HomeMy WebLinkAbout20172164 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 - { Elec.t ioor
PermitCounter: (714)647-5800 lnspection Requests 1714)667-2738 lnspector Section: (714)647-5853
Permit #: 210172164r6in*, 5{E'l 6
Proiect Address: 1265 S Cedar Sta
Unit:
Block: NA
Bldg:
Tract: 2626
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 014-223-08 Lot: 99
I
Owner:
Address:
Sandra Yaneth Diaz
1265 CEDAR ST
Santa Ana, CA 927071401
(7141 818-6889
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
Serv Meter
General Plan Update
I ssuance
Microfilm Records
Amount
57.40
23.79
59.30
4.05
Qty
1 .00
1 .00
1 .00
100
Fee
$57 40
$23.79
$5e.30
$4 05
Phone
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
t
\EXptres:
'Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Service Meter Upgrade
Occupancy:
Constr Type
Code:
R-3, U
VB
cEc 2019 Notes: Service Meter upgrade. Handout given. Owner-Builder
form on file.
Planning Conditions:
I
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Chavez, Dave ,?l''10t23t2020
Account#
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 permitis 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 79
$1 t6 70
$4.05
Fee Total:
Paid to Date:
Balance Due:
$144.54
$0 00
$144.54
lnspector MID#: 2020-162367
)
ELECTRICAL.I NSPECTOR RECORD
'-COMMENTS OWNER BUILDER DELCARATION
I h6cby affm und6 p.nslty of pajury that I u crcmpt ftom thc Contrdos' Licmc law for thc following rcmn (Se.7011.5
Busins ard Profsion Codc): Any City or County which rrquirc a pomil to coretruct, alt6, imprcvq dcmolish or rcpBir my
structuq Fior to its issuecq d$ rcquir€ thc applicst for such pctrnit to filc a signcd statmot that hc or shc b lictrcd pwanr
to thc provisios of thc Cotrtractor's Licdscd lrw (Chapt6 9, Comencing with S*tion 7000 of Division 3 of the EBins md
Prcfasiore Codc) or that hc or shc is cxempt thaefrom md thc b6is for the allcgcd exmflion. Any violation of Se'tion 7031.5 by uy
spplicmtforapfinitsubjctsthe applicmttoacivilpmltyofmtmorcthilfivchundrcddollffi($500).
--1.
as owner of the prope'rty. or my employecs with wages as their sole compensation, willdo the work and the structure is not
intended or offered for sale (Sec.7044, Business and hofessions Code: The Contractor's License l-aw does not apply to an owner of
the property who builds or improves thereon. and who does such wod( himself or herself or through his or her own employees,
provided that such improvonents are not intended or offered for sale. If. howsrer. the tuilding or improvement is sold within one year
of complaioru the Orvner Builder will have thc burden of proving thd he or she did not build or improve thc pnoperty for the purpose of
sale).
I
_1, as owner of the property. am exclusively contracting with licensed contractors to conslruct the project (Sec. 7044, Business
and Profession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a Contractor(s) licensed pursuant to the Contractor's Licerue Law).
I
-l am exempt under Section-.
o,,", WlzS/Zc)
DECLARATION
I hereby affrrm undcr pcnalty of pcrjury one of the following declarations:
_l havc and will maintain a Certificate of Consent to Self-lnsure for workers' compensation, as provided for by Section 3700 of the
Labor Codc, for the performance of the work for which the perrnit is issued.
_l have and will maintain workers' compensation insurance. as requircd by Scction 3700 of the kbor Code, for the performance of
the work for which this permit is issued My workers' comperisation insurancc carricr and policy number are:
Policy Number: Expires:
_l certify that in the performance of the work for which this permit is issued. I shall not ernploy any pcrson in any manner
so as to becorne subject to the workers' cornpensation laws of California, and agree that if I should become subject to the
workens' compensation provisions of Scction 3700 of the l-abor Code, I shall. forthwith cornply with those provisions..
WARNING: Failure to secure workers' compensation coverage is unlawful. and shall subject an and
civil fines up to one hundred thousand dollars ($100,000).
Section 3076 of the Labor Code, interest and attorney's fees.
to thc cost the
o*", l0 (l? f ?ro r
I hereby affirm under penalty of perjury that I arn licenscd of Chapter 9 (commancing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
License Class: License Number:
CONS'TRU("I'ION LF]N DI NG A(; IiN('}'
I hcrcby aflim undr penalty of pqjury that th@ is a construction btrding agqcy for thc pqfomucc of the work for which this pomit is
issued (Sec. 3097, Civ. C.).
lrnder's Name:
t
APPLICANT DECLARATION
I hcr,*y affirm under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notifrcation Federal Regulations (Title 40. Part6)
-Required
Later o f Notification
_l cerf ify that the lirderal regulations rcgarding asbestos rcmoval are not applicable to this project.
with all City and County
and County to erter upon the
above mentioned property for
Applicant or Agent
and state in[orrnation
*r",, lo/23/Zo
S ite-Work
_UnEgrground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm lDampers
Communications Cable
Building
Under Slab / Floor /l n/-/Bonding I Grounding / UFER l-WlM gfty,rct 5ru
Transformers I
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factorv Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilings (Hard & Soffit Roush
Ceilinqs (T-Bar Rouqh)
Meter Release
Rough u I I -'-/
Service Meter Iql%lct 0 wary r? q,
FINAL ruvu 'whll00r ,4fr
Noteg, RerRarks, Etc.I
,l --
It tt
-$,
Rev. 08-07-2015
f,_.r,
P.C.
Carrier:-
Drte: Contractor:_
Pernritee name (printY:(-
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