HomeMy WebLinkAbout20171971 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 lectrical
PermitCounter. (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: illr'l)AqI-SASS
Permit #:2O171971
Pin #: 55780
Proiect Address: 2606 N Flower St
Assessor's Parcel: OO1-244-25 Lot: POR 10
Unit:
Block: NA
Bldg: Address Range:
Tract: POTTS, BORDEN &tllistoric: Yes
Suite Range: q
Zoning: R1
Owner:
Address:
Phone:
Carol Cossaboom
2606 N Flower St
Santa Ana, CA 927061547
(714138344s4
01 1 16002 5'1603
01 1 16002 5160C
01116002 51603
01116002 5777C
Fee Type
Air Conditioner
General Plan Update
lssuance
Microfilm Records
Amount
104.40
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
Fee
$104.40
$23.79
$59.30
$4.05Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
BoUch+:56673 - ?/29/217211 IDr qmor.crlesLS
Offire: CTYH Tnnns*: 19 I ci 3Acct*: Ref*: 2t1l7l',)71
Rcpt+:tr3lr7460g - 9/29/202tr lrr:14 Al1
Tronsoction Totsl 148$.96
Corol Cossobooa
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
A/C Comp Water Heater
Occupancy:
Constr Type:
Code:
R-3
VB
cEc 2019
Genersl Plon Updote Fee
01I l61102- 5l60urJ00-
Electr' i col
01I16002- 516rJJil0Lr-
ll icrof i 1l & Docurents
rl1 1 l60112- 1?77 0t7tJ0-
llaster Cnnd
CC+ : ***r**r.**r** 1574
Notes:
Fee Total
Paid to Date:
Balance Due:
$496.96
Auth+:22.9?45
Arabe, Jill
Hernandez, Kathy
09t2912020
09t29t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Date:
Date:
Date:\tF
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 is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51603
01116002 57770
$23.79
$163.70
$4.05
$191 .54
$0.00
$191.s4
lnspector MID#: 2020-161798
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS OWNI.]R IITJII,DI'R I)l.]I,CARATION
I hereby affirnr unJer penulty of 1rrjury that I anr exeDpt frcm lhe Cbntracton' Liccnse law for thc following reason (Scc.7031.5
Ilusincss and Proltssion Codc): Any City or County which rcquircs a pcrmit k) construcl, altcr, irnp()vc, dcmolish ot rcpair any
structure, pri(,r k) its issuanca. also requires thc aplllicailt tor such pef,rrit to file a sits[ed stalerrcnt that lE or she ir liccilsed pursuant
lo rhc previsions ol tlE Conirack)r's l,iccnscd lnw (Chaptcr L Commcncing with Scction 7tru0 oI l)ivision I ol thc Businc$s and
ProfessionsCodc)orthurheorsheisexeDrpttlerelionrandtlEbasisfbrtlrcallegedexen4nior. Anyviolali(DofSectiutT03l.5byauy
.pplicinl for a pcnnil sub.jccts the rpplicilnl 10 d civil penalty of not mre lhan five hundred dollars ($50(J).
_1. s owncr oI thc proFny, or my ernployccs with wagcs as thcir sle cohpcnsation. will do thc work ard tha stMtuc is frtr
intcftlcd or olTercd for slc (Sa.7044, Busincss and Prcfcssions Codc: Thc Conlraclor's Liccns kw d@s not apply to e owncr of
tlE pmFny wlD huild3 (rr itr{rows lhermn. ud wln d@s such work himelf or l*rslf or thruuth his or her own efiployees,
provided that such improvcmots m fr{ iilcftlcd or olfcN-d for ssjc. li howcvd, (lrc boiHing or ifiprovcmn( is $ld within one ]ca
ofcotrplcrio( thc Owrcr Buildcr will luvc t}E burdcn ofpmving lhd he or shc dil mt buill or inporc 0E prcpdly for lh. purpo* of
sle).
_1, as owncr of thc propcny, am cxclusiycly contrlclinB with licensd contractoN to conslrucl lhe proi.tcl (Scc. 7(X4. Busiresr
axl kot!:sionCrxle:TheContrack,r'sLicerscLawdr*snotapplytoilownerofprolEdy*hobuildsorinrprov€sthereoil.
and *ho contracls for such Fojccls wilh a ContEck)(s) liccnscd pursumt to the Conuactor's Liccnsc [iw).
I anr exemnt urder Sectirrt
,r,r",q-Zq-UZ0
DECLARATION
I hercby afliril undcr pcnalty ofpcrjury onc oftlrc lollowing decldatioN:
_l have ild will nuintain a Ccilil'icale of CoDscnt k, Sel[lnsurc for workds' compensation, as providcd for by Scction 3700 of rhe
Iabor Code, tor thc pcrfornrece oflhc work lirr which thc pcrnit is issued.
_lhavcandwilln)aintainworkers'conrpemalioniDsurancc,as requiredbySeclion3T00oflhcLahorCode,fotlheperfornErceof
thc work for which this lErtrrit is issucd. My workcrs' conlpcnsation insurucc cmier and 1rclicy nunrbcr uc:
Policy
_l ccnify rhar in rhc NrlilrnraNc of rlr w(trk for which this pcrmit is issucd, I shall not cnDloy any pcrson in any manncr
$ astobcconEsuhjccttothcworkcas'conlpcnsationlawsofcalifonria,andagrcethatiflshouldbccorrcsuhjccttolhc
sorkers' cotrrpeosttion prorisior$ of Scclion l?00 of the hbor Code, I shall, fonhwith comply wilh lhos ptovisions..
WARNING: Failurc to scur. worlicrs'cotnpcnsation covctagc is unlawful, and shall subjet an cmploycr to riminal pcmhts and
civil firEs up h ulc hundrcd rhousahd dollars ($100.000). in addition to lhe cost of compcNtion, danBges s providcd for lhc
Section 1076 ofthc t tu Codc. intercs( and dtorrcy s [ccs.
o,,", Q-241'ZOLO
I hereby aflirnr under pnaltyof pcr.iury that I anr licen*d under povision 9 (conrnEncing wilh Scction 7000) ofDivision 3
of the Business and Profcssions Codc. and my liccnse is in full forc and effect.
Licerrsc Clr.*:-LiceDie Nunrber:
-
Dste
-
Contmctor:
@
issuer.l lSec. l(r97. ('iv. C.).
lrnder's Nanrc
kndcr's Addrcss:
@NI,.DEELABA'IION
I hrEby ttllilm undcr frnalty of pcrjury onc of thc li)ll(,wing d6lilations:
Dcnmlition Pcrmits-Asb(sk,s Notificaliiln Fcdctal RcBulalions (Titlc 40. Pd6)
_Requircd lxllcr of Notilicalion
_l cdily (hal rhc tcdcralrcgulations rcgildinS asbcsbs rcrmval dc not applicablc to this prcjct.
-l
ccnify lhal I lurvc rt-atl this applicali([ ild stalc lhal lhc ah)vc informlion is co[ect- I agre to conply
I rcprc*mativcs ofthis Ciry
wilh all Cily aod County
and County h colcr upon thk
Q-zo -zozo
ordinanccs md Slatc ljws rclatinS k)
abovc trcntioned pmpeny lor
Applicana or Agmt
Pcmrilcc nqnrc
conshclion, and hcrcbJ, autlnrizc
Site-Work
Underqround
Pole Bases
Lioht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondins / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rough
Ceilings (T-Bar Rough)
lMeter Release
Rouqh
Service lVeter
F!NAL /0 -'7ao [- Crct vf Aos ry-y
Notes, Remarks, Etc.
Rev.0B-07-2015