HomeMy WebLinkAbout20169477 - Permit (3)Permit #:2Oi69477
Pin #: 47{85PermitCounter: (714)647-5800 lnspection Requests. (714)667-2738 lnspectorSection: (714)647-5853
Project Address: 2229 1/2 W La Verne Ave Unit:
Assessor's Parcel: 109-121-15 Lot: 15 Block: NA
Bldg:
Tract: 1346
Address Range:
Historic: No
Suite Range:
Zoning: R1
city of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA92702 Electrical
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier.
PBlicy #:
Expires:
DAVID & ANGELICA MEDRANO
2229 W LA VERNE AVE
Santa Ana, CA 927043509
(7141 501 -726e
Fee Type
01 1 16002 51603 Serv Meter
01116002 5160C General Plan Update
01 1 16002 51603 lssuance
Amount
55.37
22.95
57.20
Qty
100
1 .00
1 .00
Fee
$ss 37
$22 95
$57 20
Botch+:91602 g/ZI/}rtI? ID: t1f,IHE0A
Off i ce: CTYH Trnns+: 21 1 ol iAcct*: Ref*: ?1J16'747i
Rcpt*:u2723436 g/21/20L9 lLr:48 AH
Tronsoct ion Total S135.5:J
DAUID & AHGELI(:A HEDRAHO
Generol PInn Updobe Fee
ttl I 16t:r02- 5l 6u0ltt-t0-
Electn i cnl
ttl I 1601t2- Slott3uttrt-
V iscl
(:(:# : r*r*r * ** r x x x7122 Auth*: tr?1lli''
Building Use:
Job Type
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Accessory Dwelling Unit-C Occupancy:
Conversion Constr Type:
ADu/Service Meter Code:
R.3, U
VB
cEc 2016 Notes: New service meter for ADUHand out given. Auth on
f ile.
Zuniga
Date:
Date:
Date 08t21t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Buiuins Permit #: 10198834
Every permit rssued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe srfe by such permit,s suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#' 2018-1481 30
01 1 16002 51600
01 1 16002 51603
$22 e5
$112 57
Fee Total
Paid to Date:
Balance Due:
$1 3s 52
$0 00
$135 .52
w
ELECTRICAL-INSPECTOR R ECORD
nof
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrcby alfum undcr pcnalty of pcrjury that I am cxcmpt from lhc CotrtracloN' Liccns Lnw for lhc following rcasn (Str.70.11.5
Busilc$s and Profcssion Codc): Any City or Counly which rcquircs a ,Ermit to conslrucl. allq, improve. demlish or rcpdir any
structurc. prior lo its i$suure, also requircs thc a0plicant for such frcrmil to lile a signcd stalcmnl that hc or $he it liccnsd pursuant
lo lhc pmvisions of thc Contractor's Licenscd Law (Chaptcr 9. Comrencing with Scction ?000 of Division 3 of thc Busincss and
ProfessionsCodc)orthttlrcorsheisexcmptthcrcfromandlhcbasisforthcallcgcdexcmption. AnyviolalionofS@tion70.1l.5rbyany
applicant for a pcrnrit subj$ls lhc applicant to s civil pcnalty of not [prc lhan fivc hundrcd dollats (5500].
-1,
ils owncr of lhc proFny. or nly employccs with wagc$ as their srlc compcnsalion. willdo thc work a[d thc slrulre is mt
intcndc{t oroffcrcdforslc(Ss.T044.BusincssandPrcfcssionsCodc:ThcConlractor'sLicc.scllwd@snotapplylomownerof
thc pmFny who builds or imprcws thcmn. ntd who dms such work himsclf or hcrslf or thrcugh his or hcr own cmployccs.
providcd lhnt $uch hnJrmvctmnts arc ml intcndcd oroffcrcYl for slc. lf. howcvcr. lhc building or imprcrcmnt is $ld within onc )tu
of comphion. rhc Owncr Builds will haw rhc hurdcn of proving tluil he or shc did mt huiH or impmw lhc pmlEly for lhe purfns of
sah).
_1. as owncr ol'thc prof,crry, anl cxclusively conlraclirrg with liccnscd contractors lo conslruct lhe projcct (Scc. 7044. Busincss
and Pnrfcssion Code: The Contractor's Licclrsc Law docs not apply to an owncr ol prolrcrly u'ho builds or improves thercon.
and who contracls for such projccts with a Contraclor(s) liccnse'd pursuant to thc Contractor's Liccnsc Law).
_l arrr cxcrnpl undcr & P.Cl.rcil \( ) ll.
Drr".S,2L n
I)l':('L,\ R,\'l'l( )N
I hereby affirm under pcnalty of pcrjury onc of the folklwing dcclarations:
_l have and witl maintain a Certificate of Consent to Sclf-lnsure fbr workers' compensation. as provided for by Section 37fi) of the
Labor Codc. for the performance of the work for which the pernrit is issued.
_l have and will maintain workers' compensation insurance. as rcquircd by Scction 3700 of the [:bor Codc. for thc performance of
the work for which this permit is issucd. My workers' compcnsation insurance carricr and plicy number are:
Policy Number: ExPires:
_l ccrtify that in tlrc pcrt'orrnancc ot'thc work for u,hich this prnrit is issucd. I shall nol entploy any pcrson in any nranncr
so as lo bcconrc subjcct to thc rvorkers'colrrpclrsalion laws of Califrrrnia. lntl agrce lhat il'l shttuld bcconrc subjcct lo tlrc
workcrs' cornJrcltsation provisions of Sccti<ln 37fi) of the Lrkrr Cloclc. I shall. f<rrthwith conrply wilh thosc provisions..
WARNIN(}: Failurc lo sccurc u'orkcrs'covcragc is unlawtirl. arrd shall sub.icct an cntptoycr to crimi?al pcnalties and
civil fincs up lo onc hurtdrcrl thousaltd dollars irt arltlitiort to thc cost ol'damages as provided for the
aScclion lo7(r of lhc Labor Ctxlc. itrlercst and l'ccs.
o^
I)Ii( I,AR,\I ION
I hcrchy all'irrn untlcr pcnalty ot'pcrjury that I arn liccrrscd undcr provision ol'Chaptcr t) (comttrcncing u'ith Scct ion 7m0) of Division 3
ol' the IJusiness and Prol'cssions (lodc'. and rny liccnsc is irr lull lirrcc trd cll'cct
Liccnse Class: Liccnse Nunrbcr:
Date:- Contractor:
C()NS'I'I{U(:'I'ION I,I.]N I )IN(; A( ; IlNC\'
t hcrchy aflirm utrdcr Frcnallyof pcrjury rhot thcrc is a constructiotr hrding rgcncy lor lhc pcrforrorcc of lhc work for which this ttrmit is
issucd (Scc. 3097. Cir'. C.).
Irndcr's Nanrc:
[.cntlcr's Acldrcss:
APPLICANT DECLARATION
I lrreby aflirm undcr pcnalty of perjury one of the following declarations:
Dcrnolition Pcrmits-Asbestos Notification Fcderal Rcgulations (Title 40. Part6)
-Rcquircd
lrtter of Nolification
-l
ce.tify that thc fcdcralrcgulstions rcgurding asbcslos rcmval ue not applicablc to this pmject.
_l ccnify that I havc rcad rhis applicglion atd slatc th81 rhc stnve infirnmtion is corct. I agre to conrply with all Cily snd Coutrly
ordindnces and Statc L8ws rchlingrrfauilding construction. and bcrchy autluizc rcFcsentalives of this Cily 8nd Counly to enlq u[nn thc
vi:x:
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Sl ab I Floor
Bonding I Grounding / UFER /o4a-/c ,Ea/a
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouqh
Ceilinqs [-Bar Rouqh)
Nleter Release /a")-/e ,iB.,l?r-5
Rouqh
Service Meter /0291 'fulat -/1
FINAL lV'19- lh ,i\rb(r^1eP tty
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