HomeMy WebLinkAbout20173365 - PermitProject Address: 3621 S Harbor BIvd
-
Assessor's Parcel: 414-261-07 Lot: POR 3
Unit: 130 Bldg' Address Range: 3601-3631
Block: NA Tract: WILLIAMS Historic: No
Suite Range:
Zoning: SD58
I City 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^173365
Pin #: 280,4f6
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address.
Phone
CCF PS lll Harbor, LLC
11777 San Vicente Blvd. #650
Los Angeles, CA 90049
(657) 325-8400
Beach City Electric, lnc
18421 Gothard Street #300
Huntington Beach, CA 9264
(7141 848-2872
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
125 Volt Receptacle
FWU
Min Fee Adj
General Plan Update
I ssuance
Microfilm Records
Amount
1 .57
26.71
46.73
23 79
59 30
405
Qty
1 .00
1 .00
100
1.00
1 .00
1 .00
Fee
$1 s7
$26 71
$46 73
$23 79
$5e 30
$4 05
State Lic #: 837701
Lic Type: C-10
Bus. Lic #. 315738
Workers' Compensation I nsurance:
Carrier: lnsurance Company of the West
Policy #: WSD504182402
Expires: 0710112021
,Building Use:
Job Type:
tNature of Work:
Planning Conditions: lnterior T.l. Only
Planning Approval By:
Plan Checked By:
Permit lssued By: Chavez, Dave
Subject to Field:
Buildins Permit #: 101 106075
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2021-164757
Commercial
Alteration
Demising Wall
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
B
V B, SPK
cEc 2019
0512112021
Account#
*"""r0/
neceif :
Recept:
Iro,,,
Notes:
Fee Total:
Paid to Date.
Balance Due:
Misc
Misc.
Misc.
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23.79
$134 31
$4 05
$1 62.1 5
$0 00
$162.15
iicpt;ii.
Tr nn gar:
Ref*:
N / ?LI?I
$
upouBl
6r_r[rtru0"
503tttttt'
lnstall a demising wall to create suite 130.
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDb,R DELCARA'I'ION
I herehy affirm untler penalty of perjury that I arn exempt fnrm the Contractors' License Law for the following reason (Sec.7031.5
Business arxl Profession Crxle): Any City or County which requires a prmit to construct, alter, improve. tlennlish or repair any
structure, prior to its issuance, also requires the applicant for such permit to file a signed staternent that he or she is licensetl pursuant
to the provisions of the Contractor's Licensed Law (Chapter 9. Commencing with Section 7fi)0 of Division 3 of the Business and
Professions Cotle) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031 .5 by any
applicant for a permit subjects the applicant to a civil penalty of not nx)re than five hundred dollars ($5tXl).
_1. as owner of the property. or my empkryees with wages as their srle compensation. will do the work and the structurc is not
intended or offered ftrr sale (Sec.7(X+, Business and Professions Ccxle: The Grntractor's License L:w does not apply to an owner of
the pmperty who builds or improves thercon. and who ckres such work hirnself or herself or through his or her own emphyees,
provided that such improvements are not intemled or offeral for sale. If, however. the buikling or inprovenrnt is sokl wihin one )rar
of completion, the Owner Buikler will have the burtlen of pnlving that he or she tlid not buikl or imprcve the pruperty for the purynse of
s:lle).
-1,
asownerof theproperty, amexclusivelycontracting with licensed contractorstoconstruct the project (Sec.7M4, Business
and hofessi-ln Code: The Contractor's License Law does not apply to an owner of progrcrty who builds or improves thereon,
antl who contracts for such pnrjects with a Contractor(s) licensed pursuant to the Contractor's License Law).
-IamexemptunderSection-'B.&P.C.forthisreason.
Date:
WORKERS' COM PD,NSA'TION
Dk'cLAlLd'iloN
I hereby affirnr un<ler penalty of perjury one of the following declarations:
-l
have and will maintain a Certihcate of Consent to Self-lnsure for workers' compensation, as provitled for by Section 37fi) of the
Labor Code. for the performance of the work for which the permit is issued.
-l
have and will maintain workers' compensation insurance, as required by Section 37fi) of the Labor Code, ftrr the performance of
the work for which this permit is issuetl. My workers' compensation insurance carrier and gllicy number are:
Carrier:
Policy Nurnber: Expires:
-l
certify that in the performance of the work ftrr which this permit is issued, I shall not employ any person in any melnner
s() as to beconp subject to the worliers'comflensation laws of California. and agrce that if I shoukl become subict to the
workers' compensation provisions of Section 37ffi of the Lahlr Ccxle, I shall, frrrthwith cornply with those pnrvisions..
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and
civil fines up lo one hundred thousand dollars ($l00.Un), in addition to the cost of compensation, damages as provided for the
Section -3076 of the Lahlr Cule, interest and attorney's fees.
Dete:A nnlir.onl.
LICE,NSED CONTRACTOR IDF,CLARATION
I hercby affrm under penalty of perjury that I am licensal untler provision of Chapter 9 (comnrcncing with Section 7Un) of Diviqion 3
of the Business and hofessions Code. and my license is in full force arxl effect.
a
License Number:
CONSTRUCI'ION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the perfrrrmance of the work for which this permit is
issued (Sec. 3097, Civ. C.).
Lender's Name:
APPLICANT DECLARATION
I hereby affnm under pnalty of Jrerjury one of the following declarations:
Dennlition Perrnits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Requ
ired Lrtter o f Notifrcation
-l
certify that thc federal regulations rcgarding asbestos rernrval are not applicable to this project.
-l
certify that I have read this application and state that the ahrve information is correct. I agree to comply with all City and County
ordinances and State Laws rclating to building construction, and hcreby authorizr representatives of this City and County to enter ufnn the
above rnentioned property for inspectir)n purposes.
Applicant or
l'rrrtritrr n:rnrc (;lrilrl l:
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Groundins I UFER
Transformers
Torqueincr
Sub-Panels
Air Conditioners
Roof Top Equipment
Factorv Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouqh I ///^,1/
Ceilinss (T-Bar Rouqh)7/dfl,i//ftu*Z ,%Jf1
l\Ieter Release t/
Rouqh //Ir
Service Meter / q/+///K-n
FINAL (7tD
Notes, Remarks, Etc.,l
ELECTRICAL.INSPECTOR RECORD I
Rev. 08-07-2015
Date:
knder's Address: