HomeMy WebLinkAbout20165717 - PermitP roj ect Aa a ress :SfuLluslinl\ye Unit:
Block: A
Btdg.t*t AddressRange:
Tract: A.B. CHAPMAN Historic: No
a?
Assessor'sParcel: 396-251-55 Lot: 8
Suite Range: Unit l-5, Unit l-8
Zoning: R4
City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
l nspection Requests: (7 1 41 667 -27 38 l nspector Section. (7 1 4) 647-5853
Electrical Permit #: 201G5717
Pin #: 50323
Owner:
Address
Tenant Name:
The Bascom Group
26 Corporate Park Drive Suite 200
lrvine, CA 92606
(866) 695-s591
01116002
01116002
011 16002
01116002
01'116002
51603
5't603
51603
5't600
51603
Fee Type Amount
125 Voll Receptacle 1.40
Light Switches, Occ. Se 1.52
Lighl Fixtures 1.0'1
General PIan Updale 21.25
lssuance 52.98
Qty
10.00
14.00
8.00
1.00
1.00
Fee
$14.00
$21.28
$8.08
$21.25
$52.98
Phone
State Lic #: 1009989
Lic Type.: . B
Bus. Lic #: 366547
Workers' Compensation lnsurance:Carrier: Madwest Employer's Casualty Company
Policy #: BNUWC0139070
Expires: 0110112019
llot ?rro Renc.,'nt i
GEneral P!(tn updqte I
frM 6r:r!?- 5 1 4r:I:t0!j[r -
E lectr icql
011 I 600:- 516r3(fl:r_r-
ICL Check 00299t:l
ICL (:heck 002?89
Building Use:
Job Type:
Nature of Work
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #i
R-2
VB
cEc 2016
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Chavez, Dave
Every pefinit issued shall bocome invalid unless the wotk on the site
authotized by such permil is commenced within 180 days aflet ils
issuance, or iflhe wo* authoized on the sile by such permit is suspended
or abandoned for a peiod of 180 days after the time the wo* is
commenced.
lnspector MID#: 2018-142956
05110t2018
Account#
011 16002 51600
01 1 16002 51603
$21.25
$96.34
$117.59
$0.00
$117.s9
Phone:
Katerra Renovations, LLC
3200 Earhart Orive
Carrollton, TX 75006
(972) 818-106s
Contractor:
Address:Bdtrh+!439,(3 - 5./t 7,1?r'rl9
0ff ice: (:TYH Tr,:!n!+; !AcEta: Fei'
Rcpti:0226F660 - 1t l? t:
TronsoEt ion Totsi
II
l|l:. i,l
Notes: Fixture change outs (unit 5,8).
Fee Total:
Paid to Date:
Balance Due:
II
Multi-Family (5 or more uni Occupancy:
Alteration Constr TYPe:
change out fixtures (unit 5, lcode:
Planning Conditions:
Date:
Date:
Date:
APPROVALS DATE ID/SIG.COMMENTS OWNI'R BUILDER DELCARATION
I hcrcb, rmrn lndcr Fn,ky of p.rjury ltu I 0,D crc'llpt lmm lhc C.nrtucro6 Liccnk ljw for lhc fouo*iis rcasn (s...mll 5
Bu\in.sr a.d Pr.Ls*rn Cde) Any Cny or Cou.ty *hkh rcquird r Fnnir ro consruct. lltcr. improw, dcm.lnh ot Ennr un),
*trucrlrc, Drffro ils issuancc, ols,cqlircs rhcrorlicanr ad suchlf,irnil to filcasiSned \tdremnr rhxr hc o. sl'. ( liccn.c.l nuFu.nt
ro rh. pmvhionq orrrE controcbls Liccnscd tiw (Chapt.,9- Conftncin8 wnh Scdion 7000 of Divhion I .l thc Busincs ond
Pmfcsions Cod.) or th.rh.or shc h cxcryr lh€rcfron dlheb6nrorrh.dlcE.dcrcmntion.Anyvi{,lnri.nofsdion}0ll5b}rny
rltlicant lb. a pcnnit subjdsrhe aprlicanr 16 acivillcnalryornot trrclhan iive hundrcd dolla^ {St00).
-1.
N owner or rlr ptupcdy. or my cnDloyces with *aacs as lhcir {nc co'nFns{io.. *'ill do rhe w.rt oxl rtr sMm s mr
intnd.d orolTclcd ftr elc (56 ?()14. Busincs rnd Ptulcssiotrs Codc Thc Conrracrois Li.cnsc Lrq does not onPJy ro 3.own$of
rhc!tuFny who trildsor itrDrowr thcEn. ri who d*s ikh wort hnssclior h.rslfo. ihough hh o! hcr owncmPlorcct.
Drolidcd rhtrr such inPlokmnh nrc nor inlcMcd or oltcrcd t$ slc li lswcvd. rhc huildi"-! or t'll'rckcm h sold wnhir nc ,cr
ol co plclion. llE Ovmr ltliHs will h,h rh. rontcn or pmvin8 rhar tr or shc dn d buiu or itrlmrc $c pmpcny tor rh. trq$e of
l. is osrE ol'rhc pRrpcny, r'n crlxsivcly c.nrtclir8 *ir h liccn\ei contactr k, .onsru.r rlE tmj€l (Ss 7O4 r' Bu.in.$
md lbfL\sion Codc rhcConlrocroas l-i.cnsc l-!* d.cr noi aptlyb 0.ouncr.lnroPcnr*h. buildi or iml'lovcs lhcr.on.
lnd who conrracrslnr \r.hpn*cr\ wirh r conrflrtr(s) licc.{d Pursuanr h rh. conarrors Ltcnsc Lr\'l
I )r cx.'nfr trnd.r Sr.r
Dole: Orner:
WORt(En.S' COMPT'NSATIoN
DEII.AIAIIgN
I h.rcby a0nmundcr pcnaltyofp.rjuryom ot rh. rollowing d(lamtions
Ihav.e *ill minrain ! Ccnirrarc ot c(nMnt
'o
s.lr-l trrurc rbr workcn conD.nsarnr, .s l,ovidcd for h, Sdrn,n ]70o ol rhc
l,l$r codc. for lhc pc{omuncc of I hc work r(r wh i.h rhc |).rmil is issuci.
I h^r LMNillmn air s.rkcrs .onpenslrion in\nrrn.c. as rrqutM by Sccri{'n .17(D of I hc trtxn G)dc. for rh. Pcrtorroncd ot
rhd sork ntrwhth lhisrcrnril is hsuc\I. Mr*orkcrs.. rt.nrrfn ir]sur..cccaric.lndPolicynufrhfurc
;d If)N,L^{rl 3no-?.q
I ccnilythor inthc pcrforromc ofrh. work for shi.hrhis Pctrnil is hsuql- I shtllnor cnrPloyanyPcron inDnym.nn.r
s !s r.' bccoft slbi*i h rhc workc^' conDcns.l ion laNrofcrliturnir, nM.8nc lh.r ift should hecoft subii ro Il'.
*ortc6 mmpensrrio. p$visi,ns ofScdnrn 3?(x)olrhc lilir Gxk.l sh.ll.lonhrith.omply wirh rho{ ptuvthns
W RNING lj(ilurc ro su.. $rkc*' .omr.nsdion covcnSc is unlNful. md sh,ll subicr an cnDloytr b onni.d lf,naltis and
civil lincs u!) lo orc hudrcd rhuuia.d dollnt ($100.fiIJ). in oddirn,n b rh. co{ ofconrlcnsrlion. dahucs rs ptovidcd ntr $c
S..r D .ro7a ol ih.l rhr
-nAI 17 '&isx,:'^"'
I hcEhyafllrnlndcr p.nalry o I pc.jury Ih.l I a'n liensd uodcr pn,liri.norCh0flcr 9 (comflstuin8 enh sccr6. 7uO0) ofDivhion.l
ol rhc Busircss snd Prurcssions codc, orn my liccnse n in tullfore d cffftr.
\rgoqtqs,
NAY
C,ONIIAI]SIONIENDIIC.IAIN1;I
I hcrby afirnundc! IE.ahroapcrjury rhnr thft h a snsrtrli,tr lcndins ascry t r lhc Felotn:amc ollhc wo litr uhi.h rhh !.rmil is
hsued (S.. 1097. Civ. C.).
AffLICANLDECIAf,AIIQN
I trNbr.finm undcr pcnllty otpedurydnc otlhc following ddlomlions:
Dem,liion Pfimirq Ash.nos Nolificltion r{dcralRcElLlions (Tnh 40. Pd6)
-Rcq!ired
Lcrrcr of Norificdi0'
I ccrlili lhol ihc fcdcral rcslhrions EsardinP asbcst s Enrval nrc ml a0tli.ahk k, rhir Pmj.tl.
-lccnilylh.r
I hsvc r..d rhisamli.lliona sl!t.lhar Ihc atnv. intomrion is corol I!Ealoo mplt s hrllCiltnnd Counrt
Ciry.nd Counly 1,, rnrr t|i)nrltodinlNcs o Srrrcljw\ toldrinAto buildinS.on(ncli,,n- unl hcnht
nlF\. mtrri l nrcprny lor t,.ltrrriotr pur|x HAY n V mlfi
,1DplimDl or Atetrl Signalu(
*n'/rt,.x-
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouoh
Ceilinqs (T-Bar Rouoh)
It/eter Release
Rouqh u.o(rt Q dultl .{,uq ol
Service lvleter-FINAL K'?{Ll/t e 9D 6s
Notes, Remarks, Etc
ELECTRICAL.INSPECTOH RECORD
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