HomeMy WebLinkAbout20172567 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: 2o^172567
Pin #: 3o.2{3
EY
Project Address: 3900 S Bristol St
Assessor's Parcel: 412-131-22 Lot: NA
Unit B
Block. NA
Bldg:
Tract: NA
Address Range: 3800-3950
Historic: No
Suite Range:
Zoning: CR
Owner:
Address:
Phone:
Tenant Name:
Contractor.
Address:
Phone:
Arne Youngman, SDC/Pacific/Youngma
One Corporate, Suite 200
Newport Beach, CA 92660
(e4s) 760-8591
Hobby Lobby
Hobby Lobby Construction
7707 SW 44th Street
Oklahoma Gity, OK 73179
(405) 745-15s7
Fee Type
01 116002 53601 Revision
01116002 51600 General Plan Update
01 1 16002 57770 Microfilm Records
Amount
239.34
23.79
405
Qty
200
000
1 .00
Fee
$478 68
$0 00
$4 05
Bqt ch * : 59rr4 7 2/ gl ?r:r? t
0f f i ce : (:TYH Tr.qn s.* :
A--tIr,-lLL L r r
Rcpti:tts19,297+
Trnnsnct i on Totn
FI
?/gi
I
State Lic #: 948265
Lic Type: B
Bus. Lic #: 371314
Workers' Compensation I nsurance:Carrier: Ace American lns Co
Policy #: WLRC67814885
Expires: 1213112021
Hobbs Lobbs ConEtr.u,:t ior
11 i cr of i I rn & Docurnen t, s
Lrl 1 16110?- 5777tt[r[rr-r-.
I (:L (:h e,:Ir L7 +4?? +
Notes: Revision to 20270960, 20172017, 20172432 - electrical
revisions
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Mark
Amsden. Julie
01t20t2021
02t0812021
Account#
Misc. Receipt: 75121
Misc. Receipt:
Misc. Receipt:
Total
Commercial
Revision
Revision
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
B, M, S-1
V B, SPK
cEc 2019
01 1 16002 53601
01 1 16002 57770
S+7&68-
$4 0s
Fee Total:
Paid to Date:
Balance Due:
$482.73
$478.68
$4.05
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.
lnspector MtD#' 201 9-155793
__l
)
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/S!G COMMENTS
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under SIab / Floor
Bonding I Groundinq / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
N/eter Release
Rough
Service N/eter I I A
FINAL ZI*IZI Jpl vu ,
Notes, Remarks, Etc.,l
I hcrcby dllirm undcr Fnalty of pcrjury thal I m cxempt fmm lhc ContracloN' Liccnsc kw for thc following rc8sn (Scc.7031,5
Busincss arxl Profcssion Codc): Any City or County which rcquircs a tEmit to onstruct, allcl imprcvc. dcmlish or rcpaL any
structurc, pri)r to its issuancc. also rcquircs thc applicant for such [Ermil to filc a signcd slatcmnt that hc or shc is liccnsd pursuant
to thc prcvisions of thc Contr.ctor's Liccnrcd taw (ChapIcr 9, Comrrcncing with Setion 7000 of Division 3 of thc Busircss md
PmfcssionsCodc)orlhathcorshciscxcmptthscfromandthchasisforthcallcgcdcxemption. AnyviolationofselionT03l.5byany
applicant for a pcrmil subjccts thc applicant to a civil pcnally of nol rmrc lhan fivc hundrcd dolltrs ($500).
_1. as owner ot'thc propcrty. or my enrployecs with wagcs as thcir solc compcnsation. willdo the work ancl thc slnrcturc is not
intcndcd or oll'crcd f'or sale (Scc.7044. Busincss and Prol'cssions Codc: 'Ihc Contractor's Liccnse hw docs not apply lo an owner of
thc propcrty who huilds or inrprovcs thcreon, and who docs such work hinrsclf or herself or through his or hcr own enployecs.
Jlrovidcd that such irrrprovcrrrcnts arc not intcndecl <lroflbrcd ttrr salc. lt, howcvcr. the building or inrprovcrncnt is sold within one ycar
of cornplclion. thc Owncr Buildcr will havc thc burdcn of proving that hc or shc did not build or improve thc pmprty firr lhc purynsc of
salc).
_1, as owncr of thc propcrly. anr cxclusivcly contracting with liccnscd contractors to consuuct thc projcct (Scc. 7U4. Business
and Profcssk>nCodc: Thc Contractor's Licensc Law docs nol applylo anowncr of proJrcrtywho builds or irrtprovcs lhercon.
and who contracls for such projccts with a Contracto(s) liccnscd pursuant to thc Contractor's Liccttsc [.aw).
-latncxctuptundcrScction-.B.&P.C.forthisrcason.
Owner:
IuOBTEESSQMTENSASQN
DECIdEAIION
I hcrcby sflirm undcr pnaltyof prjury onc of the following dcluations:
.7lt
g!]havcmdwillruintrinaCcnificatcofConsnltosclflnsurcforworkcrs'compcnsathn,as pmvidcdforbyScction3T0Oofthc
kbor Crdc, for thc Frfomncc of thc work for which thc Frmit is issucd.
havc and will rnaintain workcrs'compensation insurancc, as required byScction 3700of the [:borCodc. forthc pcrlbrnunccof
thc work for which this pcrrnit is issucd. My workcrs' comlrcnsalion insurancc carrier and policy nurnbcr arc:
sAJ f,t_/r\7\
Policy h.-21-)l
_l ccrtily that in thc pcrfonruncc of thc work for which this pcrrrrit is issucd. I shall not cnrploy any 1rcrson in any nranncr
_so as to bcconrc subjcct to thc workcrs' comJrcnsation laws of California. and agrcc that if I should bccotttc subjcct to thc
workcrs' compcnsation provisions of Scction 37fi) of thc Lahlr Codc. I shall. tbrthwith cornply with thosc provisions..
WARNING: Failure to sccure workers'compensation covcragc is unlawful. and shall subject an empl<lycr to criminal penalties and
civil tincs up to onc hundrcd thousand dollars ($100,00t11. in addition to the cost of compcnsation. danrages as providcd for thc
Scction 3076 of thc labor Code, intercst and attorncy's fecs.
nare:1.-8-I\ Appricanr: #csU"V-t^-b,
LICENSED Ct)NTRACTOR I
DECLARATION
I hercby affirm undcr pnalty of Jrcrjury that I am licenscd undcr provision of Chapter 9 (commcncing with Scctbn 7000) of Division 3
of thc Busincss and Profcssions Code. and my licensc is in full forcc and cffcct.
aqa c.bSLiccnscNutttl."--r:
Date:_L
W
I hcrcby affirm urdcr Jrcnulty of pcrjurythat tlrcrc is a onstruction hnding lgcrcy for thc pcrlbrmncc of thc work for which lhis tsmit Ls
issued (Se. 3097, Civ. C.).
lrndcr's Nam:
lrndcr's Addrcss:
APPLICANT DECLARATION
I trcrcty affrnn undcr pcnalty of pcrjury one of the following declaralions:
Dcrnolition Pcrrnits-Asbcstos Notification Federal Rcgulations (Titlc 40. Pan6)
_Requircd lrttcr of Notification
_l ccrtify that thc fcderal regulations regarding asbcstos rcmovalarc nol applicablc to this projcct.
D ccrtify rhat I havc read this application and statc that thc atnvc irrtbrmation is correct. I agrce to cotttpty wirh all City and County
ordinanccs and Statc Laws rclating to buildirrg construction. and hcrcby rcprcsentativcs of this City and County to entcr upon thc
atxrvc nrcntiortc<l ;lroJrcrty krr
2-8:21
Dere: C.-d'-2 |Applicant or Agent
Permitee name (print):
Rev 08-07-2015
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