HomeMy WebLinkAbout20159706 - PermitPermit #:20159706
Pin #: 31263
city of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA 92702 Electrical
Permit Counter: (714) 647-5800 lnspection Requests. (714) 667-2738 lnspector Section: (714) 647-5853
Project Address: 618 S Rosewood Ave
Assessor's Parcel: 010-283-17 Lot: 55
Unit:
Block: NA
Bldg:
fracl:1470
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Fidel & Delia Quezada
618 S Rosewood Ave
Santa Ana, CA 927034518
(714) 393-7858
Verengo lnc
20285 S Western Avenue, #i
Torrance, CA 90501
(7141744-69',t1
Fee Type Amount Qty Fee
PAIDState Lic #: 935263
Lic Type: B, C-10
Bus. Lic #: 328493
Workers' Compensation lnsurance:Carrier: STARR INDEMNITY & LIABILITY COMPANY
Policy #: 1000001 259
Expires: 1010112016
t'1AR 2I 2016
City anta Anaofs
Notes: lnstall solar panels/fee pd on 10188750
Fee Total:
Paid to Date:
Balance Due:
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permil lssued By:
Subject to Field:
Single Family Dwelling
Solar
Solar
Hernandez, Kathy 03t29t2016
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R.3, U
VB
cEc 2013
\K
Buildins Permit #: 10188750
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permit is suspended
or abandoned for a period of 1 80 days after the time the work is
commenced.
$0.00
$0.00
$0.00
lnspector ttllD#: 2016-127756
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcreby aflrm under pcnllty of pcrjury that I dn cxcDrpt frcnr lhc Cotrlrxclors' l-icen$c Law l'or thc folk)wing rcayr (Scc.7oJl.5
Busincss and Prolcssion Codc): Any Cily or County which rcquircs n Ircrnrit k) construcl. nltcr. inrprovc. dcil()lish or repuir any
slruclurc. prior k) its issuance. also rcquires lhe applicant li)r such [f,rmil lo lilc a signed slaterrcnt thal he or she is liccnscd pursuanl
k, lhe provisions of lhe Conlracbr's Liccnscd Law (Chaplcr 9. Corrrnencing wilh SectioD 7000 ol Divisbn 3 ol thc llusincss and
ProfcssioilsCodc)orlhallEorshciscxcmlillhcrcfronrandlhchrsisforlhcallcgcdcxcnrpthn. AnyviolatioilofScclionT0]l.5byany
apflicanl for a pcrmil subjccts thc applicant to a civil penahy of not more thdn llve hundrcrl dollurs ($5(X)).
-1.
as owncr of lhc propcrly. or my enlployccs with wagcs rs thcir solc compcnsation. willdo thc work aod thc rtruclurc is txil
irlculcd or olfcrcd firr elc (56.7044. Busincss and Prolc\sions Codc: 'l hc Conlracklr's Liccnsc Irw docs Dot npply k) rn (,wncr of
lhcprcpcny whobuildsorirnprovcslhemn.andwhodoessuchworkhiorselforhcrsclforihroughhisorherownetrtployccs.
provided lhal such improvctrEnts irc nol iilendcd orollcrcd lor sale. li howcver. thc huilding or inprovcnunt is soki qithir inN )eu
o[complction. lhc Owncr Buildcr will hilvc lhc hurdcn of provi0g thrt hc or she did trot huild or inrprovc thc pm|rcrly li)r thc purF)* o[
salc).
-1.
cs owncr of lhc propcny. am cxclusivcly conlracling wilh liccnscd conlrdclors lo conslrucl lhc projcct (Scc. 7()1,1. Busiilcss
ond Pn)ll\siil Codc: l he Conlractor's Liccnsc Law docs D(il lfply to un owtrcr o, propcny wh() huikls or inrprovcs lhcrcon.
and who cotrlracls for such pr(,jccls with a Corilmcbr(s) licenscd pnnuant k) lhc ConlrilckrJs Liccnsc Luw).
-Iamexcmptundcrsccli()l1-.B,&P.C.forlhiSreason.()wner:
WORKERS' C(TlltPENSAl'ION
DECLARATION
I hcreby aflrm under pcnshy ofpcrjury one ofthe Ibllowing dcclarations:
-l
have atrd will mintain a Cerlificale otConsent lo Selllnsurc lor workers' comlrensation. as providcd lbr by Scction 3700 of the
tibor Codc. for lhc pcrfortrEncc ofthc work lbr which thc pcrmil is issucd.
|E[l havc ana will rnainlain workers' compensation insurance. as rcquircd by Scction .1700 of thc tibor Code. for thc pcrlbrruncc of
lhc work for which this fcrrnit is issucd. My workcrs' conrpcnsaliorl iilsuruncc canicr and grlicy rrurntrcr urc:
coni",,9(A(l4L lN OeM rr ( r','li1 ItPolicy Nu I0oO0o z lo
_l cerlify Ihut iri lhc pcrlornlancc of lhc work tbr which lhis pcrmit is issucd. I shlll not cnrphy any pcNon in dny rnunncr
v) as b bcconE suhjel b lhc workcrs'conlpcnsalion laws ofCalili)rlia. rnd iltrcc thnt if I should hcco[r subjcct to tlrc
workers'coilllrcnsationprovisionsofScclion3Tfi)olthclitx)rC(xlc.lshall.foilhwithconrplywiththo{pt1)visions..
WARNING: Failurc kr sccurc workers'cotrrpcnsalion covcrngc i! unlawtil. and shall suhiccl ut etnpk)ycr tr crinrinll pcnahics and
civil fincs up lo otrc hundrcd lhousand dollrrs (Sl00.UI)), iD addition to lhc cost ofcotrtpelsntion. rhnngcs ar proli(lcd fi)r the
Scclion 1076 ol thc (ixlc, irilcrcst xnd nlkrnrcy s ltcs
3,'2q 4 !/ /-/
I hcrcby aflirnt undcr pcnalty of pcrjury lhal I am liccilscd undcr p,r)visi(n ofChuplcr 9 (cotrril1cncing with Section 7(XX)) ol l)ivision 3
of the Busiucss rnd Prolessions Code. uild my liccnsc is irr lirll li)rcc rnd clltct.
l.iccnsc 0 c- lo Nurrra(r:lrsz 6 :t
I hcrcby affirrn undcr Jrcnalty of Jrcrjury th{l lhcrc is a conslruction lcndiig agcncy for thc pcrforil)ilncc oi thc work t-or which lhis JErmit is
issucd (Scc. 3097. Civ. C.).
hndcr's Nanrcr
kndcr's Addrcss:
APPLICANT DECLARATION
I hcrr,by allim under penalty of perjury onc of lhc folbwing dcclualions:
Dcmolilion Pcrmits-Asbcstos Notification Fedcral Rcgulations (Tille 40. Pan6)
El'(cquired t*trer <)f Noritlcarion
p-l ccnify rhar rhc fcdcralrcgulations rcgarding asbcslos rcmoval orc nol applicablc h this prejcct.vil
Ll ccnily that I havc rcad thrs applicatioo nrd slalc that thc ntnvc infornulion is corcct. I sgre b comlly wilh tll C-ity and County
ordinsnces and Slale Laws rclatinS lo building construclion. md hereby authorizc represeDtativcs of lhis City and Counly to entcr upon the
purFnscs.tln
Pcmlremme(p.inr. Pf/O t tv 6
_ r^,", l/ul /fi
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueino
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouoh)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Rouqh)
Meter Release
Rouqh
Service N/leterFINAL 6ffirh&*
Notes Rem Etc.I
no n7 o.\i (