HomeMy WebLinkAbout20170572 - PermitProject Address: 515 1/2 W Cubbon St
Assessor'sParcel: 010-244-09 Lot: POR 7, POR 8
Unit:
Block: 18
Bldg: Address Range:
Tract: POLYTECHNIC VlLLblisloric: No
Suite Range:
Zoning: SO40
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cAg27o2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714\ 667-2738 lnspector Section: (714) 647-5853
Permit #: 2017o572
Pin #: 5682t1
Phone:
Tenant Name:
Conlraclor
Address:
Gustavo Caldera
605 W CURIE AVE
Santa Ana, CA 927073920
(s49) 981-6368
Owner-Builder
5160:
5160:
5160C
5160:
5777C
Amount
55.37
3.70
22.95
57 .20
3.91
Fee Type
Serv Meter
0-1 HP, KW or KVA
General Plan Update
lssuance
Microfilm Records
01 '1 16002
01116002
01116002
01116002
01116002
Qty
1.00
1.00
1.00
1.00
1.00
Fee
$5s.37
$3.70
$22.95
$57.20
$3.91
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
;ci;; Reii I ?017U-l-,72
:piitu:964i6; - ir'i3/2u!Lt 11r02 All
|.onsoci ion iotoi tl4J. 13
I taFi (-lIfl
,:15!t0V0 t.RtOer'!r
ii i5/ztt2tt I0: qnor 01e515
i|$rr:,i: G9 1 cf I
$ 143.1 3
$0.00
$143.13
ij.1(ir:rr.r;i- -i77 r '.'rr':"1"Notes: Hand oululven. Auth on file^ ..1:i: * i +t* * * * r* i*.2 JJ 7
ienePoi Pifln tipdgLu icc
i i illnni_ .lioitr.rtrl-'rectr'i,::oi.
. iiioo'i:- iiooSottll-iianofil i ltuuunerrL>R-3
VB
cEc 2019
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
lnspector
.\/01113t2020
Account#
Date
Date
DateZuniga, All
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every pe.mit issued shall become invalid unless lhe v/ork on the site
authoized by such permit is cornfienced withn 360 days aftet its
issuance, ot t the work authotized on the site by such permit is suspended
or abandonecl fot a peiod 01360 days aftet the time lhe work is
commenced.
01 1 16002 51600
01 1 16002 51603
o't116002 57770
Fee Total
Paid to Date:
Balance Due:
$22.95
$116.27
$3.91
MtD# 2020-157026
Owner;
Address:
Accessory Dwelling Unit-O Occupancy:
Miscellaneous Constr Type:
Service Meter Code:
4.rr 9E
$116.?7
t3.9I
$143.13
Authi: 151:rr:r?d
Building Use:
Job Type:
Nature ol Work:
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARAIION
I h€..t! afirm undd pcnalty oa pdjury rhd I m .r.mpr no,n the Conlmclos Lic.6.lrN forlhc folbwine r.Mn (5*.?011.5
Busi.ss ond P(&3etun Cod.)r Any Cily or Counly which r.quir6 a p6hir to connN.r, 01t6, improvc, dsnolisn or r€p.t /rny
struduc F'ior to ns isuoc.- also r.qut6 lhc .prli.dl lor such pamn lo frlc a siBn.d statmenl lhal h. or 31E ; licd&d pcuml
ro rhc prorisiom ot $. Co.Im.rors Licfls.d L,u (Chapt( 9. Conoc.ci.g {irh Sdiion 7000 of Division 3 ollhc Busns dd
Potsions Cod€) or rhat he or shc is .rc'npr $re6oo od rhc b6i! for rhc all+.d .rGnplion Aoy violarion oaserion 701 I s by m,
pp[c.fl o,,pd tubJdF'h. amhc.nr ro,cnilrcmhvolnor rnorcrhan fiL. hundrddolltu\(troolt1
,l.sosnenlrh.prcp€a).orry€mnlo)6$lhsalssth.trrnle..mpfuon.Lqlldorhc(orL.ndlheq(,mtrn^r(r5lo.Ld o! o F6.d aor sl. (s{ 7oc-4. Bu!D6 Md Ptuli6sioB code TtE coni.aclois Lics. l}w do6 nol tpply to d own6 of
f rh. Fipd, "lE h,il& or,mprc6$san. snd qh. d6sMhr.:l him.lf .t h6.laor ihmusn nh or h( oM @ploy.6.
i tro J.J rhar !u.h mprovdmrs m nor miod.d or afi6.d aor el.. li ho*Bd, rh. hrildana or inForllrd is eH Nithin onc ta
lolcompladn,lh.OsnoBuitlawillhawlncbudoofpmvinBlh.ltcorsh€didiolhildorim|rottth.prtrFrytorlhcpurpoFot
I. !r o*rq oarh. pmpdy, m ercl$irelyco.lraclins riih licms.d $.lracio6
'o.o6rtud
rh. pmj€d (S(. 701{. A6ioN
md PNasion Cod.r Th. Conrracloas l.icdse tjrv do6 nol apply r. mosntr of p.op€ny rvho builG ot ihpro!.s rhdon.
and *ho conracls for such pnlds wirh a Conlmto,l9 lic€Ed Pu6ua'r lo lh. Conra.bas Licm L,v)
li r.rcfr lrld S..r.D
D.r. . -) 4' --/-L/J*',, r,.nxr ni'i'nn',iii^ rnrr'_ t)l|( l,\R\ll()\
I n€r.br.ilu undd petrallyofpsjuryone orrhe rolk\!i'r! dtlararions
I ha$ od *ill maimain o Cen ifical€ ofconsl lo Sclf-lnsu.t 16r \york6' coftp.cal ion. s provid.d fo, by S<tion 1700 o f (h.
L.bor Codc, tor rh. poionndc. of lnt vork aor shich th€ p6mil is i:sucd.
I h.v.and trillnrai oinsorkm co,npensalion insuraoce.6 rcqut.d bySdion 171$oillE LaborCode.lorrh.pdfonndc.ol
rh. \rcr I lor which this pflnil is isu€n My *ort6 cohpcBario. i6urin.c cmi€r and Flicy numbs ac
I ccnify rhal inlhcpslornanceoflh.tro,k rorqhichlhis punn is issncd,I shall nol.mploy any ptNrn in tnyn ner
s ash bdohe shj(l ro
'lE
sortds conlpNlion la*s olcslilonia, and asrdrhd ifl should b€.onE subjd ro lhe
\rork6.oftp.Garnrn,rovisioNofSdtun3700olrhcI"&"Code.Ish.ll,lonhNilhomdysilhthoFpmvisioc
WARNING: Failoic ro FUre Norkqd comp€nsarion co\qa!. is unlawidl. Md shall strbjccl o dploF l.r Gininal pdahie and
.ivil nn.s up Io onc hundcd lhosand dollaB (t100,00o). in.ddnion lo lhe cosl of comp€Ntion. dmag6 a prolidad lor lhe
S..riLir tr)7(, .lrli. I ilu l.nc. nr€'({ )ndrrttrrcr \ li.r
DeJ'17 - I apDlldnr' -'_ r.rrirsirx <r.r r rrir1x -
DEC!4AAI(I!
I hs.by.r[rE undd p.naliy o apcjrry lhal I m licens€d undd Fovision olchapro 9 (conrnmcing N n Sdion 7000) ofDilision ]
oa lh€ Busins ed lrof*ions Codc, and my licac. i5 in lull forc. md .ftel
,.ic€nscNunrb6:
-
CONSTRUCTION LENDING AGENC'V
I hcEby atfm unda pcnaty of pdjxry thrl lh6c is s coNlruclion Lndhg a86cy fo. rh. pafot:mcc of th. woIt tur {tich lhi! pdni a
issued (Str.3097. Civ C.).
l.nd..s Nam.
^ l\drf) ria h. f.daa. rcsularioN rclddins 6bG$"\ rcm"\alac i.{ ard'.ablc ro IhE poid.
,fE .-
'O '
n* , ** ,* ,ns applror'on dd srarc r hd $. ablc inronndion is cofta-l I .s,c ro co(pry t irh arr ciry and coonry
-odman.6 ed Sr,rc ks Ela ins ro burldtrs.cot rrudF( &d h6.bl +rhorir rcprslaliv6 orlhi. Cty dd Comiy lo 6ra uP.n th.
t --)r??2
nl{,\c tr.trrtrfrcd .N,r\ l1n nslcdifr Iuyrc!
ppllci.r o. age rsianrrurc - ,'._,Ll
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor /n\
Bonding / Grounding / UFER _2-7-ru \ ):410
Transformers
Torqueing
Sub-Panels
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rough
Ceilings (T-Bar Rough)
lvleter Release l*2a-20
Rough
Service Meter \-21-2a
FINAL i-71-',u ,t
Notes, Remarks, Etc
l'U.-'7b|o ^ o[L rEY fu,.<. -1> l-a,]& epr: s+*.co h^4
o$ o() StL')'q' -) b'Gtl2 @E
Air Conditioners
VNAl
t
AETIICAILDDCIABAIIO!
t holby afllm uidd Fn.lt, of pdjury on€ of lh€ follo$inB dslsalio.s:
D.molirion Psmits-Asbdros Norili.arion F.ddal R.golalions (TnL 40. Pu16)
-R.qunrd
I,aldoaNori6cat!o6
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 2015
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a b,uilding permit has been submitted in your name listing yourself as the builder of the prope(y improvements
spec ified ah cl .r5 ).t.2-- tt), z-_L ?9%?z/ t--I_ Z._A. a9frl.-r.
We are providing you with an Owner-Builder Acknowledoment 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 atourotficial 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.
tr,'|JZ1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build-
ir{g permit that enoneously implies that the property owner is providing his or her own labor and material personally. l, as an
Owner-Builder, may be held liable and subject to serious flnancial risk for any injuries sustained by an unlicensed person and
his or her employees whjle working on my property. My homeownefs 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 in.iuries to workers on my prop-
erty.
,U- '.r--2. I understand buildinq permits are not required to be signed by property owners unless they are responsible for the
E r.tru"tion and are not hirini a licensed Contractor to assume this responsibility.
[t/ a. t understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect
MFetf from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own. .
l/
<L-c I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
11,I r " 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total
/r/alue of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an.employe/' under state and federal law.
.'/' "=t6. I understand if Iam considered an "employer" under state and Federal law, Imust register with the state and federal
[-overnment, withhold payroll taxes, provide workeri' compensation disability insurance, and c6ntribute to unemployment com-
pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.
,',)
\ )- 7. 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/l 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
with 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 owner(s) that result from any latent construction defects in the workman-
ship or materials.
a 9. I understand I may obtain more information regarding my otlligations as an "employea'from the lnternal Revenue Ser-
0. I am aware of and consent to an Ow ner-Builder building permit applied for in my name, and understand that I am the
posed construction activity at the following ad-gall T 2-
nciall nst le for
.,!ice, the United States Small Business Administration, the California Department of Benefit Payments, and the California Divi-
sion of lndustrial Accidents. lalso understand lmaycontactthe California Contractors' State License Board (CSLB) at1-800-
321-CSLB (2752)or www.cslb.ca.qov for more information about licensed contractors
_1
party le v po
d
','1'1.Iagreethat,asthepartylegallyandfinanciallyresponsibleforthisproposedconstructionactivity, lwill abidebyall
ay'pf,cable laws and requirements that govern Owner-Builders as well as employers.
I ,^Jn. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
tf5ve 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 flnancial 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, youwill be responsible for verifying
whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage.
Signature of Property Owner 4?)t( A-z-\Date:| - )V- 7at-c\ - ={Z-*tsy-,a-rz t:4<-4>A-4Print 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
Permit for my proJect.
Project Location or Address
Name of Authorized Agent
Address of Authorized Agent:
I declare under penalty of perjury that I am the property owner for the address listed above and I personally fllled out the above
information and certify its accuracy.
Property Owneds Signature Date
Note: A copy of the owner's driver's ,icense, form notarization, or other verification acceptable to the agency is re-
quired to be presented when the permit is issued to verify the property owner's signature.
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. /Vote.' A copv of the propertv owner's driver's license. form notariza-
tion, or other veification acceptable to the aoencv is reouired to be presented when the Dermit is issued to verifv the
DroDertv own er's si d n atu re.
ScopeofConstructionProject(orDeScriptionofWork):
Phone Number of Authorized Agent:
Print Name of Owner: