HomeMy WebLinkAbout20166021 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Sanla Ana, CA92702 Electrical Permit #: 20{5602{
Pin #: 7476,6
l nspection Requests: (7 1 41 667 -27 38 lnspector Section: (7'1 4) 647-5853
Proiect Address: 2029 N Millwood St Unit:
Block: NA
Bldg:
Tract: 3902
Address Range:
Historic: No
q
Assessor'sParcel. 395-04'l-34 Lot: 79
Owner:
Address
Trung Dam
2029 N Millwood St
Santa Ana, CA 92705
(71418754448
Fee Type
011 16002 51603 Air Conditioner
01116002 51600 General Plan Update
01'1 '16002 51603 lssuance
Amount
93.28
52.98
Qty
1.00
1.00
1.00
Fee
$93.28
$21 .25
$s2.98Phone
Tenant Name:
Contractor
Address:
Stephan Refrigeration
12812 Knott St
Garden Grove, cA 92841
(714) 894-6s00
e(ltchi:44039 - 5/30/20180lf ice: CTYH Trone+: 49i.cti: Ref+:
Fl,:p ti:02284401 - 5/30/2r:r18
Tronsact ion Totol
I0: JG
2
2t116S
1:16
tJ,53,'Phone
State Lic #: 658149
Lic Type; C-20, C-38
Bus. Lic #: 342972
Workers' Compensation lnsurance:
Carrier: State Farm Fire & Casualty
Policy #: 90CW8362
Expires: 01/30/2019
tephnn Refr ieenot ion
ienersl Plon Updote Fee
r_r1116002- 5160r:1000-Elertr icol
r:t1116S02- 516(130(10-
Viso
{:C+ : r*rrrri}**}18648 Auth+;r
Building Use:
Job Type:
Nature of Work
Single Family Dwelling
Miscellaneous
A,/C & Furnace
R-3, U
VB
cEc 2016
Planning Conditions: A./C in rear yard
Planning Approval By Date:
Date:
Date:
Plan Checked By
Permit lssued By
Subject to Field:
Building Permit #
B S 05/30/2018
Account#
Every permil issued shall becone invahd unless the wo* on the sito
authorized by such permit is commenced within 180 days aftet its
issuance, ot if lhe wo* authorized on the site by such pemit is suspended
or abandoned fot a period of 180 days after the time lhe wo* is
comfienced
$167.51
$0.00
$167.51
MID#: 2018-143288
01 1 16002 51600
01 116002 s1603
$21.25
$146.26
Fee Total:
Paid to Date:
Balance Due
Suite Range:
Zoning: Rl
Occupancy:
Constr Type:
Code:Notesl
Misc. Receipt:
Misc. Receipl:
Masc. Receiptl
Total
lnspector
ELECTRICAL-INSPECTOR HECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Salety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilin gs (Hard & Solf it Rouoh
Ceilings (T-Bar Rouqh)
lvleter Release
Rough T'to/b 4z 1-i>fi)L*:7W1
Service Meter
FINAL
Notes, Remarks, Etc.
OWNER BUILT}ER DEI,CARATION
I hcrchy rmrm utotcr Fnrky of Frrury rhar I m.x.mfl li1,o rhr c(nnrrtu' Li..n$ tiw f.r rh. followinS rcNon (Sc. ?0.11 5
Busincs and Pmfe$ion Codci Any Ciry or Coun'y whi.h rcqutcs a Fnnn to con{Dcl. nll6. imnrolc. dcmlhh nr EIrn rny
ctu(, tri.rti irs is\uan.c. trl\. rquncs rhe ap icrnr f{tr such rEnni ro filea sirncd {arcftnr rh,r lE.r sh. is ltonql puisurnt
ro lhe lnvhions oa th. Cotrlrlcror's Liccn*d Lnw (Cnaplcr L Conmrn.in8 wilh Scclion ?ur) ol Divhion :l olrhc Busin.$ and
toorcs\nnN Codc)orrhlt ltor shc hcichpr rhcrcfroni lnd rh.hlsh fo, rhcrllc8qlcrcnurn,n. An, v{lf,rion .f Sdi Fn 70:l I J by.ny
opplrrir fom Fmrir \ubicr\ rh aptlica h a cilil pcnrhr of nor mE rha! filc hundrcd doll!6 {$5Oo).
-1.
as oqncr ol rh. lmtrny. o, ry cmployccs w h w.e.s a( rhcn $b .omlcns.rir{. will do lhc $!rk and ltr (nrlurc n mr
inretrhd or ofiscd fo. slc (Sa 7044- Ausirc$ and Pr.ac$iotrs aodc: Thc Conrraclols ,-tens l.i* dcs nor arpl, b ,n uwncr or
lh. D$Fjdy wk) builds or inryoEs OEErn. Md *h. d*s skh knl hims.ltor hcsclror rhmu8h hh or h.r of,ncmployccs.
ln)vidL\l rh3r \rch iDprolc'Enh dc nor lnrcndcd or ofi.rcJ r'or slc ll hrwcvc,, rtr hxilttrg or iq,rownrnr ir $ll w hin oN ]cd.f.oq'tri.n. ltE Ouncr Buikc. *ill lErc rhc h{rden of prcli.g lhd lE or .hc dil mr build or impmrc lhc Impsly lor rhc rlrFr ot
L a\o*ncrofihc prol}cnt, d)cxch\ircltconlrncrin8 wirh li..nsed conirmror\ ro cotr{tuc! rhc pn,l..r (SL\. 7(!l4. Buucs
rM h.l$sin Codc: Thc clnkidols Liccns. Lrs d.cs.ur upply h.n owmr olpro|xdy !h. builds or nnnrncs rhcrcon.
rnd who conrr0cr\ ior such rn Fts wir h ! Cotrlnrdo( s) lncrNcd Nr{uinr ro rhc On rucroi s l.iccns. tjs )
I a .xcmPr unncr Sccli(nr-. B. & t'C thrthi\.ca{'n
}rcBKD&I3;AIISENTAIIQN
DIICLdIAUAN
I hcaby rfft rndcr Fnrlry oflf,rluryonc ofrhc r(rlowing dc.lnrdion\
-l
hrvc nd rillNinrain a Cenincorc oiCons k,Sclf-lnsurclo!workqrco,nF{suri,n.usprovid.dnrbyscctn'ni7{Dolrhc
tibor Oodc. lbr thc ,.rformrEc of lhc qork for phi.h rhc lEnni is hsucd
lhrrc r rl willminrrin workcrs conrp.n\dnnr in\lrnncc. as 'qonrJ h!Sc.ii,rr 17(X,.frhc l;rh.r Cidc. io rh. pdlhrnMrccol
rhc woik turwhi.hrhis p.rfrir is ilsxci My work.( .unl).nsrr i,n, i'rsuhn.c.nri$a Flicy trutr$cr rc
-l
ccdily thd ln rnc tErloirrrmc olrh. wolk for {hi.h rhis ncnnir is nsled. I rhill not cmploy ony pcron in any ornmr
n Nloncqrmc $'l,jcd ro lhc rorken' co n{c nsal io n hs\ofCalil'ornia- rnd x8rce rhrlir I dblld hcoft {hj.d ro rhc
$orkcn compcnsilion pmvnion\ ofScction 3700olrhc L.tDr Cdc.I sh.ll.lonhLvirh mnnly Nirh rho{ pmvnion\
civil fitrcs u0 tu onc hundrcd lhousnd dollan ($).()(lo), in diidr ro rhc c.{ (n .omp.nsrrion- dan$E.\ as pdvidcd for rh.
s..ri, 3lr76 olrhc I rhr(in[. i'ncr.n
I h.icht {lfinn un c, l.n,ht .r r.rjury rlu l ,b lienwl u i( t (,vi\bn or Ch,J'rc. 9 (GnnnE..nr8 wilh Serion ?dI)) ol Divhion .l
or ihc Businesnnd PnfcssionsCodc. and nryliccNc n in fulllnrcc ad cfiirl
66s t4e
ft
I hcahy nltunru cr F-.nrlryol lcrturyrhd I is u.nnslruction lcndin8 rrcncy aor rh. pcraornEnN olrhc work lbr whi.h rhh Frn n
issucd (S.r :ltD7. Civ. C.)
A.TIUCAXI,DECIAf,AIION
I h.nt y arm unde, r.nal y of pcrjury oe of rlE rollowins &{le!l ionsl
Ocmliriotr PcnDjts.Ashesros Norilicrrion Fcdcr.! RcBullrions (Tirlc40, PIn6)
-RequiEd
Lcllcrof Notincarion
*,"'fi'j:',.,1},:l
aguhrn,n\ rcEnding aslcstos rcmovd lrc nol umlic,hlc x, rhir pR,j.tr
k 0rpllcdionrrldnalcrhur rh. alr,v. inftrturbn is.onccr L&re Io conply wirh rll Ciry ond Counry
ring ro buildinS .ondrud ion. arld h.rchyrurhorir rcprcs lovclofrhisCiryoodCounryrocnrslrontlE
^pplic!nl
or Asdr sisn!lury
Pemi'Nmne,pri;LJ4
-f!,yAlw
L.dci" Addrc*:
-