HomeMy WebLinkAbout20165986 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-1 9), Santa Ana, CA 92702
lnspection Requests: (714) 667-2738 lnspector Sectionr (714) 647-5853
Electrical Permit#: 20{65986
Pin #: 65273
Proiect Address: 2424N Tustin Ave
Lot. 8
Unit:
Block: A
Bldg: 24-F Address Range:
TTact: A.B. CHAPMAN HistoTic: No
Suite Range: LJnit F-13
Zoning: R4
q
Assessor'sParcel: 396-261-55
Owner;
Address:
Contractor
Address:
Fee
$7.00
$18.24
$4.04
$21.2s
,.' .; $9?,98
Phone
Tenant Name:
The Bascom Group, lnc
26 Corporale Park DriYe, Suite 200
lrvine, CA 92606
(949) 9s5-0888
Katerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 818-1065
Fee Type Amount Qty
125 Volt Receptacle 1.40 5.00
Light Switches, Occ. Se 't.52 12.00
Llght Fixtures 1.01 4.00
General Plan Update 2'1.25 1.00
lssuance Bot,-h+:OO196 S2Bfi7;i rS 1.qg
0ff ire: CTYH Trqn-!i: !iAr':Li: I pr t;
Rclt +rt22g99ig r L. f,_'ii r;
Tl.onsoct i(]n Totd I *:-r
t.55?8,5{E'H
(flterro fienovnt ionE i, LL
State Lic #: 1009989
Lic Type: B
Bus. Lic #: 365547
Workers' Compensation lnsurance:Carrier: Midwest Employer's Casualty Company
Policy #: BNUWC6139070
Expires: 01/01/2019
6enel.ol PIon Updote Fee
01116002- 51300001:r-
Ele,:tr icol
01116r:10?- 516l:r3tr00-
ICL Che,:k ()02999
t21,25
$92.26
isrrs.27
Building Use:
Job Type:
Nature of Work
Planning Conditions
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Multi-Family (5 or more uni Occupancyl
Alteration Constr TYPe
Fixture change outs (unit 13Code:
Date
Date
Date
R-2
VB
cEc 2016
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Chavez, Dave
Every painit issued shall become invalid unlessthe work on the site
authorized by such pemit is commenced wilhin 180 days aftet its
issuance, ot il the wo* authorized on the site by such pennil is suspended
ot abandoned for a petiod ol 180 days aftet the time the work is
commenced.
05/3't/2018
Account#
$103.51
$0.00
$103.51
lnspector MID#: 2018-143612
01 1 16002 51600
01116002 51603
$21 .25
$82.26
01116002 51603
01116002 51603
01 't '16002 51603
01 1 '16002 51600
01 1 16002 51603
Phone
Noles. Fixture change outs (unit 13)
Fee Total:
Paid to Datel
Balance Due;
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS O\{NER BUN-DER DELCARATION
I hcrcty alfirm unds Fnahy ot !€dury lhol I r cxcnpt fmnr rhc Contnclon l-tcnrc ljv lor lhc follo*ins mn,n (S*.?o:ll 5
Busin.ss alxl Prorc*ion C.dc): Any Ciry or Counry whth rcqotdi s Fnn ro onirud. axcr, imF..vc, dcnn'lth .r rcpln sny
(ruc1!rc. ! orto ils issuarcc. al$ rcquircs rhcappli.ant lor suchFrmit io filcssisncn n emnl rh hcor shc is lienscd I,unuanr'
lo rhi pmvisions ortr Conhcror's Li..ns.d Ins (Chafl.r 9. Cdmftfting wirh S.clion ?cu) ol Divtion I oflhc Ausincrs and
PmtesionsCodc)orth.llEorshcncremptlhcrctomrnd$cblshnxlhcalkgedcrcmption.Anyviolarionofs(li.oT0.ll5bylry
q'plicant tbr a pcmil subjels lhc applic.rnl to 0 civil l).nllly of nol 'mrc than filr hlndrcd dollars ($5U))
-1.
,s o*Br ol rh. pmFny. or my cmploros pnh wtrgcs as rhct nrc .onrlcnsll ion, will do lhc r! ood lhc srBrurc is nol
inlcnlcd or oticrcd lhr ule (Scc ?044. Businc$ Md Pmfe$ions Code The Conrrrcloi\ Liccn{ tiw d@i Nr r{'/y b m.wtur or
rh. pn,f ry who btrilds or inpdvcs rh.E,n. md w'x, dds ruch w6* hins.li or hftslf o. rhmugi htr or hc. ostr cmploycel
prolidcd rhat such inDoEmnh dE not inrcndcn oroftcrd for sL.ll tx)scv$, rtE huiui.F or nrq,mm.nl ir sld wilhin om )16
oI on{,hlhn. tlE Owmr Builr.r vill hjrc rh. bodon of fmvi.g thn hc or sh. dii mr buikl or inproK Ihc ,$ttry fo }r pur,[s of
-!.
rsowtrcrolthclopcny. rnrcxclusivclyco racrin! wrh li.cnscd coftrdom ro .onnrucl lh. nrclccl (Scc.7()'tl. Bo\incss
a'rl lbfcsin Co,lc Thc Conrmckn s t-icensc l -a' d.c\ nor alrply ro r owncr of pi(,Frry *no h ild\ or impn,v.\ Ihcrc.n.
and Eho .unr ts f.r su.h lmj.rls wirh d cln ncbd\) lt.nsrd pursu r ro rhc cbnrlcroi \ Liccr€ ti*)
lr'ncxcmtrundcr Sccliotr .B &PC i rhNrcNrr
}TOEfi]&T:IAUITNSAIIANlu(L nIIll)N
I h.rcbtrlTn utrdrr p.uhyorp.rjor!onc ofrh lnllosing d..irrrtions
lhrvctud will rimainaCcdificarcofC.nscnrbSelfln\urct(r$orkrf.oniFn\rrnnr.rs Jro\idcd Lr bySc(rion:17(rOoIlhc
lihor Gdc. for rhc perLnuncc oirh. qo* tu nhi.h thc pcnnir n n\ucd
I hrlc rnii trill nrn rin *orklN .on1Fisrri,,n inntuncc. rs rclrncd ht Sc.r i(n l7m or rh. trhd Ci)dc. lir lhc Nrlinn Ec ol
rl'c qo'k turshich rhis p.rmir i\ i\nnl My worltcrs m.T.ns: i{)n i'Nrrn.c crdi.r rd tx)lict nun$cr c
i[[.,D,.^xl Ca.i'l^ f$\ K
l \ .\"r
I .cniiy th.l in lhc pcrfofluncc oftlE work tor qhich
'his
p.flnir is i$ucd- I shall nol cnDloy any pcnon i', Dny nrntur
v' a k, tf,@nE sul,jd n' lhc rorkcs com!.nidt,n hws olCalifffnil atrd asN rhd irI \honld h..om sutjNt
'o
rhc
w.rkc^ conrpcnun,n pmlixt, s of Ssrion l7tu.t rhc l ntxtr C,xL. l \hall, fr)dhwirh onlplt wirh thoe nmvnio"\ .
WARNINC: Failurc ro scurc wortc^ comp.nsllio. ovcr,Bc is u.laetul. and shrll subicl m cmploycr ro cihin{l lrfllrkx tnd
civiT 6n.s up lo on. hun&cd lhou$nd dollan (Sloo,mo), in oddnion to lhc cosr oicomFnetion. danuB.\ ds tDvidcd rar rhcil:L5j& TX:;:d#:
I hccb, alfirmundcr pcMlly of pcrjury lhd I um licenrt ufl'lcr riDvhion ofChspro 9(c.'tumn.in! silh scrhn ?000) ol Divhion l
of thc Busirc$ and Pmacsions Codc. ond my ltcnE is in tull torcc and clfrl.
a Ft.t.f'Y-"
IOd9IBUqIION.LEIjDITICENII
I hcahy nfftrm undcr J[idryorpctury rhar rhcrc i\ i mnnocri,i h.dine agctrcy lor rhc pcrforru.c otthc work r'or whi.h rhn pcnni is
hsucd lss 109?. Ci! C )
attllcarfDEcl,AS{Ilr!
I h.1rt, afrimr undcr licnslty ol n€rjur, om oflhc lolkrwins d€l08lionr
DcnDliiion Pclnits-Ashc(os Nolificrliotr FcdcEl RcSulolhtrs (Tnb 40. Pan6)
-Rcquircd
Lclls of NorifEalion
-l.cnil'_vthal
lhc icdcrnl rcsuhrion\ rc8dnins arE(slos rcnmvil arc n.r rpplicrhlc k, rhil pmJc.r
It6,u,t,, t t,'.,.,a,ti.,nnt.,ri('nl\coftc.r. l,gmh.o'nprywirnallCilyrndCounry
o'di"anc$ rtrd Srxrc l:'s\ mh!iry i) huiiln,g oirhis city.nd Coutrry to cnrcr u{$n Ihc
ubovc nrnri,nctl popcny lor iI
Appllcs orAsetrlShnniuE:
Ac
Lnto"
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Lile Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding i Groundinq / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Rool Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soffit Rouoh
Ceilings (T-Bar Rouoh)
lvleter Release
Rouoh 6h /tk ,l' 41''
Service l\ileter
FINAL 7/6/ E SA*$
Notes, Remarks , Etc.
L.ndcis AddE$.
-
Site-Work