HomeMy WebLinkAbout20165710 - PermitProiect Address: 909 N Sheffield St
Assessor'sParcel: 100-444-50 Lot: 50
U nit:
Block: NA
Bldg:
T.acl:2454
Address Range:
Historic: No
Suite Range:
Zoning: R'l
q
20 Civic Center Plaza (lvl-19), Santa Ana, CA'92702
lnspection Requests: (714\ 667-2738 lnspector Section: (714\ 647-5853
Electrical Permit #: 2IJ16'571iJ
Pin #: 16458
City of Santa Ana
Permit Counter: (714) 647-5800
Owner:
Address
Phone;
Tenant Name
Contractor:
Address:
Owner-Builder
01 1 16002
01 't '16002
01 1 16002
01 1 16002
0'1 1 16002
Amount
1 .40
1 .52
1.0.1
21.25
s2.98
Fee
$70.00
$30.40
$40.40
$2't.25
$52.98
51603
51603
51603
51600
51603
Qty
50.00
20.00
40.00
1 .00
'1.00
Fee Type
125 Volt Receptacle
Light Switches, Occ. Se
Light Fixtures
General Plan Update
lssuance
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Botch+:43477 - 4 /21/'!t-tlgoff ice: (:TYH TronE+i r
Acct+ I t:efRcpti:i2?4rl1g:{ - 4 , ),! ,')
Tronsnct ion Totol
,_t1
TI
.'l
Tr in itc 6ome:
4
Building Use:
Job Type:
Nature of Work
Plan Checked By
Permit lssued By
Subject to Fieldl
Building Permit #
Single Family Dwelling OccuPancY:
Alteration Constr TYPe
Remodel Kitchen/831616661Code:
Date:
Date:
Date:
R-3, U
VB
cEc 2016
r.rotes, nemo,{ffffidl8l' irrooo_
ICL theclr 29i (
Planning conditions: No change in floor plan
Teri o4t2512014
Account#
19625 3 01 1'16002 51600
0'1 116002 51603
$21 .25
$193.78
Fee Total:
Paid to Date:
Balance Due:
$21s.03
$0 00
$215_03
Every permit issued shall become invalid unless the work on th€ slte
authotized by such permit is connenced within180 days aftat its
issuance, or if the wofu authoized on the site by such permit is suspended
or abandoned fot a peiod of180 days aftet the time the wo* is
commenced.
lnspector MID#: 2018-142933
Trinity Gomez
257 E. Osgood Street
Long Beach, cA 90805
(307) 256-7837
$?1,?:
t193.79
s1 , r-r[r9, ]s
Genernl Plnn Updatp FEe
r11 I 1 6002- 51 6t:r(tlr:r(-
Planning Approval By:Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Lile Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondinq / Groundino / UFER
Translormers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinos (Hard & Solfit Rouqh
Ceilings (T-Bar Rough)
Rough 1\1L\\X,/r ldr'l
Service lvleler
FINAL //'-/f/g--zV-ltsr 'fbrz-?/
Notes, Remarks, Etc
OWNER BUILDER DEI,CARATION
I h.rny ar6rm uMcr p.tr ly of !.aury thal I m cxcnry rmrn lhu cotrt .loE Lkcns tiw for lhc follositrS rcasn ls.c.7ol l .5
tsusitrcs nl Prolcsion Codc): Any Cny.r Counly shth rcquncs , Frmil ro onnrucl. 0hq- imrmr. dcmlish or ErEt ,
srtocrlrc- prir ro irs hsurmc. !l$,cqlircs ricryplicrnr ior suchrermir to filco signed rrarcnrnr rhtrl hcor\hc il liccn$d pxnu{r
ro rhc p$vnions ol lh. contacrol! Liccnscd Liw (ch,flc. 9. conrmncirS eilh Scclion ?()()o of Division I or rhc Bu\inc\i u,l
PronssionsCodc) or lhar hc.rshe kcrc'npl lhcrcflom.nd lhc b.sis for t hc allc8cd cxc mpl ion Any liinarion o, Sdion 701I 5 by any
afi,li.lnrfor{FrmirsuhjccrsrhcDpnliQmt,r.ivilpcnllryofnor nrcrhm l_rvc h"nd!.d doll*s (!;5m).
-1.0s
owncr ofrhc nmpcny. or mycmDlo)er virh sa8cs as {hct slc contEnsa'ion. willdo rh€ sork {d dc nturm n R
inrcndct oroircrcd for slc (5(.7044, Bu\incs nnd hofcssiotrs Codc Th. Coirrrttr'\ Li..ne ljw d..s nor tpply ro M on'ftr ol
lhc p$Fny vho hoilds or i itfl)s thcu)n. dxl who ilo.s such *,& hims.ll or hcncll.r rhmugh his or hcr o{tr c Dloycc\.
pfuvidLal rhrr such inpnNnrtummr inr. lcrl oronbftl fir sk I[ horos, rhc hriUin8 nr imprcwn.nr h s,ld wirhin.k ltd
ol.ompLlhn. rhc Owncr Ruildcr * ill hlE rhc ho.dcn of lr.viry llul hc or shc did ml tdild or irqrrorc 0E pmlcny for rh. purlr,* or
Lr\owncrotrhcpn,tdr.a'ncrch\ivclyconrncrinE*irhliccn\cd.ontackn\r'd,n{flcirhcpn,r.cr(Scc.1(}14.Busirtrs
afrl lh,lc$i.n Codc Thc Contracnn s Liccnsc Lr* docs nor rl)Plt lo rn owB ol rrop.ny tr ho huild\ or imr(Nr\ rhcr.. ,
rid (ho co rach fff soch pnJjmr\ wirh a Cu Dcktr(s) liccnscd,rBua r k, rhc Conrn.kn r Lt.nsc bw).
-l
o eicnrfl !ftlcr Sccr
I hcrcby rfirtrrundcr |xnrlryoi
DIiCLrnd[rN
Ih.v.ad*iltfrrinrrindCcnifi.dcolConscnrros.lr-lnsur.f..wolkcs coqEnsarnnr.0r providcd lor by Sccri.n]700 of rh.
bhix C{dc, for rh€ performicc oI rh. wolk for whki rhc Frfrn i! issocd
_l hrvc 0nd willnraintunr worhcn compensaln'n iNurnncc. rs rcquncd bySccli{,n 3?(Irol'lhc IihorGdc. ror lh. l)crLirmrrr or
rhc Norl forwhichlhn pcn.it is tssd My rortcr' con{'.nsd ion insumncc clri.r,nd Fnicy nrobcr e:
l.cniry rhar ii rhc l.rfonn.trs ofdr work fd whi.h ihis l.nDir is irsu.d. I shrll nor lnploy.ny 0cron in rny mlnncr
s a!lo hc.onE $rh]cfl lo rh. sortcfs conrFNalio.luws ofcaiifolnl0- ond asre lhar if I \holld hcom suhiecr nr rr*
sorfici\' cinDcn\orion prclilions oI Sdion :l?(Il of lhc ljtnr Cdq I \noll, iodh*irn <,mply sirh rby rmvisk,ns .
WARNIN(; F.ilurc to s.nrc p.rkcn'coDrpcD
civil lincs ut r(J om huidrcd rhousrnd dollnrs
..vcnrc N utrltrwlirl. ud lhrll snhj..r rn cnrplorcr ro ci'ni'[lp.D]lric\ and
l0o.(xx)). h rddkion to dc cosr ofcompcnsltion. dom8cs a\ proliicd tor rlrc
Ihcrcbya irnr u cr pctrolryofpcrjuryrhll Irm liccn$d ptuvirior oiChqrlcr 0 (commminE Firh Sccrbn 7(rX, ofDi!(ion.l
oI rhc Bd\i',.\\ rnd Pfl,rrssi{Dr Codr. n' trir- liccn\c n i', tullturr klcflccr
rctr'c Nunrhcr:
-
C!)XIIIBII(:IIONIENDIN(i-&ADNqI
I hcrcl,y rfnrmundcr penllty o t pcrjlry rhd rh6c is! on$ruclhn lendin-q as.ty ttr rhc Pjrlummc or rhc work ror which lhh tEmil 6
tsucd (Scc.109?. Civ C.).
APILI!'INLIEIIABAIIO!
I hcrct y i1fm undcr pcnally ol,rerjuryonc oflh! iollowinS dcclmlnrns:
Drnn,lirn,n Pfnrir* Asbc os Noriflcdion Fcdfi{l RcCtrlarioN lTirL lu). PM6)
Rcquncd btr.r of No frdirn
*,,/J
',M"?h\{'1
l'l rhc icd.rrl rcguldtnN rcE{Ji,rS ish.do\rcnurlrr nor rpplicrhfu t, rhi\ n'oj.cr
lhavcrctul rhisrptli.[i,r md srJcrhar rltr rtr)vc intuirndion isc.nccr lrBrerocomplrwirhnllCiryandCounry
s.otr{d.tioi. d hrrcbyrurhorirrc,'rcscnl ivcsoflntCiryandCounr,ki.trrcrrF,nr}E
(-i 6 W^r-
,.,"q:?5-\B
Meter Release
t ndcr'" Addr..i
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