HomeMy WebLinkAbout20171459 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 9?702 - Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection. (714)647-5853
Permit #:2O17{459
Pin #: 8O97O
Proiect Address: 2106 W Avalon Avea
Assessor's Parcel. 101-581-15 Lot: 71
Unit:
Block: NA
Bldg:
Tract: 3834
Address Range:
Historic: No
Suite Range:
Zoning: R1
Owner:
Add ress:
Phone:
Tenant Name:
Contractor
Address:
Phone:
Arturo & lrene Garcia
2106 W Avalon Avenue
Santa Ana, CA 92706
(7141 336-7538
Kevin Hernandez
11251 Sierra Ave #2E1133
Fontana, CA 92337
(951) 334-9370
01 1 1 6002 51 603
01 1 1 6002 51 600
01 1 1 6002 51 603
01116002 57770
Fee Type
Serv Meter
General Plan Update
lssu a rt ce
Microfilm Records
Amount
57.40
23.79
59.30
4.05
Qty
1 .00
100
1 .00
1 .00
Fee
$57.40
$23.7e
$59.30
$4 05
Bcrbcht
tlf f ire
ArIC t,,1 l
ttrpt* I
State Lic #: 101 3179
Lic Type: C-10
Bus. Lic #: 374952
Workers' Compensation I nsurance:Carrier: Exempt
Policy #:
Expires:
I ron,i(
Ket, ii,
Gen er,
t-r I I t,{r
ll irnr,
rtl t l,{t
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
Alteration
Service Meter
Verduzco
.\-\
, Violet \
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
Occupancy:
Constr Type
Code:
Date:
Date:
Date.
R-3, U
VB
cEc 2019
07 t06t2020
Account#
Every permitissued 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 sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 s1600
01 1 16002 51603
01116002 57770
$23.79
$1 16.70
$4.0s
$144.54
$0.00
$144.54
lnspector IVI ID#: 2020-1 59935
NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safetv /Low Voltaqe
Fire Alarrn / Dampers
Communications Cable
Buildinq
Under Slab / Floor I
Bondins I Groundins I UFER lz lo Dkffi a
Transformers l
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilinqs (Hard & Soffit Rouoh
Ceilinss [-Bar Rouqh)I I ,
Meter Release Ot 7t t /) lT-tr fl-l
II
Rough tl
Service N/eter ll-(,/1)) l)frv -y/
FINAL L d D*a -yl
Notes, Remarks, Etc./t I
OWNI,R BUII,DI'R DI'I,CARATTON
I hereby affrm under penalty of perjury that I am exenrpt fronr the Contractos' License l-aw for ttrc following reaxln (Sec.7031.5
Busincss and Prol'cssion Code): Any City or County which requires a permit to construct, alter, irnprovc, demolish or rcpair any
structure, pior to its issuance. also requires the appliciurt for such pernril to file a signed staternent that lrc or she is liccrrsed pursuanl
to the pmvisions of the Contractor's l,iccnsed L-aw (Chaptcr 9. Commcncing with Section 70O0 of Division 3 of the Busincss and
Professions Code) or that he or she is exempt therefrom and tlre basis for the alleged exemption. Any violation of Seclion 7031.5 by any
applicant for a pennit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
_1. as owncr of the propcrty. or my cmployees with wages as thcir solc compcnsation, willdo ttrc work ard thc stnrclurc is not
interded or offered frrr sale (Sec.7(}l4. Business and Prcfcssions Crxle: Thc Contraclor's Licensc l-aw does not apply to an owncr of
thc prcperty wlro builds or inqroves ttrrmn urd wlro does such work himself or lrerself or through his or her own enployees,
provided that such improverrnts arc not intcndcd orofhred for sah. Il. hnwever, thc building or irprovenrcnt is sold within onc year
of completion, the Owrrcr Buil&r will havc the burden of proving ttrat he or shc did rrct buikl or improve tlrc propcrty for thc purposc of
sah).
_1. as owner of thc propeny, am exclusively contracting with liccn.sed contraclors to construct thc prujcct (Sec. 7044, Business
arxl hottssion Code: The Contractor's License Law dtres not apply to an owner of property wtro builds or improves thereorL
and who contracts for such projccts with a Contractor(s) licenscd pursuant to thc Conuactor's Liccnse hw).
-IantexemptunderSectit,n-,B.&P.C.tbrtl$sreason.
WORKtsIIS' COMPENSATION
DECLARATION
I hcreby affirm undcr penalty of perjury one of thc tbllowing declarations:
_l have arxt will nrainlain a Ccrtilicate of Consent to Self-lnsure for workers' conqrcnsation, as provided for by Section 3700 of the
Labor Code, for thc Jrcrfiormance of the work lbr which thc perrnit is issued.
_l have and will nraintain workers' conrpensation insurance, as required by Secti<ln 3700 of the l-abor Code, for the perfornrance of
thc work for which this pernrit is issued. My workers' compcnsation insurance carricr and grolicy numbcr are:
PolicyV
7\l cerrify that ilr tlrc prlbrnuncc of tlrc work for which this pcrmit is issucd, I shall not cnrploy any pcrson in any manncr
so i.s to bccome subjcct to the workcrs'compen.sation laws of California, and agrce that if I should beconrc subjcct to thc
workers' conrpensation provisions of Section 3700 of the Labor C<xle, I shall, forthwith conrply wilh thosc provisions..
WARNING: Failure to s€cure workers' compensation coverdge is unlawful, and shall subject an employcr to criminal penahies and
civil lines up to one hundred thousand dollars ($100.000). in additiort to tlrc cost danuges as providcd for thc
Scctkrn 3076 Lahor intcrest and attorncy's l'ccs.
1
I hercby affirrn under penalty of perjury that I anr
of the Business and Professions Code. aml my I
LICENSED CONTRACTOR
DIiCI,ARATION
, licenserl under pruvision of Chapter
license is in full lbrce und cl'fect.
9 (conrnrncing with Section 7000) of Division 3
License to Number:LotbtA\Fr;
CONSTRUCTION LENDING AGENCY
I hcrcby al'lirrn undcr penalty of perjury that thcrc is a construction lcnding agency for the pcrlbrmancc of thc work for which this permit is
issued (Sec. 3097. Civ. C.).
I:nder's Name:
I*ndcr's Addrcss:
APPI,ICANT DECI,ARATION
I hcrcby aflirnr undcr pnalty of pcrjury one of thc folkrwing dcclarations:
Dc nlo lit io n Pcrnrit s- A strc'sl us Noti ficat ion Fctlcral (rirb 40, Part6)
-Required
l,cttcr of Notification
_l ccrtily that thc fcderal rcgulations to this project.
-[.ccrrity that I havc rcarl tlus ap;rlicaliort corrccl. I agrtlc to conrply w itlr all City and County
ordinances and Statc Laws rclating to
abr;r'c mentioned pruperly for inspection
Applicant or Agent
I'crnrilcc nanrc (
represcntativcs of this City and ugrn thc
Rev. 08-07-201 5
I'[/L
I)ate:
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