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HomeMy WebLinkAbout20165754 - Permit20 Civic Center PIaza (M-19), Santa Ana, C492702 lnspectaon Requests; (714\ 667-2738 lnspector Section: (714) 647-5853 Electrical Permit #: 20165754 Pin #: 10,479 City of Santa Ana Permit Counter: (714) 647-5800 Proiect Address: 1545 W Seventeenth St Assessor'sParcel: 399-121-39 Lot: 1l Bldg: Tract MABURY Address Range: 1311-1601 Historic: No q U nit: Block: 293-38 Phone: Tenant Name: Contractor Address: Justin Storm 777 S, Harbor Blvd. La Habra, CA 90631 (916) 893-1 536 CVS Pharmacy, lnc. Bryon James Hamad 7962 Chaffee Rd NORTHFIELO, OH 44067 (2161 s44-3O72 011 16002 01'1 16002 01'1 16002 01116002 011 16002 5160: 51603 5160: 5160C 5160;' Fee $18.85 $49.58 $33.88 $22.08 $5s.04 Fee Type '125 Volt Receptacle Dedicated Circuit Low Voltage/Comm General Plan Update lssuance Amount 1.45 24.79 33.88 22.O8 55.04 Qty 13 00 200 100 '1 00 100 Phone State Lic #: 948312 Lic Type: B Bus. Lic #: 370385 Workers' Compensalion lnsurance:Carrier: Exempt Policy #: Expires: Bqtch+ I {5.'i99 - 0f I i.e: a-:TYH R{pt+ 1023637,11 &/27 /2fi18 Trflns+:157 - 8/2? /2ttLB iD: {:{.:lrl zrj16575 3r 33 f'll $.91t..5?fr(tfiso,-t ion Tot.o I [1r9on ifl,ne9 H(lfiod 6enerol Plsn Updale F€e tll I 16002- 516t-1rr000- E lectr icql 0 1 1 I 611112- i1603trj0- ICL (:heik $0010895 ICL Che,:k l:[:r3t3l Building Use: Job Type: Nature of Work: Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Commercial Tenant lmprovement T.l. - Accessibility Occupancy: Conslr Type Code: \..hrn"nue., xatnv 04t27 t2018 Account# $179.43 $0.00 $179.43 Every permit issued shall become invalid unless the work on the site authoized by such pemit is commonced within180 days after ils issuance, ot il the wo* authonzed on the site by such permit is suspended ot abancloned fot a period of 180 days 1ftet the time lhe work is commenced. lnspector MID#: 2018-143056 011 16002 51600 011 16002 51603 $22.08 $157.35 Suite Range: Zoning: C2 Owner; Address: $4 "$JrM V B, SPK cEc 2016 Date: Date: Date: Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Notes: Fee Total Paid to Date: Balance Due: ELECTRICAL.INSPECTOR RECORD APPHOVALS DATE IDiSIG.COMMENTS Underqround Pole Bases Light Standards Spas, Pool, Fountains Siqns (monument) Lile Safety /Low Voltaqe Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bonding / Groundinq / UFER Transformers Torqueino Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilinqs (Hard & Solfit Rouoh Ceilings (T-Bar Rouqh) It/eter Release Rouoh C^.^ FINAL Notes, Remarks, Etc t* (,WNER BUII,I)ER T'ELCAR{TION I hclcby al6!n undcr Fnah!.r pcrjury rhd I am cxcnDr rio'n rhc (ntu&xtrr Liccnsc Lj$ for lhc r'ollo*ins r.r* (s.t.70.115 Businc\\ iM Profcrsi.n Codc): Aflt Cily or Couniy which .cquncs u Frmir t, coo(dcr. rltcr. improvc. dcniolish .r En.ir rtry $rudur.. 0rior ro ils iss,orcc. ala rcqutcs rhc arplicanl lo! uh p.,mir b lil. r sismd urcnt 'ho' h. or she is litcn{d purtusnr k' rhc nrcvtn,ns ot rh. Cont,.ror's Li.cnscd tiw lch.!r.r 9. c{mmcncin8 $irh Scrlion Tixro or Oirisi.n I of rhc Busincs ond Pr,r.st,*cod.)oirhirtrorsh.iscrcnDlthcr.liomrndthclxshlorrhculLEqlcxc'npri,tr1 A.yviol,rionofSccrionT0:ll5$yany srplir.d n)rapcirnir {uhjals rhc rpplicanr ro rcivilIl.i,lry.fno' nrrrhitr lllc hundrcd d.1la.s(S5(x)) l. ,\ owmr of rhc pmpcny. or trry employes $irh waScs as lhcir ele conf(n\d( bn. *ill o th. wmk Md lhc slmrw i\ dn inrcndc.l oroflcrcd for qlc (Ss.7Or4. Businc$ od hotesrnrn\ C,xlc ThccoDkr.loasLiccnetiwdoc\noraprlyrornowncror thc rrJpcdy who builds o. iqrorcs rtumf. nl wtr dms fl.h M!( hnnscllor hcnclfn rhmuh hn or ncroNn eq)loyc$. pn,vidcd rhar such i'npmvcmnh m mr inrcndcd or ollcrn for sk l[ ho*cri th. hildin8 .r imptuvcmnr is $ld wirhinoic rd ofcollll'Llbn,rh.ONnrBnilrkr*illh!v.rhcbordcnoff,mlingrk!hcorshcdil hnikl or inDroE th. !$p.ny forlhc Purlx,sof L r\.N cr olrh. p'otr'ry. xnicx.tusivcly..nnn.rinE rilh li(cf\cd .ontr.rtr' r) coidnr.r rlt frclc.r 1Scc. ?O'11.Ilu\nc\\ r lhnc\\ian(inlc: lhc Contr.ntr \ I ir.n\o,-rq.loc\ or rt)tnyro rr os mr ol polrcny $ho huild\or nnpor.\rhcrcotr. rnd {ho coitr.r\n, \uchtn'Fl( wir[i Contkk)arr ]i.crr\ci lunurnr h th. Contlttr \ Li.cNr Lr() _l trnrxcnrpr undcrscrion .B &PC lorlhhrca\on. Daler o*ner w()RKFRS', COIIIPEN\I',nrtN DE TIAAIIO! I hcrchy ufilrd und.r p.mliyor!.rjury onc olrhc tbllowir8 dNlffolions: *lhrrcMd*illnuinrlinoCcnili.dcofCoscnrn,sclfln\urunnsorlcrlcompcnsirion.aspovidcdfoibys(rintrll0ool'lhc titltr cdq rorrhcl.rrunemc ollhcnntlnr whichlhc lcnnl is nrucd -l hdvc 0trd $ill ui ain $orkcrs c.nr.n\irio inrurrkc, sr r.quircd hySccrion:l7U)oIrhc liborCodc. forrhc rdlinninccoi lhc rork for which rhis pernir is h{t.d. M,wurkds .o rp.trsrli.D nNurtncc cmicr and Inicy nunh.r tuc: I'{ni.y Nun*,cr -Erlnc\ Iccriifyrhalinlhcp.raormncc('frhcNorktffwhichrhisrcrmirisissu.d.Ishallnolcmploy!rrypcroninnynDtrncr s 6 ro heo.E sltJccl h 'h. w)rkrJ .o,!rnsd ion laws or C.hronria, atrd asrc I h,r il I 3h6old b..om suhitl ro rhc workcr coEpensarion pi(,vi\i.nsorS(tion lT0oorrhc tibor Codc.l shrll. nrdh*irh co,nply wirh rhos [nvisions..) IVARNINC: Irai]ff. t, {cnrc *o'l,rr\ .o ,rc \ rtr"i ..\crr$ r\ urrowtul- i rhall n,hl.ci rn e .ivil lincs up lo orE hundEd rhor\ nd d.ll{\ (51(n.UXD, i'r rddirtr to llE 6{ .f co datuecs as p('viJcd hr rhc ryru'- I hcrhyslti,nu dcr p.MlryolNrjury rhil I anr ri.ctrkt undcr tmvtion ofChrprcr nn ri. e $irI S..ri{nr 71xx)) ol l)ni\i,n,.] oI rhc ll',\i',csrr lrolisnnN Codc aDd n! lic.n{ is ii tulllarccrtrdcllccr LLc.sc Nx I hcRby rnirn und.i pcn,h, ol r.rjury lha' ln.rc k a .o hsucd (ss.1097. civ c ) in8 +.trct fu rh. FrlnrnM.. oi rhc *ork for $hich ihn Frntir n Lcndcis Ad&c* - AIILICANI.DECLABAUAN l,Erhyafmn!.dq pcnllry ot p.rjury om oltlf, aollowine d..ldlthfls: Dcmlilion Permirs'Astcsros Notificarion Fcd.ral Rcguhri,ni (Tirlc40, Prn6) -Rcquned Lctter of Norifi.,li,n _l ccrliiyrhar ric lidcrrl rcgu ld io ns rcgrrd nr8 osh.nos.cnsvJrc tror l.cnrlirhr I hrk rcld rhi rytliclrionad isrN loc.nrfly$nh rll Ciry.tul Coniry ordinrNc\ i0d Sratc t;r$\rclalinglo hui rtrc.dlrhi\C ) JRlC unryr'rtrrcr ulnnrhc rtxr. nrnrtr,rd pn,I[n,lar r,\fr.r Appli.snl or AEent Si,tnnlorc:"1?4, I Site-Work Service lVleter /a/"//,r *tt;z- f------r----- I