HomeMy WebLinkAbout20172415 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 2fJ17241 5
Pin #: 8{ 267
Proiect Address: 916 N Louise Sta
Unit:
Block: NA
Bldg: Address Range:
Tract: LOURIES SUB. Historic: No
Suite Range:
Zoning: R1Assessor's Parcel: 405-262-09 Lot: NA
Owner:
Address.
Patricia Lopez
916 N Louise Street
Santa Ana, CA 92703
(7141 6314010
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
$s7.40
$23.7e
$59.30
$4.05
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
l-lJ I $+.51
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Alteration
Service Meter
Occupancy:
Constr Type:
Code:
R-3
VB
cEc 2019 Notes: upgrade
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Verduzco, Viofet.J\
Date:
Date:
Date:12t09t2020
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 fhe 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
$1 t 6.70
$4.0s
Fee Total:
Paid to Date:
Balance Due:
$144.54
$0.00
$144.54
lnspector MID#: 2018-143149
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWN IO,R BUII,DTiR DI'LCARATION
I hercby affrnr under penalty of perjury that I anr exenrpt fronr the Contractors' Licensc l-aw for the following rcason (Sec.7031.5
Busincss and Prol'cssion Codc): Any City or County which rcquires a pcrmit to construct, altcr. itnprove, demolish or repair any
structure, prior to its issuance. also requires the applicant for such pemrit to frh a signed statemenl that lr or slrc is licenscd pursuant
to the provisions of thc Conlractor's l.iccnscd l:w (Chapter 9. Commcncing with Section 7fiX) of Division 3 of thc Busincss and
Professions Code) or that he or she is exen4rl therefrom and tlre basis for the alleged exenption. Any violation of Section 7031.5 by any
applicant for u pennit subjects the applicant to a civil penalty of not morc than five hundrcd dollars ($500).
_1. as owncr ol'thc propcrty. or my crnployees with wages as thcir sole compcnsation, will do the wrnk and the struclure is not
intendetl or offered ftrr sale (Sec'.7044. Business and Professions Code: The Contractor's Licensc Law does not apply to an owner of
the prcperty wlro builds or improves tlrcrarn, arxl wlro does such work himself or herself or through his or her own enrployees,
providcd that such improvc'mcnts are not intcnded or ollcrcd for sale. It, howevcr, thc building or imp,rovenrcnt is sold within onc )€ar
of conpletion, thc Owner Buil&r will luvc the burden of proving that hc or she did not builJ or impmve tlre property lor thc purposc of
sah).
_I. as owner of the propetly, am exclusively contracting with liccnscd contractors to conslrucl thc project (Sec. 7044, Business
and Pnrtl.ssion Code: The Contractor's License Law dms not apply to an owner of property who builds or improves thereon.
and who contracts for such projccts with a Contractor(s) licenscd pursuant to thc Conuactor's Licensc Law).i
_l anr exernpt ultder B.
I 1...,..
DECLARATION
I hereby aflirm undcr penalty of perjury one of the lbllowing declarations:
_l have and will nraintain a Certificate of Coruent to Self-lnsure for workers' conryrcnsation, as provided for by Scction 3700 of the
lahor Code, for the pcrforrnance of thc work for which the pcrmit is issued.
_l have and will maintain workers' comfrcn.sation insurance, as required by Section 3700 of lhe l-abor Codc, for the perfornrance of
the work for which this pcrmit is issucd. My workers' compcnsation insurance carrier and policy number are:
Carrier:
Policy Nunrber: lixpires:
_l ccrrify that in thc ;^-rfornuncc of tlrc work frrr which this pcrnrit is issucd, I shall not enploy any pcrson in any manner
.so as to becornc .subject to thc workcrs' compcnsation laws of California. and agree that if I should becotne subject to thc
workers' contlrnsation provisions of Section 3700 of the Labor Cotle, I slrall, forthwith conply wilh thosc provisions..
WARNING: Failurc to secure workers'compensation coveruSe is unlawful, and shall subject an to crirninal Srenalties and
civil lirres up to one hurrdred lhousand dollars as provided for the
Scction 3076 otthc [:bor Codc. intcrest and attorncy's
Date:
I hercby affirnr under penalty of perjury that I ant licensed 9 (corrunencing with Scction 7000) of Division 3
of the Business and Professions Codc. alxi mv license is in full force arxl effect.
License Class: Licensc Nunrber:
Date:
CONSTRUCTTON LENDING AGENCY
I hercby aflirm undr-'r pc.nalty of perjury that therc is a construction hnding agency for the pcrlorrnancc of the work l'or which this pcrmit is
issued (Sec. 3097. Civ. C.).
lrnder's Nanre:
frnder's Address:
APPI,ICANT DECI,ARATION
I hreby affrnr undcr penalty of pcrjury onc of the folkrwing dcclarations:
Dcnrolition Pcrnrits-Asbcstos Notification Fcderal Rcgulations (Tillc 40, Part6)
_Rcquired lrttcr of Notification
_l ccrtily that thc fedcral rcgulations rcgarding asbcstos rcmoval are not applicablc to this projcct.
_l ccnily tlul I havc rcatl this application iud statc tlral thc atxrvc inlbrnution is corccl. I
ordinanccs and Statc [,aws rclating to building constructi()n. and thc
ab<lve rncntioned property lor
Applicant or Agent
I'crnritec
C *r", [1--7- ?C
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under SIab / Floor
Bondinq I Groundinq I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouoh
Ceilinos [-Bar Rouoh)
Meter Release
Rouqh tl I
Service N/eter llllK/2o lffurfu 7D-
FINAL tLl)hl?n l.Llryr a 7tf-fK(
Notes, Remarks, Etc.I
Rev. 08-07-201 5
addition to llrc cost of
City and County
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