HomeMy WebLinkAbout20173042 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests'. (714) 667-2738 lnspector Section: (7141647-5853
Permit #:2fJ1730,42
Pin #: 82687
Project Address: 2800 N Main St
Assessor's Parcel: 111-111-11 Lot: 1
Unit: 2825 Bldg: Address Range:
Block: NA Tract RESUB OF SHAFEftlistoric: No
Suite Range:
Zoning: C2
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Centennial Real Estate Company
8750 N Central Expressway, Suite 1740
Dallas, TX 75231
(323) 798-2530
Spike Construction lnc
7915 Harper Ave
Downey, CA 90241
(s62) 454-7673
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01116002 5160.c
01 1 16002 51603
01 1 16002 51603
Fee Type
125 Volt Receptacle
Light Switches, Occ. Se
Light Fixtures
Air Conditioner
Dedicated Circuit
Low Voltage/Comm
0-1 HP, KW or KVA
Amount
1.57
170
1 13
104.40
26.71
36.50
3.84
23.79: 59.30'
405
Fee
$47.1 0
$3 40
$22 60
$104.40
$53.42
$36.50
$3 84
$23 79
$s9.30
$4 05
Qty
30 00
200
20 00
100
200
100
100
100
100
1.0Q
State Lic #: 435582
Lic Type: B
Bus. Lic #. 378785
Workers' Compensation lnsurance:Carrier: Berkley Nat'l lns
Policy #: BNUWCOl54643
Expires: 0711312022
PERM IT cA].lcELLED 3l I ffi3ffi ;] :3: ::ffi:,"''.r,yrfl:
..tb;5 C E s\ rCIL\L r 01 llooozstrrc Microfitm (ecor*
DATE: i.,r'=*-ic\ -\q -:)l ; (,
INIIIAL: I:;, :
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By.
Plan Checked By
Permit lssued By.
Subject to Field:
Commercial
Tenant lmprovement
TI
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
M, S-1
II A, SPK
cEc 2019
Notes: Tl--Remove "nJ install partition watts, t-bar ceiling and
interior door
09/01 t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Amsden, Julie
Buildins Permit #: {01 106290
Every permit issued 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.
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23.79
$330.56
$4.0s
Fee Total
Paid to Date:
Balance Due:
$358.40
$0 00
$358.40
lnspector MID#: 2021-165209
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\.
ELECTRICAL-INSPECTOR R ECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding I Grounding I UFER
Transformers (
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Wails (Rouqh)
Ceilings (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
Meter Release
Rouoh
Service Meter
F!NAL
Notes, Remarks, Etc
I hcreby afftrm undcr pcnalty of pcrjury that I m excmpt ftom thc Contrsctors' Liense law for lhc followinll,rcasn (58.7031.5
Busincss and Profcssion Codc): Any City or County which rcquircs a Jrcrmil to @nstruct, altq, improrc. dcmlish or, rcpoir any
struclurc, prior to its issuare, also rcquircs thc applicant for such Frmit to filc a signcd statcrcnt that lrc or shc is licensd iursumt
to thc prcvisions of thc Contractor's Liccnsd [iw (Chaptcr 9. Comrcncing wilh Setion 7000 of Division 3 of thc Business and
PrcfcssionsCodc)orthatheorsheiscrctrrptthmfrcmandthcbasisforthcsllcgcdcxcmption. AnyviolationofScctionT03l.5byany
applicant for a prmit subjccts thc applicant to a civil pcn8lty of not !rcrc than fivc hundrcd dollus ($50O).
-1.
as owner of the propcrty. or my cmployccs with wagcs as their solc comlrcnsation. willdo thc work and thc stnrcturc is not
intended or offcrcd for sale (Scrc.70l4, Business and hofcssions Codc: The Contraclor's Liccnsc law docs nol apply lo an owncr of
thc property who builds or improves thcrcon. and who docs such work himself or hcrsclf or through his or hcr own cmployecs,
provided that such improvcnrnts arc not intcndcd or offcrcd for sah. If. howcvcr. thc building or improvcnpnt is sold within one year
of comphtion, thc Owncr Buildcr will havc thc burdcn of proving Orat hc or shc did not build or improve the propcrty for thc purposc of
salc).
-1,
as owncr of the proprty, am exclusivcly contracting with licensed contreclors to construct thc proict (Sec. 7044, Business
and Profcssbn Code: The Contractor's License Law docs not apply lo an owncr of propcrty who builds or improves thereon,
and who contracts for such projc-cts with a Contracto(s) liccnscd pursuant to the Contractor's Licensc kw).
-IamexcmptunderSection-,B.&P.C.forthisrcason.Date:
WORNFIIS' COMPTNS {TION
DF'CLAITATION
I hcrcby affirm undcr penalty of prjury one of thc following dcclarations:
-l
have urd will maintain a Certificate of Consent to Self-lnsure for workers' compensation, as providcd for by Section 3700 of thc
[:bor Code, for the pcrformance of the work for which thc prmit is issued.
{,
thc
have and will maintain workcrs' compcnsation insurance. as rcquired by Section 3700 of thc labor Codc, for the lrcrfornunce of
work for which this pcrmit is issucd. My workers' comlrcnsation insurancc carricr and plicy numbcr are:
Policy c1 I l\l7L
-l
ccrtify that in thc lrcrformancc of thc work for which this;rcrnrit is issucd. I shall nol cnploy any pcrson in any manner
so as to bccomc subjcct to thc workers' cornlrcnsation laws of Calitbrnia. and agrcc thal if I should bccomc subjcct to thc
wortcrs' compensation provisions of Scction 3700 of the l-abor Codc. I shall. forthwith contply with thosc provisions..
WARNING: Failurc lo liccure workcrs'compcnsation covcragc is unlawful. and shall subjcct an crnploycr to crintinal pnaltics and
civil fincs up lo onc hundrcd thousand dollars (S100.0m). in addition to thc cost of comlrcnsation, damagcs as providcd for thc
Scction 3076 of thc l-ahlr Codc, inlcrest and attortrcy's
DF'CI ARATTON
I hereby affrm under pcnalty of pcrjury that I am liccnscd undcr prcrvision of Chaptcr 9 (commcncing with Scction 7000) of Division 3
of the Business and Profcssions Codc, and my liccnsc is in full force and effcct.
Liccnsc *!*,'hr b5n.
0{conrr".tV 4tt IVJ. (Ai/\' -t
W
I hercby affirm under Fnalty of pcrjury that thcrc is a construction lending ogcncy for thc perfornuncc ofthc work for which this Frmit is
issucd (Sc. 3097, Civ. C.).
Lcnder's Name:
lrnder's Address:
-l
certify that thc fedcral rcgulations rcgarding asbcstos rcmoval arc not applicablc to this projcct.
certify that havc read this application and slalc that thc above inlbrmation is correct. I agrcc to comply
I rcprcscntatives of this City
with all City and County
and Statc laws rclating building construction.and County to cntcr
above rnentioned property for
oqApplicant or Agent
Permitee name
lo
purlnscs.
and hcrcby authorizc
ot
upon thc
[Jnrr nA n7 ')n'l tr
APPLICANT DECLARATION
I hcrcby aftirm undcr pcnalty of pcrjury one of thc following dcclarations:
Demolition Permits-Asbcstos Notification Fcderal Rcgulations (Title 40. Parl6)
-Rcquircd
l*ttcr of Notification
7