HomeMy WebLinkAbout20171903 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: 2o-171 9O3
Pin #: 59664
Proiect Address: 1922 W Moore Avea
Unit.
Block: NA
Bldg:
Tract: 8200
Address Range.
Historic: No
Suite Range:
Zoning: RlAssessor's Parce!: 412-283-22 Lot: 3
Owner:
Address:
Thien Nguyen
1922 W MOORE AVE
Santa Ana, CA 927046132
(7141 725-9327
Fee Type
01116002 51600 General Plan Update
01 116002 57770 Microfilm Records
Amount
23.79
4.05
Qty
000
000
Fee
$0.00
$0 00
Phone:
Tenant Name:
Contractor:
Address:
Phone:
TLP Electric lntegrations db
2460 North Glassell Street, I
Orange, CA 92865
(7141 599-1 13s
State Lic #: 824287
Lic Type: C-10
Bus. Lic #: 343655
Workers' Compensation I nsurance:Carrier: Starnet lns Co
Policy #: BNUWCoI 37148
Exprres: 0710112021
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Solar
Solar
Occupancy:
Constr Type:
Code:
R-3, U
VB
cEc 2019
Notes. Electrical for new roof mounted solar PV system.
Planning Conditions:
Planning Approval By:Date:
Date.
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Plan Checked By:
Permit lssued By:
Subject to Field:
Smith, Mark
Amsden, Julie
09t21t2020
12t14t2020
Account#
Building Permit #: 1 01104667
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 permit is suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Fee Total:
Paid to Date:
Balance Due:
$0 00
$0.00
$0.00
lnspector MID#:2020-1 61531
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under SIab / Floor rl
7lBondinq I Groundinq / UFER 7 1ti 7 Dtw<6 /
Transformers I /
Torqueing
Sub-Panels
Air Conditioners tt o
Roof Top Equipment l?.I bA*'Y 7
Factory Wired Unit l- l
Walls (Conduit)
Walls (Rouoh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs [-Bar Rouqh)I I I
N/eter Release IZ 11 I UDtYB fr
l- |
Rough
Service N/eter tl
FINAL }tA:w Y)
Notes, Remarks, Etc./rt
I)I.]I,CARATION
I hereby affrnr under penalty of prjury that I arn exenrpt from the Cbntractos' License [:w for the following reason (Sec'.7031.5
Ilusincss and Prol'cssion Codc): Any City or County which requircs a pcnnil to construct, alter. itnprove. demolish or rqrair any
structure, prior to its issuance. also requires the applicant for such pernrit to file a signed slatenrnt that lre or she is licerrscd pursuanl
to thc provisions of thc Contractor's l.iccnsed taw (Chaptcr 9. Commcncing with Section 7fi)0 of Division 3 of the Business and
Professions Code) or that lr or she is exentpt therefronr and tlrc basis for tlre alleged exenption. Atry violation of Section 7031 .5 by any
applicant for a pennit subjects the applicant to a civil pcnalty of not more than five hundrcd dollars ($stltt).
_1. as owncr ol'tltc or my crnployecs with wagcs as thcir srrle compensation,
and Profe.ssions Ctxle: Tlrc Contractor's
willdo thc work and thc structure is not
Liccnsc l-aw does not apply to an owner ofBusiness
thc property wlxr builds or inprows thereon, and wlro does such work himself or lrcrself or through his or her own entployees,
providcd that such improvclrrcnts arc not intcndcd or ollcrcd for sah. ll. howevcr, the building or inprovenrcnt is sold within one ycar
of conrpletioru tlrc Owrrer Buikbr will travc thc bunlen of pmving ttrat hc or she did not buikl or inprove ttrc propcrty for thc puqposc of
sale).
_I. as owner of the propeny, amexclusively contracting with liccnscd contracloni to conslruct thc project (Sec. 7044, Business
arxl Protession Code: The Contractor's License Law dtxs not apply to an owner of property who builds or improves thereon.
and who contracts for such proi.cts with a Contractor(s) liccnscd pursuant to the Conuaclor's Liccnse law).
-l
anr exenlpt under Section-, B. & P.C. tbr this reason.
WORKERS' COM PETTSATION
DECLARATION
I hercby alfirm under pnalty of perjury onc of thc following declarations:
_l have and will nraintain a Certificate of Consent to Self-lnsure for workers' compensation, as pruvided for by Section 3700 of the
Labor Codc, for the Jrcrlonnance of the work for which thc perndt is issued.
Anhave anrl will rnaintain workers' conqrensation insurance, as rcquircd by Section 3700 of rhe L-abor CorJe, for the grcrformarrce of
'?h:l work tbr which this pcrmit is issuc'd. My workcrs' compensation insurance carricr and plicy numhcr are:
A
Policy +l(l.lrrr
_l ccrtify that in thc prfornnnce o[thc work for which this pcrmit is issucd, I shall not enrploy any lrcrson in any manner
so as to bcconrc subjcct to thc workers' compcnsation laws of California. and agrce that if I should bccornc subject to the
workers' conrlrnsation pruvisions of Section 3700 of thc L-abor Code, I shall, forthwith cornply wilh thosc provisions..
WARNING: Failure to srcure workers' compensation coverage is unlawful, and shall subject an employer to criminal penaltics and
civil lines up to one huudred thousand dollars ($100.000). in additiort to the cost of compensation, danrages as provided for the
Scction 3076 of the Co<le, intcrcst and attorncy's
I hercby affrnr under pnalty of perjury that I anr licenser,l under provision of Chapter 9 (conmrcncing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full forcc and effect.
Licen.se Nunrber:&s+
CONS'TRUC'TION I,EN I)ING AG T]NCY
I hcrcby al'lirrn undcr pcnalty
issued (Sec. 3097. Civ. C.).
lrnder's Nanrc:
ol'pcrjury that therc is a construction hnding agency for the pcrforrnance of thc work for which this Jrcrrnit is
APPI,ICANT DECI,ARATION
I lrcrcby affirnr undcr pcnalty of pcrjury onc o[ thc folklwing dcclarati<lns:
Denxrlition Pcrmits-Ashestos Notification Fcdcral Regulations (Titlc 40. Part6)
-Rcquircd
lrttcr of Notification
ccrtily that thc l'cdcral rcgulations rcgarding asbcstos rcmoval arc not applicablc' to this prcject.
tlral havc rcad this application iurd statc that thc abovc inlirnrration is corrccl.agrcc conrply with ull City ancl County
ordinanccs and Statc [,aws rclating
abovc rncntioned property for
Applicant or Agent
Permitee
to building construction,afiJ hcrcby authorize rcprcscntativcs o[ this cilv and County to t:ntcr urr)n thc
ELECTRICAL.INSPECTOR RECORD
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Rev. 08-07-201 5
I 111 r)
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