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Home My WebLink About20470366 - Permitcity of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA 92702 Electrical Permit #:2o,47o366 Pin #: 613O9Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Project Address: 3201 S Halladay St Assessor's Parcel: 4'11-152-01 Lot: POR 1 Unit: Block: NA Bldg: Address Range: Tract: SECCOMBE Historic: No Suite Range: Zoning: Ml Owner: Address: CHOU JACK C 3 WHATNEY lrvine, CA 926182806 (7141317-0040 Fee Type Amount Demolition (includes ren 50.36 lnvestigation 100.57 Penalty 252.69 Min Fee Adj 13.54 General Plan Update 22.95 lssuance 57.20 Microfilm Records 3.91 Qty 1.00 1.00 1.00 1.00 1.00 1.00 1.00 Fee $s0.36 $100.s7 $252.69 $13.54 $22.9s $57.20 $3.91 $22.9:i $3.91 i474.36 of Auth. filed. E._1;15. rir.r ,qi ..;{) $501.22 $0.00 $501.22 Phone: Tenant Name: Contractor Address: Owner-Builder Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #: Expires: 01 1 'l 6002 51603 01 1 1 6002 s1 603 01116002 51603 01 1 16002 5't603 01 1 16002 51600 01 1 16002 51603 01116002 57770 Botchi:5337? - t2/tt:t/?ttt? ID: or'torsIeElS 0fl'ice: CTYH Trnns*: S4 1 ol IAccti: Ref *: 2r147[r:J66 Rcpbi:0?932329 - t?/llt/?tt 19 2:34 F'll Trqnsocbion Totql t501.2? T:HOU JACN (: Building Use: Job Type: Nature of Work Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: lndustrial Alteration Remove/Repair Electrical R",".,$l*FB'iii' "rElfJle]ll[.att", 6enernl PInn Updcrte Fee !_r1 I I 61102- 5 16110(100-IticrofiIn & Docunents 01116002- 577701100- Electricol C:hnnee Occupancy: Constr Type: Code: B, S.1 V B, SPK cEc 2016 Date: Date: Date:12t',t012019 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Notes: Fee Total: Paid to Date: Balance Due: Every permit issued shall become invalid unless the work on lhe site authorized by such permit is commenced within360 days after its lssuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 360 days after the time the work is commenced. 01 1 16002 51600 01 1 16002 51603 01116002 57770 $22.95 $474.36 $3.91 lnspector MID#: 2018-145332 1 ELECTRICAL.INSPECTOR RECORD DATE ID/SIG COMMENTSAPPROVALS Site-Work Underqround Pole Bases Liqht Standards Spas, Pool, Fountains Siqns (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bondinq / Grounding / UFER Transformers Torqueinq Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilinqs (Hard & Soffit Rough Ceilings (T-Bar Rough) Meter Release Rough Service Meter /^\ FINAL \a-\\-11 K \L{UJ Notes, Remarks, Etc.U\J OWNER BUILDER DELCARATION I hereby affinn undq p€nalty of p€rjury thal I an exernpt fiom lhe Conlractos Licmse larv for thc follow'ing reen (5(.70.11.5 Businas md Profasion Code): Any City or Countl rvhich requira a penrrit lo conslrucl, alltr. improve, donolish or rqtair any structue. prior to its issuance. also requirB the applicant for such pmrit to file a signed stalment lhat he or shc is licssed pursuant to the provisioru of the Contraclor's Licensed law (Chaptcr 9. Cornmencing with Strtion 7000 of Division 3 of the Business od PrefessionsCode)orthatheorsheisexcrnptthqefrornMdthebasisfortheallegedexonfnion. Anl.violationofsectionT0.ll.5byany applicant for a pmit subjsts the applicant lo a civil penalty of nol rnore lhan five hundred dollars ($500). _1. re owns of the prope(y. or my employB with wag6 6 (heir slc compsBtion. r'ill do the work md the strudue is not intoded oroffqedforsle(S{.T044.BusinesmdProfasionsCode:TheConlractor'sLicoseLawdo6notapplyloanownsof the fmpsty who builds or imprcvG thson. od who doc such wo* himse lf or hmelf or through his or hr o*r employec. provided lhat such improlsnmts oe not intodcd orolTqql fur sle. lf. howflc. the building or improvsnot is rcld rvhhin one ya ofcompletion. thc O1t'ns Builds rvill have the turdm ofprnving tha he or she did not build or imgove the prcJrty for the purpor of sle ). l. o owner ofthe property. run exclusively contractinS with licensed conlnclos to constnrct the lroject (Sec- 7044. BNins md PrcfesionCodc:TheContractor'sLicenseLawdoenotapplytoilownerofpropertyrvhobuildsorimproveslhq'eon. and \\'ho contractsforsuchprojectsuithaContraclor(s)licensedpursuiltlotheContractor'sLicrueLaw). --.1 m excmpt under S6tion--+. B. & P.C. for lhis remon. o^,"-\z-to -17 .# h,,\*ffi-* I hereby aflirm undo pmalty ofpajury one ofthe following drclrations: _lhareodrvillmaintainaCqli6catcofconsmttoSelf-lNureforworkqs compmsation,a prolidedforbySection3T00ofthe Labor Code. for the psfomance of the work for which lhe pmnit is issued. lhaveandrvillrnaintainrvorkm'compensalt)niNurance.6 requiredbySection3T00ofthel-aborCode.forthepsfomanceof the work for rvhich this pmit is issual. My rvorkos' composation insurilce caris md policy numbe ue: Cuier: Policy Numbs:-Expires: I cenify that in the pqfonnance ofthe *ork for rvhich this permit is issued. I shall not mrploy any pmon in any rnanntr so as to become subi$t to lhe work6s'compflulion la\s ofCalifomia. and agree that ifl should beonre subject to the workqs'conpensalionprovisionsofSction.lT00oflheLat rCode.lshall.forthrvithcornplyrvithlhoseprovisions.. WARNINC: Failure lo scue workffi'compemation coverage is unlarvful. and shall subjcct an mployer to oiminsl FEnalli6 and civil fines up to one hundred thousand dollas in addition lo lhe cosl of compeNation. dmages as providcd for the sillion 1076 of thc t-atnr Code. intsGl ild ,..,-.\2- lO - /1 I hereby amnn unds pcnalty of pqjury thal I an licensed under provision ofchapts 9 (commencing rvith Smion 7000) of Division 3 of the Busines md Profixsions Code. md my licose is in full force md effet. Liccnse Cla$: Datel -l-icense Numbe: .- (l)nl rficlor: CONSTRUC'TION LENDINC AGENCY I hreby aflirm undo penahy of psjury that thse is a construclion lcnding agency for the pofonnuce of lhc rvork for rvhich this pornit is issued (Ss. -1097. Civ. C.). Lcndq's Name: -- APPLICAN'I DDCLARA'I'ION I hqrby affmn under psalty of pejury one ofthe follorving dwlarations: Dcmolition Pnnits-Asb6tos Notification l'edqal Regulalioos (-fille 40, Pdt6) -Required t*tter of Notification *ith all City and ('ounty dd County to mtq upon thc 2-to-l I celify that the federal regulations regdding mbslos renoval ae not applicable to this prejet. Ltrds s Addrs: I Zc/ r/q?/1 Planning & Building Agency Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-s800 www.santa-ana.org APP-13 CBC 2016 NOTICE TO PROPERW OWNER Dear Property Owner: An application for a specified at buildin'3 z- g permit I name listi ng rself as the builder of the improvements C>qqlq 6 We are providing you with an Owner-BuilderAcknowledqment and lnformation Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEGMENT AND VERIFICATION OF INFORMATON DIRECTIONS; Read and initial each statement below to signify you understand or verify this information..^:l -|_|l/|L,f understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builde/' build- ing permit that erroneously implies that the proper$ owner is providing his or her own labor and material personally. l, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop- erty.yL,nderstand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility <M-understand as an "Owner-Builde/' I am the responsible party of record on the permit. I understand that I may protect myseF from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. ., ![L I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. rfrtL\ \/" [5 I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value'of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an 'gmploye/' under state and federal law. 14 understand if I am considered an "employer" under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com- p;lnsatiggr of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.-tM) )_JYI understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless a// work is performed by licensed subcontrac- tors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract ffi ;ffi [JJ,*Lxffi 5iry.,%yi:it*,J:ilt#r,T;*i.ffi rffi ]:'$t*';:T:*Jrn ship or materials. q , _/1 1-fl6' understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Ser- vice, the United States Small Business Administratlon, the California Department of Benefit Payments, and the California Divi- sion of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800- 321-CSLB iZISZ) or www.cslb.ca.qov for more information about licensed contractors..({-a \ 'F \d'l am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the partyTegally and financially responsible for proposed construction activity at ihe following ad- I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all laws and requirements that govern Owner-Builders as well as employers. 2.1 notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I on this form Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copv of the propeftv owner's driver's license. form notariza- propettv ow ne r's si q n atu re. re of Property Owner Address of Authorized Agent: Date lZ-10't? CL, OPrint name of Owner AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permrt for my project. Elec+r,'<.4 \ \.*, oScope of Construction Project (or Description of Work) Project Location or Address 3 0l 5 tf f". Au*roil^llo J^ d*r." of Authorized Agent.0o Lqt' Phone Number of Authorized Agent:7oZ-Ze o-L{o7 O I declare under penalty of perjury that I am information and certify its accuracy Property Owner's Signature: for the address listed above and I personally filled out the above z. Irr,n, Name of owner:h5(/ Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is re- quired to be presented when the permit rs issued to verify the property owner's signature.