HomeMy WebLinkAbout20159708 - Permit (2)I
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:2O159708
Pin #: 94797
NI
Proiect Address: 618 S Rosewood Ave
Assessor's Parcel: 010-283-17 Lot: 56
Unit:
Block: NA
Bldg:
Tracl:1470
Address Range:
Historic: No
Suite Range:
Zoning: R1
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Fidel & Delia Quezada
618 S Rosewood Ave
Santa Ana, CA 927034518
(714) 393-7858
Verengo lnc
20285 S Western Avenue, #i
Torrance, CA 90501
(7141744-6911
Fee Type
0'1 1 '16002 51603 Serv Meter
01 1 16002 5'1600 General Plan Update
01 1 16002 51603 lssuance
Amount
48.1 0
19.93
49.68
Qty
1.00
1.00
1.00
Fee
$48.1 0
$19.93
$49.68
$19.93
$97. 7S
$61?.71
Bqt,:h*:333*O - 312i72t-rl$ ID: PL0F'EZ5
1}PP iss: I"TYH Trnns*: 4$ ? of ?A,:ct*: Rel*: 2tl15t7rj$
Frcpti:r-rl51936? - 3129/2il1& 1r:r;29 Afl
Tronsqct ion 'fotsl t61?.71
State Lic #: 935263
Lic Type: B, C-10
Bus. Lic #: 328493
Workers' Compensation lnsurance:Carrier: STARR INDEMNITY & LIABILITY COMPANY
Policy #: 1000001 259
Expires: 10101120'16
Venenso Inc
Genernl PIsn Update Fee
L]I I l6rJtr2- 5l60tlrJrliJ-
L.l ectr icnl
t]1 1 l6LilJ?- Sl6Lt3llDtr-
It:L Chertr n25596
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Miscellaneous
Service Meter
Occupancy:
Constr Type:
Code:
Date:
Date;
Date:
R-3, U
VB
cEc 2013
03t29t2016
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: handout given
Fee Total:
Paid to Date:
Balance Due:
I'd
Hernandez, Kathy
Building Permit #: 10188750
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 rs suspended
or abandoned for a period of 1 80 days after the time the work is
commenced.
01 '1 16002 51600
01 1 16002 51603
$19.93
$97.78
$117.71
$0.00
$117.71
lnspector MID#: 2016-127756
Phone:
ELECTRICAL.INSPECTOR BECORD I
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcreby aftirm under penalty ofpcrjury lhat I am cxempt lrom lhe Contractors' Liccnsc Law lbr thc following reason (Sec.7031.5
Busincss and Profession Codc): Any Cily or County which rcquircs a pcrnrit to conslruct. allcr. inrprovc. dcnxrlish or rcpair any
slruclurc, prbr to ils issuancc. also rcquires the applicant tbr such pcrmit to tlle a signed statcnrcnt lhal he or she is liccnsed pursuant
lo thc provisions of the Contraclor's Liccnscd Law (Chapter 9. Commencing with Scction 7000 of Division 3 of lhc Busincss and
ProfcssionsCodc)orthathcorshciscxcnrpllhcrcfromandthcbasislbrthcrllcgcdcxcnllion. AnyviolatiorrofScctionT0-ll.5byany
applicantlbrapennitsubjectsthe applicanttoacivilpenaltyofnotmorethanfivehundreddollars($5U)).
-1.
as owner of lhe property, or my cmployees with wages as thci sole conrpensalion. willdo lhe work and the structure is not
intcndcd orolfcrcdforsalc(Scc.T044,BushtcssardProfcssionsCodc:ThcContractor'sLiccnscLawdocsnotapplybililownerof
thc prcperty who builds or inlproves ther@il, and who does such work hinlselfor herselfor thrcugh his or hcr own enrpbyccs.
provided thal such improverenls tre nol intended orotlbred tbr salc. lt. however, the huildiug or inprovcnEnt is sokl withitr (nrc ,rtr
ofconrplction, lhc OwDcr Buildcr will hnvc thc burden of provirlg that hc or shc did not build or inrprovc thc propcrly for thc purfx)rc of
salc).
_1. rs owncr of lhc propcny. am cxclusively contracling with licenscd conlraclols lo corlslrlct thc projcct (Sec. 7(N4. Business
and PmfessionCodc:ThcConlraclor'sLiccnscLawdocsnotapplytoanowncrofpropcrtywhohuildsorinrprovcsthcrcon.
and who conlracts for such pmjccls with a Corilracbr(s) liccnscd pursuatrt lo lhc Contrtrctor's Liccnsc Law).
-Ialnexemplundcrscclk)n-.B'&P'C.[orthisreason'
WORKERS' COTIPBNSATION
DECLARA'TTON
I hcrcby afllrm undcr pcnnlty oI pe{ury onc of lhe ti)lkrwing dcclarutions:
-l
have and will rmintain a Certilicate of Consent to Self lnsurc for workers' compensatiul. rs provided fi)r by Section 37U) of the
Labor Codc. for thc perfonnance ofthc work tbr which thc pcrmit is issucd.
l/llhrvcandwilltuittninworkcrs cornpeisati(rlinsurancc.as tcquircdbyScclion3T(X)oftheLoborCode.lbrthcpcrli)rnmnceof
' thc work t'or which this pcrnlit ic issucd. l\4y workcrs' compcnstrtioD insurarcc crrricr and policy nunrbcr ilrc:
Policy oooDDlZt o
-l
certify that i[ lhc pcrfornrance of the work for which this permil is issued. I shall not eilrphy any pcrson in a[y nrunncr
so rs lo hcconrc suhjcct lo thc workcrs'compcnsatbn lnws ofcalilornir, nnd agrcc thal if I should hccotrrc suhicct b thc
workcrs'conrpcnsationprovisionsofScclion3T00ofthcLaborCodc.lshall.lo[hwilhconrl)lywilhlhoscprl)visidls..
WARNING: Failurc to sccurc workers'conlpcnsrti()rl covcragc is uilhwful. und shall suhjcct an eillpbycr k) crimhral pcnaltics and
civil fincs up lo onc hundrcd thousand ilrllars (Sl(X).(Xx)). iil addithn to lhc cosl ofconrpcnsation,ris l)rovidcd for lhe
Scction of thc Codc. inlercst and atk)rncy's fccs.
I hereby alllm undcr peilalty of pc{ury that I am licensed under provision ofChaplcr 9 (connncncing with Section 7000) of Division 3
of lhe Busincss and Professbns Code. and my license is iu tull lbrce md elltct.
Liccnsc C a Nlrilrll r:f 3 rzc z
4 Lr/
CONSTRUCl'ION LENDING AGENCY
I hcreby afllrfi undcr Fnalty ofperjury thal therc is a constructbn leding agcncy lbr thc perfornrancc ofthc wt)rk lor which lhis pcmit is
issucd (Sec.3097. Civ. C.).
Lcndcr's Nunrc:
Lcndcr's Addrcss:
APPLICANT DECLARATION
I hmby atiinn undcr pcDalty of perjury one of the following dcclarations:
Dcmolition Permits-Asbeslos Noli6catioD Fcdcral Rcgulations (Title 40. Part6)
f,fi t\eqdr ed l*r tcr o f Noti lication
///Ll cenily thtt lhe federnl regulations rcgarding asbcstos rcmoval rrc not aplllicahlc k)lhis pmjccl.
I agrcc to conrply with all City and Countya0d stalc th{l lhc rtx)vc inli)rnrdti(nl is corrcct.
corrslrlrclion. and hcreby ruthorizc lhis ( ily xn(l (i)ntrly l(, cillcr u|]on lhc
ahovc nrntiotrcd frofrcrly lbr
Applicont or Agcnt
I'ermitee nanre (/
,^r., z/-?/i
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Sions (monument)
Life Safetv /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouoh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
Meter Release
Rough
Service lt/eter il
FINAL aW&W
N -4
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