HomeMy WebLinkAbout20130409 - Permit (3)city of santa Ana 20 civic center Plaza (M-19), Santa Ana, cA 92702
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738
Electrical Permit#:2O13O4O9
lnspector's Section: (714) 647-585g .{ J
Project Address: 5007 W Fifth St
Assessor's Parcel: 100-242-09 Lot: POR 11
Suite:
Block: NA
Bldg:
Tract: 1078
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Tenant Name
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Owner:
Address:
Phone
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Westminster Press lnc
4906 W lst St
Santa Ana, CA 927033110
(7141210-2888
Single Family Dwelling
New
New sfd w/att garage
Davis, Scott
Amsden, Julie
Fee Type
New Res
New Garage
Air Condit
Fwu
Low Voltage/Res
Dedicated Circuit
Serv Meter
PIC 650/o
lssuance
Amount
0.06
Qtv
3,316.00
708.00
1.00
5.00
1.00
5.00
1.00
412.34
1.00
Fee
$198.96
$42.48
$36.00
$44.50
$18.90
$44.50
$27.00
$268.02
$32.50
$712.86
$235.58
$477.28
jtr
a6.00
8.90
18.90
8.90
27.00
0.65
32.50
Occupancy:
Constr Type:
Code:
Date:
Date:
Date;
cEc 200'l
-1
08/30/2005
05/09/2006
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
M46158
Notes: Letter of auth on file.
Fee Total:
Paid to Date:
Balance Due:
CBuilding Permit
This permit shall expire by limitation and become null and void if the work authoized by this permit
is not commenced within 180 days from the date of this permit, or if the work authoized by this
permit ls suspended or abandoned at any time after the work is commenced for a peiod of 1 80 days.
Before such work can be recommenced, a new permit shall be first obtained fo do so.
Account #: 01 1 -01 -591 3 lnspector MID#: 2004-54539
@
N $
.-'-
DATE ID/S!G.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
Rough
Service lt/eter
FINAL
Notes, Remarks, Etc.
Owncr-Builds Declaation
I h6cby affm unds penalty of pejury that I m cxmpt fom thc Contracbre' LiccNc Law for thc following reon (se.7031.5 BNin6s
md Profssion Codc): Ary City or Cowty which rcquirc a pmit to coNtruct, alt6, improve, dcmolish or rcpair ey structuc, prior to its
issuucc, also rc4uir6 rhc applicmt for such pmit to filc a sigtrcd statmmt that hc or slrc is licffid pm@t to thc provisiom of thc
CoDrrctor's Liccns.d Law (Chapt6 9, Com@citrg with Setion 7000 of Division 3 of thc Buiass md Profsiou Codc) o, thal hc or
she is cxcmpt[Eeftom ad $c basis for thc allegcd amptioa .Atry violatio! of Setioa 7031.5 by my applicut for a p@it subj€ts thc
applicayfa civil pemlty of not morc thu 6vc hudred dollm ($500).
l(* o* of th.prcpsty, or Ey cmployc with wag6 6 rhctr slc compcrctioq will do thc work ed thc slrucluc is not iilodcd
Kr offocd for sale ( Sa.7044, B6in6s @d Profcssiom Codc: Thc CorEetor's Liffi Law do6 not apply to a omc of thc prcpoty
who builds or improvc thqon, ad who doc such work himclf or hcclf or tkough his or h6 ow cmploye, provided that such
improvmcnts dc trot intcndcd or offacd for salc. If, howcvq, the buildhg or improvmcnt is sold withil onc yo of complaion, thc
Ownq-Buildq will havc thc budcn ofproving that he or shc lot build or improvc for thc purpo* ofsalc).
_1, 6 oM6 of thc prop6ty. m cxclusivcly conracting with liccEcd coouactoE to coshd rhc prcjet ( SG. 7044, Buins ed
Profsion Codc: Thc Conmdor's Lic@ Iiw do6 not apply to u omo of propay who buil& or improve thooa , ad who
conracs for such projdts with a Contncto(s) licocd pmumt to thc Contractor's Lic6c taw.).
Im uda Setion P.C. for this reon.
I hoeby affm undo pcnalty ofpcrjury one
_l bavc md will maintail a Cdilicatc of CoE@t to Sclf.Isuc for work6' compsation, s providcd for by Sction 3700 of thc
l:bor Codc, for the pafomocc of thc work for which thc pcmil is issucd.
_l havc ad will maintab worko' @DpcNtiod iDsuacc, r rcquircd by Section 3700 of thc tabor Codg for thc p6fo@c of thc
work for which this pqmit is isucd. My wod(s' compcmtioo iasuuc ceiq ud policy oubq uc:
Policy
need not bc complctcd if the pmit is for Onc hundrcd dollm {00) or los)
cdiry that in the pcrfomilcc of thc work for which this p6mit is issucd, I shall not oploy my pasoo in uy mmd so 6 to
subjet to thc workc ' ompcusatioa laws of Califomi4 ed agre that if I should b6omc subjct to thc workm'
provisions thc labor Code I foflhwth comply thosc prcvisiom.
6
WARNTNG: Failuc to seuc work6' coEpsation unlawful. md shall m cmploya to oiminal pcBltiq ad civil
fE6 up to orc hudrcd thouud dollm ($100,000),in addition to thc cos of compmalion, dmag6 I lrovidcd for thc Setioo 3076 of
thc Labor Codc. irtsst ad anomcy's fe.
LICENSED CONTRACTORS DECLARATTON
I h6cby affm undq pcnalty of pojury that I m licc$cd udq prcvision of Chapra 9 (omctrcing with S@tiotr 7000) of Division 3 of
thc BwitrN ud Profssioro Codc, md my liccu is in full forcc md cffar.
Liccrc Liccnsc Numbq
Datct Cotrrdor:
[.ods's Ad&sl
CONSTRU('TION l,ENDING AGENCY
I h6cby affm und6 pcnalty of pgjury that thqc is a coNtruction loding agcncy for thc pofommcc of thc work for which this pmit is
issued (Se. 3097, Civ. C.).
Lcnds's Nme :
APPLICANT'S DECLARATION
Dmolition Pmits-Asbcstos Notificatiotr Fcd6l Rcgulations (Titlc 40, Part 6)
_ Rcquircd tatc of Notification
I eqil{that thc fctaal rcgulatioos rcgadiag 6b6tos rmoval dc not applicablc to this projdt.
,2( caity urat t navc rcad this applicatioo ud statc that thc abovc infomatioa is cortrl I agr@ to comply with all City ud Couty
'ordimcs md Sratc Laws rclathg to buildiog corotruction, ud hocby authorize rcpracntativcs of this City ed Couty to atq upoo the
abovc mcntioned inspetion
6 / )/za<rdApplimt or agat sig.
Pmiuerc(priil)
ELECTRICAL.I NSPECTOR RECORD
Word\wp5