HomeMy WebLinkAbout20171529 - 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 #:2o^171529
Pin #: 46808
Proiect Address: 3950 W Hazard Avea
Assessor's Parcel: 1 00-26140 Lot: 1
Unit: D
Block: NA
Bldg:
Tract: 1 1004
Address Range: 3820-3950*
Historic: No
Suite Range:
Zoning: R2
Owner:
Address:
Phone
Tenant Name:
Contractor.
Address:
Phone
Frederick Digieonn
3950 W. Hazard Ave.
Santa Ana, CA 927032649
(s4s) 278-3862
Rightime Home Services
3030 Myers Street
Riverside, CA 92503
(714)- ee8-4300
Fee Type
01 1 16002 51603 FWU
01 116002 51600 General Plan Update
01 1 16002 51603 lssuance
01 1 16002 57770 Microfilm Records
Amount
26.71
23.79
s9.30
405
Qty
1 .00
1.00
1 .00
1 .00
Fee
$26.71
$23.79
$se.30
$4.05
State Lic #: 765074
Lic Type: C-36, C-10, C-20
Bus. Lic #: 351300
Workers' Compensation lnsurance:Carrier: Liberty Insurance
Policy #: WA763DS08631018
Expires. 10/01 12020
Building Use:
iJob Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Condominium
Miscellaneous
A/C change out
Enriquez, Gisse!
Chavez, Dave
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
.;-.;.'-'.-,
Notes: A/C change out.
Fee Total:
Paid to Date:
Balance Due:
*P{'-
0711612020
07117 t2020
Account#
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-1
VB
cEc 2019
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 site by such permit rs suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23.7e
$86.01
$4.05
$1t3 8s
$0.00
$t t 3.85
lnspector IVID#: 2020-1 60156
I
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq I Groundinq I UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs [-Bar Rouqh)
Meter Release
Rough /\
Service N/eter r\
FINAL l=---1-Zr\2 ,V,UZT
Etc.'\-/
OWNE,R BI.'ILDER DIiI,CAIIA'TION
I hereby affrnr under penalty of perjury that I anr exenpt from the Contractors' License l-aw for the following reason (Sec.7031.5
Busincss and Profession Codc): Any City or County which rcquires a pcrmit to construct, altcr, irnprovc, dcmolish or rcpair any
slructure, prior to its issuance. also requires the applicant for such pernrit to file a signed staternent that lre or she is licenscd pursuanl
to the pmvisions of the Contractor's l,icensed law (Chaptcr 9. Commencing with Section 7000 of Division 3 of the Busincss and
Professions Code) or that he or she is exen4rt therefronr and the basis for the alleged exentption. Any violation of Seclion 7031.5 by any
applicant for a pennit subjects the applicant to a civil penalty of not nxrre than five hundred dollars ($500).
_1. as owncr ol'thc propcrty. or my cmployccs with wagcs as thcir sole compensation. will do thc work and the stnrcture is not
inrerxlal or offered frrr sate (Sec.7Ma. Business and Pnrfcssions Codc: Tlrc Contractor's License l-aw docs not apply to an owner of
the trroJrcrty wlm builds or improves therarn, and who does such work himself or herself or through his <lr her own entployees,
providc.d that such improvcrncnts arc not intcrdcd or olTcred for sah. ll. hcrwcvcr, ttrc building or improverrcnt is sold within onc )tar
of complction, tlrc Owner Buikhr will have thc burtlen of proving ttrat hc or shc did not buikl or improve Orc propcrty for thc purposc of
sale).
_1, as owner of the propeny, am exclusivcly contracting with licenscd contractors to construct ttrc proi:ct (Sec. 7044. Business
and Protssion Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon.
and who contracts fcrr such projccts with a Contractor(s) liccnscd pursuant to the Conuaclor's License Law).
-l
anr exempt under Section-, B. & P.C. tbr this reason.
Date: Owner:
WORKER"S' COM PENSATION
DECLARATION
I hcreby aftirm under pcnalty of perjury onc of thc following declarations:
_l have anl will nraintain a Cerrilicate of Con.sent to Self-Insure for workers' conrgrcnsation, as pnrvided for by Section 3700 of the
##;
for thc pcrlonnarrce of the work for which thc pcrmit ls issued.
will nraintain workers'3700 of the l-abor Code, for the grcrfionrunce of
which this ts iruxl prlicy nunrbcr arc:
\]
t2 D
Policy
_l ccrtify that in thc lrcrfornuncc of tlrc work for which this pernrit is issucd, I shall not cnploy any pcrson in any manncr
so as to becomc subjcct to the workcrs' cornpcnsation laws of California. and agrec that if I should bccome subject to thc
worliers' conrlrnsation provisions of Section 37fi) of the L:bor Code, I slull, forthwith conrply with those provisioru..
WARNING: Failure to secure workers' compensation coverage is unlawfiul, and shall subject an employcr to crirninal pcnaltias and
civil tines up to one hurrdred thousand dollars ($100.m0). in addition lo the cost of compensation, danuges as provided fgr the
attorncy's [ccs.
\
I hercby affirnr under pnalty of perjury that I anr licenscd under provision of Chapter 9 (contnrencing with Section 7000) of Division 3
of the Business and Professions Code. arxl my license is in full forcc and efifect.
(,
License
o (
CONSTRUCTION LENDING AGENCY
I hereby alljrm under pcnalty of pcrjury that thcrc is a construction hnding agency for the pcrlbrmance of thc work lbr which this pcrmit is
issued (Sec. 3097, Civ. C.).
Lender's Naure:
lrnder's Address:
APPI,ICANT DECI,A RATION
I lrrehy affrnr undcr pnalty of pcrjury onc of the lbllowing dc,clarations:
Dcnnlition Pcrnrits-Ashcstos Notification Fedcral Regulations (Tillc 40, Part6)
Rcquircd [-ctter of Notification
/! ccrtify that the fcdcral rcgulations rcgarding asbestos rcmoval arc not applicablc to this projc.ct./
VI ccrtify ttrat I havc rcad this application and state tlrat the above information is correct. I agrc'c to conrply with all Cily and County
ordinances and Statc laws relating to building construction, and hercby authorize reprcsentativcs of this City and County to entcr upon thc
above rncntioned properly for inspection
Applicant or Agent
I'crmilce
*,",,Wit{f )0
08-07-2015
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