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20166453 - Permit
Proiect Address: 2424 N Tustin Ave Assessor'sParcel: 396-261-55 Lot; 8 Unit: Block: A Bidg: 24-G Address Range: Tract: A.B. CHAPMAN Historic: No Suite Range: Unit G-3 Zoning: R4 q 20 Civic Center Plaza (M-19), Santa Ana, CA92702 lnspection Requests: (714\ 667-2738 lnspector Sectionr (7'14) 647-5853 Electrical Permit#: 20{66453 Pin #: 64599 City of Santa Ana Permit Counter: (714) 647-5800 Ownerl Address Contractor Address: 01 1 16002 0'1 1 16002 01 1 16002 01 1 '16002 01 1 16002 51603 51603 51603 51600 51603Tenant Name: The Bascom Group 26 Corporate Park Drive, Suite 200 lrvine, CA 92606 (866) 695-5591 Katerra Renovations, LLC 3200 Earhart Drive Carrollton, TX 75006 (972) 818-1065 FeeType Amount Qty Foe 125 Volt Receptacle 1.45 5.00 $7.25 Light switches, occ. se 1.58 12.00 $18.96 Light Fixtures 1.05 5.00 $5.25 General Plan Update 22.08 1.00 $22.08 lssuance 55.04 1.00 $55.04 Botchi:45194 - 8/3/2OlA I0: C(:tJl,i-l,Ari 0f f ice: CTYH Tronsi: I 6 of .-19 Acrti: R€f+r 20165453 Rcpti:02347444 - 8/3/2018 ?.22 Ptl Tronsoct i on Totol 15r243,53 Kflterno Renov(tt ionsr LLCState Lic #: 1009989 Lic Type: B Bus. Lic #: 366547 Workers' Compensation lnsurance:Carrier: Midrvest Employe/s Casualty Company Policy #: BNUWC0139070 Expires: OllO'll2O19 Generol Plcfi UDdate Fee 01116002- 51600000- Electr icol 01116002- 51603000- ICL Check 0030m Viso CC+: rllrilrrrr*15069 $?? . r.l i5' 143. ?r:l t99.63 Aut,h+:052r:r17 Building Use: Job Type: Nature of Work Planning Conditions: Planning Approval By Plan Checked By: Permit lssued By: Subject to Field: Building Permil #: Date: Date: Date: R-2 VB cEc 2016 Notes: Fixture change outs (unit 3) Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Chavez, Dave Every pefinit issued shall become invalid unless the wotu on the site authoized by such pernit is commenced within 160 days aftet its issuance, or if lhe wo* authorized on the site by such permit is suspended ot abandoned for a pedod of 180 days aftet the time the wo* is commenced. lnspector t{ito#. 2018-144740 08/03/20r8 Account# 01116002 5'1600 01116002 51603 Fee Total: Paid to Date: Balance Due: $108.58 $o.oo $108.s8 Phone: Phone: Multi-Family (5 or more uni Occupancy: Miscellaneous Constr TYPe: Fixture change outs (unit 3) codei $22.O8 $86.50 ELECTRICAL.INSPECTOR RECOHD APPROVALS DATE ID/SIG.COMMENTS OWNER AUN-DER DELCAR TION I hcrcby afirm undcr Ftroxy of pcrjury lhal I aD cxcnpl liom thc Conr,adoF Li.cn{ ljw ro. lh! followi4 rcN,n (S\-' ?o.t l 5 ausin.s .nd Prolision Codc)r Any Ciry or Colnry which GqliEs n Fnnir ro .onnrucr, altcr, imp,ot. dcmlkh or rcI'0n any srrucrurc. rrhrh ns issuancc. al$ r.qutB rhc,rn!i.dr ror su.h Fnnil lo lilc a sisncd rlllcmnl rhtr lfoi shc is licctr*d Puruanl x' rhc 0oviions ol thc Contfrclols Liccnscd t w (Ch.plcr 9. CoD.rn.inA wirh Sccrior 7000 of Division 3 ofrhc susncss aDd PnrlcsionsCodc)orlhlrhco6hch.x.nDrlh.r.rromandrhcbasislorrhcalksedcxcnprnn.Anyvn,hrionolSR-lion'703l5l,yeny aptli.a r.r s pcrnir sublcch rhc amlicani lo !cililpcnalltolnot morclhoi lile hunildd dollrs (Ssujl. -1. n ovtrcr ol'rhc proDcnr, (r my conl.Fcs *irh sases u\ rhct s,lc .omrctr\(n,n. uill do thc suk ,'t rh. qrmrurc i Rn inrcnd.d or orercd fr slc (S( 70rl. Businc$ md Pft,fcsion Codc Thc aonlacror's Litnsc hw docs nor aPply ln an o*t. of lhcDmruly qI[ huilds or nnnovcs rhcrG'n, trfrl eho docs sdch w(, hnnsclrorhcrcllorlhnushhisorhcrowncmrloyccs. prcvidcd ihnr5uch nnlmhrrnr\.ErF ir cndcd oroflaEt L, \..Il howcvcr rhc l,uiklinp orinDmt' m is qikl wiihin nc rrrr ofconrrlcri,n. rhcOs.cr AuiLld wil hrvc rlE blrdctr oftrulinS rhd hc or shc did norhild or i'nEovt rh. fmr.dy tbr ltr puqDs of I. !s own.rorrM tmtMy, ancxcl$ivclyco ractins with li.en\cd conrra.i)n ro (rsrdct ttE l)mrcr (Scc 7Or4. Bue..$ ird tbfc$hn CodD ThcConrractn s l-ic.nsc l-,w d.cs n.r arplth.nowmrof[o!cnyvho huildsdr imttuvcs Ihcreon. rid who.onrmrsforsuchFmj.rtswirhaconrBcbnnlicenscdlrusus 6rh.conta.roisLiEnscL!*) I ancrcnr undcr Scclio ItaB$&5:r9lltINSArlQN DLC].d36IION I hcrcby !finn undcr pcnrhyorp..jury on. orrhc roll.win8 dcclaorion\l -l havc aid sill minrnin . Ccnific0ic of Conscnt hSclaInsuEi wortcd Nmp.nuion. as ,mva.d for ny S(li)n l70o .f thc Lihor Codc. for ltc pertormnft or rhc wort ror whi.h lhc ,cmiit is tsrrd. I hrv..nd will nuinhir workcrl c.nDens(lion insulimc- !\ rcqutcd byS*rion:l7Lx).tthc Lrbor Codc, nnrhd p.{or Nn.c of I [tr{lrLrl'r'ri r i. i\{'rJ Nl\ uurlrh'fil.lo+'t- c/^i\ co'nfctrsriion insur,mccarid 0ft1lolicynumbcr e 1.16. rNvurcoo?d>e'r.\. -l .cn ify lhlr io ihc pcrfo,tun.. or rhj work ror which rhis ,)cn r n n\ucd. I dull tr.r cnlplot any n rcn in an, manmr $ * ro btcom subir h $c woAcl conrraosd bn l!r'r or Calituhir, did r8r. rh.r il I should tEcom sbjcd b rhd workm{ .o'npctrsi ion pmvnions ol Ssrn,n l7(X) of rhe Utrtr Cdl.. I shtrll. lonhsirh oniply *irh rhos pmvkio.s WARNINGT Frilurc ro surc workcrs'conlpcoslrion ovemsc is ,nlxrlll. aiJ shrll suhjcct irr cmPli'ycr k, di irlFMlrar rnd civil turcs up ro oDc hundr.d lhousund dollEs ($l(r).fin). in rddi'ion n) rhc cosl ofcompcnsarion, datul$s,s Providcd hr rhc sccriotr 1076 ollhr rjhor Codc. inrcrcsl a.d lllomy \ fe\ "",tuG0 3 20LB ^*,'-*, DECIABAIION I hcrchylmmrlndor penalry of pcrjury thsl I m liccnsd xnd.r Frevhbn olChlllq 9(co.rmnchg snh sc.lion ?U)0) otDilnion l or $. Brsin.ss dd Pmlcsions Codc- ud my liccns t in tull forc d'd .fi.cr.o lAfr.$.t. '+ft$$J!.3 201b '(t*cfru C(TNSTRIICTION I FNDIN(i A(IENCY I herchy nmrn undc, rrnDhy ot lerjury rhar rh.r. h d con{fl.trrn Lndins uscnc, for rhc t.rrortuncc of rhc work for which rhis Fnir i1 issucd tse.3097. civ. c.) ATILII;ANLIIECIdAAUON I hcrd'y.fmr u.dcr pcnrlly ofpcrFry onc or'ht roll.Bing dNldilons: Dcnmlirn,n Pcrnrirl Ast (os Nol ilicat io n ,:cderr I ttcs u lar ions (Tirlc 40. Pd6) Rcquncdlr(.rofNo l.dion -l ccdiry rhd rhc lcdcralrcgul ions EgudinB osbcslosrcmrvlllre nor,pplicabk lo lhis fmicr. dlcnify Ihd I hr( rc0d rhh utplicarion el surc rhar rhc shrvc inturmridr i\ coflsr. I lsre ro comrly wirh rllcily0ftl Counry ordirrtrccs.nd Srarc bws Ebriry ro hu dhuvc nrtrrbncd pmlcny tu iNFcri,nr ivcs ofrhn Ciry nnd Counrr lo cnrs upon lhc ADpli.anl orAEenlSknnlurc Qat +4 A,'-o- *"qu6 +8 2019 Underqround Pole Bases Light Standards Spas, Pool, Fountains Sions (monument) Lile Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding / Groundinq / UFER Translormers Torqueino Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilings (Hard & Soffit Rouoh Ceilinqs (T-Bar Rouoh) [/eter Release Rouoh 7t</K 711) Service Meter 7/tzls ?t6Y Notes, Remarks, Etc Site-Work FINAL lxnd. \ NJmc. - Lndcr'i Addr.qq: -