HomeMy WebLinkAbout20158455 - Permit (3)city of santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Electrical Permit#:2lJ158455
Pin #: 55555-\
Projebt Address: 1521 W Anahurst Pl Unit:
Block: NA
Btdg:
Tracl:2207
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor'sParcel: 408463-13 Lol 42
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Francisca Abarca
1521 W Anahurst Pl
Santa Ana, CA 927045142
GALBAN ELECTRIC
4680 GRANADA AVENUE
Riverside, CA 92504
(9491 73s-2720
Fee Type Amount Qty
Notes: lnstall solar panels. All fees paid on 10187289.
Fee
State Lic #: 961385
Lic Type: C-10
Bus. Lic #: 352563
Workers' Compensation lnsurance:Carrier: Exempt
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Solar
Solar
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-3, U
VB
cEc 2013
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buildins Permit #: 10'187289
V 01t21t2016
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
PERilTT CffiCELLED
DATE:
IMTTAI:
t7/t {-z;ritiEvery permit issued shall become invalid unless lhe 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 is suspended
or abandoned for a period of 1 80 days after the time the work is
commenced.
Fee Total:
Paid to Date:
$0.00
$0.00
$0.00
lnspector MID#: 2015-124017
Balance Due:
@
Phone:
I
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEI,('ARATION
I hreby allirrn under pnalty of pqjury that I an exenlpt friln the Contrado6' License Law for the folkrrving re.$n (56.7031.5
Business and Profession Codc): Any City or County which requirs a pornil 1o constnlct. alta. irnprove, dernolish or repair any
structue. prior lo its i$uece. also requirB the applicanl for such pennil lo file a signed slatenrent lhat he or she is licensed pmumt
lo the Fovisions of the Conlraclor's l-icensed Law (Chapts 9. Commcncing wilh Scction 7000 of Division ]t of the Busins md
PrcfesionsCode)orlhalhcorsheiscremptrhtrefiomandthcbasisforlhcallcgedcxonption. Anyviolat'rrnofsstioilT0-3l.5byany
applicantforapmritsubjtrlsthe applicanttoacivilpcnaltyofnolrnorethmfivehundrcddollds($500).
I. o orvner oflhe progrny. or my employs with wage s their mle conrpensation. rvill do the work md lhe stnrdue is not
intoded or oflered for slc (Sa.7044. Busine and Profesions Code: Thc Conlraclor's Licosc Larv do6 not apply lo sn omq of
the propeny u'ho builds or irnpove thqon. ed \\'ho do6 such No* himself or hmelf or through his or her orrn empkry-ec.
provided that such improvonmts ue not intmdqi orofToed for sle. lf. horvo's. the building or improvement is wld rvithin one yw
ofcomplelion. the O\rncr Builds will have thc burdm ofproving that he or she did not build or irnprove the propdly for the pur[nse of
sle).
_1. ro orvnm of the propoly. am exclusi\ ely contracting \\'ith licosed conlr.cloE lo coilslrucl the preifr1 (s('. 70.1.1. Uusins
and ProfssionCode:lhe('ontractor'sLicenseLawdo6notapplytoanorvnerofproJrny$hobuildsoriilprolesthcreon.
and who conlracts for such projecls with a Conlractor(s) licensed pursuanl b the Coillrnclor's License l,nN ).
I an ereillpl under S<tion I] &l'C forlhisrcason
Drte:__-. _ Owrer:
WORKERS' COTIPI]NSA'I'ION
DECLARA'TION
I hercby afiirm undo penalty ofpojury one ofthe follorving d*luations:
_l have md rvill mainlain a Certificate of Consflt to Self-lnsure for rvorkos' compensalion. as pnvided for by S(tion :1700 of the
Labor Codc. for the pofonnmce ofthc work for which thc pfinil is issued.
I have antl s ill nrainlain srrrkers'irsurance. as requirecl by Section .1?(X) otlhe Labor (i)(le. [or lhc ps linrnance of
lhe Nork for \\'hich this pcnnit is isued. My cornpmsation insurance caria ad policy numbcr are:
Cmiq:- t O
Policy t'lurnbcr,-9 Expircs
_l ccdify lhat in the perforrnance of the $ork for $hich this pqmil is issued. I shall nol eilrploy ailr pcrson in an)'fiailnq
m mtobccornesubjatlotheworkm'compqs.lionla\\'sof('alifomia.andagrccthatiflshouldbcconlesubi(ttothe
workqs' composation provisions ofSetion 3700 oflhe t-ah)r Code. I shall. fonh\\'ith conrply with lhosc provisions..
WARNINC: Failure to scurc workers'conlpenstion covqage is unlas'ful. and shall subiect an onplolo to oirninal perBlti6 ild
civil linesuptoonehundredthousanddollffi($100.000).inadditiontothecosto[cornpensatior.darnagesasprovidedforthc
S(lion 1076 ofthe t bor Code. intsGt and attomef'\f*)r
Date:---L- Appllcnnt: \
LICENSED CONl'RAClOR
DECLARATION
I hmby affirrn undo pmahy of perjury lhd I m licosa.l under prcvision of Chaptr 9 (conrmqcing \rith Selion 7000) of Division J
of the Busins ild Profcssions Code. md rny license is in full lorce md cffet.,-
ti"rrt ctut"t C-l O
Dsre: y</ //6_-r\
License N ",,,r*,
qf I -\/f2 -
t "*."${44LO4tu1 p-7 rcrdn 4
CONS'TRUCTION LENDING ACENCY
I hoeby aflirm undo pcnalty ofpojury that thoe is a construction loding atsency for (he pdfoonance ofthe rrork for $tich this pqrnil b
issued (Sa. 3097, Civ. C.).
findq s Narne:
lsds's Addres: _
APPLICANT DECLARA'TION
I harby alfinn under poalty of pejury one ofthe following decluationsl
Demolition Pennits-AsbGtos Notification l:ederal Regulations ('l'ille 40. l'ar16)
-Required
Lats olNolifi cation
-l
c6tify that th€ federal regulations reguding asbestos rcrnoval are nol npplicable kr lhis proiect
I cfiify lhal I have read this application and stale lhal the atx)ve infornflli()D is colr$1. I agre
orrjirrancs and State [:s s rclot ing,1p builtling cory'n/tion. and heteb) aulh,riTe reprsenlali\ 6 o
::_ : , T::1.:l"T'"**IZnADolicrnt or Agent Sienrlurt: -tt
----j"
::J
to conrply s'ilh all Cily and County
fthis ('ity and Count) lo eDlq upon lhe
lhlc t,tz/rc
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildins
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
Rough
Service Meter
FINAL
Notes, Remarks, Etc.