HomeMy WebLinkAbout20172402 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714\647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (7'14)647-5853
Permit #: 2o^1724o.2
Pin #: 11827
Proiect Address: 3505 S Ross Sta
Unit:
Block: NA
Bldg:
Tract. 7058
Address Range:
Historic: No
Suite Range:
Zoning: RlAssesso/s Parcel: 410-183-02 Lot: 28
Owner:
Address:
Quang Luong
3505 S Ross Street
Santa Ana, CA 92707
(7141 552-1417
01 1 16002 s1603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
FWU
General Plan Update
lssuance
Microfilm Records
Amount
26.71
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
Fee
$26.71
$23.79
$5e.30
$4.05
Phone
Tenant Name:
Contractor:
Address:
Phone:
Alicia Air Cond & Htg lnc
26824 Vista Terrace
Lake Forest, CA 92630
(949) 770-2495
State Lic #: 525314
Lic Type: C-20
Bus. Lic #: 129292
Workers' Compensation I nsurance:
Carrier: Employee Service Group
Policy #: WC027116942
Expires: 0710112021
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling OccuPancy:
Alteration Constr Type:
Fu rnace/Com pressor Com blCode :
R-3
VB
cEc 2019 Notes: replacemenUfwuforcompressor
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Guevara, Jerry Date:
Date:
Date:
12t07 t2020 Misc. Receipt:
Misc. Receipt.
Misc. Receipt:
Total
Verduzco, Vio,"nl{12107t2020
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 worl< is
commenced.
01 1 16002 s1600
01 1 16002 51603
01 1 16002 57770
$23.79
$86.01
$4.0s
Fee Total:
Paid to Date:
Balance Due:
$1 13.85
$0.00
$1 13.85
lnspector MID#: 2020-1 63119
ELECTRICAL-I NSPECTOR R ECOR D
COMMENTSAPPROVALSDATEID/SIG.
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondins I Groundins I UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouoh)
Ceilinos (Hard & Soffit Rouqh
Ceilinqs [-Bar Rouqh)
N/eter Release
Rough
Service N/eter tl
FINAL tTltflu DnWgt 7/
Notes, Remarks, Etc
OWNE,R BUII,DER DEI,CARATION
I hereby affinn under penalty of perjury that I anr exenlpt frcm the Contractoru' License l-aw for the following reason (Sec.7031.5
Busincss and Prol'cssion Codc): Any City or County which requires a permit to construct, allcr, itnprove, dcrnolish or rcpair any
structure, prior to its issuance. als<l requbes tlrc applicant lbr such perndt to fih a sigrrcd staternenl that lre or she is licenscd pursuanl
to the provisions of thc Contractor's l,iccnsed l-aw (Chaptcr 9. Cornmencing with Scction 7000 of Division 3 o[ the Busincss and
Professiorrs Code) or that he or she is exenqrt therefrom and tlre basis for the alleged exempion. Any violation of Section 7031.5 by any
applicant for a perrnit subjects the applicant to a civil penalty of not more than five hundred dollars ($stttt).
_1. as owner ot'thc property, or my crnployccs with wagcs as thcir solc compcnsation, will do the work and the stlucture is not
interx.lal or offered for suh (Scc.7U4. Business and Professions Cqle: The Contraclor's License Law does not apply to an owner of
tlrc prcperty wlro builds or inrproves there<rn, and wlxr dots such work himself or lrerself or through his or her own entployees,
providcd that such improvcmcnts are rmt intcndcd orolfercd for sale. Il. howcver, thc building or inprovenrcnt is sold within oIrc ),car
of completictn, rhe Owner Builder will have the burden of pruving ttut hc or slrc did not buikl or inprove 0rc propoty for thc purposc of
sale).
_1. as owner of the property, am exclusively contracting with licenscd conlraclors to construct thc project (Sec. 7M4. Business
arxJ hotbssion Code: The Contractor's License Law dtxs not apply to an owner of property who builds or improves thereon.
and who cont"racts lor such projccts with a Contracto(s) liccnscd pursuant to thc Contractor's Licensc [aw).
-l
anr excmpt unrler Sectiorr-, B. & P.C. lbr tltis reason.
WORKE,ITS' COMPENSATION
DECLARATION
I hercby affirnr untlcr pcnalty of pcrjury one of thc lirllowing dcclarations:
_l have and will nuintailt a Certiticate of Consent to Self-lnsure for workers' contpettsation, as prcvided for by Scction 3700 of the
L^abor Code, fior the Jrerfonnance of the work lbr which thc pcrmit is issucd.
H have and will nraintain workers' corupernalion insurarrce, as required by Section 3700 of the Labor Code, for lhe Jrerfornunce of
work which this prmit is issucd. My workcrs' con4rcnsation carricr uxl lxllicy nunrbcr iue:
rYl u{q u9--
- t- ?-lPolicy1
_l ccrrify that in tlrc Jrcrfornnncc of thc work for which this pcrmit is issucd, I shall not cmploy any pcrson in any manncr
so as to bccome subjcct to the workcrs' compensation laws of California. and agrce that if I should becomc subject to the
workers' compensation provisions of Section 3700 of the labor Cqle, I shall, forthwith comply with thosc prcvisions..
WARNING: Failure to secure workers' compensalion coverdge is unlawful, and shall subject an employer to crirninal penalties and
civil lines up to otrc hundrerl thousand dollars ($100.000t. in addition to lhe cost of comlrcnsation, danrages as provirled for the
Section 3076 ot Codc, interest and attorncy's l'ccs. ILuLo
I hcreby affrnr under penalty of perjury that I anr licensed under provision of Chapter 9 (conrnrncing with Section 7000) of Division 3
of the Business and Professions Code. and my licenrc is in full forcc urxl effcct.
License C
CONSTRUCTION LENDING AGENCY
I hcrcby al'lirm under pcnalty of pcrjury that thcre is a construction lcnding agcncy for thc pcrformance of thc work for which this permit is
issued (Sec. 3097. Civ. C.).
lrnder's Name:
[rnder's Address:
APPT,ICANT DECI,ARATION
I hcrctry affirm undcr pcnalty of pcrjury ttnc of the following dcclalations:
Dcnplition Pcrmits-Asbcstos Notification Fcdcral Rcgulations (Titlc 40. Part6)
_Required l-cttcr of Notification
_l certily that thc fcdcral rcgulations regarding asbcstos rcmoval iuc not applicablc to this prolxt.
I agree to conrply with all City and Countystalc tlrat lhc ahlvc ittlot'lttaliott is cotrcct.
above rrntioncd property for inspcction
Applicant or Agent
Pcrmitec nanre
irnd authorize o[ this City and County to cnlcr upon thc
Da'e: 1?hla)
08-07-201 5