HomeMy WebLinkAbout20173041 - PermitCity of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA927O2 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:2o^1730,41
Project Address: 2800 N Main St
Assessor's Parcel: 111-111-11 Lot: 1
Unit: 2385 Bldg: Address Range:
Block: NA Tract: RESUB OF SHAFEFI-listoric: No
Pin #:
Suite Range.
Zoning. C2
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
Phone:
Building Use:
Job Type:
Nature of Work.
House Of Sportsmen lnc
1432 SANTA FE DR
Tustin, CA 927806417
Spike Construction lnc
7915 Harper Ave
Downey, CA 90241
(562) 454-7673
Commercial
Tenant lmprovement
TI
Amsden. Julie
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777C
Fee Type Amount
125 Volt Receptacle 1 .57
Light Switches, Occ. Se l.TO
Light Fixtures 1 .1 3
Min Fee Adj 67.91
General Plan Update 23.79
lssuance 59.30
Microfilm Records 4.05
Qty
200
100
2.00
100
1 .00
1 .00
1 .00
Fee
$3 14
$1 .70
$2.26
$67.91
$23.79
$s9.30
$4 05
State Lic #. 435582
Lic Type. B
Bus. Lic #: 378785
Workers' Compensation lnsurance:Carrier: Berkley Nat'l lns
Policy #: BNUWC0154643
Expires: 0711312022
lERiltTCANCETLEDJ):\ cstrVFcrcto-
TATE:
1-\'-{ -21
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
M, S-1
II A, SPK
cEc 2019 Notes: Tl--Remove and install partition walls, t-bar ceiling and
interior door
Planning Conditions:
Buirdins Permit #: 101 106288
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 permit rs suspended
or abandoned for a period of 360 days after the time the work is
commenced.
09/01 12021
Account#
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 s1603
01 1 16002 57770
$23.7e
$1 34 31
$4 05
Fee Total
Paid to Date:
Balance Due:
$162 1 5
$0.00
$162.15
lnspector MID#: 2021-165214
Planning Approval By:
Plan Checked By: f
Permit lssued By: i
Subject to Field:
ELECTRICAL-INSPECTOR R ECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby affirm undcr pcnalty of pcrjury thal I m exempt ftom the ContractoE' Liccns kw for thc followinS rcasn (54.7031.5
Busincss and Profcssion Codc): Any City or County whhh requircs a trcrmit to construcl. altcr, improve. dcmlish or rclDr any
structurc. prior to its issumc, also rcquircs the applicut for such lrcrmh to lile 8 signcd stalcmnl that hc or shc ir licctrsd pusuant
to thc pmvisions of thc Contructor's Liccnsed Lrw (Chaptcr 9, Comrcncing with Setion 7000 of Division 3 of lhc Busircss and
PmfcssionsCodc)orthatheorsheisexeml,tthsefiomandthebasisfortheallcgcdcxemption. AnyviolationofscctknTO3l.5byany
applicant for 8 lrrmit subjtrts thc applicant to a civil penalty of not mrc than fivc hundrcd dollus ($500),
_1. as owncr of the propcrty. or my employees with wagcs as their solc compcnsation. will do the work and thc structurc is not
intcnded or offered for sale (Scr.704+. Business and hofessions Codc: Ttrc Contractor's Liccnsc L:w does not apply to an owner of
thc propcrty who builds or improves lhereon, and who docs such work himsclf or hcrself or through his or hcr own cmployces.
providcd that such improvcnrents arc not intended or offered for salc. If. howevcr. thc building or inqlrovcnrcnt is soH within onc )rcar
of completion, thc Owner Builder will havc the burden of proving that hc or shc dirt not buM or inprovc the propcrty for thc purynse of
salc).
_1. as owncr of thc propcrty. am exclusivcly contracting with licenscd contractors lo construct thc proict (Scc. 7W, Business
and Profcssion Code: Thc Contractor's Liccnse Law does not apply to an owncr of progrcrty who builds or improves lhcreon.
and who contracts for such projccts with a Contracto(s) liccnsed pursuant to thc Contraclor's Liccnse l-aw).
-IamexcmptunderSection-,B.&P.C'forthisrcason.Dete: Owner:
uo8f,EBS3o![tENSATI0N
DECI-,1\RATION
I hercby affum under pcnaty of pcrjury om of the following delantions:
-l
havc ard will mintain a Ccrtificate of Consnt to Self-lnsre ffi rcrkeE' @mpcnstion, s ppvidcd for by Setion 3700 of the
Labor Codc. for thc pofoffi of thE mrk fd which tlrc Fmit is issued.
I
\ill havc and will mintsin workcE' @trrpcNation iNmrce, I rEquircd by S€tion 3700 of the kbor Codc, for thc pcrfomce of
thc work for which this pcrnrit is issued.Myt workers' compcnsation insurance carrier and prlicy nunrbcr arc:
\n 4,/an'l
Policy ,llrt lzt
_l ccrtify that in the pcrfornrancc of the work tbr which this permit is issued. I shall not cmploy any pcrson in any manncr
so as to bccornc subjcct to thc workers' compensation laws of California, and agrcc that if I should becomc subjcct to the
workers' conrpensation provisions of Section 3700 of the Labor Codc, I shall, forthwith comply with thosc provisions..
WARNING: Failure to rcurc workcrs'compcnetion covcmgc is unlawlul. and shrll subFct an onploycr to aiminal pmlties and
civil lincs up to onc hundrcd ahousand dollars ($100.000), in addition to thc cost of comJEns.tion, damgcs u prcvidcd for lhc
Scclion 3076 of thc Latnr Codc. intcrcst and attorncy's fccs.
q L IDate:_
DECI-ARATION
I hcrcby affirm under pcnalty of prjury that I am licensed undcr provision of Chapter 9 (comrncncing with Sectbn 7000) of Division 3
of the Busincss and Professions Code, and my liccnsc is in full force and cffect.
License cr"rs B Liccnse Number:1_
oq al
W
I hercby atfrm under pmlty of lErjury that therc is a construction hndhg agcrcy for the JErfomc of thc work for which this pcrmit ir
issucd (Ss. 3097. Civ. C.).
[-cn<lcr's Narrrc:
[-cndcr's Addrcss:
AIELIGANLDECiI.AMTITN
I My 8trm under pen8lty of perjuy orc of rhe folbwing dElarstbns:
Dcmlilion Pcrmits-Asbcstos Notificatioo FedErrl Regulations (Titlc 40, Pan6)
-Required
Latter of Notifrcstion
-l
ccnify that thc fcdenl rcgulstions rcgading ubesos remva.l re rct rpplicablc to this prcix].
th qtify tmr t Uve rc8d this apptbatiotr std state thrt thc abow infomtion is coret. I 888 to omply with 8ll City 8nd Counry
'odinares rnd State Laws rchting to buiuing @nstruction, ard hereby suthoria rcprcsnt8rires of this City 8nd Couoty lo ents upon thc
atxrvc nrcntioncd propcrty ltlr purymscs.
Applicant or Agenl
IDernrilee name forintf: V ?.tlu'. L(V ur\r,r\Ll--l-
o",. oor /o\lrz[
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding I Grounding I UFER
Transformers
Torqueincr
Sub-Panels
Air Conditioners
Roof Top Equipment
Factorv Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilings (Hard & Soffit Roush
Ceilinqs [-Bar Rouqh)
N/eter Release
Rouoh
Service N/eter
FINAL
Notes, Remarks, Etc.
GJn., nA n-7 Onl q
r,;