HomeMy WebLinkAbout20172522 - 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^172522
Pin #: 52E66
z{4
Project Address: 1241 E Dyer Rd
Assessor's Parcel: 411-131-36 Lot: NA
Unit.
Block: NA
Bldg:
Tract: NA
Address Range: 1231-1241
Historic: No
Suite Range:
Zoning: SD63
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Greenlaw Partners, LLC
1231 E Dyer Rd Ste 240
Santa Ana, CA 92705
Star Electric lnc
1344 E. Valencia Drive
Fullerton, CA 92831
(7141 680-3342
01 1 16002 51603
01116002 51603
01 1 16002 s1600
01 1 16002 51603
01 1 16002 57770
Fee Type Amount
Light Switches, Occ. Se 1 .TO
Light Fixtures 1 .1 3
General Plan Update 23.79
lssuance 59.30
Microfilm Records 4.05
Qty
21 .OO
60 00
1 .00
1 .00
1 .00
Fee
$3s 70
$67 80
$23 79
$s9 30
$4 05
Phone
State Lic #: 877367
Lic Type: C-10
Bus. Lic #: 328013
Workers' Compensation I nsurance:Carrier: Truck lnsurance Exchange
Policy #. C0931603S
Expires: 05/01 12022
Botch*:59t:r56 i/i/2r-t1t ID r EL IZABET,Off i ce: CTYH Trnns*: 11 I ot 1Acct*: Ref *: 2rrl Z7::ZlRcPti:03282263 ?_,/i/?tt2l 1r.r : 17 AHTrqnsoction Tobol $l?tJ.6,4
Stnr Electric Inc
Genercrl Flnn UridctL* F,.:r I:,.i,i.1,,
r_r1 1 I6t:u:tZ.- I l,5r_r[rr_rr-ru _
ll i,-:r'ef ilm & Do,:ufi1r:nt.:,. liir.i-i1.,t:t1I l6r:rr:r?- :l i7 /r_rr_u-trl-.
t J r,:tr ir-nl $ l. l,,i , iit.,
Erectri#iJ,ttffi t';lfh#+,insh.Fee door exil $ r ,;,ir-..r,
modificationc foi ADA adri Ti 6ir'dribtnd ftoor incfufidritr L.
restroom ADA upgrades.
$1 90 64
$0 00
$190.64
' Building Use:
: Job rype:
t Nature of Work:
Commercial
Tenant lmprovement
TI-ADA Upgrades
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
A-3, B
V B, SPK
cEc 2019
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field.
Buirdins Permit #: 1 01105577
Every permitissued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after ifs
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.
Chavez,Daven? C .0s105t2021
Account#
Misc Receipt:
Misc. Recerpt.
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
01 116002 51600
01 1 16002 51603
01 1 16002 57770
$23 79
$1 62 80
$4 0s
lnspector MtD#. 2021-163553
t
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG,COMMENTS OWNER BUILDER DELCARATION
I hcrcby affrm under pcmlty of lErjury lhat I m cxcmpt fiom thc Contractos' Liccnrc ljw for thc followitrg reNg (Ssr03l.5
Busincss and Prcfcssion Cqlc): Any Cily or County which rcquircs a pcrmit lo construct. dlcr. improvc. demlish or rcIEir any
structurc. pdor to its issuancc, also rcquircs thc applicant for such Jrcmit to iilc I sigrcd statcrent that hc or slrc is licensd pwant
to thc prcvisiom of thc Contractor's Liccnsd hw (Chaptcr 9. Comrcrcing with Scction 7(m of Division 3 of the Busircss aid
Pmfcssions Co&) or th.t hc or shc is cxcmpt thcrcfrom and thc basis for thc allcgcd cxcmption. Any violation of Setion 703 1.5 by any
applicant for a pcrmit subjsts thc .pplicrnt lo a civil pcmlty of noI mrc than livc hundrcd doll{s (S500).
_1, as owncr of thc propcrty, or my cmployccs with wagcs as thcir sole compensation, willdo thc work and the structure is not
intcnded or offcred for salc (Scr.7044. Busincss and Professions Code: Thc Contractor's Liccnse l,rrw docs not apply to an owncr of
thc propcrty who builds or funprovcs thcrcon. and who does such work hirnsclf or hersclf or through his or hcr own employces,
providcd that such improvcnrcnts arc not intcndcd or olTcrcd for salc. If. howevcr. thc building or improvcrnent is sold within one year
of conrplction, the Owner Builder will havc thc burdcn of proving that hc or shc did not build or irnprovc thc propc'rty for thc purgnsc of
salc).
_1. asowncrof thc propcrty, anrcxclusivclycontracting with liccnsed contractorsloconslrucl thc project (Scc.7W, Busincss
and Prol'ession Code: Thc Contraclor's Liccnsc Law docs not apply lo an owner of propcrty who builds or improves thercon,
and who contracts for such projccts with a Contractor(s) liccnscd pursuant to the Contraclor's Liccrrsc taw).
_l anr cxctnpt undcr B. & P.C. for this reirson.
Date:
WO ITKERS' COM PENSATION
DECLARATION
I hcrcby affirm under pcnalty of prjury onc of thc following declarations:
)24 nou"and will maintain a Ccrtificatc of Conscnt to Setf-lnsure for workers' com;rcnsarion. as provided for by Scction 3700 of thc
I-abor Codc. tbr the perfbrmancc of thc work for which thc pcrmit ls issued.
_l have and
the work for
37fi) of the Labor Codc, for thc performancc of
and policy numbcr arc:
O
Policy . 5-l.LL
_l ccrtify that in the pcrformancc of thc work for which this pcrmit is issucd. I shall nol cmploy any person in any manner
so as lo bccomc subjcct to thc workers' comgrcnsation laws of California. and agree that if I should bccomc subjcct to the
workcrs' com;rcnsation provisions of Section 3700 of thc Labor Code. I shall. forthwith cornply with those provisions..
WARNING: Failurc to sccurc workcrs' c<lmlrcnsation coverage is unlawful. and shall subject an employcr to criminal penalties and
civil lincs to one hundred thousand dollars ($100,000). in Io thc cost compcnsation, damages as provided for the
Scction Lrbor Codc, intcrcst and attorncy's tbcs.
o L )
LICI'NSI'D CONTRAC'I'OR
DI'CLARATION t
I hcrcby affirm undcr penalty of pcrjury that I arn liccnscd under provision of Chaptcr 9 (commcncing with Scction 7000) of Div[ion 3
of lhc Business and Profcssions Codc. and rny liccnsc is in full forcc and cffcct. t. CuOLicensc Class: Liccnse
'l 9c
fl.rla. )q .<-L\
C(TNS'I'RUC'TION I,F]N I)ING,\( : I'N C}'
I hcrcby affrm urder pcnalty of pcrjury th8t thsc is 8 @nstruction hndirg agcrcy for thc pcrfome of the mrk for which this Fmit is
issucd (Se. 3097, Civ. C.).
kndcr's Nam:
[,cndcr'.s Address:
APPLICANT DECLARATION
I hcrcby aftirm undcr pcnalty of perjury onc of thc following dcclarations:
Dcrnolition Permits-Asbcstos Notification Fcdcral Rcgulations (Title 40. Part6)
_Rcqu ircd l,cttcr of Notification
I ccrtifv thal thc
{Z"iry,n*rhavc
fedcral rcgulat ions rcgarding rcmoval are not applicablc to this projcct.
read this applicaliorr ud statc the to comply with all City and County
ordinanccs and Statc l-aws relating to of this City and County to entcr ug)n lhc
abovc rnentioncd property for insJrcction
Applicant or Agent
Pernrilee nanle >(
and
is corrcct. I
t
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safetv /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildins
Under Slab / Floor
Bondins I Groundins I UFER
Transformers
Torqueincl
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)I ^r -
Walts (Roush)-fiZ{l?L DtrYK 7
Ceilings (Hard & Soffit Roush JI
Ceilinqs [-Bar Rouqh)
lVleter Release
Rouqh
Service N/eter rl ?
FINAL Wl)rl1/r Vf.WK 1
Notes, Remarks, Etc.
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