HomeMy WebLinkAbout20172310 - PermitCity 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 #: 2o^17231 O
Pin #: 42474
Project Address: 31 18 S Rita Way
Assessor's Parce!: 412-022-04 Lot: 16
Unit:
Block: NA
Bldg:
Tract: 6564
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address.
Phone:
Tenant Name:
Contractor:
Address:
Phone:
MIKE PESAK
31 18 S RITA WAY
Santa Ana, CA 927046737
(7141 557-e01e
Safe Step Walk-in Tub Coml
15262 Pipeline Lane
Huntington Beach, CA 9264
17141 373-8s45
01 1 16002 51603
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
125 Volt Receptacle
Dedicated Circuit
General Plan Update
I ssuance
Microfilm Records
Amount
1.57
26.71
23.79
59.30
4.05
Qty
1 .00
1 .00
1.00
1.00
1.00
Fee
$1.57
$26.71
$23.79
$5e.30
$4.05
State Lic #: 983603
Lic Type: B
Bus. Lic #: 365881
Workers' Compensation Insurance:Carrier: State Compensation lnsurance Fund
Policy #: g0024TT
Expires: 0110112021
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approva! By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Alteration
Walk in Tub
Verduzco, Violel (-
11118t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: electrical for tub
Fee Total:
Paid to Date:
Balance Due:
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-3, U
VB
cEc 2019
Every permit issued shall become invalid unless the work on the site
authoized 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 afterthe time the work is
commenced.
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23.79
$87.58
$4 05
$1 15.42
$0.00
$1 1 5.42
Gener0I F'1n
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lnspector MID#: 2020-162810
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ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER B UII,DER DE,LCARATION
I hereby affirnr under penalty of perjury that I anr exenpt fr<rm the Contractors' License [:w for the following reason (Scc.7031.5
Busincss and Prolbssion Crxlc): Any City or County which requires a permil to construct, altcr, irnprovc. dcmolish or rcpair any
structurc, prior to its issuance. also requires the applicart for such Srermit to file a signed statefiEnt that lrc or she is licenscd pursuant
to thc provisions of thc Contraclor's Liccnscd I:w (Chapter 9. Commencing with Section 7000 of Division 3 of the Business and
Professions Code) or that he or slx is exenrpt therefrom and tlre basis for tlre alleged exentption. Any violation of Section 7031.5 by any
appticant for a permit subjects the applicant to a civil pcnalty of not nrcre than five hundrcd dollars ($500).
_1. a-s owner ot'the propcrty. or my elnployecs with wagcs a.s thcir solc compensation, willdo thc work and the stnrcturc is not
interxtetl or offered for salc (Sec.7U4. Busincss and Profcssiorrs Code: The Contractor's Liccnsc Law docs not aPply lo an owncr of
the proJrerty wlro builds or improws thereo& and wlxr dtxs suclr work himself or lrerself or through his or her own entployees,
provided that such irnprovcmcnts arc nol intendcd or olfercd for salc. If, however, thc building or inprovcmcnt is sold within orc )tar
of completion" the Owrrcr Buildcr will have thc burden of proving that he or she did not buikl or impmve fic property for thc purposc of
sale).
_1, as owner of the property, am exclusively contracting with licensecl conlractors to conslrucl thc project (Sec. 7(X4, Business
and Prrofession Code: The Contractor's License Law does not apply to an owner of property wh<l builds or improves there<ltt,
and who contracts for such projccts with a Contractor(s) liccnscd pursuant to the Contraclor's Liccnse Law).
_l am exempt under B. & P.C. tbr this reason.
I l^. ^.
WORKERS' COMPENSATION
DECLARATION
I hc'rcby aftirm undcr Jrcnalty of pcrjury one of tlre lirllowing dcclarations:
_l have ard will nraintain a Certilicate of Consent to Self-ln.sure for workers' compensalion, as provided for by Scction 3700 of the
l-abor Code, for the pcrformance of the work lbr which thc permit is issued.
_l have atrd will nuintain workers' conrpensation insurance, as required by Section 3700 of the l-abor Code, for lhe pcrfornunce of
thc work for which this pcrnrit is issucd. My workcrs' compcnsation insurarrcc ciurier aml plicy numbcr arc:
9aH 6adCarrier:
Policy l/r/rl
_l ccnify that in thc lrcrfornuncc of tlrc work frrr which tlris pcrmil is issucd, I shall not cntploy any lrcrson in any manncr
so as to become .subjcct to thc workcrs' conrpcrrsation laws of Califomia. and agree that if I should becomc subject to thc
workers' conrpensation provisiorrs of Section 3700 of the Labor Code, I shall, forthwith conply with those provisions..
WARNING: Failure lo secure workers' comlrcnsation coverage is unlawful, and slrall subject an ernploycr to crirninal penaltias and
civil fines up to one hundred thousantl dollars ($100.m0). in additi<ln to the c<lst of competsatiotl, danrages as pr<lvided for the
Section 3076 of the [:bor Code, intcrcst and attorney's [ees.
o^.u, lil'lt'Zol
I hereby affirnr under penalty of perjury that I anr licensal under provision of Chapter 9 (comnrncing with Section 7000) of Division 3
of the Business and Professions Code. arxl my license is in full forcc ard effect.
License
Date:
Number:
ll.-lr-to f
CONSTRUCTTON LENDING AGENCY
I hereby affirm under pcnalty of pcrjury that thcrc is a construction lcnding agency for the performancc of thc work l'or which this pcrmit is
issued (Sec. 3097, Civ. C.).
[-cnder's Name:
APPLICANT DECLARATION
I My affrm unrler penalty of perjury one of the following declarations:
Denrolition Permits-Asbestos Notification Fe<leral Regulations (Title 40, Part6)
Required l-cttcr of Notification
_I ccrtify thu the fedcral rcgulations regarding asbestos removd are not applicable to this project.
I certify that I have read this application arxl state that the above infornration is correct. I agrec to conrply with all City and County
ordinances and Statc l-aws rchting to building constructiorL and hereby auttxlrize representativcs of this City and County to enter upon ttrc
above rEntioned property for
Applicant or
Pcrnritcc namc
*,", ll'Klu
Site-Work
Underqround
Pole Bases
Lioht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under SIab / Floor
Bondinq / Groundino I UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinos (Hard & Soffit Rouoh
Ceilinos [-Bar Rouqh)
Meter Release
Rough
Service Meter )-
F!NAL // tQf -Q)lz 04 vcle -25t7
Notes, Remarks, Etc.
Flev. 08-07-201 5
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