HomeMy WebLinkAbout20144381 - PermitProiect Address: 1570 E Seventeenth Sta
-
Assessor's Parcel: 400-251-07 Lot: NA
lnspection Requests'. (714) 667 -2738 lnspector's Section: (714) 647 -5853
Suite Range:
Zoning: C5
Unit: A
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
O Cify of Santa Ana
Permit Corrnter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical Permit #:2Q14438{
Owner:
Address:
Phone:
Tenant Name:
Contractor.
Address:
Phone:
Easter Seals of Southern Calif
1801 E Edinger Ave #190
Santa Ana, CA 92705
(7141 834-1 111
Easter Seals of Souther Calif
Tl's By Design
3595 Cadillac Avenue, #103
Costa Mesa, CA 92626
(714l. 434-0se6
01 1 1 6002 51 603
01 1 16002 51603
01 1 16002 51603
01 1 1 6002 51 603
01 1 16002 51603
01 1 1 6002 51 603
01 1 1 6002 51 603
01116002 53601
01 1 16002 51600
01 1 16002 51603
Fee Type Amount
125 Volt Receptacle 1 .19
Light Switches, Occ. Se 1.29
Light Fixtures 0.86
Dedicated Circult 20.30
Low Voltage/Comm 27.72
Add'l Devices/Low Volt 2.64
Subpane! 43.56
Ptc - 65% 0.65
General Plan Update 18.00
lssuance 45.00
Qty
60.00
16.00
186.00
14.00
I .00
101 .00
4.0c
711 .09
.r.c0
1.00
Fee
$/1 40
$20 64
$159.96
$284.20
$27.72
$266.64
$'i'i4.24
$462.21
$18.00
$45.00State Lic #: 565438
Lic Type: B
Bus. Lic #: 148210
Workers' Compensation I nsurance:Carrier: State Compensation lnsurance Fund
Policy #: 713-0034531
Expires: 0912912011
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Buiicling Use
.iob Ty.'ner:
l'.lature oi Work
PiannrnE Conditions:
Frianning Approval By
Plarr Checked By
Permit lssued By:
Subject to Field:
Building Permit #:
Cori.mercial
Tenant lmprovement
TI
Davis, Scott
01 69777
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
11t04t2010
01t24t2011
Account#
B
VB
cEc 2007
, Julie
Every permitissued shail become invalid unless fhe work
on the sife authorized by such permit is commenced within
180 days afterifs issuance, or if the work authorized on the
sife by such permif is suspended or abandoned for a period
d 180 days after the time the work is commenced.
Inspector rv rD# . 201 0-93765
01 1 1 6002 51 600
01 1 1 6002 51 603
01116002 53601
$18 00
$1 ,049.80
$2t2.87
Misc. Receipt: M56891
Misc. Receipt:
Misc. Receipt:
Tota!
Notes:
Fee Total:
Paid to Date:
Balance Due:
$i,530.0 i
s249.34
$1,280.6 r-
LI
a
r7L /24/ lL
T r'flrr s.* : 34
Ret't
r.Jvt I
$3r6
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/S!G COMMENTS Oms-Buildcr Deluation
I hercby affirm unde pcnalty of p.rjury that I m qcmpt fiorm thc Conraciors' Lienrc Law for thc following ruon (w.703 1.5 Busincss
md Profcssion Code): Any City or Couty which rcquircs a pcrmit to @Nhd, rltcr, imprcvc, dcmolish or rcpair my strucue, prior to it
isumc, also require thc Epplimt for such permit to filc a signcd ststmcnt thst he or rhe is liccnrcd pursuut to thc prcvisions of thc
Conraaor's Liered Law (Chaptcr 9, Comcncing with Setion 7000 of Division 3 of thc Business md Profesioos Codc) or that hc s
shc is excmpt thercfrom ud thc buis for thc rllcgcd excmption .Any violuion of Scrion 7031.5 by my appliwt for E pcmit subjeds rhc
applicant to a civil pctrilty ofnot morc Ihe fivc hundrcd dollrs (3500).
-1,
ro omer of the popcny, or my employes with wrgcs rs their sole @mpctrsaiorl will do thc work and the st uct[G is not intsdcd
or olfrcd for slc ( Src.7(X4, Bwincss ud Profcssions Codc: Thc Conrmor's Liccns Law doq not rpply to m oma of rhc propcny
who buildE or improvs thcr@r! ud who dos such work himsclf or harclf or through his or hcr om cmploy€, provided that luch
imProvemcnts ac not intcndcd or offrcd for salc. l4 howfls, thc building or improvcmcnt is $ld within onc y6 of @mplctio4 thc
Owner-Builder will have thc budcn ofproving that hc or shc not build or imprcve for the purposc ofsalc).
I, s owner of the propcny, am cxclusively @nrading with li@nsd contradors to @nltruct thc proicd ( Sc. 7044, Businqs ud
Profcssion Code: Thc Contraci.or's Li@ns Law d@s not apply to u omc of proprcny who builds or improvw thqcon , md who
onrrcts for such prcjccts with a Cotrhctor(s) liccnsed pursuant to thc Contrt€tor's LiEns. Lsw.).
_l arn exempt undcr Section
Date:
& P.C. for this reason.
WORKERS COM PENSATION DECLARATION
I hcrcby aflirm undr pcmlty of perjury onc of thc following delmtions:
-l
havc md *ill msintrin s C€nificatc of Comnt to SclfJNurc for workcrs' compeGatioq a providcd for by Sslioo 37OO of thc
Labor Codc, for the pcrfomue of thc work for which thc psmir is isscd.
1 76iud will naintain workers' @mpcmtioo in$ruc.q u rcquired by Section lToo of thc labor codq for rlrc pcrforrru@ of rhc
Srork for which this pcrmit is iscd. My workcrs' ompcnstion inme uicr ud policy uumbo uc:
d
Policy
(This section need
_l certify that in
One hundred dollars {$100} or less)
the performance of the work for which this permit
of California, and
is issued, I shall not
became subject to the workers ' @mpensation laws agree that if I should to the workers'
provisions of Section 3700 of the Labor Code, I provisions.
Failure to secure workers' compensation is and shall subject an employer to criminal penalties and civil
fines up to one hundred thousand dollars ($100,000),in
the Labor Code, interest and attorney's fees.
to the cost of compensatior\ damages as provided for the Section 3076 of
LICENSED CONTRACTORS DECI"ARATION
I hcreiy rlftm unde pcmlty of psjury thrt I m liensd unda prcvision of Ch.prq 9 (omcncing wirh Sccrion ?000) of Division 3 of
the Busincss and Profcssioro Code, ud my licens is in full for@ ed cffwt.
License
Date.
I hereby alfirm under penalty of perjury that there
issued (Sec. 3097, Civ. C.).
Lender's Name:
a 88ency perfbrmance of the work for which this permit is
Lender's Addrcss:
APP LICA N'T'S DECLARATION
Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part 6)
_ Required Letter of Notification
asbestos removal ile not applicable to this project.
state that the above information is correct. I agree to comply with all City and County
above mentioned property
and hereby authorize representatives of this City and County to enter upon the
Applicant or agent sig.
Permittee name (print):
}
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm I Dampers
Communications Cable
Building
Under Slab I Floor
Bonding / Grounding / UFER 32
Transformers
Torquing 6 -#
Sub-Panels o/ 7/rt J*
Air Conditioners .,L
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)l.JrrJ -,2@
Ceilings (Hard & Soffit Rough /4,1@
Ceilings (T-Bar Rough)*J*a^t4/W
l\Ieter Release
Rough .22*xZ ".€?Service Meter I I -/
F!NAL /0lhl-l D[Wb 1fulda-?b/PAI.
Notes, Remarks, Etc 11
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r'F,,3 3t I / w--
@ =&t/tsz.5b
a
Carrier:
in any manner so as to
-LiccnseNumber
5 6 f <t Z P
contraoo'' -T -E r
and
Date:_
3t.