HomeMy WebLinkAbout20162122 - Permit!
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, 8A 92702 Electrical Permit #: 20162122
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (7 14) 647-5853
Project Address: 2545 N Hesperian St
Assessor's Parcel:
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
State Lie#:
Lie Type:
Bus. Lie#:
001-303-20 Lot: 30
Kim Le
2545 N Hesperian St
Santa Ana, CA 927061433
(714) 553-1996
Alpha Electric AC/DC
9479 Ellis Avenue
Fountain Valley, CA 92708
(714) 493-9920
961072
C-10
x364036
Workers' Compensation Insurance:
Carrier: Sentinel Ins Co
Policy#: 12WECPK4975
Expires: 11/09/2017
Building Use: Single Family Dwelling
Miscellaneous
Occupancy:
Unit:
Block: NA
R-3, U
VB
Bldg: Address Range:
Tract: 6114 Historic : No
Fee Type
01116002 51603 Serv Met er
01116002 51600 General Plan Update
01116002 51603 Issuance
Pin#:
Suite Range:
Amount
49.63
20.56
51.26
Zoning: R1
Qty
1.00
1 .00
1.00
48004
Fee
$49.63
$20.56
$51.26
Job Type :
Nature of Work: Service meter
Constr Type :
Code: CEC 2013 Notes: Upgrade/handout given.
Planning Conditions:
Planning Approval By: Date:
Date: Plan Checked By:cx.
Permit Issued By:,
Subject to Field: \_ 1 ·-,
Amsden, Julie Date: 12/05/2016
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#: 2016-133271
01116002 51600
01116002 51603
Misc. Receipt:
Misc. Rece ipt:
Misc. Receipt:
Total
$20.56
$100.89
Fee Total:
Paid to Date:
Balance Due:
$121.45
$0.00
$121.45
APPROVALS DATE ID/SIG.
Site-Work
Unde rqrouiid
Po le Bases
Light Standard s
Spa s, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Grounding / UFER '5 / ~ / 17 ,,,, .,.Iv(.( q-jq
ELECTRICAL-INSPECTOR RECORD
COMMENTS OWNER BU I L DER l)ELCARAT ION
I hereby affinn under penalty of perjury that I run exempt fro m the Contractors ' License Law for the fo llowin~ renson (Sec.703 1.5
Business and Profession Code): Any Cil y or County wh ich requires a permit to cons1111c1. alter. improve, demo lis h or 11 pai r any
stnictun:. p1"K,r to its issuance. also requ ires t he applicant for such permit to file a signed statement th.it he or she is licensed pursuant
to lh e provisions of the Contractor's Licensed Law (Chapter 9. Commencing wi1h Section 7000 o f Divis ion 3 of the Uusi·1ess and
Professions Code) o r thal he or she is e)[e111p1 th erefrom and t he basis for the a lleged exemption. A11y violation or SeL·t ion 70J 1.5 by any
applicant for a pennit subjec1s the applica nt to a civ il penalt y of not more than five hundred dollars ($500). t
_I. as owner of the pro~1ty. or my employees with wages as their sole compensation. will do the \\'Ork and the stnJti un:: is no!
int ended or offered for sale (Scc.7044. Business and Pro fessions Code: The C'ontractor·s License Law docs not apply to m1 owner of
the propcity who builds or improves thereon , and who docs such wo rk himself or herself or thmugh his or her own cmplo)ccs.
provided lhfll such imp rovemenls are not intended or offered for sak:. IL however. the building or impro,·cmcnt is sold within one year
of completion. the Owner Builder will have the burden of proving th at he or she did no! build or improve the pmpe,1 y for the puqx,se of
sale).
_I. as owner of the propeit y. am exclusively conlract ing with licensed contractors to co nstmcl the project (Sec. 7044 . Bus iness
and Pmfcssion Cude: The Contractor's Li ce nse Law dot:s not apply to an ow ner of proper1 y who bu ilds or impro ves thereon.
a nd who co ntracts for suc h projects w ith a Coutrn<.:tor(s) licensed pursuant to the Cuntra<.:tor's License L:1w).
_1 am c.,cmpt under Section ________ . B. & P.C. fo r this reason.
Date: __________ Owner:. _______________________ _
WOl!KEl!S' COM PENSATION
D ECLARATION
I hereby affi rm under penalty of pe1jmy one of the fo llowin g dec laratio ns :
_I have and will main1a in a Cert ifica te of Co nsent to Self-In sure for workers' co mpens.it icm. as provided for by Section 3 iOO of the
La bor Code. for the perfo rm ance o f t he work for wh ich th e pcnnit is iss ued.
Tran sf armers ~ .......__....., _I have aml will maintain workers' compensat io n insur,mcc. as requi red by Section 3700 oft he Labor Colic. for t he pcrfonnancc of
'lJ1cb,.~v ~~ 17 '7-h.,u co \ {)rV\ h l \ 'l \ l l M-11 t;(Jo rJ ;··'"· work ro:;•hich this;r;-i~ iss,rl. My r ork:s' con~tion insnrancecr~~li~~n~~crare:
Sub-Panels , '---\ Cnrric,____2-e\l\ ~l (Vl ~\A _u. U!.. r
t-A-:-i:-r-=c-o-n-,-di-tio_n_e_r_s -----f-----+-----+-------------'d PolicyNnmber: \2. Wee? 1/( ~q'7 r E>pircs_l_L 0\3 2_
t--------------------,-,-------+-------1-------------------lf,, Roof Top Equipment _I cc11ify that in the pe rformance of the wo rk for whi ch this perm it is issued, I shall not employ any pei-son in an)' manner
so as to become su4icc1 to 1hc workers' compensation laws of California. a11 d agree th at if I should become subject to the F actorv Wired unit wo rkers' rompcnsation provisions of Section 3700 o r the Labor Code. I shall. fo11hw ith comply with those provisions ..
Walls (Conduit)
WARN ING: f a ilure to secure workers' compensation coverage is unlawful. and shall subjcc l an employer to l1iminal pc:naltics and Walls (Rouah) ci vil lines up lo one hun dred lh ousand dollars ($100,000). i n adll il iu n to the cost orcompcnsati o11 . danmgcs as prodded for the
( S~tion 3076 o fthf Labor C~,c, intcresl and attomcy·s fees. £,,
t-cc-=--e1-:-111n_,1Q.,_S---'c'-H_a_rd_&_S_o_ff_i\_R_o_u_,_,___gh-+------+----I------------IV'.~tc, t 21 os-1 \ 6 Ai>i>licant, A.,,/ c.__ -
e11ngs T-Bar Rough, ~· 1 1 u r 'ENSE1"·=n "f'{IR
M t R I ., ' I A l.A,,, Cf ll ) DEC LARATIOI\ I e e r e ease \ °\ [ 7 / 'r '-1( 7\ / J I hereby ar!irm un der penalty of pc1jury that I mn licensed under provision of~pter 9 (commencing with Section 7000) ofDivision 3
or th e Business and Professio ns Code. and my license is in fu ll force and effec l.
Rouqh , f _•"ctcensc('llas~ ~o'~ \\ ~--,_ L. ''"~'"""~ C \ 0
t-S=e:-::--r::-::v-:-ic_e _M_e_te_r _____ --l,l'--,1-,,--/i-,-/_+-+.----,,-,-i---1------------11/ ~ -~ ~ -i -l ~ Conlractor: A-I OW} t 1-e C:J~ t., ,! (_ /K
FINAL 'O/Zo//'-1-1,l'\-G'b ~-..... N_o_t_e_s_,_R_e_m_a-rk_s_,-E-tc-. ____ __...,....;.;.,._.-;, _ __. ...... ..,... ___ ..._ ______________ ---1 coNsTR u cT10N LENDING AGENcv
I hereby affirm miller penalty of pc1ju1y lh al there is a co11st ntctio n lending agency fo r the pt.'1·fonmmce of the work r~lf' wh ich this permit is
t;/,fl1 /Mo J✓ f tl,Tvt fu~ H//1.J,t..../J 'rft/Ct:.-0 -l--i h~ :;~~~/~~~;.,~97_.c_;"_·c_.J. _____________ _
),tiJ/r I
Lcnder'sAcldrL.-ss: _________________________ _
APPLICANT D ECL ARATION
I htTeby unirm under penalt y of perjury one of 1he follow ing declar,11 ions:
Demoliti on Permits-Asbc..-stos Not ific at io n Federal Regu lations (Title 40, Pai16)
_Requ ired Letter o f Notification
_I ccr1ifythat the federal regu lntions l'Cgarding asbestns removal are not ~pplic able to thi s project.
_I Ct.'111fy that I have real.I this app\1i~·at1011 and st at hm the .1bovc 111fo111m11on 1s concc:1 I agree 10 comply \\ 1th all C ity and County
01dmanc es and State La,,s relat ing to bu1l cons uct1011 . and her eby ~hon ze reprcsc111at1\CS of I Ills City and County to enler upon 1he
above mentioned ptopc1t y for mspecl1ot urp s --"'!! ......____. ) I
t----------------------------------------------------\.-l/4p1,licant or Agen t Sign1>lnrc • ( ~ -IJ,llc \ 2 0 S I{,
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