HomeMy WebLinkAbout20171102 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrica!
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 20171102
Pin #: 24175
Proiect Address: 1105 W Pine Sta
Unit.
Block: B
Bldg:
Tract: HEIL
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 008-222-21 Lot: POR 1
Owner:
Address:
GUSTAVO SAUCEDO
1105 W PINE ST
Santa Ana, CA 92703
(7141 717 -1904
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777C
Fee Type
Serv Meter
General Plan Update
lssuance
Microfilm Records
Amount
55 37
22.95
57.20
391
Qty
100
1 .00
1 .00
1 .00
Fee
$5s.37
$22.95
$57.20
$3.e1
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work.
Single Family Dwelling
Miscellaneous
Electrical
Occupancy:
Constr Type.
Code:
R-3
VB
cEc 2019 Notes: Electrical
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field.
Building Permit #:
web ,'M Date:
Date:
Date:05/1 112020
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 sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
N/A - No Balance
N/A - No Balance
Fee Total
Paid to Date:
Balance Due:
$1 39 43
$139.43
$0.00
lnspector MID#: 2020-1 58876
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underqround
Pole Bases
Lioht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor l
t)Bondinq / Groundino I UFER Lt 'rt+a
Transformers I
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouoh
Ceilinqs [-Bar Rouqh)I I
Meter Release Ir /t,w )kw31o,
I
Rough I
Service N/eter ll (lu -l,O >wgq
FINAL 1r/
Notes, Remarks, Etc.II
OWNER BUILDER DI,LCARATION
I hereby affirnr under penalty of prjury that I anr exenpt frorn thc Contractors'Licensc [:w for the following rcason (Scc.7031.5
Busine-ss and Prolbssion Codc): Any City or County which requires a pcrmil to construct, alter. improve, dcmolish or rcpair any
structure, prior to its issuance. also requires the applicant for such Jrernrit to filc a signcd slaternenl that he or shc is liccnscd pursuant
to thc provisions of the Contractor's l.iccnscd L-aw (Chaptcr 9. Commcncing with Section 7000 of Division 3 of the Business and
Professions Code) or tlut lre or slu is exempt therefrom arxl tlre basis for tlrc alleged exenption. Any violation of Section 7031.5 by any
applicant for a permit subjects thc applicant to a civil penalty of not more than five hundred dollars ($5Ott1.
_1. as owncr ol'thc prol*-rty.or my ernployecs with wages as thcir sole comgrcnsation, willdo thc work and the stnrcture is not
interxlal or ofTercd for sah (Sec.7tX+. Business and Professions Cotle: The Contraclor's Licensc Law docs not apply to an owner of
the propcrty wlxr builds or inpnrves ttrreon, and wlro &rs such work himself or lrerself or through his or her own employees,
provided that such improvcnrcnts arc rnt intended or offcrcd for sah. Il, hcrwever, thc building or inprovcrnent is sold wilhin onc ycar
of comphtioru thc Owncr Buikler will have thc burdcn o[proving that hc or she did not builJ or improve ttrc property for thc purposc of
sah).
_1. as owner of the property, amexclusively contracting with liccnscd conlractors lo construcl thc project (Sec. 7044, Business
arxJ Prutbssion Code: The Contractor's License Law dtxs not apply to an owner of property who builds or improves lhereon.
and who contracts for such projc'cts with a Contractor(s) liccnscd pursuant lo lhc Conuador's Liccnsc Law).
_l anr exempt under B. & P.C. lbr this reason.
I l^. ^.
WO RKE,RS' CO[}T PIiNSATION
DECLARATION
I hcreby aflirnr undcr pcnalt.v of perjury onc of the tblkrwing dcclarations:
_l have ard will nrainlafur a Certilicate of Consent to Self-lnsure for workers'conryrensation, as provided for by Scction 3700 of the
L:bor Code, for the pcrlorrwrce of thc work lor which thc pcrmit ls issucd.
_l have and will maintain workers' conr[rcnsation insurance, as required by Section 3700 of thc l-abor Code, for the perfornunce of
thc work for which this permit is issued. My workcrs' cornpcnsation insurance carricr and policy number are:
Policy Numher: Expires:
_l ccrtify that in tlrc Jrcrftrrnuncc of thc work for which this Jrcrmit is issued, I shall not cnrploy any pcrson in any manncr
so as to bccomc subjcct to the workcrs' compcnsation laws of California. and agrcc that if I slnuld bccorne subjcct to the
workers' conrpensation provisiors of Section 3700 of the labor C'ode, I shall, forthwith conply with thosc provisions..
WARNING: Failure to sccure workers' compensation coveraSc is unlawful, and shall subject an cmployer to oiminal pcnaltics and
civil fines up to one hulxlred thousand dollars ($100.0001. in arldition lo the cosl of compensalion, danuges as provided for lhe
Section 3076 of the latnr Codc, intcrcst and attorncy's [ccs.
LICENSED CONTRACTOR
DT]CLARATTON
I hercby affirm under penalty of pcrjury that I anr licensctl under provision of Chaptcr 9 (cornnpncing with Scction 7000) of Division 3
of thc Business and Professions Code. and rny licensc is in full forcc and cffect.
License
Date:
Numbcr:
CONSTRUCTION LENDING AGENCY
I hcreby allirm undcr pcnalty of pcrjury that thcrc is a construction lcnding agency lor the pcrlbrmance of thc work lbr which this permit is
issued (Sec. 3097. Civ. C.).
lrnder's Name:
I-ender's Address:
APPI,ICANT DECI,ARATION
I herchy affirnr undcr pcnalty of pcrjury one of thc following dcclarations:
Dcnxrlition Pcrnrits-Asbestos Notification Fcderal Rcgulations (Title 40, Part6)
-Rcquircd
l,cttcr of Notifrcation
_l ccrtify that the l'cdcral regulations rcgarding asbcstos rcmoval arc not applicablc to this projcct.
I certify tlrat I havc read this application and state tlrat thc above information is corrcct. I agrce to conrply with all City and County
ordinances and Statc taws rclating to building construction, and hereby authorize represcntatives of this City and County to enter upon the
above rrrcntioned properly for inspcction purposes.
Applicant or Agent Signature: Date:-
Permitce name (print):
ev. 08-07-2015
hltq*
I bA-*n