HomeMy WebLinkAbout20266601 - Permit20 Civic Center Plaza (M-19), Santa Ana, CA 92702
l nspection Requests: (7 1 41 667 -27 38 l nspector Section: (7 1 4\ 647 - 5853
Electrical Permit #: 2026660{
Pin #: 35524
City of Santa Ana
Permit Counter: (714\ 647-5800
EProject Address: 1130 S Broadway
Assessor'sParcel: 013-142-20 Lot: I
Unitl
Block: NA
Bldgl
Tract: 458
AddressRange: 1130-1132
Historic: No
Suite Range;
Zoning: R2
Owner:
Address:
Phone:
Tenant Name
Contractor
Address:
Phuong Phan
1130 S BROADWAY
Santa Ana, CA 927071206
(7141 200-9132
Owner-Builder
Fee
$48.46
$22.O8
$55 04
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
80tchi!45252 - 8/7/2itt8 I0: t_R0sALEs0ffice! CTYH Trnns+: 2 + of 4Acct+: REf+: ?r_'r?666t:r1
Rcpti:(12349694 - 8,/7../2t:tlg 8;l$ Aflfronsoct ior Totol $S?g,70
Phuone Phon
Generol PIon tlpdnte Fee
r'11 1 I 6110?- Et6D000r't-
El ertr icol
01116002- s1603000-
Viso
CC9: *irlr*r*rrlr709?
$??.0s
s1(r3.:i0
t99S.70
Aulhi:1177770
Planning Conditions
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Chavez, Dave
'v.o
10297244
Occupancy:
Constr Type
Code:
R.3, U
VB
cEc 2016
Date:
Date:
Date:
Misc. Receipt:
[Iisc. Receipt:
Misc. Receipt:
Total
Demo unpermitted garage conversion kitchen,
bathroom, partition walls and return garage to original
use. Remove drywall from ceiling. Remove washer
and dryer from garage, relocate laundry tacilties into
the main residence.
08t07t2018
Account#
Every pormit issued shall become invalid unlesstho work on the site
authorized by such permit is commenced within 180 days after its
issuance, or ifthe work authorizod on the site by such permit is suspended
ot abandoned for a peiod of 180 days after lhe ume the work is
lnspector MID#: 2018-145'154
01116002 51600
01 116002 51603
$22.08
$103.50
Fee Total:
Paid to Date:
Balance Due;
Fee Type Amount
01116002 51603 Demolition (includes rer 48.46
01116002 51600 General Plan Update 22.O8
01116002 51603 lssuance 55.04
Qty
1.00
100
1.00
Phone:
Building Use:
Job Type:
Nalure of Work:
Single Family Dwelling
Alteration
N^r'
Noles:
$125.58
$0.00
$125.58
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER AUILDER DET-CARATIUN
I hcrchy !finm undcr rEnolty oa perjnry thar I dn crcnnr r6n rh. Co ractoF Licenrc ln* for rh. rolhwirB Eabn iscc 7011.5
Blsinc$ Dnn Pn,fcsio. Codc)r Any Cny or Coutrry vhi.h rcquncs ! IEnnil ro orn{ d. ahci ihFrcrc, dcmlth or r[an !n,
srrucruc, pri{, k, ih irsxrncr. aho rcquircs lhc 0pplicnnl fnr such Fmir x, filcx lisn d rar.mnl lhd hcorsh. is licco(d tuBu r
ro rhc n.ovirions ol rhc c{,nrrs.roil Li.c.sd kw lchrprcr 9. Conmcncins wilh Sccrion 7000 or Divhion 3 ol thc Busines and
Por.\rn,ns Codc) .r rhar hcorshc hcxcm lhcrcaron and lne b&sn tu rhc rlhgcd.xenrprion. Any liolation of Sdi.n 701I 5 b, iny
aDplicnnr lor rFrnril snbjrrh lhc q,tlicanr Io acililpclalryofnor fr)rrhrn nvc hun.lrd doll&s ($500)
!fr-,, "-*,",'r"n ,nnr..r m, c'nrlorcc\ s h wrsc\.s rhct q'lc on,pcnslrn,n. wil!do rh. w.* ald rtE (urm ir mr' dctrdlrl or ollcrcd lu ak tSL\ 7(x4, Busdc$ antl Protcssion\ Codc: thc Conrmct, \ Lt cne bw docs nol aIPl, ro 3n ownf of
rhe pmdy rho build\ or iq,oks rh.6n. dnd *ho ddr $.h srk hiNcllor hctsclfor lhrough hk or h.r own.mployccs.
nrovidcd rh{ su.h impmrcmnrs e rer inrendcn or oficrcd nn salc I I how.\q. rh. hdilditrS or in{,mBEnr is sold wirhin nnc
'tdor.onpkrion. rh. owmr Buikh! will h3rc ltE burdcn ofrJDvins rhd hc or {hc did nor build or impmlc rh€ I,DtEl, ior tlE PUrFc or
+1. r\.wmrorrhclnlpcny, rtrrcxcluslcly.otu1.lin! wilh li.ctrscd conh rttr\ t, .oNract thc ttroi(r (Scc 7Ou. Bu\in.*
dkl PNli:ssiin cudc Tn. Conr r$ror's Liccns. I nw (hN nor rl|rlt b ntr oq Nr .l lro|cn) who huild\ or i'nltuvcs rlrctcon.
trtrd lho.onrad\tusu.[t]ojLrhw[hrCotri.r.lor(nliccrrscdtUr\umrbrhcG'nrn.tr'sLiccnschN)
,^" . t /t /r c --*J4 8".-.^
DECIIIBAIION
I lErby aifi.m lodd F.ahy of pdjury onc of 6c f.l,oein8 dcclur! ions:
-l
havc d will tuinl.i. a ccniftare ol Consnr ro Sclf-lnslE lor *orkss s'b|).ns.rbn. as Imvidcd for by Sdrkrn 1700 ol
'lELd$r Codc. for rhc tdfo@ffe or thc wo* for whah lhc Frn l is i$ucd
-I
hov. lnd will mrinlain workeF compcnsltion insurtrcc,6s r.qxiEd hy salion 1700 ofrh€ Llbor G)dc. ror lhc P{rformme of
th. sort for which lhis pemir is isskd, My e6rkds ontp.nqri.n insunna clris ud Flicy numbcr r.
ffl.cnir! rhrr in rhc pqli,nhn c orrhc work ror qhrh rhir rcrnrir n nsucd. I \h!ll nor cnlPloy dny P.^on i. ily nruner
cr as r' tNonr subjLrr lo rhc workcn .ompcf\orion hss ol Calir(rnin. dd derc rhd if I sl$uld hcco,E {bj(r k,rh.
w.rkcn' .otrfcns ior DFvhions ol Sdion .lT00 .a rhc Lrhnr Codc. l sh.ll, n)nh$ilh dnnPly wirh lhoY fovisiohr
civil uDrs up t,.ft hrndrcd rhousa.d dollrn (Sl0u.00o). ir lddirt,n t, rhc.od.r.o dauxg.\ r\ I'o!'dcd l,n rhc
/c
nrcrcs lnd brcy s lss.
lpptmr: E
t)[(],,\R,\t ll)N
I hcrcbyrft utulcr J*.ilr, ol p.Uury that I am liensn undc, prcvtn'n orchnprcr 9(.onnNncin8 *irir S6.'rion ?fiD) ol Drui\bn l
of rhc Bu\ircs rnd PrnassionsCodc. ddmyliccnsc G in inllfore &l cficcr
coNs'rtlk: rl{rN I trtlDIN(l A(iENCY
I h.Ehy ann undcr rcnah, ol pcrjury rhar rhcrc is N .onsfl.rion lc.dirs ascncy fot rhc Ii.rro'mkc or rhc sork r'., which rhi\ IErril i\
isuc iS.. :10q7. Cr C)
AfILICANTDECIJSAIIA!
I tlity lnim undcr pcnrhy ol l,.rjlr, otu olrhc r(rk *ins d..l!i,rions:
Dc'n,lirn,n PcrfriKA\h.nos Nolificalion Fedcral R.Bulltions iTirlc40,I'M(,
R.quncd l-orrrr ot N.rifi .rrtrnr
-l
ccni,ilhnl th. ndcral rcsu lar io na bgedhg ,sb.sros r.rmvularc mlapplicahlclo rhi\ phjecr.
pfi ccniry rhd I have rcad rhis ,mlic{ion .nd srarc rhar rhc bhovc info'mlrion h.oimr.l asre rocomplysirh rllciry,nd counry
.rdiMncc\ 3nd Shrc Laws r.larinl ro
ibvc rfttrrirrrd proncny hr inspccl
!urlNrDc rcn.c\cnrxrivcs orrhLr Ciry rtrd Counryl{) cnrrr tr| rlr
PH '","t2/t/, s
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Sions (monument)
Life Salety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinos (Hard & Soffit Rouqh
Ceilinos (T-Bar Rouoh)
It/eter Release
Rouqh
Service lt/eter
FINAL trltt ltt i4 krv4el-A >5/
Notes Remarks Etc.
Site-Work
?/7
Liccnsc Clo$:-Li.. \c Nunrh{r:
-
D"r. co.r.Ector:
tJndd .r AdCrc$:
-
It,lirr lor,\sr lSigtrilure
l'€nnilc+ naN lp.ini): 9A-
I
I