HomeMy WebLinkAbout20173039 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Electrical
PermitCounter: (714')647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714) 647-5853
Permit #:2O173039
Pin #: ,"n,
Proiect Address: 2800 N Main St-a-
Assessor's Parcel: 111-111-11 Lot: 1
Suite Range:
Zoning'. C2
rUnit 2345
Block: NA
Bldg: Address Range:
Tract: RESUB OF SHAFEFI-listoric: No
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Phone
Centennia! Real Estate Company
8750 N Central Expressway #1740
Dallas, TX 75231
(7521 888-8044
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
01 1 16002 5160C
01116002 5160r"
01116002 5777C
Fee Type Amount
125 Volt Receptacle 1 .57
Light Switches, Occ. Se 1.70
Light Fixtures 1 .1 3
Min Fee Adj 67.91
General Plan Update 23.79
lssuance 59.30
Microfilm Records 4.05
Qty
2.00
1 .00
200
1 .00
1 .00
1 .00
1 .00
Fee
$3.1 4
$1 70
$2 26
$67 e1
$23.7e
$se 30
$4 05
State Lic #. 435582
Lic Type: B
Bus. Lic #: 378785
Workers' Compensation lnsurance:Carrier: Berkley Nat'l lns
Policy #: BNUWC0154643
Expires: 0711312022
PERITI]T CA].ICELLED
\1 Co*ftg.ncto-
DATE:c\-\r"-\- 71
INITIAL:
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approva! 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-Remoye and install partition walls, t-bar ceiling and
interior door
09/01 t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Amsden, Julie
Buildins Permit #: 101 106286
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 fhe site by such permit rs suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 s1600
01 1 16002 51603
01 1 16002 57770
$23 7e
$134.31
$4 05
Fee Total
Paid to Date:
Balance Due:
$162 15
$0 00
$162.15
lnspector MID#: 2021-165212
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/S!G COMMENTS OWNER BUILDER DELCARATION
I hcrcby aflirin undcr pcnalty of Jrcrjury lhsl I m cxcmpt from thc Contractos' Liccns tiw for tlrc following rclmn (58.7031.5
Busrncss and Profcssion Codc): Any City or Counly which rcquircs a Frmit to construct, altcr, improvc, dcmlish or rcpair any
slruclurc, lrior lo its issuancc, also rcquircs thc applicant for such lrcrmit lo filc a signcd statcrenl thst hc or drc is licenscd pudmt
to thc Imvisions of thc Contmctor's Lrcenscd lrw (Chaplcr 9, Commcrcing with Scction 7000 of Division 3 of thc Business and
Pmfcssions Codc) or lhil hc or shc is cxcmpt thc.cfrom and rhc bosis for thc ollcgcd cxcmplion. Any violation of Setion 70.11.5 by any
ilpplicanl for I pcrmil subjcts thc applicanl lo . civil penally of nol morc thon fivc hundrcd dollars ($500).
-1.
as owncr of the propcrty. or my cnrployccs with wagcs as lhcir solc compcnsalion, will do thc work and thc structure is not
intcndcd or ofTcred for salc (Scr.7044, Busincss and Professions Codc: The Contractor's Liccnse Law docs not apply to an owncr of
thc propcrty who builds or itnprovcs thercon. and who docs such work himsclf or hersclf or through his or hcr own cmployees.
providcd that such improvcnrcnls arc not intcndcd or offcrcd for salc. If. howcvcr, thc building or improventnt is sold within onc ycar
of complction. thc Owncr Buildcr will have thc burden of proving that hc or shc did not build or improve thc propctty for thc purposc of
salc).
_1. as owner of thc propcrty, am exclusivcly contracting with liccnscd contractors to construct thc project (Sec. 7W, Business
and Pmfessbn Codc: The Contractor's Liccnsc Law does not apply to an owner of propcrty who builds or improves thereon,
and who contracts for such projccts with a Contractor(s) liccnsed pursuant to thc Contractor's Licensc [aw).
_l amcxcmpl undcr Scction_, B. & P.C. for this rcason.
I)rrIr.
WORKERS' COMPENSATION
DECLARATION
I hcreby affirnr undcr pnalty of perjury onc of the following dcclarations:
-l
havc and will rnaintaina Certificate of Consent to Self-lnsurc for workcrs' compcnsation. as providcd for by Section 3700 of the
,ffi;for the pcrformance cif the work for which the permit is issucd.
will maintain workers' compcnsation insurancc, &s requircd by Section 3700 of the l-abor Codc, for thc performance of
which this permit is iszud. My workers' compensation insurance carrier and policy number are:
'f
Policy v
_l ccrtify that in lhe grcrformancc of the work for which this pcrmit is issucd. I shall not cmploy any lrcrson in any manncr
so as to bcconrc subjrxt to the workcrs' comJrcnsation laws of California, and agrec that if I should bccome subjcct to thc
workers' conrpcnsation provisions of Scction 3700 of thc Labor Codc. I shall. forthwilh comply with thosc provisions..
WARNING: Failurc to sccurc workcrs' compcnsation covcragc is unlawful. and shall sublt'ct an cmployer lo criminal pcnalties and
civil fincs up to onc hundrcd thousand dollars ($100.0m). in addition to thc cost of compcnsation, damagcs as provided for the
Scction 3076 of thc [:bor Codc, intcrcst and attorncy's rccs.
q ollzt
I hcrcby aftirnr undcr pcnalty of Jrcrjury that I am licenscd Chaptcr 9 (comnrcncing with Scction 7000) of Division 3
of thc Busincss and Professions Codc, and my liccnse is in full forcc and cffect.
Liccnsc Numbcr:r,t < SsrL
4u IAL Con< kvah'on !n.,='r
W
I hcrcby afftrm undcr Fmlty of Frjury lhal tlm is a onstructbn lendiq 8gcrcy for the pcrfomrce of th€ mrk for whbh this permit k
issucd (Se. 3097. Civ. C.).
Lcnder's Name:
[-cndcr's Addrcss:
APPI ICANT DT'CI ARATION
I trcreby affrm under pcnalty of pcrjury one of the following dcclarations:
Dcmolition Pcrnrits-Asbcstos Notification Fedcral Regulations (Title 40. Part6)
-Rcqu
ircd l-ct tcr of Notification
_l ccrtify that thc fcdcral rcgulations rcgarding asbcstos rcmoval arc not applicable to this projcct.
_l ccrtify that I havc rcad this application afll st8te that thc above infonBlion is coret. I agrc Io comply with all City and County
ordinorccs and Statc ljws rclating to building construction. ad hcrcby authorire rcprcsntalivcs oflhis Cily and County to cntcr upotr lhe
aborc mntiorcd prcIEny for inslrcrtion purposs.
Applicant or Agent
I'crnritee nanle
o,r" ocl [c\ (zl
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab I Floor
Bonding lGroundinq I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Wails (Rouqh)
Ceilinss (Hard & Soffit Rouqh
Ceilings (T-Bar Rouqh)
Meter Release
Rouqh
Service Nleter
FINAL
Notes, Remarks, Etc.
Elr'rr nO n7 Onl tr
f,s
it r h L ( aa,nlr.1