HomeMy WebLinkAbout20167938 - Permit (2)@ City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 a Electrical
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:2O167938
Pin #: 73121
'Project Address: 2430 W Elder Ave Unit:
Block: NA
Bldg:
Tract: 1346
Address Range:
Historic: No
Suite Range:
Zoning: R'lAssessor'sParcel: 109-123-01 Lot: 84
Owner:
Address:
Martin Gonzalez
2430 W Elder Avenue
Santa Ana, CA 92704
(949) 544-9901
Fee Type
01 I 16002 51603 New Garage
0'l 'l 16002 51600 General Plan Update
01 1 '16002 51603 lssuance
Amount
0.14
22.O8
55.04
Qty
441.00
1.00
1.00
Fee
$61.74
$22.08
$s5.04Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Botchi:48189 - ?/1/2trl9 ID: LRrlSAt_ES
0f f ice: CTYH Trons*: 54 9 r,f' 11Acct*: Ref*: jt-rl,l7?39
Rcpt+rtr25?239? - 2.i1/2{ttq Ir l? pH
Tronsoct ion Tqbul $8r11?3.|i?
llnrt in 6on;o 1e:
General Plan Updnte Fee
01 I 16r:r0?- 5150110011-
Electr irnl
01 1 16002- 51603rlllrl-
Itnster Cnrd
CC+: **r***ffr***3559
ICL Check n09l:r4
$1 16. 7S
$5 r t-rilil. [rfr
Auth+!L1lt55,tE
$3 r t-t9f,,5?
$138.86
$0.00
$138.86
$??. r:ri:q
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
New Garage
New Garage
97099
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permit ls suspended
or abandoned for a period of 1 80 days after the time the work is
commenced.
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
U
VB
cEc 2016
02t05t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: New detatched 2-car garage.
Fee Total:
Paid to Date:
Balance Due:
01116002 51600
01116002 5'1603
$22.08
$116.78
lnspector MID#: 2017-135399
APPROVALS DATE !D/SIG.COMMENTS
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
Meter Release
qt2//%Rough '/4,ZZJQ t 0r 7-19-2-b*.ff" /o-
Service Meter
FINAL Ltc-"2 \r{ rr>
Notes, Remarks, Etc
OWNER BUILDER DELCARATION
I hoeby affum undr penalty of perjury thal I m exempt fiom the Contractors' Liccnse Larv for the following rffi (Se.70-11.5
Busines ad Profmion Code): Aoy City or County rrhich require a pornit lo coBlruc{. alto, improvq dmolish or rcpair my
structuc, pdor to its issumce. also rcquirG the applicant for silch p€mit to file a signed statcment thal he or she is,lic@sed pusui\nt
to the provisions of lh€ Contractor's Lic€nsed law (Chapler 9. Commencing with S(tion 7000 of Dir isir/c -1 of th: Busins od
ProfessionsCode)orthatheorshcisexemptthtrefiomandtheb6isforthcallegc<lexmption. AnyvioteionofsectionT03l.5byany
applicant for a pmit subj(ts the applicmt to a civil pcnalty of not more thil five hundred dollas ($500). . '
D
_1. 6 owns ofthe propeny. or my employe with rrago a their mle composation. $ill do lh€ work md the slructm b nol
intmded or offqed for mle (Se.7044, Businss od hofasiou Code: The Conlraclor's License Law doe not apply to m ownq of
the pmperty u'ho builds or improve th@n, md s'ho do6 such rvort himself or hmelf or through his or he om cmployee.
provided that such improvmots tre not intmded or offoed for sale. lf howsq. the building or improvemmt is sold within one ,q
ofcomplc{ion. lhe O*nq BuiHq will have thc hrdo ofpreving thd he or shc did rcl build or improve the progrty for th€ purfD* of
salc).
I
_1, m owner of the propffy, an exclusivcly contracting with lice6cd contractore to construct lhe preject (Src. 7044, Uuinss
ed Prof6sionCode:lheConlractor'sLicenseLarvdoenotapplytodownsofpropcnyrvhobuildsorimprovGthq@n.
and who contracts for such prejats with a Conlracto(s) licssed pursuanl to lhc Conlraclor's Licse l,aw).
-l
m erempt uder r]. &.c.
on", z-o<r-/::
Dlr(I.,ilt\|loN
I hoeby affirnr undo pmalty ofpojury onc declaralions:
_l have md will maintain I Certificate of Coreent lo Self-lNure lor rvorkers' conrpensalion, 6 providcd for by S@tion 3700 of lhe
Labor Codc, for thc pqfommce of the wo* for which the ptrmil is issued.
-l
have and will maintain wo*ers' compcmalion ireurance, c required by Srction 3700 of the tibor Code, for thc pofommcc of
the work for which this pennit is issucd. My workers' compcnsalion ireurmce cu io od policy number a c:
Policv Numbo: Exoires:
-l
colify that in the perfornrance of the work for which this permil is issued. I shall not ernploy ary psson in any manner
e as lo become subj(l to lhe work6' compenetion laws of Califomia. dd agree that if I should become subjet to the
workes' cornpensation provisions ofSection 3700 oflhe Labor Code. I shall. foflhwith cornply with those provisiom..
WARNING: [failure to wure workqs'compruation covqagc is unlawlirl. and shall subjet a onployo to qiminal penalliG and
civil fmcs up to one hundred thoumd dollm (in addition b the cost of dmages I provided for the
Scction 3076 oflhe l,abor Code. interGl 's fecs.
Orrrr?-F:-/?
I hqeby amrm undn pqalty ofpqjury that prc\'ision of Chaptq 9 (commmcing
I force md cffat.
7000) ofDivision 3
of the Busines ad Profwiom Codc. md my licme is
Licc6e Class:-Liccme Numbs:
Dste: Contnctor:
CONSTRUCTION L}'NDINC AGFNCY
I hercby affrm undo paalty of ptrjury that lh6e is a coNtruction lflding agmcy for the pqfommce of the rvork for rvhich this pqrnit is
issued (Se. 3097, Civ. C.).
Lender's Ad&s:
APPLICAN'T DECI ARATION
I horby aflim under pmalty ofpcrjury one ofthc following declarations:
Demolition Pcrmits-AsbGtos Nolificalioo Fedqal Regulations ( fitle 40. Pan6)
-Required
lrtts of Nolification
_l cdiry that regulatiom Egffding Nbestos rqnoval ue not applicable lo lhis prcjet.
_l read this application ad state lhat the above infonnation is cord. I aSre to comply sith all City aod Couoty
ordinanc6 taws relatif,g lo building construction..oflhis Cily and County lo entcr ufxln the
above
Applicanl or
Pernilee nNnre
I
for inspeclion
*r" ? -6- /?
ELECTRICAL.INSPECTOR RECORD
Lender's Name: