HomeMy WebLinkAbout20165947 - Permita ElectricalCity of Santa Ana
Permit Counter: (714) 647-5800
20Civic Center Plaza (M-19), Santa Ana, CA 92702
lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #= 2O{65947
Pin #: 58845
Proiect Address: 4014 W McFadden Avea
Assessor's Parcel: 108-601-25 Lot:
Unit: MTR01
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning
Owner:
Address:
Phone.
Habitat For Humanity Of OC
22OO Ritchey St
Santa Ana, CA 927055308
(7141 920-1 814
Fee Type
01 1 16002 51603 Serv Meter
01 1 16002 51603 Min Fee Adj
01116002 51600 General Plan Update
01 1 16002 51603 lssuance
Amount
51 29
19.35
21 .25
52 98
Qty
1.00
1.00
1.00
1.00
Fee
$s1.29
$1e.35
$21 .25
$52 98
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation ! nsurance:
Carrier:
Policy #:
Expires:
Bnb,:h*:+3?2rJ 3/?3/'7ttlS
[j['f ice: (:TYH J'rnnE*; 2'/
IT
tT ;ir7?69:i54
nct i on TotnI
b i t.nt F or' ;lumnn
GenerqI Flqn Updote Fee
r-r1 L 16[Lr?- :;l5Lttt0r.rtr*
Ele,:tr icol
r-rl I 161102- 51603[t[t[t-
Building Use.
Job Type:
Nature of Work:
Other
Miscellaneous
Service Meter
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
N/A
N/A
cEc 2016
***r*rrr****l{4++
Planning Conditions:
Planning Approval By: Orozco, lvan
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Hernan dea Kathyvk
05t23t2018
05t23t2018
Account#
Misc. Receipt:
Misc. Receipt.
Misc. Receipt:
Total
Notes: for irrigation system
Fee Total:
Paid to Date:
Balance Due:
01 1 16002 51600
01 1 16002 51603
$21 .25
$123.62
$144.87
$0 00
$144.87
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
rssuance, or if the work authorized on the site by such permitis suspended
or abandoned for a period of 180 days after the time the work is
commenced.
lnspector MID#: 201 8-143531
ELECTRICAL.INSPECTOR RECORD
f),ta n7 Dn{ H
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARA'I'ION
I hcrcby affirnr undcr lrnalty of pcrjury th{l I am cxcmpt fmm lhc Contraclos' l-iccnsc tlw for tlrc following rcasn (Ss.7O-11.5
Busincss ard Profcssion Codc): Any City or County which rcquircs a prmil lo construcl. alt6, inurrovc. dcmlish tr rcpair any
struclurc. Jrhr to ils issuance. also rcquircs thc applicant for such lrcrmil to lilc ! signcd slalemnl lhat hc or shc is liccnsd pursudnl
to thc pmvisions of lhc Contractor's Liccnsed lnw (Chaptcr 9. Commcrcing wilh Scclion 7000 of Division -1 of lhe Busincss and
Profbssions Codc) or rhil he or she is excmpt thcrcfrom and thc basis for lhe allcgcd cxcnrption. Any violation of Scclk)n 703 L5 by any
applicant for a pcnnit subjsls thc applicant to u civil pcnaltyof not mrc than fivc hundrcd dolltrs ($5fi)).
_1. as owncr of thc proprly. or nly enlployccs wilh wagcs as thcir sole compcnsation. will do thc work and thc structurc is not
intcndcd or offcrcd lor salc (Scc.7044. Business and Prol'cssions Codc: Thc Contraclor's Liccnse Law docs nol apply to an owner of
thc propcrty who builds or improves thcrcrrn. and who docs such work hinrsclf or hcrsclf or lhrough his or hcr own employces.
providcd that such irnprovcnrcnls arc not intendcd or olTcrcd for salc. lt. howcrcr. thc building or improvcrrnl is sokl within one yeiu
of comphtir)n. ttrc Owncr Builder will have thc burdcn of proving thal hc or shc did not huild or improve the proJrcrty for thc purpsc of
salc).
_1. as owner of thc propcrty. am cxclusivcly cotrlracting with liccnsecl contraclors lo construct thc projccl (.Scc. 7()44. Busincss
and Pnlt'csskrnCoclc: 'l'hc Conlractor's Liccrrsc Law docs not applyto anowncr o[properlywho builds or intprovcs lhcrcon.
arrd who contracts lbr such projects with a Contractor(s) licenscd pursuant to thc Conlractor's Liccnse Law).
I am exemnt
Date:_
undcr Scction-. B. & P.C. fpr this rcason.
- ,wner,-p\- K,^/*4 Pd'/-e
WO RKERS' COIIT PENSATION
DECLARATION
I hcrchy all'irrn undcr pcnalty of pcrjury onc of thc lolkru'irtg dcclarations:
_lhavcandwill rnaintainaCertificateo[Conscntt<l .Sclf-lnsureforrvorkers'cornpcnsation.as providcdforby.Seclion-]700ofthc
Labor Code. for the pcrformancc of the work for which thc perrnit is issucd.
-l
have and will rnaintain workcrs'cornpcnsation insurancc. as requircd bySccti<ut 37ffiof lhc LaborCoclc. forthc pcrfornunceof
thc work for which this pcrrnit is issucd. My workcrs' compensati<ln insurattcc carricr and Jxrlicy number arc:
Policy Number: Expires:
_l ccrtily that itr lhc pcrtirrrnance of thc wrlrk lirr which this pcrrnit is issucd. I shall nttl cnrploy any pcrson in any tnanner
so as to bccornc subjcct to the workcrs'cornpcnsalion laws of California, and agrcc lhat if I should bccotttc subjcct to lhc
workcrs' corrrpcnsation provisions of Section 3700 ol'thc [.ahlr Codc. I shall. lirrthwith comply with thosc provisions..
WARNING: Failurc to sccurc workers'cornpensati()n covcrage is unlawl'ul. and shall subjcct an crnployer to crirninal pcnaltics and
civil fincs up to onc hundrcd thousand dollars ($l(X).fiXlt. in addition lo lhc cosl of conlFrcnsation. dantagcs as providcd for thc
Scction 3076 of thc Latxlr Code. intercst and atlorlrcy's l'ces.f /ry*Date:_Applicant:
DECLARATION
I hercby alfirnr under pcnalty of perjury that I anr liccnscd undcr provision of Chaptcr 9 (contmcncing with Scction 7Un) of Division 3
of thc Busincss and Professions Code. and my liccrrsc is in l'ull tbrcc and effect.
Licensc Class: Licensc Numbcr:
Date:
W
I lrcrcby sffrm under pcnatty of perjury that thcre is a @nstructbn lcnding agcncy for thc ]Erformne of lhc mrk for which this pcrmit is
issucd (Scc. 3097, Civ. C.).
hndcr's Nanrc:
lrndcr's Address:
APPLICANT DECLARATION
I ffiy affirm under penalty of perjury onc of thc following dcclarations:
Dcmolition Pcrmits-Asbcstos Notification Fcderal Regulations (Title 40. Part6)
_Required [rttcr of Notification
-l
ccrtify that thc fcdcrslrcgulations rcgading asbeslos rcmvalarc not applicahlc lo this prcjert.
_l ccrtify thal I hBvc rcad this application ard state thst lhc .tnve infomtion is corrccl. I sge to @mply with all City and County
ordinares and Statc Laws rclating to building coNtruction. 8rd hercby authori4 rcprcscnlaliws of this City and County to cnts uIDn thc
ffi*I-:il: *," dzt/tt
Permitee name ( prinl): ___
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under SIab / Floor
Bondinq I Groundi nq I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Rouqh)
N/eter Release v 'dn 5-na l;4r1 , Rk
Rough
Service N/eter
FINAL Uto ltll -ftrLa,{2il )
Notes, Remarks, Etc.I I I VU \t/
Contractor:_