HomeMy WebLinkAbout20159522 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 2o^{59522
Pin #: 44938
Proiect Address: 2520 S Birch Sta
Assessor's Parcel: 410-022-01 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range: 2520-2530
Historic: No
Suite Range:
Zoning. Ml
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
First Standard Real
2530 S. Birch St.
Santa Ana, CA 92707
(7141 545-9822
Carousel Foods USA lnc
Fee Type Amount
Low Voltage/Comm 30.58
Add'l Devices/Low Volt 2.89
General Plan Update 19.93
lssuance 49.68
Qty
1 .00
26.00
1 .00
1 .00
Fee
$30.s8
$75.1 4
$19.e3
$49.68
slg.g3
r155.4[
$175.33
01 1 16002 51603
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
Bot,:h;:3310+ 3/ Lr7/2t7L6 ID: PL0PEZS
Off ice: CTYH Trctns*: S I of IAc,:t*: Rel*: 20159522
R,.Fti:iU5111394 3/llt/2fi16 g:31 AH
Tronsoct i on Tobol Sl 75.33
[:'irst Stnndnrd ftenl
General F Isn Updote Fee
01116002- 51600u110-
Electr icnl
lll I16002- 5 t6trsrJlltr-
I (:l- Ch ec [t uttlrfl0u I t 7S
]
Building Use:
Job Type.
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #.
Zuniga, Allissa $,/03/1 0t2016
Account#
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
Total
Commercial
Miscellaneous
Fixtures
Occupancy:
Constr Type:
Code:
Date.
Date:
Date:
s-1
ilB
cEc 2013 Notes: Low voltage throughout. (36 outlets total). Auth on file.
01 1 16002 51600
01 1 16002 51603
$19.93
$15s.40
Fee Total:
Paid to Date:
Balance Due:
$175.33
$0.00
$175.33
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 180 days after the time the work is
commenced.
lnspector MID#: 201 6-127347
ELECTRICAL-INSPECTOR RECORD
f)^'. nO n7 Dn{ H
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrcby aftirm undcr pcnolty of JErjury lhal I m exempl frum thc Contraclors' Licensc law for rhc following rcarcn 1Sa.7031.5
Busincss ard Profcssion Codc): Any City or Couoly which rcquircs a pnnh to construcl. aher. irnprovc. dctr[lish or rcpair my
structure, pior to its issuonce, slso rcquircs Ihc opplicatrt for such Jrcrmit to filc ! signcd statcment that he or shc is licensd pumuant
to the Fovisions of thc Contmctor's Liccnscd [aw (Chaptcr 9. Commncing wilh Scclion 7000 of Division .l of thc Busincss rnd
PmfcssionsCodc)orlhathcorshciscxcmpllhcrcfronundthcbtrsirforthcdllcgcdcxcn[lior. AnyviolotionofSNtkilT0.ll.5byany
rpplicant for a lrcmil subjccts thc applicanl lo a civil pcnally of not rrcrc lhdr five hundrcd dolles (Ssfi)).
_l.as owncrol'thcpropcrty.ormycntployceswithwagesastheirsolccornpensalion.willdotheworkandthcslnK'lurcisnol
intcndcd or ollcrcd lor salc (Scc.7044. Busincss and Prof'cssions Codc: Thc Contraclor's l-iccnsc Law drrcs not apply to att owncr of
lhe prcperty who builds or irrq)roves thcrcon. alrd who does such work hirnself or hcrsclf or lhrough his or hcr own cnlployccs.
providcd that such inrprovonents arc not inlcndcd or olTcred firr salc. lt. howcvcr. thc building or imp()vcrrcnl is s<lltl wilhin onc ycar
of cornphtion. thc Owncr Buildcr will havc thc burdcn of provirrg thut hc or shc did not build or inrprovc thc pnrprty lirr tlrc purfnsc of
salc).
_1. as owner of thc p()pcrty. am exclusivcly conlracting with liccnscd contractors to conslruct the project (Scc. 7(H4. Busincss
and Profcssion Codc: 'l'hc Contractor's Liccnsc Law docs not apply lo an owncr of propcrly who builds or irttprovcs thcrcon.
antl who contracls lbr such projects with a Contractor(s) licenscd pursuant to thc Conlractor's Liccnsc Law).
-l
arn Ior this reason.
)
I hcrcby affirrn undcr pcnalty of perjury onc ol'the ltrllowing
_l have and will maintain a Certitlcatc ol'Consent to Sclf-lrrsurc ftrr workcls'conrperrsation. as provided lirr hy Scctiort 3700 of thc
l;rtxlr Codc. for lhc pcrtbrnuncc of thc work f'or which thc pcrnrit is issucd.
_lhaveandwill nraintairrworkers'cornpcnsationinsurancc.as rcquircdhyScclion-17(X)ol'thcLaborCodc. lirrlheprcrtbrnranceof
thc work for which this pcnnit is issucd, My workcrs' conrpcnsation irrsurance carricr an<l grlicy nurttbcr arc:
Policy Number: Expircs:
_l certily that in the Jrcrformance of the work tbr which this perrnit is issucd. I shall not cnrploy any lrcrson in any tnanncr
so as to beconrc subjcct lo lhc workers'compcnsation laws of Calilirrnia. and agrcc thtl if I should bccortrc subjcct to tltc
workcrs' comJrcnsation provisions of Scction 37fi) of thc Latnr Codc. I shall. forthwith cornply with thosc provisiorts..
WARNING: Faiturc lo sccurc workers' corrrpcrrsntion covcragc is urrlawf'ul. arrcl shall subjcct an crttploycr lo .rirrri,rrl-lrcnaltics and
civil fincs up to onc hundrcd thousand dollars ($1(X).ffiOt. in tddition to thc cost of conllrcnsation. danngcs as providcd for thc
a
I hcrcby alfirnr undcr pcrrulty of pc{ury lhat I anr licensed 9 (conrnrcncing with Scction 7000) of Division 3
of the Business arrd Professions Codc. arxl rny liccnse is in lhll tirrce and ctl'ccl.
l.iccnsc Nulnbcr:
Dale:Conlraclor:_
W
I hcrcby amrm undcr lEnalty of Frjury lhal thcrc is a onstruclhn hrxling {gcrcy for thc lrcrformrcc of thc work fur uhich rhis tmit is
issucd (Sa. 3(x)7, Civ. C.).
lrndcr's Namc:
Lcntlcr's Addrcss:
APPLICANT DECLARATION
I hcreby affrmundcr pcnalty of perjury one ol'thc folkrwing declarations:
Demolition Permits-Asbcstos Notification Fcdcral Regulations (Titlc 40. Part6)
-Required
Lettcr of Notificalion
-l
ccrtify lhat thc fcdcralrcgulations rcgarding asbcstos rcrlroval arc not applicablc to this projcct.
-l
ccrtity that I have read this application and statc that thc ahrvc irrltrrrnatiorr is corrccl. I agrc.e lo conrply with all C--ity and County
ordinanccs and State l-aws rclating to building constructiorr. and hcrchy iu{horize
atxlvc mentioned proprly ltrr
Applicant or Agent
l'crrtrilt'e nanle (;rrilrl ):z LS
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltase
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding I Grounding I UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Wails (Roush)
Ceilings (Hard & Soffit Rouqh
Ceilinqs [-Bar Rouqh)
Meter Release
Rouqh
Service Meter ,
FINAL /Qrk)tb t4 6 (b//^^-rr
Remarks Etc
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