HomeMy WebLinkAbout20270425 - PermitProject Address: 825 S Cypress Ave
Assessor's Parcel: 01 1-052-03 Lot: POR 8
Unit: A
Block: NA
Bldg: Address Range:
Tract PART OF MCFADDEII|SIOT|C: No
Suite Range:
Zoning. R2
City oi Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: 20270425
Pin #: 58693
Owner:
Address:
Phone:
Nghiem Nguyen
54 Maywood
lrvine, CA 92602
(7141 492-2607
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777C
Fee Type Amount
Demolition (includes ren 50.36
General Plan Update 22.95
lssuance 57 .20
Microfilm Records 3.91
Qty
1.00
1.00
1.00
1.00
Fee
$50.36
$22.95
$57.20
$3.e1Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Bsbch*:53531 12/ 19 /2t-t|9 ID: (:(:UEi-
Office: ITYH TrnnEi:7 2 crlAcct#: Ref*: 2t-t?7r:4?'i
Rcpt*:tr2g377tt$ 12/I?/?itL? 8:4tl Ail
Transoction Totnl $lrIB4.Si:
l','!gh i eu Hsuuen
Genernl Plnn Updqt e Fee
01 1 160tt2- 516ttt-tlttrlr-
Electr'iccrI
01 I 16trtr2- 5l6u3lr00-
11 icrr,f ilm & Dncuments
Lr 1 1 1 6r_ru2- 3777 r_t00tr-
Visn
CC+: ***r*r**r**r3748 S1 r 584.3t
Auth* :75S37DBuilding Use:
Job Type:
Nature of Work:
Single Family Dwelling
Demolition
N/V-Demo
*i-,+1
Planning Conditions:
Planning Approva! By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buirdins Permit #: 1 0 2102600
Occupancy:
Constr Type:
Code.
Date:
Date:
Date:
R-3, U
VB
cEc 2016
12t18/2019
I
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
Demo unpermitted electrical in laudry facility/walls in
garage and revert back to original use. Remove
enclosed walls in carport area and return back to
original use.
$134.42
$0.00
$134.42
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuancb, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 360 days afterthe time the work is
commenced.
lnspector MID#: 201 9-156616
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$22.95
$107.s6
$3.e1
ELECTRICAL.I NSPECTOR RECORD
T),no n7 ?n,t r:,
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hocby aflim undo pcnalty of pcrjury that I m cxcrtrpt from thc Contraclon' Liccre Law fo1 thc followilg rcmn (Sc.7031.5
Busincs and Prof6sion Codc): Any City or County which rcquirc a pomit to construct, alt6. improvq dcrnolish or rcpair my
structm prior to ils issuucc. also rcquire thc spplicilt for such pcrmit to 6lc a signcd ststmmt lhnl hc or shc b licmed plruat|t
to the ttrovisioN of lhc Contraclq's Liccnscd law (Chaptq 9. Commocing rvith Sation 7000 of Division 3 of the BusinN ud
Profsions Code) or that hc or shc is cxempt thGefrom and thc b6is for thc all€ged exmFion. Any violation of Sctiotr 7031.5 by any
applicantforapflnitsubjetsthe applicanttoacivilpcnaltyofnotmorcthanfivchundrcddollas($500).
-1.
as owner of the propcrly. or my employees with wages as their sole compensation. rvilldo the rvork and the struclure is not
intended or oflered for sale (Sec.7044, Business and Professions Code: f'he Contractor's Liccnsc Larv does not apply to an owner of
the pmperty rvho builds or improves theron. and who does such work himself or herself or through his or her own employees.
provided that such irnprovonents are not intended or offered for sale. I[, however. the building or improvement is sold within one ]tzr
of cornploion. the Owner Builder will have the burden of proving that he or she did not build or improve the propo'ty for the purpose of
sale).
-1.
as owner of the propefly. am exclusively contracting rvith licensed contractors to constnlct the project (Sec. 7&14, Business
and ttofession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon.
and who contracts for such projeds rvith a Contracto(s) licensed pursuant to the Contractor's License Larv).
_l am exempt under B. & P.C
I hereby alTirm under penalty of perjury one of the
--l
have and will maintain a Certificate of Consent to Self-lnsure for rvorkers' compensation. as provided for by Section 3700 of the
Labor Code. for the p€rfonnance of the rvork for which the perrnit is issued.
-l
have and rvill maintain rvorkers' compensation insurance. as required by Section 3700 of the Labor Code. for the perfonnance of
the rvork for which this permit is issued. My rvorkers' compensation insurance ciurier and policy number are:
Carrier:_
---l certify that in the performance of the work for rvhich this permit is issued. I shall not ernploy any person in any manner
so as to be'come subject to the workers'compensation laws of California. and agree that if I should become subject to the
workers' cornpensation provisions of Section 3700 of the Labor Code. I shall. forthrvith comply with those provisions..
WARNING: Failure to secure workers' compensation coverage is unlarvful. and shall subject an employer to criminal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for the
Section -3076 the interest and attorney's fees.
(commencing with Secrion 7000) of Division 3I hereby affirm under penalty of perjury that I am licensed under of Chapter 9
of the Business and Professions Code. and my license is in full force and effect.
License Class: License Number:
Date:( 'onl rirclrlr:
CONSTR,UCTION LENDINC AGENCY
I hcrcby affm unde pcnslty of pcrjury lhd th6c is a consruaion loding aSmcy for thc pqfoIrmcc of thc rcrk for which this psmh is
issu€d (S(. 3(x)7, Civ. C.).
lfidtr's Nmc:
l.ender's Address:
APPLICANT DECLARAI'ION
I hereby aflinn under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
_Required Letter of Notification
rt
I cedifv that the
Wrtt'urttu*'.
federalregulations regarding asbestos removalare nol applicable to this project.
read this with all City and County
and County to enter upon theordinances and State [,aws relating to
above rnentioned property for
Applicant or Agent
Pernrilee name (prinl):
purposes.
NG|?€- -
I
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm lDampers
Communications Cable
Building
Under Slab / Floor
Bonding I Groundins / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinss (Hard & Soffit Rouqh
Ceilings (T-Bar Roush)
Meter Release
Rough
Service Meter I
FINAL //22/raz ffi U
Notes, Remarks, E{c.(
Policy Nurnber:__Expires:
a