HomeMy WebLinkAbout20167363 - PermitI
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20 Civic Center Plaza (M-19), Santa Ana, C492702 f\I
lnspection Requests: (7 1 4) 667 -27 38 lnspector Section: (7 1 4) 647 -5853
Electrical Permit #:20167363
Pin #: 66693
City of Santa Ana
Permit Counter: (714) 647-5800
Project Address: 1106 N Goncord St Unit:
Block: NA
Bldg:
Tract 2648
Address Range:
Historic: No
Suite Range:
Zoning: RiAssessor's Parcel: 400-284-12 Lot: '107
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Jowala Persand
1106 Concord St
Santa Ana, CA 927013212
(714) 972-9680
Safe Step Walk-in Tub Coml
15262 Pipeline Lane
Huntington Beach, CA 9264
(714) 373-8545
01 1 16002 51603
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
Fee Type Amount Qty
125 Volt Receptacle 1 .45 I .00
Dedicated Circuit 24.79 1.00
General Plan Update 22.08 1.00
lssuance 55.04 1.00
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Fee
$1.45
$24.79
$22.08
$55.04
State Lic #: 983603
Lic Type: B
Bus. Lic #: 365881
Workers' Compensation I nsurance:
Carrier: State Compensation lnsurance Fund
Policy #: 9002477
Expires: 0110112019
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nik-rn Tub Corpnn:r
n Uponte Fee
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i*x**r1il8fi Auth*:tt?i
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Remodel Bathroom
Occupancy:
Constr Type:
Code:
Date:
Date:
R-3, U
VB
cEc 2016
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buirding Permit #: 10198292
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 1 80 days after its
lssuance, or if the work authorized on the site by such permit rs suspended
or abandoned for a period of 1 80 days after the time the work is
commenced.
't1t07t2018
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Replacement
Fee Total
Paid to Date:
Balance Due:
0't 1 't 6002 51 600
01 1 16002 51603
$22.08
$81.28
$103.36
$0.00
$103.36
MID#: 2018-147511lnspector
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hrcby allinn undo penalty of per.jury thd I m exempt fioN the Conlractors' License taw for the following roson (Sec.70.1 1.5
Buines md Profasion Code): Any City or County which requirs a ponit lo coNtrucl. altc. improve. dmolish or repair my
struclue. prior lo its isuace, also requird thc applicill for such pentril to file a signed statmot thal hc or shc is licosql pmuet
to the Eovisions of lhe Controctor's Licenscd l-aw (Chapts 9, Commencing with Setion 7000 of Division 3 of the Busincss and
ProfcsionsCode)orlhatheorsheiscxcmplthqefrommdtheb6isfortheallegedexonF,tion. AnyviolalionofsstionT0-1l.5byily
applicmtforap€milsubjststhe applicanttoacivilpcnaltyofnotmorethmfivehundrcddollds($500).
-1.
o omo of the properly. or my employe with rvage o their mle composation. will do the sort md the structue is not
intmdcd or offqed for sle (Ss.7044, tsusinss md Profesions Code: Thc Contractor's Licme Larv dos not apply to m owns of
thepruperty whobuildsorimpovethoon,ddwhodo6suchworkhimselforhsselforthroughhisorh€rownemployes.
provided that such impovmmts e oot intsded or offsed for slc. If howryc. the building or imgrcr'mt is old whhin onc yw
ofconrplaion. the Ownq Builds will have thc hrdo ofprcving that he or she did not build or improvc thc propqty for the purpo* of
slc).
-1.
a owner of lhe propoty, m exclusivcly contracting with liccNed contractoE to construct the proict (Ss. 7044, BusinN
md l'rofusionCodc:Th€Conlractor'sLicenseLawdo6nolapplylomownerofpropfiywhobuildsorimprovBthseon.
and rvho contmds for such projus with a ContEclo(s) licffed puEuanl to thc Contraclor's Licmse taw).
-ImexemptunderSetion-.B,&P,C,forthisrruon.Dfllr:()silcr:
I hereby afftrrn undo pcnalty ot pcjury one ofthe followinS declarations:
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have md rvill mainlain a Cdificatc of CoNst to Self-lNure for rvorkers' compensalion, 6 lrovided for by S(tion .]700 of the
Labor Code, for the psfomance of thc work for which the pmit is issued.
-l
have and will maintain workers' compecalion iNurance, r requfcd by Sation 3700 of the Labor Code, for the pofommce of
the workforwhichthispennit is-issued. Myworkers compflsali()ninsurancecauicrmd ;xrlicy number ae:
PoticyNumbcr:/- noz)2\77 Expi,6.t
-l
ce(ify thal in the ptrfomance of thc work fot which this pernrit is issued. I shall not employ any person in any mmff
s 6 to become subjst lo the work6' compffation laws of Califomia. ed agre lhat if I should tEome subj(t to thc
workm' compensation provisions ofSetion 3700 oflhe l,abor ('ode, I shall. fonhwilh comply wilh lhos provisions..
WARNING: Failure to sue workm'compctsation covmge is unlarvful, md shall subiat an mployo lo aiminal penaltiG ild
civil hnes up to one hunded thoumd dollas in addition lo the cosl of compensation. danages o p(ovidcd for the
Ssrion 3076 ofthe Codc. inl66l ild
(\-7-
t)1,t( 1,,\lt,\'t t()N
I hereby aflinn under g)enalty of perjury lhat I an licoscd under provision ofChapt6 9 (conrrnmcing rvith Section 7000) of Division l
of the Busins md Profsiom Code, and my licere is in full cff(t.
Liccnse
q 3bo'5Number:
CONSTRUCTION LENDINC AGFNCY
I hmby affrm undr pnalty of perjury that thqc is a conslruclion lending agflcy for the pqfommce of the work for rvhich this pamit b
issued (Src. 3097. Civ. C.).
Lender's Narne
Lendcr's Addrs:
APPLICANT DECLARATION
I lreby affm undo pmalty of pejury one of the following delaations:
Dqnolition Pmnits-Asbetos Nolification Fedoal Regulations (Tille 40. Pan6)
-Required
Lettq of Notification
_l c6tify lhat the fcdcral regulations regading abelos removal are not applicable to this project.
_l cfiiry thal I have r@d this application ild state lhal lhe above infomlation is cord. I agrtrto comply with all City and County
ordinailces and State Laws relating to corelruclion, md hercby aulhorize represcntativ6 oflhis (-ity and Counly to entq upon the
above motioned propeny for
Applicatrl or Agmt v 7
/ zrue/
_ Dste:
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
Meter Release
Rouqh
Service Meter I n I A,4 / //h
FINAL t&l+4tffi qVY- l/a EQul /f)u}/ry /// 7//(
Notes, Remarks, Etc]T
0,..,, flo t\-, t)t\attl
I)ater t Con(raclor:
I'crtrrilcc nanre (print):