HomeMy WebLinkAbout20170793 - PermitProject Address: 2048 W Washington Ave
Assessor's Parcel: 004-1 62-26 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range.
Historic: No
Suite Range:
Zoning: Rl
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:2lJ17fD793
Pin #: 5226,5
Owner:
Address:
Phone
Steven Tran
2048 W Washington
Santa Ana, CA 92706
(714!- 510-1 7s2
01 1 16002 51603
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type Amount
125 Volt Receptacle 1 .51
Light Switches, Occ. Se 1 .64
Genera! Plan Update 22.95
lssuance 57.20
Microfilm Records 3.91
Qty
2.00
100
1.00
1.00
1.00
Fee
$3.02
$1.64
$22.95
$57.20
$3.e1
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation !nsurance:
Carrier:
Policy #:
Expires:
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$ ?3!
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$?3. ?5
$61 . S6
$3, 91
?,31,
Building Use: Single Family Dwelling
Job Type: Addition
Nature of Work: Addition
Planning Conditions: All materials to match existing
Occupancy:
Constr Type:
Code:
Date:
Date.
Date:
R.3, U
VB
cEc 2019
i.TT
Planning Approva! By.
Plan Checked By.
Permit lssued By: Chavez, Dave
Subject to Field.
Buirdins Permit #: 1 01 1 01444
Yr--02t12t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Electrica! for (1) bathroom
Fee Total.
Paid to Date.
Balance Due:
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 fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#:201 9-154330
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$22 95
$61 86
$3 91
$88.72
$0 00
$88.72
ELECTRICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG,COMMENTS OWNER BUILDER DEI,CARATION
I hccby affm undo pcnalty of perjury that I m exmpt ftom thc Contmcton' Licw law for thc following llen (Sc.7031.5
Busine md Profsion Codc): Any City or County which requirc a pcmh to corotoct, Eltq, imprcvq &molish or rcpair my
structue, prior to its isuancq also rcquirG thc applicst for such pcrmit to filc a signcd stat@@t that he or shc is liccNcd pmumt
to th€ provisioN of the Contnctor's Liccnscd [:w (Chapt6 9. Commcing with Setiotr 7000 of Division 3 of thc B6in69 ed
PrcfsionsCodc)orthathcorshciscxflptth6c&omedthcbasisforthcallcgcdamplion. AnyviolatiotrofSetionT03l.5bymy
applicant for a permit subj€ts thc applicat to a civil pcnally of not morc thm fivc hundrcd dollds ($500).
_1, 6s owner of the property, or my employees with wages as their sole compensation, will do the work and the structure is not
intended or offered for salc (Sec.7M4, Business and hofessions Code: The Contractor's License Law does not apply to an owner of
the property who builds or improves th6eon. and who docs such work himself or herself or through his or her own employees.
provided that such improvanents are not intendcd or offerod for sale. If. howerrer. thc building or improvement is sold wilhin one )tar
of complaioru the Orvner Builder will have the burden of proving ttum he or she did not build or improve the propoty for ttrc purpose of
sale).
\lllr, .ls owner of the property, am exclusively contracting with licensed contractors to construct the proiect (Sec. 7044, Busincss
and hofession 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 Contracto(s) liccnsed pursuant to thc Contractor's License taw).
-l
am exempt under Section-, B. & P.C.
DECI,ARATION
I hereby affrm under pcnalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Sclf-Insurc for workcrs' compcosation, as provided for by Section 3700 of the
Labor Code for the pcrformance of the work for which the pcrnrit b issued.
_l have and will maintain workers' compcnsation insurance. as required by Section 3700 of the Labor Code, for the pcrformance of
the work for which this permit is issued. My workcrs' compensation insurance carrier and policy number are:
Carrier:
Policy Number: Expires:
U(rcertiS/ that in thc pcrformance of the work for which this pcrrnit is issued, I shall not employ any person in any manner
so ,ls to become subject to the workers'compensation laws of California, and agree that if I should become subjcct to the
workers' compensation provisions of Section 3700 of the l-abor Codq I shall. forthwith comply with those provisions..
WARNING: Failure to secure workers' compensation coverage is unlawful. and shall subject an onployer to criminal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation, damages as provided for the
Section 3076 of the Labor Code, interest and attorney's fees.
t
DECI.ARATION
I hereby affrm under penalty of perjury that I am licensed under p,rovision of Chapter 9 (commancing with Section 7000) of Divirion 3
of the Business and Profcssions Code, and my liceirse is in full force and effect.
License
Dete:
CONSTRUCTION LENDING AGENCY
t hwby alfm unda pcnalty of pqjury thst th@ is a coNtruction hrding agocy for thc pafolmce of thc work for which this pqmh i3
issucd (Se. 3097, Civ. C.).
[rnd6's Nmc:
Lender's Address:
APPLICANT DECLARATTON
I herebyaffirmunder penalty of perjury one of the following declarations:
Dernolition Permils-Asbcstos Notification Federal Regulations (Title 40, Part6)
-Required
lrtter of Notification
_l certi& that the federal regulations regarding asbestos removal are not applicable to this project.
W certiS/ that I have read this application and statc that the abovc information is correct. I with all City and County
and County to entcr upon theordinanccs and State laws rclating to building construction, and hereby
abovc mextioned property for inspection
Applicnnt or Agent
authorize
"*",2llz_l?pzo
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltase
Fire AIarm I Dampers
Communications Cable
Building
Under SIab / Floor
Bonding I Grounding / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilings (Hard & Soffit Rough
Ceilinqs (T-Bar Rouqh)
Meter Release
Rouqh Y -L/ _ZO Lert //49 *27
Service N/eter
FINAL /z-6-a 2 Ztst /e,Z6rt *AV
Notes, Remarks, Etc.
Rev. 0B-O7-2015
License Number:
Contractor:_
Permilee name (print):