HomeMy WebLinkAbout20162157 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana , CA 92702 Electrical Permit#: 20162157
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853
Project Address: 512 S Euclid St
Assessor's Parcel:
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone :
State Lie#:
Lie Type:
Bus. Lie#:
932-610-83
Diemmi Nguyen
512 S Euclid St
Lot:
Santa Ana, CA 927041054
(714) 705-3614
Owner-Builder
Workers' Compensation Insurance:
Carrier:
Policy#:
Expires:
Building Use :
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Single Family Dwelling
Addition
Addition/Patio Cover
Occupancy:
Constr Type:
Code:
Date:
Date:
Bldg: Unit: •
Block: NA Tract: 13723
Address Range: 502-520
Historic: No
R-3, U
VB
CEC 2013
Misc. Receipt:
Misc. Receipt:
Fee Type
01116002 51603 Addn/Res
01116002 51600 General Plan Update
01116002 51603 Issuance
Notes:
Permit Issued By: ~ernandez, Kathy Date:
Subject to Field:
12/12/2016
Account#
Misc. Receipt:
Total
Building Permit #: 10191244
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 180 days after the time the work is
commenced.
Inspector MID#: 2016-132571
01116002 51600
01116002 51603
$20 .56
$83.76
Fee Total:
Paid to Date:
Balance Due:
Pin#: 44866
Suite Range :
Amount
0 .13
20.56
51 .26
Zoning : R1
Qty
250.00
1.00
1.00
Fee
$32 .50
$20.56
$51.26
$104.32
$0 .0 0
$104.32
APPROVALS DATE ID/SIG.
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab/ Floor
Bondinq / Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factorv Wired Unit
Walls (Conduit)
Wall s (Rough)
Ceilinqs (Hard & Soffit Rough
Ceilinqs (T-Bar Rough)
Meter Release
,,
Rouqh {,/1 ·1/{7 ~(• )
Service Meter l
FINAL
Notes, Remarks, Etc.
ELECTRICAL-INSPECTOR RECORD
COMMENTS O WNER UUILDER DELCARATION
I hereby aflirm under penalty of pc~jury that I run exempt from the Contractors· License Lnw for the following rc.lson lSec.7031.5 •
Business and Profession Code): Any City or County which rcq l1ires a pcnnit lo constnict, alter. improve. demolish or rc;.ia ir iny
strncture. prior to its issuance. also requ ires the applicant for such pt::n nit to rile a signed statement t hat he or she is licem;ed pursu ant
to the provisions of the Contractor's Licensed Law (Chapter 9. C'nmmencing with Section 7000 of Division 3 of the Ousiness aqd
Profossions Code) or that ht: or she is exempt thererrom and 1he basis for 1hc nlleged C:'1:cmption. Any viola1 ion or Section 703 1,5 by any
applicant for a permit subjccls the applicant lo a civil pen.i lly of not more t han five hundred dol!n rs ($500).
_I. as owner or 1he prope11y. or my employees with wages as thi:ir sole compt:ns.ition. will do the work and the structure is not
intt.,u.led or offered for snle (Sec. 7044, Business nnd Prorcssions Code: The C'ontractor's License Lnw does not apply to a11 nwner or
the propt..-,1y who builds or improvt'S thereon. a11 d who docs such work himselr or herself or t hrough his or her own employees.
prm1 idcd 1hat such impro\'ements nre not intended or offered ror ~,le. 1r. howevt.·r. th e buil ding or impro,·cment is sokJ within one year
of complelion. the Owncl' Builder will have the burdl.,1 of proving th.it he or she did not buikt or improve the propci1y for the purpose of
s.1le).
_I. a.,owner of1he propei1y. am exclusi\·ely contracting with licensed c011lr.1cfors 10 constmct the project (Sec. i044. Business
nnd Profession ('ode: The Corllraclor's License Law docs ncH apply to ;111 owner of property \\"ho bu ilds or imp roves tl1ereon.
and who contracts for such projects with a Contractor(s) licensed p ursuant lo the Contractor's Licens.e Law).
_1 am e:-.empl ~nder Section ,. B. & P.C. for this rcasan
Dnlc ,J '1 /.I} 9 () ""> l,C';;,,.nc,: X /;?}.re,;;:;?~/___, -
I WQ1.n.-E n s· COl\ll'E~TION
D ECLARATION
I hereby .tflirm under penalty of pc.,jury unc of the fo ll owing declarations:
_I have aml will maintain n Certificate o f Consent to Self-Insure for workers" compensation. as provided for by Scctilln .HOO o f the
Labor Code, for the perforn,nnce of the work for which the permit is issued.
_I h:i.ve and will mnintain workers' compensation insu1T111l·c. as required by Section 3i00 of the L ,bor Code. for the pci·fonmmce of
the work for which this pcnnit is issutd. My workers' compensation insurnncc canicr and policy 1mmber arc:
C'mrier:. __________________________ _
Po licy Number: _____________________ ,Expires: ------·-__
_I certify t hnt i11 1hc perfonn:mcc of1hc work for wh ich th is permit is issue d. I shall not employ any pt.:rson in nny nmtm~r
so ns to become subject io the ,vo rkcrs' compensation laws ofCaliforn i:,, and agree thm if I should become subject 10 the
workers' compensation provisions of Section 3700 of th e Labor Code. I shall. forthwith comply with those provisions ..
WARNI NG: Failure 10 secure wol'ke rs ' compcnsaticm coverage is unlawful. and s hall subject mi employer to t.1·i111inal 1x.1mltics and
civi l fo1es up to one hu ndred thousand dollars ($100.000). in addit ion 10 tu1e n ompensntion. damages as provided for the
Scctio11 3076 ofthJ Labo1· Code. interest and allomey's fets. -/
Dn lc: /' J /.1/ 9 <),, l ~plicn n1:V /--/. '/~/'?/?.-
/ 1A1\1!,NSErl C O NTRACTOR -
'DEC L ARATION ··
I hereby a ffirm under pen.illy of pe1jury tlm1 I nm licensed under provision ()f Chapter() (commencing with Sectio n 7000) of Di\'ision:;
of the Business and Professio ns Code. an<l my license is in fu ll force an d effect.
Li1.:cnsc Class:. ______________ Liccnsc Number: _______________ _
IJate:. __________ _ Co11tntclu1·:. _____________________ _
CONSTRUCTION LENIJINC AGENCY
I hereby ;.1ffin11 under penalt y o f perjury thilt lhere is a cons111..1ction lending agency for lhc performance of the work for which this p<..i·mit is
issued (Sec. 3097. Civ. C .).
Lcnder·s Name; _________________________ _
Lcnd er·s Address: _________________________ _
APPLICANT llECLARATION
I hereby affinn un der penally or perj ury one of the followi ng declarntions:
De moliti on Permit s-Asbestos Notification Federal Rcgulc1tions (Ti1lc 40. Pmt6)
_Required LetterofN01ilicmion
_I ct.11 ify that the !Cderal regufations reg~di ng asbestos remornl arc no t applicable to th is project.
_I CL-iiify th;it I have re:-id this applicnt ion nnd state that th e aOOvc infonnation is co11·1.:ct. I agree to comply with nil City and C'ounl y
01dmancc., and State Lnws 1clatmg to build mg cons~1 n. nd hc1eby authorize 1ep1escntnt 1,cs o f tl11s City nnd Count y 10 en1L'T upo n the
obo\'C menl1oncd propc,1y fo, ,nspccllon pu,poses( / ~ , c... /
Appli cnnlor Agcn l Signaliorc ~ ,~ V??~ IJ,1l c 12 f//2 2u0
Penni1ee name (pr-in t): ;) J ~ /1.--1 ~ AJ?:",,-r .vi.-:.-,., __ ) 1