HomeMy WebLinkAbout20172215 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, C492702 la Ebctrical Permit #:201722{5
Pin #: 34923PermitCounter: (714)647-5800 lnspection Requests: (7'14)667-2738 lnspectorSection: (714)647-5853
Project Address: ttOeE t*"rty-Fir"t St Unit:
Block: A
Bldg:
Tract 5910
Address Range.
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 396-172-12 Lot: 32 & POR G.L. Rt
Owner:
Address:
Kimberly Jones
1 106 E 21st St
Santa Ana, CA 92706
(7141 831-8386
Fee Type
01116002 5160C General Plan Update
01116002 5777C Microfilm Records
Amount
23.79
4.05
Qty
1.00
1.00
Fee
$23.79
$4.05
Phone:
Tenant Name:
Contractor:
Address:
Gil's Electrical Service
11024 Balboa Blvd, #275
Granada Hills, CA 91344
(818) 831-8386Phone:
State Lic #: 656037
Lic Type: C-10
Bus. Lic #. 376664
Workers' Compensation I nsurance:Carrier: State Fund
Policy #. 1426642-2014
Expires: 10/01 12021
Bstch* : 57tt55 Ll/2/2r-r2rr ID : EL I ZABI- THOffice: CTYH Tr'qns*: ?tt 2 u{''}Acct+: Ref*: ?rJ1722L,"
Rcpt*:1r31041t66 LI /2/?it?ir 10: 36 AI'i
Trnnsoction Totnl t133.{J4
Occupancy:
Constr Type:
Code:
R-3, U
VB
cEc 2019
G i I 's Elect,r i cnl Serv i ce
Building Use:
Job Type:
Nature of Work.
Single Family Dwelling
Miscellaneous
Service Meter
Notes:
Genernl Plqn Updnte Fee
handoCIUt60Lt2- 5 1 6t-tr.tr-rtrr-r -
11 icrof ilm & DocumentE
Ltl I 16r-rt t2- i;777[tlt0[t-
Viso
. CC:i: xxr.**t(lt***r,r,?Ii59Planning Conditions:t13
Autht: IJBSS:5G
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
(}Hernan dez, Kathy
Date:
Date.
Date:11t02t2020
Account#
Misc. Receipt:
Misc. Receipt.
Misc. Receipt:
Total
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.
01 1 16002 51600
01 1 16002 57770
$23.79
$4 0s
Fee Total
Paid to Date:
Balance Due:
$27.84
$0 00
$2t.84
lnspector MID#: 2020-162537
T
r
A O ELECTRICAL.I NSPECTOR R ECOR D
APPROVALS DATE ID/SIG.COMMENTS OWNI'R BUII,DER DIiI,CA IIATION
I hereby affrnr under penalty of perjury that I anr exenlpl fronr the Contractors' Licensc [:w for the following reason (Sec.7031.5
Busincss and Prolbssion Code): Any City or County which requircs a permit to construct, altcr. improvc, demolish or repair any
structure. prior to its issuance. also requires the applicant for such prnrit to file a signed slaterrcnt that lr or she is licerrsed pursuant
to the provisions of the' Contractor's l,icenscd law (Chapter 9. Commcncing with Section 7fi)0 of Division 3 of the Business and
Professions CorJe) or that he or she is exenqrt therefronr and tlre basis for tlre alleged exenlption. Any violation of Section 7031.5 by any
applicant for a permil subject.s the applicant to o civil penulty of not more than five hundred dollars ($stttl).
_1. as owncr ol'lhc propcrty. or my crnployccs with wagcs as their solc compensation, will do the wcn* and the structure is not
intcrxletl or offered for sale (Sec.7M4. Business and Professions Code: The Contraclor's License Law does not apply to an owner of
the progrcrly wlp builds or improve.s therurq auxl wln tltrs such wo* himself or lrerself or through his or her own employees,
providcd that such improvcmcnts iuc not intendcd orollered for salc. Il. trrwevcr, thc building or inprovcnpnt is sold within one )tar
of completkrn, the Owner Builder will have thc burden of pnoving ttrdt he or she did rxlt buikl or impmve tlrc propeny for thc purpose of
vdh).
_1. as owner of the ptoperly, am exclusively contracting with licen.scd contractoni to construct the pruject (Sec. 7(Xl. Business
and PnrtLssion Code: The Contractor's License Law dtxs not apply to an owner of property who builds or improves thereon.
and who contracts for such projccts with a Contractor(s) liccnscd pursuant lo thc Contractor's Liccnsc law).
-lantexenDtunderSection-,B.&P.C.forlltisreason.
Dete:
WORKI,TTS' COM PtsNSATTON
DECLARATION
I hcrcby aflirm undcr pcnalt.v of pcrjury onc of thc tirllowing declarations:
_l have and will nuintafur a Certilicate of Consent to Self-lrrsure for workers' con4rcnsalion, as provided for by Seclion 3700 of the
Labor Code, for thc perforrrunce of thc work for which thc pcrurit is issued.
_l have and will nraintain workers' conrpen"sation insurance, as required by Section 3700 of the l-abor Code, for the pcrf<lrnutrce of
thc work for which this lrcrnrit is issucd. My workcrs' conqrensation insurancc carricr and policy numbcr are:
Policy Numbcr: Iixpires:
_l ccrtity that in thc lrcrfornuncc of thc work for which this prmit is issucd, I shall not cmploy arry pcrson in any manncr
so astobcconrcsubjccttothcworkcrs'conrpcrrsationlawsofCalifonria.andagrcethatiflshouldbccorresubjccttothe
worliers' conrlrrrsatiorr provisiorrs of Section 3700 of the Labor Code, I shall, forthwith conrply with those provisions..
WARNING: Failure to secure workers' compensation coverdge is unlawful, and shall subject an employer to criminal pcnaltics and
civil fines up to one lruntlred thousand dollars (S100,000). in addition to tlrc cost of compensation, danrages as provided for thc
Scction 3076 of the Labor Codc, intcrest and attorney's [ces.
//2/4
I hercby affirnr under penalty of perjury that I anr licensetl under provision of Chapter 9 (conrnpncing with Section 7000) of Division 3
of the Busincss and Professions Code. arxl rny licensc is in full forcc and effect.
License
l\... ^.Contractor:!/
.unrr{,\..n,I",n" ."ni"
I hcreby aflirm under penalty of perjury that there is a construction lending agency for the performarrce of thc work lbr which this pcrmit b
issucd (Scc. 3097, Civ. C.).
l,ender's Nanre:
Lrnder's Addrcss:
APPI,ICANT DECLARATION
I hcrcby arffirm under pcnalty of pcrjury one of the following dcclarations:
Dcnxrlition Pernrits-Asbcstos Notilication Fedcral Regulations (Tille 40, Pan6)
_Required kttcr of Ntilification
_l certily that thc fcdcral rcgulations rcgarding asbcstos rermval iue not applicable to this project.
_l ccrtify that I have read this application and statc tlrat thc ahove informalion is corrcct. I agroe to conrply
ordinanccs and State l-aws rclating to building construction, and hercby authorizc represcntatives of this City
with all City and County
to cntcr upon tl^.
above mentioned property for
Applicant or Agent
Pcrnritcc nanre
purPo:scs.
and
o
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under SIab / Floor A,.r-a,
Bonding / Grounding / UFER l['7? 7rt)uz44 Tmdr
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
Meter Release
Rough AI ts?
Service lMeter il'i0./O U@t*Ot iff
FINAL tl-u-)o lJ.{u/,trzrv
Notes, Remarks, Etc.
cru"r, { -/ d LicenseNumber: 6-f;A: Z
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