HomeMy WebLinkAbout20166837 - PermitCity of Santa Ana
Permit Counter (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702 Electrical Permit#: 20{66837
Pin #: 299{5lnspection Requests: (7 14), 667 -2738 lnspector Section: (714) 647-5853
Proiect Address: 1220 314 N Bristol St unit: METO2
Block: NA
Bldg:
Tract: 680
Address Range:
Historic: No
Suite Range:
Zoning: SP1
q
Assessor'sParcel: 004-113-35 Lot: '1, 2, 3
Owner:
Address
MARSHALL-KELLEY LLC
9662 BIXBY AVE
Garden Grove, CA 928413711
Fee Type
01116002 5160: Serv Meter
01116002 5160: Fee Exempt
01'116002 5160C General Plan Update
01116002 5160: lssuance
Amount
53.28
-130.40
22.O8
55.04
Qty
1.00
100
1.00
1 .00
Fee
$53.28
$-130.40
$22.08
$55.04
Phone
Tenant Name;
Contractor:
Address:
Los Angeles Engineering, lr
633 N. Barranca Ave.
CoYina, CA 9'1723
Phone
State Lic #: 591176
Lic Type; A
Bus. Lic #; 17901
Workers' Compensation lnsurance;Carrier: Old Republic General lns. Corp
Policy #: A1CW37191807
Expires; 0410112019
Building Use:
Job Type:
Nalure of Work
Other
Miscellaneous
Service Meter
Occupancy:
Constr Type
Code:
N/A
N/A
cEc 20't6 Notes: for traffic signal/city job-fee exempt
Planning Conditions
Planning Approval By:
Plan Checked By;
Permit lssued By:
Subject to Field:
Building Permit #:
Zuniga, Allissa
Date
Date
Date 09/05/2018
Accou nt#
l\4isc. Receipt:
l\,lisc. Receipt:
l\,lisc. Receipt:
Total
Every pefinil issued shall become invalid unless the wo* on the site
authoized by such permit is comnonced withtn 180 days aflet its
issuanca, ot if the wotk authoized on the site by such pemit is suspended
ot abandoned lor a period of 180 days after the time the work is
commonced
$0 00
$0 00
$0.00
lnspector MID#: 20'18-145901
N/A - No Balance Fee Totat
Paid to Date:
Balance Due
APPROVALS DATE ID/SIG.COMMENTS
I. as .wn rofthc ln,Fdy. or nry c.fkrrrc\ wnh wascl L\ rhcir $h conllEnsarion. willdo lfu w{lrk anl rh. {drm i\ mr
inrcndcd or olTcrcd lor $lc (Sa ?o{4, Busircs lnd Eorcrsiotrs Cdlc: rtu cont.d.r's Licctrrc riw doer rer +Ply b dnowncr or
rhcnnrEny who builds or inDmws rhc@n.,Jd who dms so.h MIl himscllor hcr$lfor tlrou8h his or hcr own.mlloyccs.
rolidcd rhar soch impbvemms m nor inrcd.d or oftcn\] rd srL. l( ln'wcvcr. ltE huikliq or inwotftnr is oll wnhin onc )tr
olon{'lcrion. thc Osrer Builler willhaE Ihc butrh. ol prcvnrg $arh.orsnc dil rei build or inrp vc rh.ImFry ror lh. NqFe oi
-1.
as owncr ofrh. Oqrny.0mcrclu\ivclycoDtrclins uirh liccrsc{ conrruchN ro.oinru.r rhc pm]cct (Scc. 70.14- BNncs
x'nl t\)lis\irnCodc'IhcCoit,ctr'{Li.cnsctjsd.cstrordprlyro0nowncrofpropcrtywiohuildsorinDrcvcsrh.r.on.
.nd who conrkk lor such projcch wirh r Conrncto(s) liccnq, pururnr ro rhc Cnnrrucrois l.iccn* I-ns)
I n .x. rl, und.r S..r
thl€ Ownerl
rvoRl<a-i's' coMrltNrs Trd^i
I}ECLIIA.IIAN
I hcrcby rlIlfl. utrdcr p.Mllyolrrluryorc ollfic lollownr8 d(lanlions:
I lDvc rxl will mnnrh r ccnilE0re of Co.scnt b Self lnsure for worksi Nmpcisarion, a. Fovidcd ror by Scctnnr 3'rOO ol rhc
tjh.r Codc. for rhc pcf.nM collh. work for whichlh. p.rmil h hsucd.
Xt hnv. trndwillnuinhin workcr'cnnpcns ion insurance. rs lcquiEd bys(ii(,n l7(x) orrhc Lahot C{dc. ror lhc pcrfonBncc of
Nlysorkcn conrprn\ n,n insdrancc. di.r d B,li.yntrtr$crarc
0l c@ Cozp.l/r/ r a- rq iBo I
lcrnifyrh in (hc nerti)nuncc ofrhc *ork for *hich rhi\ p.nnir ir is\ucd. Inrlln.r cnrpliy any Ix son ir !n, muncr
$dsk,bc.omsobjftrt,rhcworkcn'cotrrpctrsrr,otrhws.rcrlironrir.md{Srcdharil,shoul(lhccotrE\ur'j..rr,ih
w rkc^ .oml( \d t'n pm$6n\ ol Sccrnr lTm of rhc Litsr Qxlc. l shall. n)n h*irh conDly u irh rk){ pmrisnnr
wARNINC: l'iilurc lo ecurc rorkcn
civil 6n.s up ur .nc hundrcd rhou$n
Sc.li,r 1076 ol ltc L'htr(.ic. i crcsl
onpc.srlk,n colc6se h unlo*tu|, did shdl \ubltr M cmploycr ro criminalFmlrts aid
drto'. {!t^O.qx)'. in dd,lirtr,n r. rh. .u{ I lrnrrnsd'o1, damgcs r. n.n\idcd for rhr,^r,L"".lr-. , , /
*"V,ub&,l(c,d_&ca <
// LTCENSED C0NTR CIoR
, ,/ I,IEOJBAIION
hjTl n l'ccn{ uM.r nov'{,,n qlCrJrra a rcommn( rnp qrrr snrx'n 7n0i" olotrF.',n I
md nry licen* is in tullforc and cITNl.
I hcrhf rfit'n trnd.r Nfrhyoflrrry r
ol {hc l]lri'r$ rnd lt.la\\n,ns Codc,
c'?:1 C
I K-
SANIIAIJCIIIINIENpINCAGENCI
I h.Bby amrn u.d.r Fnshyotp.rjury rhd thcE h a conerudion lcndine qcncy for tlE pcrforrotue ollhe *orr ror whih thk ncrmii i
hslcd (S(. 3097. Civ. C.).
AITLI!]ANLDECLAMIIO!
I M)y fim undcr p.nal' y or pcijury om of lhc following d( lrat n,nsl
Dcmoliin,n Pcr.irs Astrc(os Norifiori.tr Fedctul Rcgularioos (Tnh 10. Pan6)
Rc!oiBd lJrrcr of Norirr@rion
-l
ccniylhd rhc itdcro I eau lol ions rcsudins asbcstosEmvll re nor arpliclhlc b rhis pDjccr
Al .cn 'r) rhJr I h!\ c rc,d rh'\ hlnlrsr0n ui {,rdhd rhc lbovc inrornEr i(,n is codc.r I aere ro omply wilh ill Cn, and G'ury
ordinarccs and Srarc La*r rlarins ro hlildins.onnoorion. and hcrcht nurhornc rnrcsrnhliv.s olthis Cily dnd Counl, n, cnlcr oB,n rh.
rh,v. nrcrrnnrd |m,!cny f{tr ir\
,\pDlirul or,\!rnl Si{tr h'rr ;, q-51B
!P&ti
al"lu e@ GdCL
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Lile SaIe ty /Low Voltage
Fire Alarm / Dampers
Building
Under Slab / Floor
Bonding / Groundinq / UFER
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Solfit Rouoh
Ceilinos (T-Bar Rouqh)
Meter Release
Rouoh I VrlP*tci\/
Service I\Ieter ffnn"V fflAJd4tt ltt /
nt\i t/Ffir*i 7K'
Notes, Remarks, Etc. t w
\, \, |[
I
ELECTRICAL-INSPECTOF RECORD
Site-Work
Communications Cable
Translormers
FINAL
OWNER BUII,DER DELCARATION
I h.aby arfinn und.r F.,hy or pcrjury rhnr I an ex.mpt rn n rh. ConlmcroN Licctrs l-aw tor rhc fouowins rcnvrn Isc..70ll.5
Busi.c$ and Proi€ssion Codc): Any Ciry or Counly which rcquncs a pcmil ro 6n{tucr. altd, impovc, dcmolith or E|Et lny
(tucru... prif b ns isuak!, al$ Equtd rh. appltMr ror sxch Fmrn b tb r ri8flcd $ak,mnl that hc or th. is liens.d ,uNMl
lo rh. pmvisions oflhc Conlrnclrt Liccn*d L.w (Cnaplcr 9, CommtuinE wirh S.cri.n 7(xn or Division I ofthc Busincs and
Porcsnrns Cdc) or rhar heor{hc i\cxrmpr rhcrcrronand rhcba\ir r(trrh.rllcgcd cknrlion Any violorionofssrto 70.1l5bynn,
$Ilimd ror 0 p.rnir subj.ck rhc $plicanl ro a civil pc.rlry or nol mn lhan five hundrcd dollds ($50o)
a,c:-1s^
tt
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