HomeMy WebLinkAbout20162055 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Sama Ana, CA 92702 Electrical Permit#: 20162055
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853
Project Address: 934 W Sharon Rd
Assessor's Parcel:
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone :
State Lie#:
Lie Type:
Bus. Lie#:
001-231-17 Lot: 16
Heather Lenz
934 W Sharon Rd
Santa Ana, CA 927061534
(213) 268-8507
Accurate Electrical Services
147 W Route 66-#605
Glendora, CA 91740
(626) 331-4707
860517
C-10
337042
Workers' Compensation Insurance:
Carrier: Republic Underwriters Ins Co
Policy#: ATW 0100089-00
Expires: 06/11/2017
Building Use: Single Family Dwelling Occupancy:
Job Type: Miscellaneous Constr Type:
Nature of Work: Switches/Fixtures/Ded Cir Code:
Planning Conditions:
Planning Approval By: .-... Date:
Date:
Unit: Bldg: Address Range:
Block: NA Tract: 1236 Historic : Yes
R-3, U
VB
CEC 2013
Misc. Receipt:
Misc. Receipt:
Fee Type
01116002 51603 Light Switches, 0cc. Se
01116002 51603 Light Fixtures
01116002 51603 Dedicated Circuit
01116002 51600 General Plan Update
01116002 51603 Issuance
Notes:
Plan Checked By: •~\ ,
Permit Issued By: ___ r~~ows ·, T ri Date: 11/22/2016 Misc. Receipt:
Subject to Field:
Building Permit #: _,,,/
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 s uspende d
or abandoned for a period of 180 days after the time the work is
commenced.
Inspector MID#: 2016-132143
Account#
01116002 51600
01116002 51603
Total
$20.56
$98.85
Fee Total:
Paid to Date:
Balance Due:
Pin#: 42924
Suite Range :
Amount
1.47
0.98
23.09
20.56
51 .26
Zoning: R1
Qty
10.00
10.00
1.00
1.00
1 .00
Fee
$14.70
$9.80
$23.09
$20.56
$51.26
$119.41
$0.00
$119.41
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG. COMMENTS OWNER BUILDER U EL CARATION
I hereby affirm under pcnrilty of perj u1y that I run exempt from the ContrnClors· License Law for th e follo.win£ reason (:iec.7031.5
Site -Work BusinL'SS and Profession Coch::): Any City or C'oun ly which requ ires a pennit to constrnct. a lter. imp rove. demoliSh or rep; -.,y
structure. prior to its issuaucc. also requires 1hc appli cant for such penni1 to fi le a si gned statement lhat he or she is lic,·nsed p•
Underqround to the provisions o f the Contrnclor·s Licensed Law (Chnplcr 9. Cornm e11ci11g wi1h Section 7000 of Division .1 of tl1e llusin ...
Po le Bases
Profess ions Code) or that he or she is exem pt 1herefrom and the basis for the alleged exemption. Any violat io n of Section 703 1.5 by an)
applic;mt fo r a pennit subj ects the appl icant to a civi l penalty of not more th;m five hundred doll ars ($500).
Light Standards _I. as owner or 1hc propc:11)', or my employees wit h wages as their sole compensat ion. will do tl1e work and the s1ruetw·e is not
..
' Spas, Pool, Fountains intenck'tl or offered for snle (Sec. 7044. Bus iness and Proft.-ssious ('ode: The C'ontrnctor's License Law docs not apply to an owner of
the prope11y who builds or improves thereon. and who docs such work hi 1nself or herselror through his or her own employees.
Signs (monument) provid ed that such im provements are not intended or om.Ted for s.1le. If. however. the bu ilding or improvement is sold within one year
of completion. the Owner Builder will have the burden of proving that he or she did not build or improve the propc,1y for the puqx:ise of
sale).
Life Safety /Low Voltage _I. as owner of the prope11 y, run exclus ivel y contracting with licensed contractors to constnict the project (Sec. 7044. Busin~s
rmd Pmfession Code: T he Co nt ractor's Lic ense Law does nol app ly to an owner o f pro perty who builds or improves thereon,
Fire Alarm / Dampers and who contracts for such projt.>cfs wit h a Contrnctor(s) licensed pursuan t to the Contmctor's License Law).
Commun ications Cab le _I mn c.'(cmpl under Section . B. & P.C. fo r this re1Li.on.
Ul\tC: Owner:
Buildin!J W O RK ERS ' COMP ENSATION
D ECL A RATION
Under S lab / Floor I hereby affir m tmder penalty of peijury one of the following declarations:
Bonding / Ground ing / UFER _I have ru1d will maint ain a C'c1i ificatc of Consent to Self-Insure for workers· compcns.ition. as provided fo r by Sec1io,1 3700 o f the
Labor Code. for the perfo rmance oft he work for wh ich the permit is issued .
T ransformers _I ha\'c and will maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. for the )h .. -rfonnance of
TorqueinQ the work for which th is pcnnit is issued. My worh.,·s· compensation insurance can-ier mid policy number arc:
Sub-Panels Can·ier:
Air Conditioners Policy Num ber: E:-:pires:
Roof Top Equipment _1 cc11 ify that in the performance of the wo rk for which I his perm it is issued. I shall no t employ any person in any manne r
Factory W ired Unit so as lo become subject to lh e workt·rs' compensatio n laws of C'ali forn ict. and ngree that if I should become subject to the
workers' compensation provis ions ofScctio11 3700 o f the Lnbor Code. I shall. fm;hwith comply with those pn:l\"isions ..
Wa ll s (Conduit) WA l~NING: Failure 10 secure workcl's' co mpensat ion co\'crngc is unlawful. and shall subject an emp loyer to ciiminal penalties and
Wall s (Rouqh) civi l fines up to one hundred th ousa nd dollars I00.000). in addi tion to the cost of compcnsnt ion. dnmnges as provided for the
Cei li ng s (Hard & Soffit Rouqh
Section 3076 of the Lalx:ir Code. in1 crcs and at
1cy"s fcc~~~~ t\u\f l)ate: \ ~/Zz../ll,, \N
Ceil ings (T -Bar Rough) p lican l:
LICENSED C O NTIU!;;TOR
Meter Re lease UErLARA T I Ojll
I hereby affirm under penalt y of per:!;!J: that I ru n · e nsed under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professio ns Code, and my license is in full force and effect.
Rouqh ~1 /'J-I (}-s "\) ·:-,~ l ~ s 6 ()SI 3-,, ; Li cense Class : License Number :
Service Meter
Date: \ l (1--Z-L I t,.,, Crl!.1-{j( L,)"" \-c.. e '€.c iv-. ,.__. , J'~.-✓,l---< \.
FINAL <}-/')-/ I"). '--:, \ r,-,:
C s ,{we I ION L EN DING AGENCY Note s, Remarks , Etc. / .,
! hereby affirm u11de1: penalty o f perjury that 117 is~uctio11 lending agency for th e perfonnance o f t he work fo r which this perm it is
issued (Sec. 3097. Civ. C.). 1
Lender 's Name:
Lender· s Addre ss :
,\PPLlrA NT UE!:;LA llATIQN
I hc.,·cb), affinn under penally of perjury one of t he rollowing declarations:
Demo lition Permi ts-Asbestos Notification f edera l Regula1ions (Title 40. Pa11 6)
_Requ ired Letter of Notificat ion
_I ceitify that the federal regulations regardi11g asbestos r emoval are not applicable to this project.
·-cci1ify I t I have read this application aud state tha t the above in fonnation is co1Tcc1. I .igi-cc 10 comply wi th .i ll City and County
ore m,1 cs, d S!nle Laws rdn1mg lo bu,ldmg conslrnc<,on.z hereby ~rL~cnln.,,c~ ofllus C11; ,md Counly 10 cnlcr upon 1hc
nb01e me 0t)ncd pwpcny for mspcctoo~__,,,-/ -
A ppr a nt o ~:Z.-t Sign.,tu ,e / Da l e
l'er ~•itcc m,n (pl int): ~\ ✓ (.\_ l,.,,_ -Hu& e ~V\
t:i,....., ni? n ··; ')fl'! i:: Y---