HomeMy WebLinkAbout20171663 - Permit (2)City of Santa A na 20 Civic Center Plaza (M-'19), Santa Ana, CA927O2
Permit Counter: (714) 647-5800
I
I n spection Requests: (7 1 4) 667 -27 38 I nspector Section: (7 1 4) 647 -5853
Electrical Permit #:2O171663
Pin #: 19226,
t
Proiect Address: 933 W Brook Stt
Unit:
Block: NA
Bldg:
f ract:1734
Address Range:
Historic: No
Suite Range:El
Zoning: RlAssessor'sParcel: 010-261-14 Lot: 14
Owner:
Address
Phone
Tenant Name:
Contractor
Address
Phone
Suzana Prado
933 W Brook St
Santa Ana, CA 92703
(714) 200-5289
Empire Solar Group
9 E Exchange Pl, Suite 400
salt Lake city, UT 84111
(800) 467-4562
0't'116002 5'1603
01116002 5'160C
01116002 51603
01116002 5777C
Fee Type
Serv [Vleter
General Plan Update
lssuance
Microfilm Records
Amount
57.40
23.79
59.30
4.05
Q$,
'1.00
1.00
1.00
1.00
Fee
$57.40
$23.79
$59.30
$4.05
State Lic #: 1062912
Lic Type C-10
Bus. Lic #: 375984
Workers' Compensation lnsurance:Carrier SCF Nat'l lns Co
Policy #: 4000844
Expires: 0612912021
l.cttch* ::,6174 - g,r
Off ice: {:TYH Tr
Hl-l-Lt r
Rcp t* : r-r3[r27! 1ii
Tr'flnsoct i on Tol0l
Erip ire SoIcl
Single Family Dwelling
Miscellaneous
Service Meter
lrandout given
Buildrng Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
\LSr",.nrnoez, Kathy
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes
Fee Totat
Paid to Date:
Balance Due:
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3, U
VB
cEc 2019
08114t2020
Account#
BuirdinsPermit#: 101104179
Every permit issued shall become invalid unless the work on the site
authonzed by such permit is commenced within 360 days after its
rssuance, or if the work authoriaed on the site by such permit is suspended
or abandoned for a peiod of360 days after the time the work is
commenced.
01116002 51600
01 1 16002 51603
01116002 57770
$23.79
$1 16.70
$4.05
$144.54
$0.00
$144.54
lnspector tt/lD#: 2020-160452
APPROVALS DATE ID/SIG.COMMENTS OWNERBUII,DERDELCARATION
'I hercby affrnr undcr pcnalty of pcrjury that I am excmpl frcnr lhe ContractoN' License hw for thc following rcason (Scc.7031.5
liusincss and Prolession Codc): Any City or County which rcquircs a permit to construct, altcr. improve. dcm)lish o, rcpair uy
slruclurc, prior to ils isruance. also rcquircs lhe applicail fbr sucl [Emtt lo filc a si8rcd statcmil thal lE or strc b liccred pusumt
to lhc pmvisions of lhc Contractor's Liccnscd lrw (Chapte, 9. Commcncing with Scction 7m0 of Division 3 of thc Busircs ed
ProfessionsCode)orlhatheorsheisexempttherefiomardtlEbasisfortlEallegedex.mption. AnyviolationofsecrirtrT0Sl.5byany
applic.nt for 0 pcnnit subjccls the applicanl to a civil pcnally of not rrcre than [ivc hundrcd dollds ($500).
_1. as owncr ol thc prolrc(y. or my crnployccs with wagcs as thcir $lc compensation, willdo ttE work and fic stmw is mt
intcdcd or offercd for slc (Se.7(X4. Busincss and Profcssions Codc: Thc Coilraclor's Liccnsc Law d@s nol apply lo e ownc! of
thepNFny wlDhildsorinprcwslhcB)triuxlwlDdffiswlrworklrimelforherselforlhroughhisorhdrownenrployees,
providcd that such irn[trovcrrcils dc mt inlcrded orollercd for $lc. If, lb*ta. the hiiHiog or irprovcmnt is $ld wihin orc ]rd
ofconpbliotr th. Owrcr Buikkr will hsvc the burdcn ofprcving tlu hc or shc did mt buill o. itrprcvc thc pmpqty for lhc purpos of
sk).
_1. as owner of thc pmperly, am exclusivcly contracting wilh licenscd contmcloE to conslruct thc prcjcct (Sac. 7(X4. Business
arrl holL-sioilCode:TheContracbr'sLicenseLawdocsnotapplytouownerofprolenywhobuildsorimprovcsthe!@n.
and who conuacls for such projccls with a Contmcto(s) licc[ed pursldl lo lhc ConBador's Liccosc Law).
_l amerempt under Section_, B. & P.C. lbr this r.a$n.
woRKER"S', ('( ll\t PItNSA',ilON
I)}:CI-ARATION
I hcrcby affirm undcr pcnaltyofperjury onc ofthe following dcclaratioNj
-l
havc and will nuinlain a Cc(il'icalc of Conscilt to Self lnsurc for work6s'compcnsation, u pmvidcd for by Scction 3700 of the
Lnhor Codc, for the pcrforDurcc ofthc work lbr which thc p€rnlit is issued.
_l have ald will nrnirilrilr workers'illsurancc. as by Scction 3700 oflhe [:krr Code, for the perfomunce of
lhc axl lDlicy numbcr dr:
tlt'olicy
_l ccnify that ir lhc lrrli)rnuncc of tlrc work for which tlris pcrnrit is issocd, I shall not employ uy frcrson in any nranncr
$ as to bccom subjcc( (o thc workcm' conlpcnsation laws of Califomia, and agrec that if I s]nuld bccorre subjcct to the
wod(ers' conrpensalion prutisions of Scction l7m of the tibor C'ode, I slull, fonhwilh conrply with tho* prcvisions..
WARNING: Failurc to *cure workcrs'compcnsation covcfrg. is unlawful, and shall subict sn cmploycr to ffiminal pcmlies ild
civil lliles up k) one huilred thousand dollars ($100.000). n1 lhc danugcs as providcd for lhc
Scction i and oltorrcy's
I hcrcby affirm under pcnalty of pcrjury thal I dnl [censcd undcr prcvision ofChapt.r 9 (comEncing with Setion 7000) of Division 3
of thc Busincss and I'rcfessions Codc. arxl rnv license is in lull force and cffect.
0 t
,?_
LiccrL\c Numb€r:
CONSTRUCTION LENDING AGENCY
I hcrcby aflirm undcr p(nahy of perjury thd thcre is a con$ruction bnding agercy for thc pqlbrlrec of thc work for which this permit is
issuc'l (Scc. 1097. Civ. C.).
lrn,ler's NanE:
knder's Address:
@ISLPEE@I!q
I hor*ry aIlimundcr Fnally of perjury orc of the following d(kalionsl
DcnDlition Pern)its-Ashcsk)s Ndfication Fcdcral Regulatkrns (Titlc 40, Pd6)
_Rcquired [xncr of Notification
_l ccnily that lhc ladcralrcgulations rcgilding asbestos rcmoval dc not applicablc lo lhis pmj(t.
-l
cmify lhal I luvc rcad tlus applicalbn iuxl stale that lhc ak,vc with all Cily and County
and County to cntu uponthcordimmcs ild Statc [iws rcLaing to
abovc rrcntioned prupcny lor
IApplicxut or Agcnl
l'cmilcc ilame
and
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouoh
Ceilings (T-Bar Rough)
l\tleter Release
Rouqh
Service Meter I
F!NAL 2/oz/z ,r4.D n.A,.fu/ )
Notes, Remarks, Elc. /r- -.-/
ELECTRTCAL.INSPECTOR RECORD
Rev.08-07-2015