HomeMy WebLinkAbout20165880 - PermitCity of Santa Ana
Permit Counter: (7 1 41 647 -5800
20 Civic Center Plaza (M-19), Slrnta A,.ra, CA92702
l nspection Req uests: (7'l 41 667 -27 38 l nspector Section: (7 1 4) 647 -5853
Electrical Permit #: 20{65880
Pin #: 44793
Bldg:
Tractr 788
Address Rangel
Historic: Yes
Suite Range:
Zoning: Rl
EProjectAddress: 2103 N Ross St
AssessoisParce| 002-111-31 Lot: 30
Unit:
Block: NA
Contractor:
Address:
Susan Edwards
2103 N. Ross St
Santa Ana, CA 927062507
Verengo lnc
20285 S western Avenue, #i
Torrance, CA 90501
(7141744-6511
Fee Type
01116002 5'1603 Serv Meter
01116002 5160C General Plan Update
01 116002 5'1603 lssuance
Fee
$51 .29
$21.25
$52.98
Qty
1 .00
1 .00
1.00
Tenant Name:
Botih+:43772 - t/I5/2U1S I0: NGAIi(
Office: CIYH Trttns+: 6(l .l rri
Accti: Ref+t 2rl165gil{.
ftcpt*:0226473? - 5/15/201S 3r?9 rn
Trsnsoct ion Totnl i'-ill ,i2
Phone
Slate Lic #: 935263
Lic Type: B, C-10
Bus. Lic #: 328493
Workers' Compensalion lnsurance:
Carrier: New York Marine and General lns. Co.
Policy #: WC201700014125
Expires: O'l2al2018
Generol Flsn updote tee
(r1 I t6tr02- i16r1rj(80-
EIectr icol
ul116tr02- 5160100(r-
lloster Cord
CC+: ***r****r***1670 Auth+:r-
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By;
Subject lo Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Service Meter
Zuniga, Allissa
10196452
Date
R.3, U
VB
cEc 20't6 Notes: Upgrade. Hand out given.
W,:05/15/2018
Account#
l\4isc. Receipt:
lvlisc. Receipt:
l\4isc. Receipt:
Total
$125.52
$0 00
9125.52
Every permil issuad sha become invalid unless lhe work on the site
autho.ized by such pemil is commenced within 180 days aftet its
issuance, ot if the wotu authorized on the site by such pemit is suspended
or abancloned fot a period of 180 days aftet the time the wotk is
commenced
lnspector MID#: 2018-143381
01 1 16002 51600
0'1 116002 51603
$21 .25
$104.27
Fee Total
Paid to Date:
Balance Due:
Owner:
Address:
P hone:
Amount
21 .25
52.98
1,/erengo Inc
Building Use:
Job Type:
Nature of Work:
Occupancy:
Constr Type:
Code:
ELECTRICAL-INSPECTOR RECOBD
COMil4ENTgAPPROVALSDATEID/SIG.
Site-Work
Unde round
Pole Bases
Li ht Standards
S FountainsasPool
monumentSiNS
Lile Safet /Low Volta e
Communications Cable
Under Slab / Floor
7.1 (
Translormers
To uern
Sub-Panels
Air Conditioners
Roof To UI ent
Facto Wired Unit
Walls Conduit
Walls Rou h
Ceilin hSHard & Soff it Rou
It/eter Release
Rou h
t ,Service lvleler
FINAL /-
Notes, Remarks, E1c.
(,\\ NT:R III II,I)IiR I)IiI,CARA'I'I('N
l hcrcby.lllrnr undcr Fctr ry (,l pcrjury rhlr l m cxcmPr tom rhc ConlrocloF Li..nsc tiw hr lnc rdllowiis rc$ntr rstr7orls
BusiDcs a8l Pfl,rcssiotr Codcl: Any Ciry or Couory which r.qutcs I !€rdir t, .onslrucl alrd. inrrrovc. d'moli\h nr mFn Jtrv
dru.rurc, piitr ro iis hsuanc.. ako rcquircslhc aPplitdtrr ror such Irerdir ro ulc o skncd (rr.mnr rhal hcor\hc i{ li'cnscd puruunr
rorhcrmlnnrsorrhcConrrucxtil-iNnscdLaw(Chafl.rg.comnrncingwiihScclion?off).rDivision:lorrh'Irtr{in'snnd
Prolts\ions Codc) or lhrl tu or shr is rxcrnPt lhcrcfronand$c btsis for rh.allcgcd cxcmrrion Anvviolarion'rS'crim Tl)ll 5 hFnv
rpplic.nl ittr tr lcrmir sxbjftc lhc lttlicanr ro ucivilPc.alryofnor $rc lhnn five hundicd dollm ($500)
l, !s ovner of rh. r,sl)cny. ot my corloyes *il h wlses sr rhcn sk omp€nqdion. will do thc $'rt ond rhc slrldm n nor
itrrcnd{d or oflcto'd fo; slt (Sa 704.a. Busincas .nd Protcsriom Codc Tlc Cinraclols Lkcn* lrr docs nol aPplv ro 'n osncr 6r
rhc p$tEny who ttilds or irpmlcs lh.nn, urd wh. dG Mh wolt himgclr or hcr$lf nr rhmuSh hk or hs own cmnloltcl'
pr"!id.d rhar $ch imlrewmnh drc mr inrctued or ofieEn for sh ll howfti (lE buiuiog or iq,6Emnr is v'ld wirhin om vts
;fcontlcrion. rh. owNr BuiBcr sill harc rhc l,olicn ol Pmling lhar hc or shc did fr, blik or i'qk,rc lh. ,mFnv ror rlE t'urlFs o'
-1,
Nowmr.f lie pmFdy, a cxclusiEly contocliB *iln lian*d .ontnctor ro con(ru.t th. tmj€cr (SN 7o4'l- Bu'i"cs
and Aotcssir codc: ih; Conkkror's Liccnsc Las d@3 nor npnly to !n o{nd ollropcnvqho builds or iDpdvcs rhcrcoo-
$d sla, .o.rsckror suchfllid(wnhacomEro(s) ltcn*d puisunl rorheCodEctoisLic..k rlw).
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a'n.xcmfl !nd.r S..rio
Drr.:
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woRl(Flls' collPB{sartrN
DECI,Af,AtrON
I hcrcby afirm undo p.Mlry ol p€dury oft of rhc rbllouins d*l,ralions:
-l
hav. arid qill minllin t CcdirEorc of Con€ ro s.lf lNurc {or srk s coryc.erion. as P,!!idcd ldr btSalion 17fl}orrhc
Lrhor C.dc, toi lh€ FrfonEtuc ofrhc ao* aor *tkh rhc pcrmir is L$ued
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h6v. nnd will mainlsin workcB com!€.slrion insuiarcc. !s tcquncd bv Sslion l70o ol lhc Lrbo! C'de lor thc I,crromncc of
rhc work lor {hich lhis Fmn is n$.d. My sorkds ompcnsrrion insrrame 6nier aid Plicv numhd dc:
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ccnify rhar h rhc r.ri.nunc. of6c *ort r'or which rhk pcrmil h hsred. I shoil nol c'nplov anv Pc6on in snvmnns
s, dr h bccom subiccr ro rhc soricF mmpcilut io laRs oI Caliromi,. dd a8rec rhar ir I should lE otu srbi*i x' rh.
*ork.B coqrcnsrionrovisionsofscclion]T0OofrhctitorCod.,sh 1. tbnhwnh .on$lv wirh rhos provisions
WARNINC: Ftriturc ro scurc wor kes' co nDc nssl ion covc.,gc is unhwful. dnd shall suhJ&r r!1 cnrplorcr b rininal P'nlllk$nd
civilfincsutidonchundrcdrhousaoddollffi($lO0.O(r)),in.ddilionrorhc.onofconrp'nsalion.damscsss,'rovidcdrorlh'
S.( ir, loll, ollh. l.iri{ (i'(1.
'^,"=4ADlJtl $*ori
IIECI.6XAIIA!
I h.rcby aflnm undo r.ndlyofpcrhry rhd I m liEnsd ondc. r.vliionofCh,ptcr 9 (conrruncing with Sath.7000) 'rDivhion l
oa rh. Businc$ and Pof.rsi.ns Codc. ud ny li.cnsc ir h tull lord a*l .dsl .
',**."r*.(') o'c-4b 1 4_{260>
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qONIn!]CIIO!i.LAiUNC.ACINCI
I hcrchy oafiro lndcr ,,ctr!ll, o{ tcrjrty lhtl I ho! t a consrrudion h0dins tg.ftv for llE pcrfomftc ol lhc work for whkh lhn Frmn 'n\u.d(Scc 1097. Civ C ).
Lcn'ic' "Nanc
-
l,.dfl s Addrc$:
APPLICANT TTFCLARATION
I hcr.Sy amm lndcr n nrl y of pcrjury orc or lh. folloBin8 d<lmrions:
Dem ion Pcrnrirs-Asbcslos Nolificslion FcdcEl Rcgularions lTille tlo. P.n6)
-R.quircd
LcrlcrolllorirEalbn
Iccnilyrharrh.rcd.rdlnsuliri('n\rc8,rditr8rshc{osr.n$!rlffcnlrmli.iblcrolhnPr+'r
_l c.nify rh.r lh.vcr$drhi\rPp )
.' rrrr\ rlsrir. lrw\ r.lari')
itr\c nrnrnnrd popcny I'or
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*,:a(y'42t\
Fire Alarm / Dampers
Buildinq
.t(lr(/q,Bondinq / Groundinq / UFER
Ceilinos (T-Bar Rouoh)
-il?r')b\J6r