HomeMy WebLinkAbout20168552 - PermitCity of Santa Ana 20 Civic center Plaza (M-19), santa Ana, cA 92702 Electrical
Permit Counter: (7141647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714\ 647-5853
Permit #: 20{68552
Pin #: 29915
Assessor'sParcel: 412-141-22 Lot: NA
Unil B
Block: NA
Bldg:
Tract: NA
Address Range:
Historic; No
Suite Range:
Zoning: c4
Phone:
Tenant Name:
Contractor
Address:
CP Bristol SA LLC
6400 S Fiddlers Green Cir #1820
Englewood, CO 80111
(720) 493-5100
L&LHawaiinBBQ
Vay Construction Corp
721 W Santa Anita Street
San Gabriel, CA 9'1776
(525) 861-8822
01116002 51603
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
Amount
53.28
20.10
22.08
55.04
Fee
$53 28
$20.10
$22.08
$55 04
Qty
1 .00
1.00
100
1 .00
Phone
State Lic #: 1015328
Lic Type: B
Bus. Lic #: 370412
Workers' Compensation lnsurance
Carrier: State Fund
Policy #: 9168098
Expires: 1011412019
Genercrl t'1on UpdotE Fee
81116[rJ2- 51600000-
E1;'ctr iaol
01 1 150U?- 516(r3ur:r0-
/ rsfl ir*l*Irr*rr*r39gtr Auth+
Commercial
Tenant lmprovement
First Time Tl
Occupancy:
Constr Type
Code:
B
V B, SPK
cEc 2016
Notes: Service meler re-set per notice to correct work
Planning Conditions:
Planning Approval By:
Plan Checked By;
Permit lssued By: Chavez, Dave
Subject to Field: 1?'
Buildins Permit #: 101 96084
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
$150.50
$0.00
s't 50.50
lnspector MID#: 20"18-142596
01116002 51600
01116002 51603
$22 08
$128 42
Fee Total:
Paid to Date:
Balance Due:
^t"-r"l
Proiect Address: 3394 S Bristol St
Owner:
Address:
Fee Type
Re-Set Mtr
Min Fee Adj
General Plan Updale
lssuance
Botchir,l?529 - 4/26/2lLP ID: smsr(tl
ofilice: CTYH Trons+i 5{ 1 ol'
Acctit Refi: 2rl169i152
Fcpt+:02610739 - 4/26/2nt9 12!36 Pl1
Tronsoct ion Totnl t 151:t.50Henrr Vog
Vog (-onstruct ion Corp
Building Use:
Job Typel
Nature of Work:
Date:
Date:
Date;
Every pemit issued shall becofie invalid unless the work o, the sile
authoized by such permit is comnenced wilhin 360 days after its
issuance, or if the wo* authorized on the site by such pefinil is suspended
orabandoned fot a period of 360 days aftet the time the wo* is
commenced.
04t26t2019
Account#
ELECTRICAL.INSPECTOR RECORD
DATE ID/SIG.COMMENTS
Site-Work
Unde rground
Pole Bases
Light Standards
,9pas, Pool, Fountains
€igns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor /A
Bonding / Grounding / UFER t1 v.\4]u
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilin gs (Hard & Soffit Rough
Ceilings (T-Bar Rough)A\
Meler Release -Jc'Wrud 6'511 t€-r4.rp)cf F
Rough /A
Service Meter \'21'1 tr_ul/t[J
FINAL {.'>(,"1 t\X'lU{n
Noles Remarks, Etc.
---t
OWNER AUILDER I)ELCARATION
I h6eby arrm und.r Fnany oa psjury th8t I an .x.mfl tum lh. (o. raclotr Lic.oe Ljw for lhc folloving r.en (Sa 701 I 5
B6i.ss od Prf*ioi Cdc): Any Cny or Cou.ty which rcqutB . p6dit ro consrrucr. alls. ioprcvq d@olish oi E an e,
sltudoe, prior b ns isudce. also rcquiB th. rppli.d aor such pdil r 6le a siBn.d sraldsl ihat h. or sllc is licds€d pum&' .
lo rhe previlioE or $€ Conra.roi! Lic.ns.d Law (Chapt6 9. ComDcocins \ ith Sclion 7090 of Diviiod I of rh. Brin* Md .
Pmt6sionsCod.)orlh.lfi.o.sh.is.x.mptlhcciommdth.basislorrh.alL8.d.r.mflion An, violalionols.clion 70]15 by y
appli.anl foraDmit subjtlsth. applicanl lo scivilp.nallyofnot morcth fiv€ hund.€d doll s($500).
_1, a o*nsoath.proFny. or my.nplot6 s,ilh tr.s6 6 rhcir $1. @np.Bdrion, $ill & the Mrl oddEn lmis tur
ints ed orofcrcd lor s.lc 1se 7044, Blsind md ftoaeioN Codq Thc (ontra.lois Licm Law do6 not .pply to u own< or
lhc popsly who builds or i'qror6th6sc d who do6 sch ss* hins.lt or h@lf or rhroush his or hs own cmploy.6.
provid.d fiat sucn impovonors @ mt idad.d or ofi6.d for sl€ lt ho$'6s. lhc h{ildins or ioFov.em i! ed s nhr on. ,a
olcoDplaio., rhc Omd Buildd will ha!. lh. hrdo oaFovins dld h. or she did @l hiild or impm!. lh. pmpGly for thc pupos ol
I. a own.r olih. Flpdy. m dclBi!.ly conlraclinB {ih li.dE d ..ntB.to6 to coNlruct th€ roj.cl (S€c. 7044. B6'n<
,nd Pofissnr. Cod€: l hc Contturor3 t.icds. Law do6 no! applyro eo$n- ofpiopdr, $ho builds or inprovd lh6on.
and qho comm* fo. sch prcjds witn r Co.rdo(s) lic6E n puFomr io rh. Conrrrclois Lic.M L.w).
l.nr.xempr umld Sc.ri.D .B &PC itn this rc8on
Drl€ osner
]EaatsDgiiau!f,rsafiqB
DECIABAIIII!
I hqeby amnn uoda pdrltyolpdjuryotr€ oflhe followinS dcclualioNl
I har. ed will mainlain . Cgrificdc oaco.mr ro SdtuNr. aor wrk6i conrp.nsarion. 6 pmvid.d tor by S<rion :1700 of Ihc
Labor Codc. lor th. pdfommc. o a$c worl foi whi.h rhc penit is hsu.d.
I have and will mainlain $ork.G comFmalio. iNuffncc. N r.qut€d by S€cl ion ]700 of thc Labor Code for lh. Ffom@cc or
\ hich I his p.nn ir i! irsu.tl My wdrkrsAd..p v,*d co,np@rion iBurm.c.rid and polict numbd ffe:
-l
ccrliiy lhal in lnc p€.for manc. ollhc wort lor which 6h pmril is ks!€d. I shau oor chploy 6ny N6on in any mmd
e d ro bdomc suhjd ro rhc {.116 compdsalion la{s otcalifodia, dd arc rhd ia l shorld tB.on. subj{l to lhc
woikds conpssarion |,olisiotu ol s..tio. ] 700 ol ihc tlbor Cod( I shnll. lonhvirh .onplt $nh rhos pruvisioE..
IVARNINC: Failu.e Io sue worke6'comp€nsfllion co fui. !!d shall subj-i d opbyd ro aininal p.mhi6 md
ro rh€ ton of conpcnehon. drmar* a prorid.n ior rh.to on. hundrcd lhoGod dollds ($100.000). in
inr66r drnorEy'r lB.
1b
I hmby amm undd po,rry o f p<jury th,t I @ licdsd @d6 povilio. ofch.pl€ 9 (mmnmcin8 \vilh Srlion 7000) of Division l
ol lllc BBin* sd PrclesioE Cod.. and ny licft. is in tuU lorce ald .llcr
. tDl44'zlqTlr[n .^,"*,1
(AXSBUSIIANIINDITC-ACE!(I
I h@by amm undo p.oahy of !sju, thar $qc is 6 coBltuclion LndhB aeocy for $c p6foil@c. of th. $o.k for shicn thie p6,nn is
issu.d (SE.109?, Civ C.).
IIIUCANLDECIAAAIIA!
I tElty atrm undd Doahy oap€riury onc ofthe follositrs d(lmrioas:
Donoliion Pdmts-tubcln Norifi.arion r'.ddal R.SulalioN flnlc40. Pd6)
-R.qtrncd
l-clrd of Nolifimt6.
-l
ccnily r hal the acdEal .{ulalions rc8ddio3 db€sros rmoval a,e nol applicable ro lhit projdr
N":*'x;. rh.l fic ,bo!c infom.lion G .odd I a8rfr io omply Nirh sll Ciry and County
Il. dd hdcbyaulnort rcpr6drrdilB o l ihh cn
aboE motioncd prop€.ly lor iNFcrion Iru,i"
APPROVALS
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Lcnd.r s AddrK
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