HomeMy WebLinkAbout20170483 - PermitCity of Santa Ana 20 Civrc Center Plaza (M-19), Santa Ana, cA 92702 Electrical Permit#:2()170,483
Permit Counter: (714) 647-5800 lnspection Requests (714) 667-2738 lnspector Sectaon (714) 647-5853 Pin #: 29E43
Proiect Address: 514 S Garnsev St Unil:
Block; 3
Bldg: Address Range:
Tracl: POLYTECHNIC VlLlHistoric: No
Suile Range:
Zoning: StXoAssessoisParcel: 010-131-'14 Lot: 13
O!,,/ner:
Address
Marlon Yllesca3
514 S Garnsey Street
Santa Ana, CA 927015438
(714l-486-822?
Fee Type
01116002 51603 Re-Set Mtr
0'1116002 51600 General Plan Update
0'1116002 51603 lssuance
01'l'16002 577 70 Microrilm Records
Qty
1.00
1.00
'1 .00
1 .00
Feo
$55.37
$22.95
$57.20
$3 91
Phone:
Tenant Name:
Contractor
Address.
Owner-Builder
Phone
Slate Lic #:
Lic Type:
Bus. Lic #:
Worters' Compensalion lnsurance
Canier:
Policy #:
Bxpires:
Building Use:
Job Type:
Nature of Work
Single Family DrYelling
Miscellaneous
Meter Re-sel
Occupancy:
Constr Type
Code:
R-3, U
VB
cEc 20t6 Nolesr Resot electrical meter due lo fire. Owner-Bullder lorm
on file.
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Chavez, Oave-Da-.
Date
Date
Date 12123t2019
Account#
Misc. Receipt;
Misc. Receipt:
Misc. Receipt:
Total
Evary permil issuod shall becone thvalid unlessthe wo* on the silo
autlpdzed by such permtl is commenced withn 3@ days altet its
issuance, ot I the wo* aulhgnzed on lhe sile by such peftn is suspended
ot abandoned fot a peiod ol 360 days aftet the limo the wo* is
cofifiencecl.
$139.43
$0.00
i139.43
lnspector MID#: 2019-156759
01 1 16002 51600
01 1 16002 51603
01116002 57770
Fee Totall
Paid to Date:
Balance Due:
Amount
55.37
,, oq
57 .20
3.91
$22.95
$1 12.57
$3 91
ELECTRICAL-INSPECTOR RECORD
DATE ID/SIG.COMMENTS O$ NER BUII.|)F.A DElINRATION
Ih6.by,mrmunddpo,olpajuryrhdId.ronflfrcnrh.Contr.1o6'l.k.Mlr*ao.rh.folbsif,!re.(sa7011.5
Bulin* and Prof6io. Cod.): Any Ciiy or ( ounly rnth r.!uir6 r Fmil ro .or<tud. la, impb!4 .ldmlirh or Ep.n By
tlru.1uc. ritr ro ir! ist[r.. lko rcqstrd rlE irlic&l for srh rmn k, fik ! .i[ftd irimr rhd lE or rlE a lk6E d l,leln
h rh. F!\irhB ol E Contdcr Lk. al h$ loqra 9. comin8 f,nh Sdion 7000 ofDni3i.. ! of rh. a6i.d.d
Prol6ioN ( or,.) d fid h. n rh. i .rmF lhqcfron md rlE lBir aor th. rllcs.d edFion tuy vioLlhn of S.dnn rolI t tryuy'
drplrdr lor !Fnn 3ubjdirh. lmlicairnr!.iv'lpo0hyor rr dorcrhb liv. htr.dEd dolld! (t500)
l, 6 o$ffi of llE FlFlr, or ny mphlE wnh w.€6 a tlEir $k mmFadbn.
"iU
(k, 0E srl rd tL {irlE b ml
dqd.d d ofd.d lG sl. (Sc 7lx{, AaiB ed fofdioB ( od.: Irr Conr.rd'r l-i!e lrr d6 br ,C} to e 016 ol
llE lllFty trlD hil& c itrs.lt€ tlEBr rd r h. dc si Ftt nin*ll or lsElf or tlmurh hn m lE o*n dprdF6.
t rvidat rhd ruch imFor.dr @mr iddld.d moiftr.d tu sl..l[ ho"@, rlE hrildnts or i,rF!\ffi irrUwihinw]d
or.on:plaion, tc (\ffi Build6 wiu h.v. rhc hlda olFovins $i l'. or Jr did L, hr6 or in'Fow d. FstEty aor llE p6Fs ot
L aoen o,'lE FoFny, m dchEn ! onrdi,B $nh kdE n.odm6ro codd rlE rmj.d tsd 7(r!. tll!6
,nd Pmasin ( .d.: Th. Cdmrdoai Ltdr. lrv &E nor q,9ly to & o* nd 6l F.pdry * ho burld! or inpr.ts rhd6n,
!n *ho tunrE 13 for uch IrtrFs *,irfi . ( oitE ro(r) lic4kd Du6u,rl k, rlE Coftr*loir Lic.M L!w)
I m c\o.rl uftjq S(lfn n .t P( turIhflrNr,
,,"".,Y- }1 aJ,^oZ**' \toRxt lt\' ( (rltPt\\ I I !rll\ra Irl fr?
ITECIAAAIjAX
I hscbyamm un& Fnrlty or pgjurr orc olrn. followinS d(ld.lio6l
I h!\c,n r ill min'lh . (-d'rEn. or('oMr ro S.ll-lBu. f( {0.\6 ontp.Miotr B Fo!lLd lor br Sdion l70O ordi
llh, Co&. lor ih. Ffome. of llr *!rt for shi.h th. pfDir . isu.d
I fiav. md will mainllin wort6 comFNl ion iBum... 6 rlqun d b, sd ion 1700 ol lh. I lbor Codc. fo. tlE FfotrMc. of
lh. sork for {fith thii Fitril i! iB.d My {srl6 omFdiin idutr..ui, dd polic!.uhb.r r.
l.diry rh,l 'nrh.Ffolrm.of th.*o& for *'hihrhi! Fnn n s.4 I dull mr onpL, uy F$. r M) maE
$ 6 lo h.c.tr $bd
'o 'lE
rod6 onFMirn Lq! of(itif.mia dd tr rhn it I JruE tE or {bj.{
'.
rl!
N 6 comFB.lhrFrvirtr'Bors.dionlT&otrlEkhtr(-odel3lEll.fonh*'nhNnplyq'hrlF ForiiIll
WARNINC: r6ilor. ro hu. *0.16l comptuion co€.s. 6 lnLwfxl. Md shall sbjdl m @doF io dinin l Fdri.r ud
.nil 6n6 up h oE hur&al rholsltd &lla (ilOO.O(x)t. h.dlnio. tr rlE roi of comFNlion, d&rs6 st oriH t ll!
DECIdEAI1a!
I horh.rm un<h. FuXt., of !.rjury $n I m !'.6n d uxlc Fovibn of Ourrd 9(offiuts s ah Strnr 7mo) of Dtaaon I
ol th. BuliB !d PFfdi,B Code .n m! lt6e i ir tull fora !d.lTd
(AIiIBUCIAXIINDIXC.AGE!(I
I hd.t! rrm undd F,hy o r Fjury thd ihd. ii r coftntod.. hdnle rsd.y aor rh. Ffrnrre. of th. Mll tu $tkh rnb rEhit i
is.d (S< 1097. Civ. C )
AITLICABLDECIISAIIII!
I ha6, .fin u,xld porlt, of Frry oE oailE 6ll6si.3 d..ldr bc:
rr.noliion P66ir$Arb6ro! Nolili.lrio, F.ddl RcSuhrion [irl. 40. Pm6)
_R.q!ir.n L.lts oaNorifi.dion
I carify rhl itc 6.dq.l E8lLlb6 r.g.di,B ddG lffr.l c 6i +plr.6L ro tn! Fljd
4rcd,E rhd I h^.6d rhsrpplE.rion d d.r.rhd rh. !trv. inromltion i! coEet I lgc ro.otrplyenh rll ciry.rd coury
.rJimc6 !d six. ttu Elrry ro buiding .odtucrioE {rd hdt,.uthortr EF.idni6 of thit Chy rn Couly lo a s Wo. UE
.;;;"- -
":::: l;-:,:Ywoz^ 4.*.^
,,!,n,,,N nxm( (p,,*,: /-,- m nn L t-., l,//t {c,* S
,>)ss//?
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
Bonding / Grounding / UFER
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouoh
Ceilings (T-Bar Rouoh)
Meter Release l'6-2tt 17 \- lelalo
Rou gh
Service Meter
FINAL ,-h-7tt \I1..1 )
Notes Remarks, Etc.
-+
APPROVALS
Lk.e NutG
-
Transformers
)J[-{q
Planning & Building Agency
Building Safety Division
20 Civic Center Plaza .
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-5800
www.santa-ana.org
APP-13 CBC 2016
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An applicatio n for a building permit has been submitted in your name listing yourself as the builder of the property improvements
dlt-l I C*JLa,r9<-w {ar.,ra--;l-.,,,t- X4 7L\otspecified at
WeareproVidingyoUwithantomakeyouawareofyour
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 at our official 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 AN VERIFICATION OF INFORMATON
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information
4l t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Buildei' build-
iny'permit that erroneously 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 financial risk for any injuries sustained by an unlicensed person and
his or her employees while working on my property. My homeowner's 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 injuries to workers on my prop-
erty.
AJ_3 I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect
my6elf from potential financial risk by hiring a licensed Contractor and having the permit flled in his or her name instead of my
own.
t_Lq. t understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on 0ermits and contracts.
A_J_s. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total
valLe of my construction is at least flve hundred dollars ($500), including labor and materials, I may be considered an
"employe/' under state and federal law.
,q 4 A. I understand if I am considered an "employer" under state and Federal law, I must register with the state and federal
goy'ernment, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com-
pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.
m y' l. t understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential
strdctures 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.
d_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-
'ciali or personal injuries sustained by any subsequent owne(s) that result from any latent construction defects in the workman-
ship or materials.
,4-2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
t-Lg I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Ser-
vic6, the United States Small Business Administration, the California Departrlent pf 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.
eLtparty le
dress:
0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
gally and fin a nciall v re pon sible for ro nstruction activi the owing ad-
bl_1l.1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
app(icable laws and requirements that govern Owner-Builders as well as employers.
/a!
hatre
12. I agree to notify the issuer of this form immediately of any addltions, deletions, or changes to any of the information I
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 financial 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 flrm is inlured 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, you will be responsible for verifying
whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage.
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. lrofe: A copv of the propertv owner's driver's license. form notariza-
,s ired to be resented when the it is issued fo
DroDertv owner's sionatu re.
Sig nature of Property Owner caL Date: I
Print name of Owner ,,vtA {LLo-,v//esc*5
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
Phone Number 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 certity its accuracy.
w ^/-r^ ?,4,.^Date tt les// r
print Name orowne. /vt A L / o-t y//rSUS
Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is re-
quired to be presented when the permit is issued to verify the propefty owner's signature.
a_
ScopeofConStructionProject(orDeScriptionofWork):
Property Owneis Signature:
;IE
9
E
H
E
i
r:
r
,
@
=
=
=
.
E
$
l9
1d
;
*.
;
P
B
s
'
U
F
!r
9
E
r
s
s
:J
O.
-
^
a
.
<
=
i
E<
P
o
-
o
Y
{
'
u
r'
3
d
S
E
s
qE
=o
a
f
3o 5
,j
d Fn .D ).
ro 5
9 $
:
;-S
)
E.
P \n
=
lt
)
1E
(mma
)
iE6'
r
-
>z
6H
Z6
rr
loo
7z<;
o T'2
CNC @(-m C)
-t oon mo CJ
)
vo-ocoo oo-g:
S.
tt
r
,o
.t
/
a
VA
l"\p N!
>z
fo
0
)
oo
Ia
Dd
o
=z
-
n
l
l
.
o
=
>
ig
ff
E
na
,
2
EI
'
4i
e
g
=9
v
a
o
'
;=
E
#
=
I
rf
=
o
z
m
=.
(
o
4
.
q
=
6P
U
E
tl
i
'
l
r
l31
n
-E
E
--
l
l
,
ia
d
t
r
t
r
t
r
9
3
i:
g
E
a
P
(n
A
q'
:
q
H
6
'
=
F
7
g.
d'
i
F
,
:
=
E
€
oJ
!P
o)
=
-
='
==
q
f
o
o
B-
n
o
cL
_
-
-o
:
L-
l
Ll
LJ
d
tr
r
m
=E
o
o
:E
3
S
g
t
r
t
r
su
5
#
s
s
8
ri
.
;
l
f
=
-
i
9E
ag
f;
r
=
=
?
r
e
E-
g
a
5
*
i
a
{
!
=€
B
l"
q
s
6
t
s
O=Er
Z
r
-
l
n
o!
!l
=Y
a
.
m
=
;€
g
g
o=
o
x
99
ei
sr
r
a
I
33
vo 3 o)xa
C\
EI
.
.
N\N O
9 -R
-q (\
t1a
7oa o-o !i
.
q)
ts
-
,
tr N!t
-k\
-
-t\ll
tr
l
lo
o:
,t
3+-
o
r'
d
6'
c\
f>\
.
o-
bc
.\
J
-
+
r0
)
ap t.
V,
A
/\
I
()
L \P
c/
)C =lT
1
q
E o =o3 6'E
rr
Ob3
\o(-a j-(
?
t-x a+-\
\Do {.-c
,]
ss
t
u
o
o
v
rc
f
t
E
n
s
-'
d
s
u
/
b
g
s
hl
g
I
fI
I
N
S
-t
o)=:,
(o *V)H)o !-c vooo.E :t
t
no o oo-q
oo-ooa 0)
(o(ooo-q :s
3o =Jo
=
lt
l+
=
r)
ln C m
I =.ct
l.o t -!o q d{!e
q
oo
oo
)
oo
oI !q ss \-\I 3o l E Nl^HF -.
-
{3o oi hshl-
\
I
j oEoo o3o $l
E o f,
Io !olo-
f o-
!3 ti
)o!3 )o -i
.o iJ6E 3 ino 3
-o
!ao o o!oc)-.o =
'9 l.3 q q Ll o-oIo,
--
t s ..
,
1J o-)o-a 3 a !3 =o-,o-
ino 3 PooEI
(n H {CS 0o
\^
,Ts
4
IE
9
6
H
E
f
i-
o
,
c
z
=
,
E
E
B
I
1.
?
;
i;
e
E
q
'
q
r
.
I
EE
E
E
g
q
X
E<
!
o
g
.;
H6
i
l
E
:
g
Yq
e
c
=
lr
l
1a
(mm(
1
3E
6)
->z
-{
(,
6H
z6
-l
oo
vZ<;
o !z
U)
le 4)sss \s O)C =lT
r
E 7ooa'o *.9r
tloo 3 3o o.
gL
lo-ga =.
!r
)
.I
l
g:ao o fo!oo =.=
E o o 0:
o)E}o o
-o
>z
=i
1
0)
oo
-
r
d
E6
o
->
-s
,e>\>O otbz
Fr
.
t^
r F -t i [n *71>\tl -N N \]+J 0 F\
lia;
ti B F.
ts
tD
tJ
'
,N)
1l
-
o
=
>
,x
4
2
6=
4
o
nd
b
z
,
En
d
i
;2
6
2
p*
o
trz o Do-o -'ocl
-
troo oo o'zo+,oo
tr ox @c.goo o.T
l
o'
o-E.
!0)
f c)Jooi(no!=.o CL
"Y
x
mr
.
:
/
)
t
D
g-
d
'
=
'1
r
=
'
UO
(
O
o:
f tr
Y
,
E
(
ll
Tr
"m
oo
oo
!o
'
og
f
:,ocOl
o
il
,
:
f,
*KE
MSs8
.
Ed
o
:r
.
fo(,
0
)
-T
l mma o(o o)TIooo
c
E3
-tU=
.
gd
0)rr
El
(D
-
(D
S
ooJ o)
f6'
r-
-
1
O)
L-
J
-
j oo4(o o)=o .T
t
oo
zo-{
]T
ID =CL ='
GI
!o l o o c E'o 3 o.L oo 3 t)rL CL 6'=o ol!=.
.lo tt a,ot AI
.:oo E-
AI3
oo 1'
!,P !r 3 ='
ct
t,!l =!r CL 9-o AI
f.o =
ao 3 A)
\o a
.)
t^
'
rL h.
N H K R $F t N F $
I 3o-o.
ci?
-\
ag)I 5 ,r
td s o!oo o 9
Eo o Io 2 of -{J o-
f.o 3 inoo 3 -'o,oo!3 i'
noo 3
t lD 3 3 o6 9.o-o o,
---
{o --
{=o o-
:.o oo 3 oo!.?{o-
I 3 !3
o.'
lI6m C m
--
l
0)o5f(o {+a }J J in ,oo .oq 3o l 1l
g.
CL noo a.E +
vo o oo-o
oo
0)
g
)
oo
o-o-oao 0)
(o
(c
)oo-o
I cf a.o tJ-!9-{!e 3
c
:s
s
S
u
o
o
v
lc
f
tS
n
s
3I
n
S
EIt $0 "Ev B 5pI -o
@C @(-mo+oo1 m U)a
To -c
lEoa,oo-
cr
:s tr o{lo
I 3o l
i E h"N,H;
l\
)
_'
F
-
:
.