HomeMy WebLinkAbout20165523 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests. (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:20155523
Pin #: 74614
Project Address: 2109 W Lingan Ln
Assessor'sParcel: 109441-13 Lot:13
Unit:
Block: NA
Bldg:
Tract 3353
Address Range:
Historic: No
Suite Range:
Zoning: R1
Owner:
Address:
Phone
Tenant Name:
Contractor
Address:
Phone:
Building Use:
Job Type:
Nature of Work:
Juan Gutierrez
2109 W Lingan
Santa Ana, CA 92704
(7',t41574-3154
Vivint Solar Developer
9847 Pioneer Blvd.
Santa Fe Springs, CA 90670
(657) 600-8252
Single Family Dwelling
Solar
Solar
C
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Fee Type
Fee Totat
Paid to Date:
Balance Due:
Amount Qty Fee
State Lic #: 973756
Lic Type: C-10, C46
Bus. Lic #: 345470
Workers' Compensation lnsurance:Carrier: American Zurich lns Co
Policy #: WC5090013
Expires: 'lll0'll2018
b;1 cor.\
b=€-Ys
(-
Occupancy:
Constr Type:
Code:
Date
Date:
R-3, U
VB
cEc 2016 Notes: lnstall new 3.19 kw roof mounted solar PV system (1 1
panels) ALL FEES PAID ON 10196007
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buildins Permit #: 10196007
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
lssuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 180 days after the time the work is
commenced.
03/30/2018
Account#
$0.00
$0.00
$0.00
lnspector MID#: 2018-142387
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS oWNDR BUILDER DELCARATION
I hcrcby affirm undcr pcnalty of pcrjury thal I m cxcmpl fronl lhc Contraclors' l-iccnsc hw for thc folbwing rcumn (Scc.7031.5 ]
Busi[css aftl Profcs\trn Codc): Any City or County which rcquircs a Frmil lo construct. altcr. improvc, dcrrelish or rcpair any
structurc.priorloils issuance.alsorcquircslhcapplicantlbrsuchFrtrlilt)filcasigncdslatcrrcnt thalhcorshcisliccn(cd pursuanl
k) thc provisions of thc Conlracror's Licenscd ljw (Chaptcr 9. Commcncing with Scclion 7fi)0 of Division -1 of lhc Burincss a(
Prcltssioils Codc) or thdt hc or shc is cxcnrpl thcrcfrom and thc basis lbr lhc allcgcd cxcmplion. Any violation ofScclion 70-1 1.5 hy ani t
applicantforapcrmitsubjcctsthc applicanlloacivilpcnallyofnol,norclhanflvchundrcddollars($500). /
(
_1. as owncr of lhc pro1rcrly. or my cmployccs wilh wages as thcir s)lc compcnsation. will do lhc work and lhc structue is not t
inlcndcd oroffcrcdlbrsah(Se.TOl,l.BusincssandProfcssionsCodc:ThcConlrachr'sLicenschwdocsnotapplyloanowrcrof
thc pr)IEdy wlxr huilds or irnprovcs ttEcnr. and wlF d(Es such work hirnsclfor hcrsclfor thrrugh his or hs own cmployccs.
providcd that such improlcnrilts m nol iilcndcd or offcrc{ for sb. ll. howcrcr. thc huikling or irnprovcnrnt is $ld within onc )au
ofconrplction. thc Owncr l]uildcr will havc thc burdcn ofpmving thil hc or rhc did mt buikl or improve fie prefrcrly ti)r th! purlns of
sulc).
_1. as owncr of thc prolErly. an cxclusivcly conlrlcling wilh liccnscd contructors lo construcl lhr projcct (Scc. 7044. Busincss
ar}l Pnrli:ssionCodc:'lhcConlraclor'sLiccnscl-awdocsnolapplyloanowncrofpropcrlywhobuildsorinlprovcsthcrcon.
and who conlrucls li)r such projccts with a Corilraclo(s) liccnscd pursuanl to lhc Contrack)r's Liccnsc hw).
-latr|cxco|pl!ndcrsccti()n-.B.&P.C,ft)rlhisrcason.Dste:__ Owner:
WORKERS' COMPENSATION
DECLARATI(IN
I hcrchy affirnr undcr pcnalty of Frcrjury onc of lhc following dccluat ions:
-l
htrvcildwill mintainaCcnificaleoiConsenlloSel[-lnsurcforworkcrs'compcnsation.as pmvidcdforbySection3T0Oofthc
labor Grdc. for thc pcrforroncc ofthe work for which thc pcnnit is issucd.
-l
havc and will maintuin workcrs' compcnsalion insurancc. as rcquircd by Section J70O ofthc Labor Codc, tor thc pcrforroncc ol'
lhc work lbr which lhis ir issucd. My workcrs' conrpclsrlion insuruncc canicr antl lxrlicy nunrbcr ru'c:
uh-
l\rlicy ilt/tv'.7t
_l ccf,ily that in thc pcrli)rnmncc of thc work ii)r which this pcrmit is issucd. I shall not cnrphy any pcrson in any ilranncr
so rs kr hccoDrc subjcct k) lhc workcrs' conrpcrsation laws ofCalili)rnir. and agrcc lhat if I rhould hcconrc subjccl t) lhL
workcrs'coilrpcnsalionprovi\i(nlsofScclion-lTOOofrhcLahrrCorlc.lshall.fonhwilhcomplywilhthosprovisi(ns..
WARNINC: Failurc k, scurc workcrs' conrpcnsattrn is unlawlul. and shall subjcct an cmphycr h ffintinal FEnaltics and
civil llncs up to onc hundrcd thousand dollars (Sl iil lo lhlxost of conrpcnsation. damgcs as provided for lhcZ./-Sccli()n
I hcrcby aflirm undcr pcnahy ofpcrjury that I am liccnrd undcr pnrvision r
o[ lhc Busincss and Proltssions Code. md my liccnrc is in tull forcc dd
9 (connmncing wilh Scction 7(D0) of Division .1
l.iccn\c
'e#l ,r,*,,- /?37)Z
l)illc
(Z=
CONSTRUCTION LENDING AGENCY
I hcrchy allirnr undcr ;rcnally of Jrcrjury thul lhcrc is a conslruction hnding agcncy for thc lrcrfornrancc ofthc work l-or which this Jrcrmit ir
issucd (Scc. -1097, Civ. C.).
lrrtlcr's Nrrnc:
APPI ICANT DECI ARATION
I lmby affim undcr Jrcnulty of perjury onc of thc following declarations:
Dcmolition Pcrriils-Ashcsk)s Nolificalion Fcdcral RcSulalions (l illc 40. Ptrl6)
_Rcquircd kltcr of Notification
_l ccf,ify that lhc ltdcra! rcSulalions rcguding flshcstos rcnrvillilrc il)t applicablc to this projcct.
_l ccnify th.t I hrvc rcrd this alplication ilnd slalc th{t thc rtnvc inli,rnurlir[ is corccl. I ilFIcc k, eonr|ly wilh :rll ('ily i0d Counly
ordinilnccs and Slutc hws rchting to hcrchy xuthorizc rcprcscnlrlivcs of this Cily rnd County lo cntcr ufon lhc
ilh()v(: ilrcnlioncd p(,fcrly li)r
Applicanl or AgeDt
PemitE Dame (print):
' L-A .a L@!
,,r",37zo//g
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Salety /Low Voltage
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)
Ceilinqs (Hard & Soffit Rouqh
Ceilinos (T-Bar Rouqh)
Meter Release
Rouqh
Service [\/eter
FINAL
Notes, Remarks, Etc
'b7
Dule: z
lrndcr's Ad&css:
To whom it may concern,
Vivint Solar Development LLC is requesting cancellation for the solar permit obtained in behalf
of the customer listed below. Please mail refund check to Vivint Solar Development LLC at 9g47
Pioneer Blvd., Santa Fe Springs, CA 90670.
Customer Name 'fVccr\ htr+-tL/yLL ( Ptr-* 6fi zvt 1)
Project Address:LWq !V L-an
^Ln
Ln cAq 2lo4
001 d0( b552
customer Phone Number: 1 I +\ 5l + - Al
lf you have any questions or concern, please call or email Noemi parra at;
n oe m i. oa i'ra@v;vi n tsola r. com or (562 ) g 4Z-L27 O.
Thank you,Rn c E r v oD
JUN O 6 2OI8
City of Santa Ana
Noemi Parra
' ^.-.^ a\
562-942-L270
Permit Number: