HomeMy WebLinkAbout20172183 - PermitProiect Address: 241 I S Salta Sta
Assessor's Parcel: 412412-04 Lot: 49
Unit:
Block: NA
Bldg:
Tract: 3963
Address Range:
Historic: No
Suite Range:
Zoning: R1
--City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #i 2fJ172{83
Pin #: 14443
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Derrick Nguyen
2418 S. Salta
Santa Ana, GA 92704
(7'.t41 890-2029
Hex Electric
1028 S. Figueroa
Santa Ana, CA 92704
(7141 856-ss37
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
Serv Meter
General Plan Update
lssuance
Microfilm Records
Amount
57.40
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
Fee
$57.40
$23.79
$5e.30
$4.05
$?3 .'79
S4. t-t5
S116.7t-t
S255. [t-l
( t4 .46)
State Lic #: 1045005
Lic Type: C-10
Bus. Lic #: 376631
Workers' Compensation lnsurance:Carrier: Exempt
Policy #:
Expires:
Botcht :5699tt Lt:t/27 / 2Lt2tJ ID : EL- I Zr\llETH
0f'f i ce : {:TYH Tr nn s* : 3tt ? of' 2Acct*; Ref *: 2ltl7:? 181
Rcpt*:0311r19?5 Lit/27 / ?Ltztr I :4r.r r'H
Trqnsot:b ion Total t250 .?-,4
Hector Pelt?nlou n
Hex E1ectr i c
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Miscellaneous
Service Meter Upgrade
Chavez,Dave
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R.3, U
VB
cEc 2019
GenernI Plnn Ur,clctLe Fee
Ul I I6l:uJ?- 5l6t-tt-tt-t[tt-t-
I'l icrc'f i 1,tt & Docurnent,s
LrI I l6ulJ?- fl7'7 71:ll:lll[r-
E I ect, r' i r0I
Se rvi cU Hr|t$tqtg rEUUr .$H$ibo ut g i ve n .(:ash
(.h0nse
'1"10t27 t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
Every permit issued 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 the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2020-162420
01 1 1 6002 51 600
01 1 16002 51603
01 1 16002 57770
$23.79
$1 16.70
$4.05
$144.54
$0.00
$144.54
,
APPROVALS DATE ID/SIG.COMMENTS OWNI'R B I' I I,DT:R DB:I,CA RATION
I hereby affinu under penulty of prjury that I anr exenlpt froru the Cbntraclors' License Law firr the filllowing, rea$lr (Sec.7031.5
]lusincss and Prol'cssion Codc): Any City or Counly which rcquircs a Jrcrmit to construct, altcr. irnprove, dcrnolish or rcpair any
slructure, prior to its issuance. also ret;uires tlre applicant lirr suclr pnrill to fih a signed slatemenl that lre or she is licerr"sed pursuanl
to thc provisions of thc. Contractor's l,iccnscd l^aw (Chaptcr 9. Comrncncing with Scction 7000 ol'Division 3 of thc Busincss and
Prot'essions Ctde) or that lw or slrc is exenrpt tlrcrelionr and tlre basis for tlre alleged exentptiott. fury violation of Section 703 L5 by arty
lpplicant for u 1rcnnit subject.s thc applicant to t civil penalty of not nrore than five hundred dollars ($5mt.
_1. a.s owncr ol'tlr prolr-rt)'. or lny ctnplovccs with wagcs as thcir soL'cornfL-nsation, will do thc work and the structurc is not
ilttended or offeretl lor sale (Sec.70r]4. Business and Professions Cotle: Tlte Corrtraclor's License Law does not apply to an owner of
the pnrperty wlxr tr,rilds or in4rroves thcrurn, auxl wlxr does such work hinrself or herself or through his or her own entployees,
providcd that such irnprovcrncnts arc not intcnded or oll'crcd frrr sah. ll. howevcr. ttrc building or furpnrvcnrcnt is sold wilhin one ]t.lr
of completiorl the Owner Buikler will havc the burden of proving that lre or she did not buikl or inrprove tlr pruperty for the purpose of
sale).
_1. as owner of the property, anr exclusively contracting with licen.sed contraclors to construct tlr project (Sec. 7044. Business
alrd Pntlbssiorr Code: 'l'he Contractor's License Law drrcs not apply to anowner of property who builds or intproves thereott.
and who contracls for such pro.iccts with a Contractor(s) liccnscd pursuanl to trpL Conl.racl()r's Liccnsc hw).
-l
ant exetnpt uttder B. & P.C. lirr this reason.
lV( )RK F:RS' ('( )NI I'l;NSA',l'lON
I)ECLARATI0N
I hcrcby affirnt unrlc'r pcnalt.v of pcrjury onc o[ tltc tirlkrwing dcclarations:
_l have anl will nuintain a Certiticate of Consent to Selt'-lrrsure for workers' corr4rcnsation. as pruvided for by Section 3700 of the
Labor Cudc, for thc Jrcrforrnancc o[ the work lirr which tlrc pcrndt is issued.
_l have and will rnaintain workers' conrpensation insurance. as rcquired by Seclion 3700 of the [:bor Code, for lhe performarrcc of
tlrc work fbr which this lrcrnrit is issucd. My workcrs' con4rcnsation irsurance carricr and grolicy number are:
,.*rrr, ' EX € {l/l P+
Poticy Number: i Expires:
a
_l ccrrity that in tlrc Jxrlirrnuncc of thc work frrr which this pcrrlit is issucd, I shall not cn4rloy any lrcrs()n in any nlanncr
so as to bccornc suhjcct to thc workL.rs' corupcnsation laws of Calil'ornia. and agrcc thut if I should bccotnc subject to the
workers' conrpensation provisions of Section 3700 of the Labor Cotle, I shall, forthwith comply with tlxrse provisions..
WARNING: Failure to secure workers' contlrcnsation coverage
civil tirres up t() ()ne lrurrdred tlurusand dollars (S100.000t. in r
Scction 3076 of thc Latxrr Codc. intc'rcst and attorncy's t'ccs.
is unlawful, and shall subject an and
to tlre cost o[the
o,.".t lo-Ll -k)
I hereby affirnr under ;rcnalty of perjury tlrat I ant licertsed 9 (cornnrcncing with Section 7m0) of Division 3
of the Business antl Profcssiorrs Code. and rrrv license is in l'ull force and effect.
License
D o
o*", 'l rr--Z 1 -7--1)
CONSTRUCTION LENDING AGENCY
I hcrcby al'lirrn undcr penalty of pcrjury that thcre is a construction lcnding agency for thc pcrlbrmancc of thc work l'or which this pcrrnit is
issuerl (Sec. 3097. Civ. C.).
Lender's Nanre:
Irrrdcr's Address:
APPLICANT DECLARATION
I Hryaffrmumlcr penalty of perjury onc of the following doclarations:
Denrolition Pcrmits-Asbcstos Notification Federal Regulations (Tille 40, Part6)
-Rcquircd
lctter of Notifrcation
_l ccrtify that thc fedcral regulations rcgarding a.sbestos removal are not applicable to ftis projct.
h/."nify that I luvc rea<l this application uxl statc thar ilre above information is correct. I agrce to conply with all City and Counry
drdf,ranccs and State Laws rclating to building constructioo ard hereby authorize representatives of this City and County to enter upon thc
above rrrcntioned propctly ftrr inspection
r\ ltlllicarrt ot' ..\genl
I't'rnrilec llanlc
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under SIab / Floor
Bondinq I Groundinq I UFER lt l'7 DWry
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
N/eter Release Iu lt?'7r0 )ftw>-/
I
Roug h ,
Service [Meter l,l l'7 '2a .bB3B /
FINAL tf:lTrE )ffi4 E
Notes, Remarks, Etc.r' I
+
ELECTRICAL.INSPECTOR RECORD er
t
Rev. 08-07-201 5
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