HomeMy WebLinkAbout20132650 - Permitcity of santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738
Electrical Permit#:20132650
lnspector's Section: (71 4) 647-5853/
Project Address: 329 E Wakeham Ave
Assessor'sParcel: 011-044-16 Lot: 7
Suite:
Block: NA
Bldg:
Tract:584
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Tenant Name
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Marco A & Josephina Chavez
329 E Wakeham Ave
Santa Ana, CA 927015953
(7141321-1949
Fee Type
Serv Meter
lssuance
Notes: handout given
Fee Total:
Paid to Date:
Balance Due:
Amount
27.00
32.50
Qty
1.00
1.00
Fee
$27.00
$32.50
$59.50
$0.00
$59.50
Building Use:
Job Type:
Nature of Work:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Miscellaneous
Service Meter
\f,* Hernandez, Kathy
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-3
V-N
cEc 2004
02t1512006
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
^J
Building Permit
This permit shall expire by limitation and become null and void if the wotu authoized by this permit
is not commenced within 180 days from the date of this permit, or if the wotu authoized by this
permit ls suspended or abandoned at any time after the work is commenced for a peiod of 180 days
Before such work can be recommenced, a new permit shall be first obtained to do so.
Account #: 01 '1-01-5913 lnspector MID#: 2006-67533
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Planning Conditions:
ELECTRIGAL.I NSPECTOR RECORD ,
APPROVALS DATE ID/SIG.COMMENTS Oms-BuildqDcclruion t , I
I hcrcby aflim undcr pcnalty of pcrjury lhat I m cxcmpt fom thc Contracto6' Liccnsc Law for thc following rccon (se.7ol L5 Buins
and Profcsion Codc): Any City or Couty which rcquiro a pcmit to construct, altcr, improvc, dmolish or rcpair uy structurc. piorG its
issuucc, also rcquiro thc appli@t for such pcmit to filc a signcd statmot that hc or shc is liccnscd punuut to thc provisions of rhc
Conractor's Licascd Law (Chapiq 9, Commocing with Scction 7000 of Division 3 ofthc Businos ud Profqsions Codc) or rlrat hc or
shc is cxcrlpt thcrcfrm ud thc bcis for thc allcgcd cxmption .Any violation of Scction 7031.5 by uy applicet for a pcmit subjcctr thc
applicqg{o a civil pcnalry ofnot morc thm fivc hun&cd dollrs ($500).
/1, o ownc ofthc prcpcrty, or my cmploycq witl wag6 4 thcir solc compcnsation, will do thc work and thc stluctuc is not inrcndcd
or offacd for salc ( Scc.7044, Bwin6s od Profqsions Codc: Thc Confiactor's Liccnsc Law doe not apply to an owncr ofthc proFErty
who builds or improva thcrcon, ud wlto docs such work himsclf or hmclf or through his or hcr own mployccs, providcd that such
improvcryriG uc not intcndcd or offcrcd for salc. If, howcvcr, thc building or improvmmt is sold within onc ycuofcomplclior, thc
O@luildcr will havc thc burdcn of proving that hc or shc not build or imprcvc for thc purp$e of sal€).
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contracts for such projccs with a Contrrcto(s) liccnscd pursuat to tha Contractor's Liccnsc Law.).
_l m cxcmpt undcr Scction .C. for this rcoon.
dDatc: Owncr:/tt
WORKERS COMPENSATION DECLARATION
I hcrcby affim undcr pcnalty ofpcgury onc ofthc following dcclrations:
_lhaveadwillmaintainaCcnificatcofConsenttoSclfJnsurcforworkcn'compcnsation,6 providcdforbyScction3TOOofthc
Labor Codc, for thc pcrfomacc of thc work for which thc pcmit is issucd.
_l havc od will maintain wqkcn' compcnsation insumcc, c rcquircd by Scction 3700 of thc Labor Codc, for thc pcrfommcc of thc
work for which this Fmit is issucd. My workm' compcnsation insurs& cmia ud policy numbcr uc:
Caricr:
Policy Numbq:
(This scction nccd not bc rcmplctcd if thc pmit is for Onc hundrcd dollm {S100) or lo)
-l
ccnify that in rhc pqfomoe of thc work fu which this"pmit is issucd, I shall nd cmploy my pcnon in any manncr so s to
bcmc subjcct to thc workm ' compnsation law of Califmil, md agrc that if I should bccomc subjcct to thc wqkcrs'
compcnsation provisions ofScction 3700 ofthc forthwith cmply with th6c proyisions.. -%* -4. 0/r"rrs
pcnaltics md civilWARNING: Failurc to sccurc workcm' compcnsation covcragc is unlawful, u
fin6 up to onc hundrcd thowod dollus ($100,000),in addition to lhc cost ofcompcnsation, damags s providcd for thc Scction 3076 oi
thc Labor Codc, intcrGt ud attomcy's fcs.
LICENSED CONTRACTORS DECLARATION
I hcrcby aflim undcr penalty ofpcrlury that I m liccnscd undcr provision of Chaptcr 9 (commcncing with Scction TOOO) of Division 3 of
thc Busincss @d Profssrons Codc, sd my liccnsc is in full forcc and cffcct.
Liccnsc Clus:_ Licrnsc Numbcr _
Datc: Contractor
CONSTRUCTION LENDING AGENCY
I hcrcby aflim undcr pcnalty of psdury that th6c is a construction lcnding agcncy for thc pcrfmancc of rhc wqk for which this p€mit is
issucd (Scc. 3097, Civ. C.).
Lcndcr's Nmc:
Lcndcr's Ad&css:
APPLICANT'S DECLARATION
Dmolition Pcmiti-Asbstm Notification Fcdcral RcSulatons (Titlc 40, Pan 6)
_ Rcquircd Lcttcr ofNotifietion
_l ccnify that thc fcdcral rcgulations rcguding sbotos rmoval &c not appliqblc to rhis projcct.
_ I ccrliry thd I havc rcrd this application ud shrc thar thc abovc infomtion is corcct. I agrcc to
ordinmcq ild Statc Laws rclating to building @nstruction, ed hqcby authorirc rcpreotativc of
comply with all City ild Counry
abovc miltioncd propc.ty
this City ud County to cntcr upon thc
Applicilt or agcnt
Pcmittcc nmc (print):
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torquing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rough
Ceilings (T-Bar Rough)
Meter Release
Rough
Service Meter
FINAL
Notes, Remarks, Etc.
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