HomeMy WebLinkAbout20171118 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Electrical Permit #:20171118
Pin #: 37730tV
Proiect Addressi 13792 N Pasadena Sta
-
Assessor'sParcel: 396-303-17 Lot:
Unit:
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Cristen Adams
13792 N Pasadena St.
Santa Ana, CA 92705
(94s) 433-3141
lon Electric lnc
1830 E Miraloma Ave Ste E
Placentia, CA 92870
(714) 993-9469
01 1 16002 51603
01116002 5160C
0't 1 't6002 51603
01116002 5777C
Fee Type
Serv Meter
General Plan Update
lssuance
Microfilm Records
Amount
55.37
22.95
57.20
3.91
Qty
1.00
1.00
1.00
1.00
Fee
$55.37
$22.95
$57.20
$3.91
State Lic #: 951482
Lic Type: C-10
Bus. Lic #: 371524
Workers' Compensation lnsurance:
Carrier: ACCREDITED SURETY AND CASUALTY COMPANY INC
Policy #: 1ATCA16000219
Expires: O9lO1l2O2O
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
Electrical
web user\_\
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cEc 2019
05t18t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Electrical
Fee Total
Paid to Date:
Balance Due:
N/A - No Balance
N/A - No Balance
$139.43
$139.43
$o.oo
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2020-158940
ELECTRICAL.INSPECTOR RECORD
Bev.08-07-2015
\-
APPROVALS DATE ID/SIG COMMENTS oWNllR IIUILDER Dl),CARATION
I hereby affrnl utrder pcnalty of per.iury thal I ur cienrpt from lhc Contraclos' Liccn* law for thc following rcason (Scc.7031.5
Busincss ard Prolcssion Codc): Any City or County which rcquircs a [*rmil to construct, altcr, improvc, demlish or rcpair any
struclurc, prior b its issuance. also rcquircs the applicuil for such [Emrit lo fih a sigrcd slatemnt that lE or slE is lice[Ed pur$il1
to the provisions of thc Conractor's l,iccnscd lrw (Chapter 9, Commcncin8 with Scction 70UJ of Division 3 of thc Business and
ProtessiorsC(xje)orlhathcorsheisexempttheretionlandtlEb6isfortlEallcgedexenrption. AnyviolarbnofSecrionT0Sl.5byany
applicant for d pcrnrit subjecls thc applicant to a civil penalty of not mre lhdn fivc hundrcd dollars ($500).
_1. as owncr ol lhc prolrc[v. or rny crnployccs with wagcs as lhcir solc comlEnsation, will do the wffk ard thc stMlm is mt
intended or ofcred for srle (Se.7(X4, Busincss and Profcssions Cqlc: Thc CoDtractor's License Law docs nol apply lo u owncr o[
thelt)ltlly wk,buildsorinp()vesthcr5n\andwhodoessuchworkhin[elforlErselforthroughhisorfurowtrenployees,
providcd that such improvqrcnts ilc frn inlcilcd or ollcrcd I'or slc. Il. howevcr. thc building or ifiprovcrftnt is sold within one yetr
ofcon\rlcli[ thc Owner Builder will havc the bordcn ofprovirS lhat he or shc ditl ml build or irprcve tlE pmfE(y for th€ plrpore of
sde).
_1. as owft. of th. prcpcny, am.xclusivcly conuactinS with liccn$ri coMetoB to (lnshcl lh. poFct (Se. 7(N4, Busircs
ard holessinCode:TheContmctor'sLicctrsellwdcsrctapplytodowftrofpropcnywhobuildsorimprovesthd@n.
atrd who contrrcts for such projects wilh a ContEcto(s) liccnsd pursuul to the Conudor's Licc6c kw).
_l an)exempt under ScctioD , B. & P.C. lbr this rcasoil.
WORKERS' COMPU,NSA'IION
DECLARATION
I hcreby aflirm undcr pcnalty ofpqjury onc ofthc Ibllowing decldatioG:
_lhavcanlwill trEinlainaCenillcalcofConscnttoSelf-lNurcforworkcrs'snr[ENdion,as pmvidedforbySetior3Tmofthc
l2bor Code, for thc Frcrfornme of thc worl for which the psmil is issucd.
_l have and will nnintriil workes c(lnlpcnsatirD insurance, as requircd hy Scction 3700 ofthe tibor Clode, for thc lErfonronce of
thc work llr wlich this Itrnit is issucd. My wrrrlcrs' compcnsation insurucc cm'iq axl grlicy nunrter uc:
Policy Numbcr: Expircs:
_l ccnify lhat in thc Frfornuncc of thc work for which this pcrmit is issucd, I shall not erploy my [rcrson in dy mMmr
s s to bcsrc subjccl lo the wo.kers' compcngion laws of Califomia. and agrce lhat if I slFuld bccorrc subjcct to thc
worlicrs' $nrpcnsation prolisioN of Scction l70U of lhc tibor Code, I slull, fonhwith conrply with rhos prcvjsions..
WARNING: Failurc b secure wokers'r.rnlEnsrlion covcrage is unlnwful, and shall subject an crnployer to cyiminal penaltics nnd
civil finesuDlo(xrehundredthousrilddollars($100.000).inaddilionk)llrccostofcompensalion,danugcsasprovidedlbrthc
Scction 3076 ofthc tihor Cfrlc. i.l.'rcst and atbrncv's lces.
Datc:_
UEEN4SNIBACTI}B
DECI-A,RATION
I hcrcby afftrnl undcr pcnally ofpcrjury that I anr liccrud under prcvision ofChaplcr 9 (conmrncing with Scction 7000) ofDivision 3
of lhe Busincss and Pmfcssions Codc. arxl nrv liccnsc is in full fore and cffcct.
Lic€use Nurrrbcr:
W
I hercby aflirm und.'r pcnahy of pcrjury lhd therc is a construction lendinS a8ercy for thc pqfomrce of lhe work lt r which rhis pqmit b
issucd (Scc. 3097, Civ. C.).
knder's Nanrc,
trnder's Address:
APPI,ICANT DECI,ARA'I'ION
I tmjty afllnr undcr I--nrlly of pcrjury onc of thc following d(luations:
Dcnx,lilioo Pcrnits-AstE'sbs Notificali()n Fcdcral Rcgulalions (Titlc 40, Pd(,
_Rcquircd bttcr of N(xificalion
_l cdily lhat thc fcdcral rcgulations rcgudinE asbcstos remval ilc nol applicable to this proj6t.
_l cenily llul I luvc rcad this applicalidl rtrd stalc llral the abovc infornulion is colrcct. I agre to @nlply with all Cily od County
ordinanccs and Stalc Laws rclating to buildinS conshction, and hercby authorizc rcprcscntativcs ofthis Ci(y and County to entcr upon thc
above lrentioncd pmpcny for inspection puqx)*s.
Appli€nt or Ag6l
Pmits Mme {prinl)r
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safetv /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinos (Hard & Soffit Rouoh
Ceilinqs (T-Bar Rouqh)
lvleter Release
Rouqh
Service lMeter t
FINAL \/7.1/ zutnt -?M.al)
Notes, Remarks, Etc.t