HomeMy WebLinkAbout20161309 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M- 19), Santa Ana, CA92702 Electrical Permit #: 20{ 6{ 3O9
Pin #: 25786lnspection Requests: (714) 667-2738 lnspector Sectionr (714) 647-5853
Project Address: 120 S Pacific Ave Unit: 37
Block: NA
Btdg:
Tract: NA
Suite Range:
Zoning
E
Assessor'sParcei: 007-320-04 Lot: NA
Owner:
Address
Olson Company
'120 S Pacific Ave Unit# 34
Seal Beach, CA 92703
(562) s96-4770
01 116002 51603
01 1'16002 51603
01 116002 51603
01 1 16002 53601
01 1 16002 51600
01 1 16002 51603
Amount
o.14
0.14
51 .29
0.65
21 .25
52.98
Qty
1,961.00
460.00
1 .00
365.01
'1 .00
'1 .00
Fee
$274.54
$64.40
$51.29
$237 .26
$21.25
$52.98
Phone
Tenant Name:
Contractor
Address:
Olson Urban Housing L P
3020 Old Ranch Pkwy f400
Seal Beach, CA 90740
(562) 5954770Phone
State Lic #: 939156
Lic Type: B
Bus. Lic #: 363131
Workers' Compensation lnsurance:Carrier: Cypress lnsurance Company
Policy #: 1NWC904693
Expires: O1lO1l2O19
Condominium
New
New Condo Wgarage
R-2, S-2
V B, SPK
cEc 20't 3
Notes: Plan 4B/fees pd on M-
Planning Conditions PAID
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Date:
Date:
Date:
l\,lisc.Receipt: 68297
lvlisc. Receipt:
l\4isc. Receipt:
Total
MAY O8 2O1B
CSG Consultanis
Zuniga, Allissa
12t12t2016
o5tozt2018
Account#
f San ta AnaCitY o
10190461 $21.25
$443.21
$7O1.72
$237 .26
$464.46
Every permit issued shall become invalid unless the work on the site
authoized by such pemit is commenced within180 days aftet its
issuance, ot if the wo* authorized on the site by such pemit is suspended
or abandoned fot a peiod of 180 days aftet the time the wotu is
commenced
lnspector MID#: 2016-130951
01'1'16002 51600
01116002 51603
Fee Total:
Paid to Date:
Balance Due:
Address Range:
Historic: No
Fee Type
New Res
New Garage
Serv Meter
Ptc - 650/0
General Plan Update
lssuance
Building Use:
Job Type:
Nature of Work:
Occupancy:
Constr Type:
Code:
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE IDiSIG.COMMENTS
Sile-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Lile Salety /Low Vollaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER lozl-tg 4*nn ,nz)
Transformers
Torqueino /o.Zfa6 Zezl S*G l4"JL d'&L
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rouqh)
It/eter Release D2q-/9 Zz-'t
Rouqh tD-il-t 9 ('-zaa
Service lvleter
FINAL /z-34 B z7c2-)a,- A.-J
Notes Remarks, Etc.,/Z
OWNER BUILDER DELCARATION
I hcehy atftrm u.d.r p.nrlry of p.lury lhir I dn cicfrpr fnrF rhc conracrtra Li.coc bw lor rnc follo{inE rco$n (S( ?0:ll J
Busincss atrd Proltssiotr Codel Atry City or C.unly shich rcqutcs a Fm i ro on(tu.r, nlr6, inprov.. d. nlish or Eton rtry
xrtudur. prior ro ns hsuune. aho rcqun.r rtu lrDlic! lu ru.h rE ni ro nh r siBkd rlllcmnl lhll h. or shc is li.enscd poro r
h rhc F)visionc of tlx Co relor's Liccnscd Las (Chanlcr 9. Coarmncins wirh Scclioo ?Un of Divi*i6n I ofrhc Ausin.s nnd
Pmra$ions Codc) or thlr hc or shc h cxcmfl rhc,ctrom and rh. ha\h n, rhc aucscd cx.ip'nrn. Any vnnrlion ofSccliotr 7011.5 hy lny
aprlicanr fu !rEmn $bjccc rh. atpli.m( b r.ivilpcmllyornor d,rrh.n nvc hundrcd dollaB (5500).
-1.
N owncr ofthc lr(,lEny. or ary cnDloyes wilh B0scs !s thcn st compctrsrion, will d. rhc wor* alld rhc $nmm k mt
inr. "ld.rolTcbdforslc(s*.T044.BusircssandPr.f.rsion.CodcrTh.contnctolsLiccnscLowdocsnorlpplyromo*Erofrh. pmrEny wk htrilds or inrpmres thercn. d who dms such wo hinsclforhcNclr.rrhFrshhhorhcrown.n,hyccs.
providcd rhar such im!.ormoh e mr iored.i oroftrcn fo! $k lt- ho*cvd. rhc hiildinBor impmrnE k sld wilhin onc )ear
ol (nvhlion. rlE owEr auilcr Bill narc rnc hudo of pmviq rhlt hc nr sh. dA !d build or irymvc l]rc pDrEiy ror rh. purln$ or
q(
^,,**' ",* n-n"nr, -rc(lui\clr.orracrnA s h lr.cn{d cnnrrccrn" tn en.lrud r hc Fn { (\.. 7o4:l. Bu(m\
lod Eofssion Codc:'Ihc Conrrocrors l-iccnsc Llq dms nol ll,ply ro on o*ncr ofrtup.ny *ho builds or imrovcs thcrcon,
rnd who.o.rfl.krorsuchpma{tswirhaConrndon9lic.nsd!,u6uunrtorheContracrolsLiccnselj{)
I amcxcmpr undcr Scclio
Orer
!l)4(E&l-ra!lfrNsA.rloN
DICLABTIION
t hcrchy nftnn:und.r nMrhy of perjury onc olrhc follo{irg dccla.rrions:
-l
hlvc und sillrMinrrinaCcnificarcofConsetrrro Sclf lnsurc lor {orksi .onFnsarn,n. ,s po,idcd forbtScctiotrlT0ooirh.
bt, cod.. tu th. lcrfonmncc oI lhc rort tor which lhc p.nnil n is$cd.
-l
harc rtu will minlain *nrker' ompcnsarn,n in\!r!ncc. ns rcqltcd b, sc.rbn r7o0 ol Dc bbor abdc. fd thc p.rfomtud of
rhc work rbrwnichlhk ncmit is i$kd Mysorkcn conrp.nsalt)n io\rx'ft.adi.t md poli.y Nnh.r uc
-l
ccniiyrh.l nr lhcrcrlormonccollnc wort for shichlhn pcnnir is h\ucd,I shrll.or cnrfloyony,)cmn in.nynunncr
w, el ro N+om $hid b rh. wrnk.n .smFnqrhn liw{ or Cnlitomm, nn,! a!rcc rhlr if I should h{com slhjar k, rhc
srrkes' $nfcnsariotr pn,visi.* of Sc.r ion l?00 of rhc bl.r c{tlc. I sh.ll. lonhwith comtly wilh lhos prolnionr
llARNlN(;: rzirui. ro s.urc workc,! conrDcn\aliotr .ovcasc is utrhwril. dd slrll \ubr.r M cnDlo)u ro ainrinal lcnalrics lnd
.ivil fi..s up kr oft hundrcd rhoustrd dollire (SILD.UJ0)
SNtion 1076.r$c Lrtsr C.dc. intcrci ond altomy s ies.
in ldrlili0n n, rhc co( ol drtrr'gcs as nrovidcd fo! lhc
IIECLAAA.IIO!
I hcEb, affim !.dcr p.tulryorFrjury lhar I ffi liccDsd und& tmvisiotr ot Chaltcr 9 (onmicing sirh sdirn 700oJ ofDivision 3
ol rhc Busirc$ .nd Pmfcsions Cndc- atn my licenr h in tull forc and caart
-o-(e
CANiIBI]SIONIEIUNAACEI.CI
I hcEby nfllr und.r Fnrny oi pcrjury dll lhft is a conslru€lion lcndinB ogcrcy f.r rhc pcrlormnc. ol lhe work for *hich lhn Fmn is
hsucd (Scc. 3017, Civ. C ).
AXSLIqANL.PECI,ASAIION
I hstt, !,im lndcr lcnllryorFrjuryonc or th. rolbwing dcclmrions:
Dcmlirio. Pcrnih'Asl,csror Norifrarion Fcderal Rc8ularion\ (Tirlc 40. Pd6)
-Rcquncd
t.rrcr of NolifElhn
I.cdifyrh.r rhc fL{cril lc3uhrions rc8ffdin8 rsh.nos rcnnul nrc nor spplicahlctu rhis l)n*.r
l.cdiliih|l I h.!c rcid rhh otpl
nrdinonccs s.d Sldc Lrss relarirBk,
i\.oftd. I aem roconllywith.ll Cirylnd Counr,
r.rr.rc.rdivcs olrhis ciryaM c.unryro cnrs rnon riF
ntrlc rcnrio.cdfmpcnylor
Appllonl or Ag.nl SIBmtuF ,",,, 9'9 -'d
"",", f-4- '9
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