HomeMy WebLinkAbout20169844 - Permitcity of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702
Permit Counter. (714)647-5800 lnspection Requests: (714)667-2738 Inspector Sectron: (714)647-5853
Electrical Permit #:20169844
Pin #: 613O94fl
Project Address: 3809 S Timber St
Assessor'sParcel: 410-062-19 Lot: 31
Unit:
Block: NA
Bldg:
Tract: 6433
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Contractor
Address:
Phone:
DAVIDV&JOMINTZER
3809 S TIMBER ST
Santa Ana, CA 927074950
(7141812-8012
Green Home Development
6501 Sausalito Avenue
West Hills, CA 91307
(818) 941-0s40
Fee Type
01116002 5'1603 r125 Volt Receptacle
01 1 16002 51603. Light Fixtures
011't6002 5't603 rFWU
01 116002 51600 'General Plan Update
01 1 16002 51603 lssuance
Amount
1.51
1.09
25.76
22.95
57.20
Qty
8.00
10.00
1.00
1.00
1.00
Fee
$12.08
$10.90
$25.76
$22.95
$57.20
Botch*:52332 - l013/?01? ID: fLIZAE[Tll
0f I ice: CTYH Trnnsi: 64 3 c,{' ::iAcct*: Ref *: ?r:116?1144
Rcpti:02770343 - 10/3/?019 12:[r? f!l'l
Transoction Totql $715.16
6reen Home Oevelopment
State Lic #: 1031586
Lic Type: B
Bus. Lic #: 374025
Workers' Compensation lnsurance:Carrier: State Fund
Policy #: 9238142
Expires: 0911312020
Generol PIon Updnte Fee
Lll I 16ttrr2- 516UIr0Ltrr-
Electr i csl
111 I l6tr02- 5l 6u3[trlr-
Cosh
(:honse
*22.9?.
$ trl5,94
$715.2r;
( $0. Lr1)
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Alteration
Outlets/Light Fixtures
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R.3, U
VB
cEc 2016
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Verduzco, Vio
Subject to Field:
Buirding Permit #: 101101709
retrN 1 0/03/201 9
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: for kitchen remodel
a
Fee Total:
Paid to Date:
Balance Due:
01 1 16002 51600
01'1'16002 51603
$22.95
$105.94
$128.89
$0.00
$128.89
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
lssuance, 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.
lnspector MID#: 2019-154876
COMMENTSDATE!D/SIG.APPROVALS
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Lile Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondinq / Groundinq / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinos (Hard & Soffit Rough
Ceilinqs (T-Bar Rough)
lVleter Release
--6r/./)
I t67/ 7 /VUL4.t a.).oRough
Itl nService Meter Dtha n-+fr4n DA:FINAL
Notes, Remarks, Etc I1 lv
ELECTRICAL-INSPECTOR RECORD
I hcrcby afiirm under pcnalty of pcrjury that I am cxempt tiom thc Contrrct)rs Licensc Law tbr thc tbllowing reason (Scc.70J l.5
Busincss and Profbssion Codc): Any City or County which requfcs a fcrnit lo constnrct. altcr. inprove. denmlish or rcpair any
structure. prior k) its issudncc, also rcquircs thc alplicant tbr such pcrmit k) tilc a siSncd statcnrcnt that hc or she is liccnsed pursuant
k) the provisi(ms of thc Contractor's Liccnscd Law (Chaftcr 9. Cornmcilcing with Scction 7000 of Division 3 of thc Busincss and
proftss()ns Codc) or that hc or she is crcmpt lhcrcfi(,m and thc basis ti)r the allegcd cxcmption. Any violation of Scction 70.1 L5 by any
applicant li)r a pcrmit subjccts thc applicanl b a civil pcnally of not lnorc than fivc hundred dollars ($5txj).
_1. as owncr oI thc propcny. or my cnrployees with wrgcs as thcir solc compcnsalion. will do tlr work and lhc structw is not
intcndcd orolfcrcd fbr sale (Sre.7044, Business and Prottssions Codc: Thc Contractor's Liccnsc Law docs not apply k) an owner of
lhe pnlFny who builds or improves thcron, md who d(rcs such work himself or hcrsclf or through his or hcr own cmployces,
providcd that such improvcmn(s trc not intcndcd orollcrcd li)r sxlc. If: howcvcr, tlrc buildin8 or improvcrcnt is sold within onc ycd
ofcomplctrrn, thc Owner Buildcr will htvc thc burden ofproving that he or shc did not build or improvc thc proFfry fbr thc purfDs of
salc).
_1. as owncr ofthc property, am exclusivcly contracting wilh liccnsed contracloF to c()nstruct thc projcct (Sec. 7044, Bttsincss
anl pruti:ssinCode:ThcContracbr'sLiccnscLawdocsnolapplyk)anowncrofpr()pcrtywhohuildsorimprovcsthcrcon,
and who contracts lbr such prujects with a Conlraclor(s) liccnscd prrsurnt to the Conlracbr's License Law).
-l
am exctnpt undcr Section_-, B. & P.C li)r this rcason.
Date:-
TVORKERS' COI\IPENSATION
DECLARATION
I hcreby aflirm undcr pcnally of pcrjury onc ofthc fbllowing dcclaratioDs:
_l havc ard will maintain a Certiticate of Conscnt to Sclllnsurc trrr workcrs compcnsation, as provided lbr by Scction ]7(x) of thc
Labor CoIe, lirr thc pcrfbrmatrcc of lhe work lbr which thc pcrmit is issucd.
-l
havc and willnraiilaiD workcrs c()mpcnsation -17fi) of thc Irbor Codc, ti)r lhe pcrfi)rmancc ol'
thc work li)r which lhis pcrmit is issucd. My ard f)licy numbcr dc:
Policy
_l ccrtily thal in thc pcrli)rmrncc of the work tbr which this pcrmit is issucrl. I shall nol empk)y any person in any manncr
so astohccomcsuhjcctk)thcworkcrs'compensatiorhwsofCalilbrnia.andagrcethatiflshouldbccomesuhjccttothc
workers' comlrcnsation provisions ofScction J700 of thc LatDr Codc, I shall, li)rthwith comply with thosc provisions..
WARNING: Failure h sccurc workcrs'c(,mpcnsat()n covcragc is unlawlil, and shall suhjccl an cmpl()ycr kr criminal pcnaltics and
civil tincs up k) one hundrcd thousand dollnrs ($100,000), in addition b thc compcnsation. damages as providcd ti)t
Section -1076 of.iDtcrcst and att)rncy's ftcs.q
I hcrcby atlirm undcr pcnalty oI pcrjury that I am liccnrctl under 9 (conmcncing with Scctin 7000) ofDivision l
of lhc Busincss and Pnrfcssiorrs Codc, md my licensc is in hrll ti)rcc Md cflcct.
Liccnsc Nnillbcr:tG
CONSTRUCTION I,ENDIN(} A(;ENCY
I hcrchy allirm undcr lrnalty ol pcrjury that thcre is a conrtmction lcndilg aeency fbr thc perli)rmancc of lhc work fbr which this pcrmi( is
issucd (Sec. -'1097, Civ. C.).
[andcr's Nanrc:
Lcn.lcr's Arldrcss:
-
APPLICANT DECLARATION
I lErcby afiim undcr pcnalty of pcrjury otrc of thc lilllowing dcclarations:
Dcmolition Permits-Asbcsk)s Ndification Fcdcral RcSulations ('I itlc 40. Part6)
-Rcquircd
[.ltcr of Notilication
-l
ccrtily that thc ttdcral rcgulations rcguding asbestr)s rcmoval arc n(n applicablc k) this pr)ject.
is corcct. I agrec to cr)mply with all Cily and County
rcprcscntativcs ofthis City and C(tunly k)
l),\, , rl* J 1; ')/i i ri
Pennitec namc
()5
ufxnl lhc