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Home My WebLink About20170792 - Permitl{fu, City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA s2702 Electrical,Permit #:2lJ17lJ792 Pin #: 43518 Proiect Addressi 2134 N Candis Ave Assessor'sParcel: 001-081-19 Lot:154 Unit: Block: NA Bldg: T(acl 1724 Address Range: Historic: No Suite Range: Zoning: R1 Owner: Address: Phone: Salvador Cervantes 2134 CANDTS AVE Santa Ana, CA 927062423 (s62) 8244465 01 1 16002 51603 01 1 16002 51600 01 1 16002 51603 01116002 57770 Fee Type Serv Meter General Plan Update lssuance Microfilm Records Amount 55.37 22.95 57.20 3.91 Qty 1.00 1.00 1.00 1.00 Fee $55.37 $22.95 $57.20 $3.91Tenant Name: Contractor Address: Owner-Builder Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance: Carrier: Policy #: Expires: Babrhi:1436A - 2/12/2L12O ID: otrtorqlesl.: 6f f i r;s; (:TYH Trnnsi: 45 1 of I Ac,:b,} : Ret*: 2tl17ll7?? f((r,L+:tr2g9?499 - 2il7/?lt1l,r lLr:53 Afl Trunsnr:Liorr Totol $13?./r.i nlvndor (:ervnnl:e: Building Use: Job Type: Nature of Work Planning Conditions: Planning Approval By Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Single Family Dwelling Miscellaneous Service Meter upgrade Chavez, Dave 02t't2t2020 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Notes: Fee Total: Paid to Date: Balance Due: Occupancy: Constr Type Code: Date: Date: Date: R-3, U VB cEc 2019 Service meter upgrade. Handout given. Owner-Builder form on file. $139.43 $0.00 $139.43 Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 360 days after its lssuance, or if the work authorized on the site by such permit ls 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 $112.57 $3.91 lnspector MID#: 2020-157711 ELECTRICAL.INSPECTOR RECORD Rev.08-07-2015 APPROVALS DATE ID/SIG.COMMENTS OWNER BUTLDER DELCARA'IION I hoeby aflinn undo penalty of pcrjury that I m excmpt from the ContractoB' Licme Law for the following r6on (56.7031.5 Businqs md Profssion Code): Any City or County which rcquirB a pqmit to coNlruct. alto. improvq dmolish or repair my struduq prior to its issuuce. also requirs the applicmt for such pemi( to file a signcd statmot that he or shc is licmed pmumt to the provisioN of thc Contractor's Licensed Law (Chapts 9, Commencing with Sstion 7000 of Division 3 of thc Busin$ md ProfesiomCode)orlhathe orsheisexemptthsefro,nildthcb6isfortheallegcdexmption. AnyviolationofSationT03l.5byany applicant for a pcnnit subjets thc applicant to a civil penalty of not more thm five hundred dolltrs ($500). I. c owno of the property, or my employc with wag6 6 their sle compwtion. will do thc work ild the struclue is not intmdel or offered for sle (Ss.7044. Businas md hofesions Code: Thc Contraoor's Licw t,w doe nol apply lo u oMer of the prcpcity who builds or improve thqen. od who do6 such mrk himself or hmelf or thrcugh his or hr om employee, provided that such improvmmts de not intoded or offsed for sle. lf, howwq. the building or improvmot is mH within one )s ofcomplaion, the o\vnq Buildq will have the budm ofproving that he or she did not tilild or improve the prcpcty for the purpos of rlc). _1, c oma of the propsty, m exclNivcly conlracting with liceNed contracloB lo coNtruct thc projcct (S(. ?044, Buins ed &ofBsiof, Code: The Contractor's Licose Law doe nol apply to m owns ofpropeny who buil& or improves thsso, and who contBcts such pojccs with a Contracto(s) licffid pursuet to the Iaw). Itun P for this I hseby affrm undtr penalty ofpojury one ofthc following I have ed will mintain a Cqtificate of CoNdt to Self-l6ure for workm' compouation. o provided for by Sction 3700 of thc Labor Code, fo. the psfomucc of the work for which the pmit is issued. _l have and will maintain workm' compcNation i6uruce. 6 rcquired by Sction 3700 of thc Labor Codc, for the pqfommcc of thc work for which this psmit is iscd. My work6' @mpqtsation irourmce cmiq od policy numbo oe: Cmir: Policy Numbcr: Expirc: _l certify thal in the pqfonmnce of the work for which this pornit is issued. I shall not mploy any prson in my mmncr s 6tobc{omesubjecltothcwork6s'compemationlawsofCalifomia,mdagreethatiflshouldbecomcsubjsttothe workffi' compeNtion provisiom of Sction 3700 of the Labor Code. I shall, forthwith comply with those provisions.. WARNTNG: Failure to wuc workers'compemation covcrage is unlawful. and shall subjat ilploys to qimiml pstsltics md in addilion to the cost of dmage o provided for thc I t)t.:( l.,^R,\'t ()N I h6eby aflim undcr penalty of pqjury that I an licmsed undo provision of Chaplq 9 (comocing with Section 7000) of Division ! of the Busins dd Profesions Code, md my licesc is in full force md effet. Liceree Clrc:-Liccroe Numbel l)alc: CONSTRUCTION LENDINC ACENCY I hqeby affirm undq p€nalty of perjury that thse is a coGtruction lqding agency for thc pofomance of thc work for which this pamit b issuui (Se. 3097. Civ. C.). Lendq's Name: [.ndq's Addr6s: APPLICANT DECT,ARATION I hetby affrm unds pqralty ofp€rjury one ofthc following dalaations: Demolition Pamits-Asbetos Notification Fedral Rcgulatioro (Tille 40, Pm6) -Requircd Lctls of Notilication &;:";::federal regulatiom rcguding rebstos ranoval ae not applicable to this prcjd. I agr€ to comply with allrmd this application ud state that the above and I o,tinanca and Statc Laws relating io oflhis City and upon the I above mmtioned prcpeny for tI Applicanr or Agent I l'rrrnittt rrrnrc u 7, ,?o?J Site-Work Underqround Pole Bases Liqht Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Building Under Slab / Floor Bondinq / Groundinq / UFER z/*{p t W*.rtq+.t*f,e/ Transformers a ur Torqueinq Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rouqh) Ceilinss (Hard & Soffit Rough Ceilings (T-Bar Rough) Meter Release Rouqh Service Meter ?,(?4lnP',Ar+N\.tyrO /&) FINAL zlull?A .1t*^^'-)6D Notes Remarks Etc. civil fines Setion sl,t .rror- Planning & Building Agency . Building Safety Division 20 Civic Center Plaza P.O. Box 1988 (M-19) Santa Ana, CA 92702 (714) 647-5800 www.santa-ana.org APP-I3 CBC 2016 NOTICE TO PROPERW OWNER Dear Property Owner: An appl ication a buildi h been tn name ng AS builder of the property improvements specified at We are providing you with an Owner-Builder Acknowledqment 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. Wewillnot issue a building permit untilyou 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/. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build- ih/pbmit that erroneously implies that the properg 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.('/\ ( I 2. I understand building permits are not required to be signed by property owners unless they are responsible for the dffiuction and are not hirin! a licensed Contractor to assumsthis responsibility. ('n .I ' a. I understand as an "Owner-Builde/' I am the responsible party of record on the permit. I understand that I may protect m)Eelf from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. fi-^ I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. ,V. U. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total va'lfe of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an 'employed' under state and federal law. ,L, I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal go\Crnment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com- p,engation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. L, I 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 a licensed general building Contractor 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan- cial or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman- ship or materials. IlL n I understand I may obtain more information regarding my obligltions as an "employe/'from the lnternalRevenue Ser- c.vlcbJne United States Small Business Administration, 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 (2752) or www.cslb.ca.oov for more information about licensed contractors. V,O f,ffi-t"s, I am aware of and sent to an Owner ilder building permit applied for in my name, and understand that I am the le pro activity the dress 11 . I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all le laws and requirements that govern Owner-Builders as well as employers.(A -Y12 I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I h'dvE-provided 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- proo ertv owne r's sio n atu re. Signature of Property Date: 'Zt?o Print name of Owner a AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personalresponsibility, 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 Permit for my project. Project Location or Address Name of Authorized Agent: Address of Authorized Agen t. Phone Number of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Property Owneds Signature:Date: Print Name of Owner: 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 is issued to verify the propefty owner's signature. ScopeofConstructionProject(orDescriptionofWork):