HomeMy WebLinkAbout20166525 - Permit20 Civlc Center Plaza (N4-19), Santa Ana, CA92702
lnspectaon Requestsr (714\ 667-2738 lnspector Section: (714) 647-5853
Electrical Permit #: 20{66525
Pin#: 73341r/
City of Santa Ana
Permit Counter: (714) 647-5800
Proiect Address: 2424 N Tustin Ave
Assessor'sParcel: 396-261-55 Lot: 8
Unit:
Block: A
Bldg: 24-S Address Range:
Tract: A.B. CHAPMAN Historic: No
Suite Range: Unit 245-4
Zoning: R4
Owner:
Address:0'1 1 '16002
01 1 16002
01 1 16002
01 'l 16002
01 1 16002
51603
51603
51603
51600
5'1603
Phone
The Bascom Group, LLC
26 Corporate Park Drive, #200
lrvine, CA 92606
(949) 955-0888
Katerra Renovations, LLC
3200 Earhart Drive
Carrollton, TX 75006
(972) 818"106s
Fee Type Amount Qty Fee
125 Volt Receptacle 1.45 5.00 $7.25
Light switches, occ. se 1.58 12.00 $18.96
Liaht Fixtures 1.05 4.00 54.20
c"n"'"r efi
fl ffii fii'ii, rrfrt i,!'ils, r 68' "!ll"!ilb,plssuanceA.,,L+: 55.04 ftEf+:1.0911166.;.1fr55.04
Rcr,ti I r"rit-{rr74;rl 9/3/!(119 7r't-J Fll'frflnsu,:i iun lol,cr I '91ir 24.1,::i.]
KQterro Renovot irin E r [.1(Phone
State Lic #: 1009989
Lic Type: . B ,r
Bus. Lic #: 366547
workers' Compensation lnsurance:
Carrier: Midw$t Employer's Casualty Company
Policy #: BNUWCo139070
Expires; 0110112019
Genenol PI(n Updote Fee
01116ff0?- 51600tr0tr-
El€dtr i.:ol
trl116D0?- 516tr3000-
ICL Chert{ t103t120
V i :-Lo
cc+ : r***r*r*x**xirl.59
t??.ft
tr3:-; .441
$:i ' 14.t.9r:l
s99.63
Auth+:1152[17
Building Use:
Job Type:
Nature of Work
Planning Conditiols:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Fieldl
Building Permit #:
Multi-Family (5 or more uni Occupancy:
Alteration Constr Type
Fixture change outs (unit 4)code:
Date:
Date:
Date:
R-2
VB
cEc 20't6
Notes: Fixture change outs. Unit4
Misc. Receipt:
Misc. Receipt
Misc. Receipt:
Total
Chavez, Dave
Every pemil issued shall become invalid unless the work on the site
authoized by such permit is commehcecl within 180 days aftet ils
issuance. or ilthe work aulhorized on the site by such porrnil is Suspended
or abandoned lora poiod of 180 days aftet the time the wo* is
commenced.
08/03/2018
Account#
$107.53
$0.00
$107.53
MID#: 2018-144922
01 1 16002 51600
01 1 16002 51603
$22.08
$85 45
Tenant Name:
Contractorl
Address:
Fee Total:
Paid to Date:
Balance Due;
lnspector
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDIIR DELCAR,{TION
I hcrcby trftrm u.dcr lcnllry or Fcrjury rhul I um cxcmlr fmm rhc Cnnrracron Li...s. trr frr rhc followinE lcfl$n tsec?O:11.5
Businc$ and Protcsion Codc): ny Cn, or Coxnrt whkh i.quncs . Frnit lo ooslruct. !llc.. im,,rov.. d.mlirh or mPifuny
(ru.r!rc. priff ro ns isuec, also rcquics rhc applicMr lor such lrnnil to nh 0 \igtud darc.rnr rhal tr or shc k liccn$d puraunlr
ro rhc flovGions olllE Conlr(.t, s l,iLrnscd tf,w (Ch,fl.r 9, Co6trndn8 *ilh Sccrion 7O(I) ol Divnion ] ol rh. Busin.ss a.d
Porc$innr Codc) o, ihar h..rshc i\.rcnrfl thcrcfnnn.nd thc h{sh rorlhcalkScdcicnprioo Ao, violurionoisccrion 7011.5 byony
qrpli.mi for a p.mit subjNls rhc applicanl lo r civil ltcmhy ol nor nmrc ftan f]vc hundrcd dollas (S50o).
l.asoenc,olrhcnropcny.ueichsnrlyonlr!.rinssirhliccn\c{t.otur.r,Nb..nslrucllhcpr+cl(Scc?(DJ.Buincss
and P.ofc\bnCodc: Thc Conts.t \ Li..trsc Lawdoe\ m( !fl,lyr) or.*ncraaprrp.nyeh(, buildsor nnpmvcslicrcon.
rtrd sho cotrrml\ nn \uch lmjccr\ sirh r (inkrcttr(\ ) li(n\cd puNrN n, rhc C:ontu.tol s l-iccn* hw)
-l
ucienrpr undcrSccri{n B & PC turr[is rciv,n.
Dale:- Oenor:
woRxERs' cl)trtPE[sATloli
DECLAMIION
I hcrcby aflnm undcr penalt, ot pdury ot drrhc r.llowing dNlanrt,nsl
-lhave!.dsillnuinrainaCcdilEar.ofCons.nrbsulf-ln\ur.r(r*orkcncon[cnsarion.]spn,lidddftrbysetion]7mofthcLlbor Codc- ao! llE I'c,fo,nurcc oi rhc woik ror whih th. Jf,rhi' i\ i\sucd
_lhrlcrnd*illrEi'nrinworkcs.ornrctrsarioninsunn.c.*rcquirdhySc.rion:lTrnofrhcLri^rrCodc.hrlhcp.alormnccoi
is ksuc{. Myw.rkcri onrNDsrrion irsmncc ca cr rnicy umh.rm
-l
rcniryrhrr inrhc p.rroflMtrcc orth. qork Ibr e[i.hthhrcrni is n\ucd- I ihllltu cmplo, any pcrwn in any mlnncr
$ rs b h...m subj(\i
'o
thc workcri conD.nsll ion hws ol Cal 'ornia. rnd dsoc rhd il I should hccom {b]cd lo rlt
work6.orlxnsdionpovhiotrsolSectn,n3?00ollhcL!ho.Co{c.Isltrll.r.dhwnhsDPIywithrhocPmvibns
WARNIN(; tilurc b {cun rork.^'crnrFi\rri( ..vcrn8c r unhNl'ul. rtrt \hrll suhJ..r xn c lplotcr I' ailnirr t^-Mhi\ a.'l
civil finci nt io .ic hxndrcd rhouslnd doll$s ISI(XJ.(I)O). ir rddilion n, rhc co{ of.on
..:iliiil.dt'"5[T:ffi
I h.Nbynfinnundcr Fnalry ol pcrjuy rhar I am liccna\, !nd.t ofCh+rcr 9(.onnmncitrB wili Sation 7flX)) ofDili\ion l
o-\ oo'14 o-ot
*"AlrG 0 a ?0ll \co flr.
coNllalclr0N.LElolNli-{GElcl
I hcEh, aanrm und.. rEfuhy of perjury fid thcrc n a con(flcrion tcndin8 tr8cncy lbr rhc Ilert mun.c or rI[ sork for which thh ,cmil h
isskd (S(. 1097. Civ. C ).
A.8IIISAIL.P&CLANAI(,N
I tmby anhn undcr pcnlh y 6r D.'jury onc orih.lollowins dc.ldarions
Dcrmlnior Pcirnils.Ashcsros Norificorion Fcdml Res!larions (Tirlc 40, Pr6)
-Requncd
Lxrrcr ot Nolifrrion
I crlifyrhar rhc liilcnr I r.8ula I ions rcB$diirE ash(n.s rc.x)ul rrc orrffli.rhlc h rhis !roiccl
R:r,:ilyrhrl lh!\c rcd rhhrtpLi.rrn)n il {Jrcrhd rlr rh,vr inrornBri, s.orccr I rsrN roconrplt wirh ullCir)_.nd County
t y surh. r izc rcprcsc alivesoflhhCirylndCornrybcnrnutl,nrh.smd Strrc Llws rchring ro 6!ilding consr
.hrvc nf,nri(,rd fl.pcny lor itrspNlion
A ppliunl or AA.nl Slarulrr.
Pentrile n{nr(Drinlr:,o/ 4,o'
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Salety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Bonding / Groundino / UFER
Translormers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
Rouoh '7fL'?ftl a\7,$
Service l\,4eter
FINAL 1/44/t't aiDc6X
Notes, Remarks, Etc
Site-Work
Under Slab i Floor
-l-
as o*nc, of rne Dmpcny, rr my cmplolc.* sirh w.8.i as rhet q,lc conFns0iion. *ill do lh. uork lxl tlt ir-_tn is ml
imcnd[d or un rd rn slc (Se 7tr44, Busim$ md PDfc$iotrs Codc l hc G) rr.(,\ l-iLrn* tiw d.cs not trplly lo a. owtr ot
rhe rmpcny pho tDilds or imrmwl rh.d4 dd {ho docs skh work hifrscltor hcr$lfor rhmuSh hh or ncr oun.nploy..s,
provid.d rhar snch inlnov.mn* m nor int.M.t o. .trcFd for sh. ll hoBE, llE hoildina or in{,otm.r i sH wnhin .ic }t
ofcory,!:ri.'n, rhc O$ncr Blil&r ,ill haw ihc bxrd.n oa tmving rhdr lt or qhc dil tror huild .r inlpreve lhc I]$rdy ror rh. !)u!-$ or
.f rhcBtrri'r*r Prolisions Codc, ud my liccn$ i\ tu tullhr.rrdrllc.r
I
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