HomeMy WebLinkAbout20165916 - Permit (2)City of Santa Ana
Permit Counter; (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical Permit #: 2O1659{6
Pin #: 79549lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 2205 S Laura Linda Ln Unit:
Block: NA
Bldg:
Truct: 2041
Address Range:
Historic: No
q
Assessor'sParcel: 408414-15 Lot: 52
Owner:
Address
Joyce L Obrien
2205 S Laura Linda Ln
Santa Ana, cA 927045027
(7141454-0121
Amount
21 .25
52.98
Qty
1 .00
1 .00
1 .00
Fee
$51.2S
$21.25
$52.98Phone
Tenant Name:
Contractor
Address:
J V A Electric
1119 Meade Ave
Fullerton, CA 92833
(714) 809-5069
Botchi143884 - 5/2L/2fr19 I0: J(0llice: (:TYH TfttnE+: 1[9 iAccti: &ef+: 2lr16i
R,:p t+: 622682.{5 - 1/21/2ttLg Stlt3
Irqnsoct ion Totql t345.:
State Lic #: 917168
Lic Type: C-10
Bus. Lic #: 369385
Workers' Compensation lnsurance:Carrier: Exempt
Policy #:
Expires:
I V A E lectr ir
Generrtl Plon Updste Fee
[r1116002- 51600u00-l lectr iccll
11r l160112- 5t603url0-
? rE(l
((:+: r** r * **r*rli5459 Auth; I r.r.1.irl(
Building Use:
Job Type:
Nature of Work
Single Family Dwelling
Miscellaneous
Service Meter
Occupancy:
Constr Type
Code:
Notes: handout given
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
nandez, Kathy
Date:
Date:
Date:o5t21t201A
Account#
Every permit issuod shall become invalid unless the work on the site
autho zed by such permit is commenced within180 days after its
issuance, ot if tho worl< authoized on the site by such pernit is suspended
or abandoned for a petiod of180 days aftet the lime the work is
commenced.
$125.52
$0.00
$125.52
lnspector ?rmD#: 2018-142795
01116002 51600
01116002 51603
$21.25
$104.27
Suite Range:
Zoning: Rl
Fee Type
01116002 51603 Serv Meter
01116002 51600 General Plan Update
01 116002 51603 lssuance
Phone:
i 1 t"l
r"{A
R-3, U
VB
cEc 2016
Misc. Receipt:
Misc. Receipt:
Misc. Receipl:
Total
Fee Total:
Paid to Date:
Balance Due:
APPROVALS DATE tD/stG.COMMENTS OWNER BUTLI'ER DELCARATION
I h.Bby atlird nnder ,'.Mlry of pcrjury th l am cxcmtr fmm rhe Coiracbs Liccnsc tjw for rlrc tollosinE rcr$n (s.c 70ll 5
Busincss dnd Profc$htr Codc): Any Cn, or Connry whth ,rqun s s Frn t lo connruct. slrcr. intmvq dcmlnh or rc,)at any
strucr!,c- prior lo ns isrudd, ulr, requims rhc oppltmr for such termil lo filc a sis.cd ntre'm.! ihd hc or stc is licened nrN!.r
lo lh. pn,vnions ofrhc ContBcrols Liensed liw (Chanr$ 9. CommminS wilh Secrion 7000 ol Divhion I ol lhc Businc$ rnd
Polc$ions Codc) or rhsr lror\hc hcrcnqr lhcr.from Md th.btrsh lhr rhc albsed ckdpr ioo anyviolalionolscdion 70:ll 5 bydny
rrpli.trnr r(tr d p.mn sub.Jdls rhc rpnlicunl ro s civil l)emlry of nor mr. rhan tlvc hnndrd dollds (3500)
-1,
as osicr olrnc pmpcny. r, hy.mpbres wirh srScs as rhct $lc omFnv'li.n. silldo rh. wolk ond lhc snEtr h nrr
i .ndcd or olr.r.d n, sb ( SN.]o4,1, Businc$ Md Professioas C{nlc 1 h. Conk,.t -{ Li.cn* Liw des ret arnly rd M owftr or
lhc loFny who toild!or innoEs rh.@., s''d wtx) ddr skh w.ik hims.lfor h.r*lfo! rhmush hh or hd.wD cmployccs.
pmrilcd rhri slch iml,.vcnrnh dc nor inr.Mcrl or oflcrtd for sh. ll howNcr, lh. tuiUinS or i,rprok.rnr ii $ld w hin orc )ur
olconplction- rhc Owncr Buihcr will hlw Dc htrdcn of pmving rhnr lu or shc did mr tnrild ot i.npmE Jrc I,Dpcny t tE luryv of
-1.
rownc,olrhc pmpcny, an.x.lusivclyc.nhdinB wiih hcc.scd connackns ro coniru.r rh pmjcd (S€. 7014. Busincs
rnd Pr,assirn codc Thc conhdols Licensc Law dcs not lpply i(' r. o*n$ or ProPcn, who builds or inpovc\ rh.r.on.
and who onrnch f.r srch pmF.G qirh a Co m.ro,{r) )tchscd pusuont ro rhc Cotrlrncior's Li.cn* tiw)
Dole ()wn..
W(IRXER\' CT)NiPENS^ fl .N
DECL/$AIIaN
I hcrchy alirdnnddi p.tulry ol lErju.y om ol lhc lollowinB dclarrtiotrsl
-lh!!catrdwillroinruinrCcnirrdrcorconrc.ltos.lrltrsurcl'or*ortcF.omncn\ario..arlrcvid.dforbyScclion3?OOoflhcLlhr adc. io. rhe pcrr,'mErcc of rk w. for whi.h rh. Frnn i! ilsuci.
I havc ,M Nill nritruin wo crl conucnsalion inslrlncc. as requncd $y sdrn'n 37ur ol I hc Lahor Cdc. ror rh. Frforrorcc ol
rhc work r(tr *hi.h rhis lE.nril is is$cn. My woltqr .onllcnsar ion in{uanc. .aricr ui Flicy numhcr &:
l.cnityrh,r inrh. pcrlonnnncco, rhc qork for uhich this p.ir.ir k is\ucd.l shill nor c floy0nrr.nnn in,nyn'nnnci
h N ro lrconE sunid lo rtc wolkcfi o,mt .\arion la*s orcaliforni{ old,8rcc rhll ifI should bccnft subj.ct ro thc
qortcr{ comnctrsl ion provnio,s or S(tion l?00 or rh. ljhtr C(xL. I xhrll. lon hwirh comply wirh rho{ l6visiotr\..
WARNINCT Frilurc to wurc workcis' com!.nsdion oemsc i\ u*!rul. nnd \hdll suhFcr !nfmrlnltr ln 6mntl Fmlras lnd
civil fi.cs u, lo onc hu.drcd lhousand dollos ($lOO.mO). in add'ftn iu rhc c.n or coFctrlion. daNScr ar lmvidd fo. ih.
SNr'.n l(rr6.rrh.lilsrcodc inr.E{ r.d dromt \ fe\ \ I /. t t ,.1 Ur* 7t>/t_,"". -29-12t/lt no,,-*, (/ ' r rcE{*p coNTRAc,lt)R
DECI.ABAIION
I hcrchy aftrn unifi p.nally ol p.rjury lh.l I an tia.*d ulld.r povhion of Chrtid 9 (onmrcin8 wilh Scclhn 7m0) ofDivirion l
of rhc Busine$ and Pmfesioos Cod.. atul ny lic..se is in tull forc {n cfist.
,\ '-*
)(
IONSIIUCUONIINDIICICEIICI
I h.abylnirm undcr rEnalryofF,ju,yrhar rhcrc is a.o.(fl.Ib. hnding agcncr lq rhc Frfornhncc oflhc mrk for whth rhn Fmjr n
isiu.dlsft 109?. civ c.).
ABBI.ICAIIJ'ECLIAAUA!
I tlnhy.rm undcr Fn.lly ol Frjury onc ofrhc followins dcclsari,ns
Dcm,lirion Pcrmn\ Arb.nd Nori,l.ariotr Fcdcr.lRc8ulati.ns ( lirb,r0. Pan6)
Rcqutcd h rd of Norificalion
-l
ccrriiyrhurrhc tcdcrdrcsrhrn,n\ rc8n tlin8 .{b.(os r.nr)u!l c Nlnpplicobb r, rhi\ tojc.r
o omply wirh rll Cily and Counry
rhic Cnya Counryro cnrcr ul,n rhc
*,", or/zr /rg
-l.fiiiy
rhur lhdv. rcsd rhF hrtlkrhnn t {Jrcrhd rhc rb.). inlomrinn r.nncd Ir8rsr
ndmomc\,nd Srrre br\ (l,r'ns ro hdrld'nF .nn{ru.rh.. drllcrrhyrurhori/c,cIYcrnlrrivr. nr
lborc nrnrnmd Impcnyl.r ir\ngclio[tuq{{- I I
{pprion, or^ss,s,s*ru* N{e! r 4711-
p.mi,mnon?(pr,D,): ifiw *olSz'r&cL/
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Salety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding i Grounding / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Solfit Rouoh
Ceilinqs (T-Bar Rouoh)
[/eter Release
Rouqh .,.:\
Service Meter 4,4t,tg I .f/iWrAe W\
FINAL qSta l/,,iAl 'rQD )
Notes, Remarks, Etc.lt \
ELECTRICAL.INSPECTOH RECORD
! r rrrnror un'xr Sccrtr'n . t! & PC for lhn'.x{n
ocfzr L
kndcac AddEis'-