HomeMy WebLinkAbout20166646 - Permit (2)City of Santa Ana
Permit Counter: (7 1 41 647 -5800
20 Civic Center PIaza (M-19), Santa Ana, C492702
lnspection Requests: (714], 667-2738 lnspector Section: (714) 647-5853
Electrical Permit #: 2O166646
Pin #: 39112
Project Address: 3229 S Towner St
Assessor'sParcel: 410-253-08 Lot: 36
Unit:
Block: NA
Bldg:
Tract: 7150
Address Range:
Historic: No
Suite Range:
Zoning: Rl
q
Owner:
Address:
Phone:
Tenant Name:
Contraclor
Address:
Loi Nguyen
3229 S Towner St
Santa Ana, CA 92707
(7141795-1246
Owner-Builder
01 1 16002
01 1 '16002
01 1 16002
01 1 16002
01 I 16002
01116002
51603
51603
51603
51603
51603
5'1600
Qty
13.00
6.00
15.00
5.00
1.00
1.00
Fee Type Amount
125 Volt Receptacle 1.45
Light Switches, Occ. Se 1.58
Light Fixtures 1.05
Dedicated Circuit 24.79
Fee Exempl -190.11
General Plan Update 22.08
State Lic #:
Lic Type:
Bus. Lic #:
Worker.s' Compensalion lnsurance:
Carrier:
Policy #:
Expires:
Planning Conditions
Plannang Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling Occupancy:
Addition Constr Type
change from contractor to (code:
Chavez, Dave
Date:
Date:
Date:
vc.
08/r3/20r8
Account#
Notes: Reference #20156333. Add family room (1) bedroom
and (1) bathroom, remodel (e) bedroordAdd patio
cover
Misc. Receipt:
Misc. Receipt:
l\4isc. Receipt:
Total
Every permit issued shall become invalid unless the work or, lhe sile
authoized by such permit is commenced within 180 days after its
issuance, ot if the work authoized on the site by such pefinit is suspended
or abandoned fot a pedod of 180 days aftet the time the wo* is
commenccd.
10197331
lnspector MID#: 2018-143093
N/A - No Balance Fee Total:
Paid to Oate:
Balance Due:
$0.00
$0.00
$0.00
Fee
$18.8s
$9.48
$15.75
$123.95
$-190.11
$22.08
Phone;
Building Use:
Job Type:
Nature of Work:
R.3, U
VB
cEc 2016
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER DUILDER DELCARATION
I h.tutrt amrfi und.r pcndlry of Friury rhdr I mcxem fmn rhc Conrr.hn l-kcns bw tor lhc f.llowinS- rcn$n (Scc.703l.5
tsusinc$ aln Profi*io. Codc): Any Cily o. County which Equics a pcrmil to conslrucl. flllcr, improlc. dcmlish o. qi{t any
srtocrurc. Eior ro irs hsuame. rho Elutcs rhc ryIltonr lor such Frmir ro filca sisncd sralemnl rhlr heorslr t\ li*nscd ru. onr
k,lh. pmvisions 016. conlrack s Li.cnsd bw (Chnprcr 9. c.nncftin8 wirh Sccrion 7fiD olDivnn lofth.Busnt$lnd
P,llcssions Codc) oi rh{t tf, or she is cicmpt rhcrcfrononn rhc blsis lor rhc ollqcn cxcmflion. Anyliol.rionolSdliJnToll.t by 0ny
,firlkafl for d pcmn slbj(ls rhc {,rlicsnr r., ciril I}.naltyofftn m,c rh!, fiv. hu.dicd dollarq (l5m)
lN. * .**r r,* o^,*nn o. my cmphy.cs wirh wrscs rs rhcn !,h onpcnsar ion. will do rtr *o,k n IlE $xiE n nor
inlcndi or ofic..d for slc (Se.7044. Busitrcs .nd Pmfcsshns Cod. Th. Conl!0dols Licctrs Llw docs nor opr y ro M o*ncr ot
rhe ln)tEny who huildror inpturcrrh.en, and *ho dms xuchs hihscll or hcrklf or rhhu8h hir or hn own.npl.yccs,
pruvidcd lnd slch inv,mrmnrs N ml inrcnd.n or offcrn ftr sk. lt lrwE. lh. buildioe or i,rmEnr n sld wnhin o*
'ttroI ongldbn.
'rE
osmr auit r wil h,rc tlE hdcn of Imvine rhoi rh or sh. did nol tu d or i,n0mw lhc ImIEny fr rhc prrFE oa
-1.as.wncrofrhclronny.0ncxclusivclyconrrlcrinswilhliccnscdconrracrosrocon(ruclrtrrmFrlScc70.14.Bu$ftt\irl lrrDtusdn Cod.r Thc Conhncror's Lic.nsc Law docs nor amly h mown r ofpn,lcdy *ho builds or inrprovcs lhercon.
ud Nho coorrach lor such prcFh sirn a Ornhcro(g ltenscd ru6u r ro rhc Cont&ttr sLic.nscllw)
-l
rDqcmpl utrdcr Sccli
t-,=l-l
DICLABAIIO!
I lrcrcby !flinnunder penrlryolp.rjuryo.c of rhc lollorvins dccliririons:
IhavcandsillnuinrriDoC.nificar€ofconrnrI.S.lllnsurctr!qo crr.ompcnsari,n,, a\ pnrvidcd for hy Sc.rn l?0Ootrhc
Llb.r Codc. ior rhc lclforromc olthc soft for which rhc pcan ir nsucd
-l
hr[ lnd*illnri oin so,kcn coflrpcnsariotr insurancc. as rcquncd hySsrnnr]7(notrhc l,horCodc. ftxrh. lcaforruNc or
lhc nuk lbr rhich this p.rmir is hsucd. M y workcn conrEnsarion insunrcr clricr xnd Ix licy nu'nh.r ,ft:
LN{ *a,ry rh ii thr p.fd,mn.. .r rh. work rd whi.h rhi !.rml is n*ued. I \hnll nor ctr[loy rtry p.mn in $y monncr
xr as lo tto!rc subj.ct lo lhc workcs' conD.nsal ion laws of Californi!, otrd rBE lhal il I sh,uld tEcort suhjccr r. rrtr
*oltca conU.nslionImvhions of Scriofl ]TOO oflhe Libor aodc.I sh.ll. ionhwilh srylt eirh rh.s rFviaions..
Scdn r 1076oflhe tih, G)dc, ir crcn nxl.lioary\ a.cs
r,,",'OE\b ^t(
^pp,ic.n,:
!<-
Ll!-t !rr!xoIl&\t_I2lt
DS:IdAAIIQN
I hcsb, lmrmundcr pcMllyofperjurylhul I an liensl under rrcvisionolChoplcr 9 (mmntming wirh Scclioh Tuxl) ofDivision l
ol lhc Busircs md Pmicssions Codc, ond my liccnsc n in 6i ll ior.c dcfl(l.
CON BUCUOIIIND,IIC.ACENqI
I hcrcby ,ifirn u.dm tfnaliy of pujury lhal lhcrc is a .on(dclb. lcndi,rB qcncy for th. pcrr'onMe of lhe lork for whth rht rEmi ir
irsucd (scc :109?, Ctu C ).
AIPIICANI.DECIdSAIIIIN
I hdrl,y anim undcr rcndlty .f r.rjury oic or rhc followin8 delml bns:
Dcmlirion Pcrnih-ArtEslos Nolificalion Fedcnl Rc8ulalions (Tnt 40. P!n6)
-Rcquncd
t.nfl of Nolifi carnn
I ftd iay rh0r $c Ld.ral nBulalions Rgarding asbcsktr n'tuvd m ml lrrltablc lo this poj.\t.
!d eiily rh.r I harc rcd rhis trpllic0rion s'd srardhrr rhc,t[rc inrdnurion nconsr. lacrc rocomplyvnh lll cary and counr,
ofllinimcs and sr.rc tjws rhrin3 to building con$ru.tio...Id htrcbyaurhori- rc[cscntalives ofrhis Ciry d Counry k, cnrd uFin rl*
rt vc trrnriohcd lmncny ttr inspcct ion lury'*s
L-
Applicmt or Agenl siamlure:
,"*u* *.",0n*,(d6ru.d o9-$-r9
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Lile Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding / Groundino / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
alls (Conduit)
Walls (Rough)
Ceilings (Hard & Solfit Rouoh
Ceilinqs (T-Bar Rouqh)
Meter Release
Rough 9t 'l flr7a)
Service [,4eter
FINAL 4 l?/r3 I \rry-\^ e/r f:n\
Notes , Remarks, Etc.fr U' \-/
-+,
5 "**.)a
tf,nd€' s Addr.$.