HomeMy WebLinkAbout20118398 - Permit (3)Electrical Permit #: 2O/l18398City of Santa Ana,5/20 Civic Cenier Plaza (M-19), Santa Ana, CA 92702 Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738
Project Address: 1314 S Poplar St
Assessor'sParcel: 109-273-13 Lot: 38
Suite:
Block: NA
Bldg:
Tract:1574
Address Range: NA
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Jesus Ramirez
1314 S Poplar St
Santa Ana, CA 92704
(714) 556-6819
Fee Type
Serv Meter
lssuance
Notes
Fee Total:
Paid to Date:
Balance Due:
Amount
23.00
22.50
Qty
1.00
1.00
Fee
$23.00
$22.50
$45.50
$0.00
$45.50
Phone:
Tenant Name
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Building Use:
Type of Work:
Nature of Work:
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling - Dr Constr Type:
Alteration Occupancy:
Service Meter Code:
Archer, Lori Ellen
per Memo
Date:
Date:
Date:
VN
R3
cEc 1998
Upgrade service meter. Handout given. No relocation per
cust
07t1312001
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
This permit shall expire by limitation and become null and void if the work authorized by this permit
is not commenced within 180 days from the date of this permit, or if the work authorized by this
permit is suspended or abandoned at any time after the work is commenced for a period of 180 days.
Before such work can be recommenced, a new permit shall be first obtained to do so.
Account #: 01 1-01-5913 lnspector Clt! $4 42? ?1301il101. r{5.9o}f
,JSIX\
-i$41t?-x9ru{ina \'
Buirding Permit #, /O / ru7-*
I
(/
Owner-Buildct Dt.ldltion
I hcreby affim undcr pcnalry ofpcrjury that I am excmpt fom thc Contracto6' Licens: Low for lhc following rcoon Scc.703 L5 Busincss
ud Profession Codc): Any Cily or County which rcquirs a pcmit to construcl, alter, improvc, dcmolish or repair uy structurc, prior to ils
issuancc. also rcquirc thc applictrt for such pcmit to lilc a signcd stalcmcnl that he or shc is licoscd puGuut to thc provisions oflhc
Contractor's Liccnscd Law (Chaptcr 9, Commcncing with Scction 7000 of Division 3 ofthc Busincss ud Profcssions Codc) or thal hc or
shc is cxcmpt thercfrom and rhc buis for the ollcgcd cxcmption .Any violotion of Scction 701 1.5 by any applicu( for a pcmit subjecb the
a civil pcnalty of not morc thil fivc hundrcd dollm ($500)
s owncrof lhe propcrly, or my employccs with wages u their sole comPcnsation,
( Sec 7044, Busincss md Profcssions Codc: Thc Contractor's Lic6s.
will do the work md thc structurc is not intended
or offcrcd for salc Law des not apply to u owncr ofthc propcny
who builds or improrcs thcrcon. md who dcs such work himselfor herelfor through his or her own cmployccs, providcd that such
improvements arc not intcnded or offcrcd for sale. lF, howcver, thc building or idprovement is sold within one ycu of completion, thc
Owner-Buildcr will have thc burdcn of proving that he or shc not build or improvc for thc purpose of sale).
_1, s owncr of thc propcny, m cxclusively contracting with liccnscd contractor to construct thc prcject ( Scc 7044. Busin6s ild
Profession Codc: The Contractor's Liccnse Law dcs not apply to m owncr ofpropcrty who builds or impnovcs thcreon , md who
contracts for such projecb with a Contractor(s) liccnscd puEuilt to lhc Contraclor's Liccnse Law.)
m cxempl under section &PC forthisrecon
Date /r,^ /r*a fli,u,--To
t','
WORKERS COIlIPENSATION DT]CLARATION
I hereby affim under pcnalty ofpcrjury onc ofthc following declarctions
_l have ud will maintain a Cenificatc of Consent to Self-lnsurc for workcn' compensalion. 6 provided for by Secrion 1700 of lhc
Labor Code, for thc pcrfomance of thc work for which the pmit is issucd
_l haveandwill mainrains,okcrs'compensationinsurmce.s rcquiredbyScction3T00ofthet-aborCodc.frrrthepcrfomanccofthe
work for which this pemit is issucd My workers' compensation insurance canier and policy nunrbcr rre'
Can'icr
(Tf on nccd not bc complelcd if thc pennit is for Onc hundrcd dollm l$ l00l or lcss)
{l ccnify rhat in rhe pofommcc of thc work for which this pemit is issucd, I shall not cmploy any ptrson in any manncr so N to
bccmc subjcct to thc workcm ' compcnsation laws of Califmiq md agrcc that if I should bffomc subjcct to thc workcm'
md civil
fincs up to onc thousand doll$s ($100,(X)0).in addition to the cosl ofcorrpensation. damagcs u providcd for thc Section -1076 of
thc Labor Code, intcr.sl Md otromcy's fccs
I,ICINSED CONTRACTORS DECI,ARATION
I hcrcby affim under penalty of perjury that I am licenscd under provision oi Chapter 9 (commencing with Section 7000) of Division 3 of
thc Rusinms Md Professions Codc. rnd my liccnsc is in full forcc ud effect
Policy Numbcr:---E*Pi.cs,
Liccnsc Cl6s:_ Liccnsc Number
Datc, _Contmctor;
CONSTRTICTION I,ENDING AGENCY
I hereby aflimr undcr pcnalty of pcrjury that thdc is a construction lcnding agcncy for thc pcrfommce of the work for which this pcmit is
issucd (Sec 3097, Civ C )
l-cndcr's Nanrc
Lcnder's Addrcss
APPI,ICANT'S T'ECI,ARATION
Demolition Pemits-Asbcstos Notillcntion Fcderal Regulations (Titlc 40. Pm 6)
_ Required Lcttcr ofNotificalion
I cenify that thc fedcril regululions regarding obestos removal are not applicable m this project
_ I cenify rhat I havc rcad rhis application md state that thc above infomation is corect I agree to comply with all City and Counly
ordinrnces and State Laws reloting to buildinS construction. and hereby authorize representatives of this City rnd County to entcr upon the
abovc mcntioncd propmy for inspcction
or agent sig
Pemittee nme (\,>
_Datc
DATE ID/SIG.COMMENTSAPPROVALS
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torquing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rough
Ceilings (T-Bar Rough)
Meter Release
I
(6>r 'ucta
Rough
Service Meter
6-Z-a p.crs za3FINAL
Notes, Remarks, Etc.
)
ELECTRICAL.INSPECTOR RECORD
o,
r/rf/ol
l I