r l Pml6sirn Codc: Thc C.nka.ror's Li.ctr{ Ldwdoc\ trorit,tlyb nuwncr.ffrrpc y wh. huildsor irn!rcvcs thcrcon.
rid sho conrrd\fttr\uchptru.cr\\irhaconrxctf(olietr{dpunr t)rhcconkrtrr\ l-iccn\c lrsr
IaItU b
I hc.chy nlltDr trndcr |tmlr, olr^--rtury ofu ofrhc lallt)*i',p dc.lrr
_l holc and will mainbin wo*c6 comocnsalion insur.Dcc. rs r.qurrcd h, Sdion 171)0 olthc Lahor Codc. forlhc p.rr.rmatuc oi
ihc uorl for *hich this pcrmil is issEd. Myworkds omFnsaliotr insumrcc c0ricr ard !.li.y numher!rc:
qfrI;'*ir rhc Frrorroncc ol rhc *or[ ftn which rhis pcrnri n i$ucd. I shtrll tror c pk,ynny ptr\on i. u y mnmr
suhlcd ro rhc *ortcr com|f,trsdon lnws.fcnlinmia. aNl {eruc rhd il I {hould hroor subJcc o rhc
trsolion [ovisiotrs oiSccrio..]7(Dorrhc bk,r c'odc.l drll lnnhwith comfly wnh rho$ pmvhions.
WARNINC failurc lo *curc *o.kcn'con,p(nsdnrn covcDsc ir uDl!*1u|. !.d shxll \dbicr rn c rpr,y.r b oinnn,l |f,trrllis Md
n, rhc con of.. Ern\rrn . danutcs rs F.ovid.n l{r rhc
IirT{"
inr.r{ rnd rnonryt lccs
Applienl:a
Ih.'oby lln tr, LnJ.' |{nrlrj_ 01p.riuy rhxr I rn li..n\.(ltrnJo',visi,n.lCh frc' 9(.onnr..nt*irhSccri( ?1IJOrof t)i\i!i!{]l
.i lhc Busincs md Prcfc$ions Codc- and my liccnsc is in tul| rbre o'd ctlNt
CIINEIf,I]CIIQNIINDING.AIiENCT
I hcrcb, affirm undcr Fnalry ol r.dury lhd rhd t a con$dclbn hndinS e8cncy for thc ll<rlbrnge of lhc work Lr whth rht Fnii ir
issu.d (Scc.1047, Civ. C.).
AItLICANLDEIL/IMION
I hcnby armn !.d$ p.tralryofpcrjuryom of$. followihg delarariohs:
tlemlirion Pernils-AslEsros Norificarion Rderal R€sllarions (Tirle 40. Pan6r
*Rcquncd Lerrc! o, Nolifi carion
Ni;
iJlrld lh. knchl r.!ulnri,rN togr nrgnslrno\ rc n^nlnr. do
r rpILi.rri,)n rntlnrl.rhxr rltr rh,vd innnnir
ahovc mnlioncd lrorcrl, lbr
IvApplicnnl or AAenl Siamlure
llii-l;,:ti':liih:1""'' ' + 'r'h\
2Al tu, L/iilw*wt tc
4r* to contrly wirh rll Ciryand Counry
ivs orrhF Ciryond C.unry ro clcr uF'n rh.* akTl&
Site-Work
Under ground
Pole Bases
Light Standards
SpAs, Pool, Fountains
Signs (monument)
Life Salety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding / Grounding / UFER
Translormers
Torqueing
Air Condilroners
Roof Top Equipment
Faclory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouoh
Ceilings (T-Bar Rouoh)
Meter Release
Rough
Service [r]eter I
FINAL 6lzt ll5/ .4,/Jt7(t2./
1NotesRemarks, Etc
ELECTRICAL-INSPECTOR RECORD
Sub-Panels
%,
I hrlc nl $ill mrinrrin rCcnillcrrc ofConscnr r, S.li lnsurc for *ork. comlrtrsrrion. ^ Iln)ridrdf(trhyS..ri(fll7(X)ofrhc
l-$or Codc- l'or rhc pcrlornnncc ofrhc worl lor which rhc rcflnir h nn'cd
I-isnsc Clssi_Licnse N!mb.r:
-
Der. C.rlEdor _
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