HomeMy WebLinkAbout20161702 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical Permit#: 20161702
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853 Pin#: 96594
Project Address: 934 W Sharon Rd Unit: Bldg: Address Range: Suite Range:
Assessor's Parcel: 001-231-17 Lot: 16 Block: NA Tract: 1236 Historic: Yes Zoning: R1
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone :
State Lie#:
Lie Type:
Bus. Lie#:
Heather Lenz
934 W Sharon Rd
Santa Ana , CA 927061534
(213) 268-8507
Accurate El ectrical 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:
Job Type:
Occupancy:
Constr Type:
R-3, U
VB
01116002 51603
01116002 51603
01116002 51603
01116002 51603
01 002 51603
01116002 51603
Fee Type Amount Qty Fee
125 Volt Receptacle 1 .35 35.00 $47.25
Light Switches, 0cc. Se 1.47 2.00 $2.94
Light Fixtures 0 .98 14.00 $13.72
Air Conditioner 90 .25 1.00 $90.25
Dedicated Circuit 23 .09 1.00 $23.09
49.63 1.00 $49.63
20 .56 1.00 $20.56
51.26 1.00 $51.26
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~·:(_(~-~:. ,~:1::t~~ 20161702
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Nature of Work:
Single Family Dwelling
Misce~us
~e~e Meter~ixtures Code: CEC 2013 Notes: handout given
Planning Conditions:
Planning Approval By: Date:
Plan Checked By: k1 / Date:
Permit Issued By: Zuniga, Allissa (-\ '-L--
Subject to Field:
Date: 10/04/2016
Account#
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 suspended
or abandoned for a period of180 days after the time the work is
commenced.
Inspector MID#: 2016-132143
01116002 51600
01116002 51603
Misc. Rece ipt:
Misc. Receipt:
Misc. Receipt:
Total
$20.56
$278.14
Fee Total:
Paid to Date:
Balance Due:
$298.70
$0.00
$298.70
APPROVALS
Site-Work
Unde rqround
Pole Bases
Light Standards
Spas , Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm/ Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Fa ctory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rouqh)
DATE
Meter Rel ease -'t / )-/i 1-
Rouqh
Se rvice Mete r
FINAL
Notes , Remarks, Etc. I
ID/SIG.
ELECTRICAL-INSPECTOR RECORD
COMMENTS O\\'N ER IIUILIJER DII L.CA llATION
I hereby nnirm under penalt y or pc1j ury th:it I am cxcmpl from the Co11lrnL·tors· License Lnw fo r t he fol lim•111g l'l'.1~111 \~'(·. 703 15
Businl-ss and Prorcssim 1 Code): Any City or Count y which rcq\drcs a permit to c.-om,1ru ct. niter. improve. dc molis11 t1r rt11~ ""Y
structure. prior to its issuance . .l l so requires the npplicm11 fo r stu:h per mit t o fi le a signed s1 :11c m en1 t hat hem she is l il'.•~1scd pu
10 1he provisions of 1he Contrnc1or·s Licensed Law (Chapter 9. f'o111 111enci11g \\'i1h Sec1ion 7000 o f IJ i\·ision 3 o r 1hc n usint .,
Professions C'odc) o r tlml he or she is exempt 1h crefro m :md the basis for the a lleg ed c,cmpticin. Any ,·ioh1tio11 <1fS n·till11 7UJ 1.5 by any
.i pp licant fo r a permi t subj ects t he applicant to a civi l penally of nu t murc than Jive h undred dollars lS500).
_I. as o wner o f the propc11y. or my employees with w.i gcs .is I heir sole cnmpensat iu n. wil l dl, !he m ,rk aud the strrn:1urc is not J
intenck"(I or offered for sa le (Sec.7044. Business and Pro fessions C'od e: The Contractor's Lice11se Lnw does 11(11 npply 1<1 an owner of
the prnpci1 y who bu ilds or improves lhcrcon. nnd who do es such work himself or herself or th n,ugh his t'II" her ow11 L't11 pk1y1;\--s .
provided that such improvemems are no t intended oroni.,-ed fo r sale. If. hll \\'C\'C'f, tht.: building. m impro\'cm cnt is sold w i1hin o ne year
of complctitm. the Owner Duild1..1· will ha\"l.: th e bunlt..11 of pro\'ing th :11 he or she did 1101 build or imprcl\c the propt"11)' fcir lhc puqXlsecf
sale).
_I, a." owner of the pmpcl"I)'. am exclusively c.::onlrm:li11g with licensed contraL·tors to cons truct 1he pr(l_ject (~ec . 70 "1 . B11~i11(.'SS
nnd Pm rcssion Code: The Cont ractor ·s License Lnw d~1cs not apply to an owner o fprnpcrty who builds l'r impnH'C!-1h1.n~o11 .
and who cont racts for such projects wit h a Contracto r(s ) licensed pursua111 10 the Co11tra,1nr"s Lk:e11se La \\·).
_I nm e.xc mpt un der Section ________ . B. & P.C. fo r th is rcnson.
Da te: __________ O wncr:.~=====~====~---------
1\'0RKEllS' CO~ll'ENSATIUN
DEC L.A llATION
I hereby .iITirm under pcn.ilty o f pc1jury one of the follow ing dc..-c l.irnt ions:
_I have and will 111ai111 a in a Ce11 iftcatc of Consent lo Self-In sure for ,,·orh,...-s· cc1111 pl'nsatio11. as prn\'idcJ fo r b~ St.:diun J 700 of the
L1 bor Code. for the perfo rm ance oft he work for wh ich the p<.·rmil is issued .
_I have and will mninrn in workers' compensnt ion insurance. ns required by Sec1 ion 3700 of t he Lnbor ( "ode. for the ))l't'formm1cc of
lhc work for whic h this pennit is issu ed. !Vly workers· co mpensat ion insurnnce cni,·icr mid pCllicy m1 111bcr arc:
Corrico: '-R. C ~~ u-.,..c)e,w,;\f'!, \A,1. (<J _____ _
Polic y Num ber: -, 4 .; l ~ --~ ~ I (_ l:l fap ircs: ~~ (3 / / 2 () 18
.l...; l<", ':':,e_ a.. ~ OS I-,. ..
_I r.::c11ify th::ii in the Jm r fonn .incc of1he work for whi c h this permit is iss ued. I sli::ill no! employ any per~t111 in ;my mmme1
so as to become suqjcct 10 the workc,·s' compcnsntio n lnws ofC'alifomin. n11d ngrec that if I shnul d heccime s u~ject t1.i the
workers' compe nsat ion provisions of Seel io n .HOO o f t he Ln bor Code. I s ha ll. fmthwith rnmply w ilh th<)SC prm ·isiti ns ..
W A H N I NG: F.iilurc lo secu re wc,rkcfs ' r.::0111pcnsn1ion CO\'crage is unl::iwful. n11d shall subject an employer to criminnl pcmtltil'S and
c ivil fines up to o ne hundred thousand dollars (S100.000). in nddit io n 10 the cost o f co 111 pc11s,11iu11. da 111ag r.::s :is pnwidcd for the
Sectio n 307& oft he Lnbor Code. in1crest nncl allomey ·s recs.
IMc: lOl'-1 ( 2,-<r l (, Applican1_'.k{ s~~ It 1-\-1.!(" . ...J
I "ENSF,D CONT llACTO R
r Ul'.("LA RATI O N
I hereby n ffir m u nder penalt y or peijur y 1hm I am licensed under provision o f Chapter 9 (cmnmcm.:ing with Sei.:tir,11 7000) of Div ision J
o f the Ousiness and Professions Code. and my license is in full force mk.l cffct·t
,-
License Clnss: C -\ \) ~"o51r Licens e Nl11111Jcr: _______________ _
C ONSTIIUCTION LENDI NG AGE NC Y
I hereby affirm under penalty o f pc1:iury that th ere is n conslniction lending. ag.cnc y for the pcr fonnnnce or the \\'t)I k fr1r whi<."11 th is pcnnit is
issued (Sec. 3097. ('iv. C.).
Lender's Na me: __________________________ _
Lender 's Ad dress · _________________________ _
A l'l'LICANT DECL.AllATIUN
I hereby aninn tinder penalty or pc1j ury o ne of t he followi ng. d ec laratio ns:
Dcmoli1iun Pcrmi1s•Asbcslos NQl ificati()n Federnl Regula1it111s (T itle 40. Pnrt6}
_Rcq11ircd LellerofN01 ific:ilio 11
_I cc..'11ify 11ml t he fcdcn1 I reg ulat ions regardin g asbc..>s los remo vn l nrc UN ap plic,,blc 10 this projec1.
_I cc11 ify lhr1l I hm·c read this np plicallon and state that the abo\'c infi:mnatio n is con-cct. I ngrcc to comply wi1h .i ll City and County
ordmn nces nnd St.tic Lm,s 1clm111g to b11dd 111g cons;~rnc ll n nnd he,eby a 11tho11z e 1ep1ese111.,11ves t1 r 1111s City and Co u11 I\ to c ntcr u pon the
above mcnt ,oned p1o p c11y for mspect,on put pose.,; 11----
A pplic:mtcn Agcnl Sig n nt u r c , / 5 " l).,:_~o / '--1/Z.O'IC,
l'crm i1l'c name (In-int): 1---~ SA~ I-{ H~-!I_: ti'-~