HomeMy WebLinkAbout20167377 - PermitI City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702
lnspection Requests: (714) 667-2738 lnspector Section; (714) 647-5853
Electrical Permit #: 2l)167377
Pin #:9{586r.j \j
Proj ect Address: 1115 S Rosewood Ave
Assessor'sParcel: 013-0'14-04 Lot; 141, POR 142
Bldg:
Tract: 557
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address
Contractor
Address:
Phone
Tenant Name:
FRANCISCO BEATRIZ
11r 5 S ROSEWOOD AVE
Santa Ana, CA 927071019
(657) 720-8038
Andean Electric
824 N Verdugo Road, #A
Glendale, CA 91206
(323) 830-5206
Amount
s3.28
22.O8
55.04
rn llpd0te Fee
516r'r0t00-
5 1 6Ll30r'lfi -
n,xx****2771
Fee Type
01 'l '16002 51603 Serv Meter
01116002 51600 General Plan Update
01116002 51603 lssuance
Qry
1.00
1 .00
1.00
Fee
$s3.28
$22.08
$55.04
Bt1t
0ff
Acc
Rrp
Trn
Uir
And
- 11/9/2lrl8 ID: H6A
Tronsi: 20 1Ret+r 2[1675)4 - tL/9/2fr18 1(t.36Totnl t22S,4t:
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tor
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Building Use:
Job Type:
Nature of Work:
Planninq Conditions:
Planning Approval By
Plan Checked By
Permit Issued By
Subject to Field:
Building Permit #
Single Family Dwelling
Miscellaneous
Serv Meter
Occupancy:
Constr Type
Code:
R-3
VB
cEc 20't6 Notes: Upgrade/handout given. Auth. filed
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
rod , Teri
Every peftnil issued shall bacomo invalid uhloss the wod< on the site
authorized by such permit is commenced within 180 days after its
issuance, ot if lhe work aulhorized on the site by such pemit is suspended
ot abandoned fot a period of180 days after the tine the wod< is
cofirnenced.
11109t201A
Account#
01'1'16002 51600
011 16002 51603
$22.O8
$108.32
$130.40
$0.00
$130.40
U nil:
Block: NA
Phone:
State Lic #: 1033114
Lic Type: C-10
Bus. Lic #: 371078
Workers' Compensation lnsurance:Carrier; exempt
Policy #:
Expires:
Date:
Date:
Date:
Fee Total:
Paid lo Date:
Balance Due:
lnspector MID#: 2018-147570
ELECTRICAL-INSPECTOR RECORD
DATE ID/SIG.COMMENTS
Site-Work
Unde rground
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
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factgry Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rouqh)tl rfl I ,'
I rl r!y107/'fX\ fl tt+llA-k?h) t
'*1t't t 0 - (l!-./,/y
Rough )\)\
Service Meler ."I
FINAL ,L 't-20-t,'J lesDt Det)
Notes, Remarks, Etc.
OWNER BUILOEII DELCARATION
I hercby .mnn utrdd pdally of p..jury thal I m .x.np{ &on rh. ConlracloB Lic.nse tiw lorIh. aollowing r€Mn (Sd7011.5
Busin6s d Prol6sioo Cod.): Any Cily or County nhich rcaut6 a p6nil to conslrucl, .llo. imprcv.. danolish or rqxir uy
srtu.tu., prior io il3 i$ud.., rbo rcqunG rhe applic&r for su.h pdful to nlc r 3igned rbrdor lhd h. or sh. i! li.dEd pcuet
to rhc Fovisio6 ofthc Conrrdcrors Licen$d Lsw (Ch.pld 9. Commcncins wilh SdFn ?000 of Division 3 ofrh. B6in.s ed
Proa.sqions Cod.) oi thar h. or sh. is .rcmp rho.from od thr bsts ror rhc allcgcd .xdprion Any liolarionoaserion ?O:11.5 by.ny
applicanlaoraFnnilsubje8thcapplicanlloacivilpc.rlryolnornor.thmfivchundrcddolles(!500).
l. a ow.d oflh. propdry, or ny cnploy6 virh q aB6 d then sn. conFsarion. *ill do lhc worl dd lhc shrodc i! nor
inlcrhl or ofid.d aor eL (Se.7044. Buins md PrufBioB Codc Tnc Conlroclois Licft. l,s do6 not apply to o ownd ol
rh. F.pdy Nl$ b!il& or inpov6lhsar.. ed *ho do6 s$h Ntl hins€llor h6ello. rhreugh his or hd oMrnployc,
plovidcd ltal such nnprov.lMts m ml hl6i.d or oltu.n for eL. lf, bowes. fi. hrildi4 or imprevoml is $ld wnhin .nc )@of.ontkio[ l1'. OMs Blildd Gll havc rhe hndd ofpmlins thd h. or $. drd ol buiH or iepo( th. FoFty aor Lt FrFeof
l. aopneotrh.Fopdy, &n.rcluiv.lyconkadi,S wnh c.r*l con(tro$ ro coNrud tbt pmjd (Sa.,0{4. Asin6
and ftolBin Cod.: Ih.conr.cbr's Lic.orc Law doB nol arply ro do*nd oapropdry { ho buil& or improvd (ll66n.
and $ho conhcls aor such projdls with a Coihclo(s) licG.d pu6u,, lolt Co"lB.lor's LiceN La*).
I tun.rc,npr ondd serion_, B &PC for rhi! rce.
OrrF:
llaa(lSl.tauEENrall9!
DECLTAAIIOT
I hr.by arirm undcr F ahy ot pqjury onc ot th. aollovin8 &.lsatioN:
-l
hev€dds'U mmlain ! Cen i,icalc of Co6or ro S€l! lreurc for $orkda @.D€neridn,6 prolid€d iorbySdrionlT00 oflh.
L.bo, Codc. for lt. psfonnm.c ofthc volt for whicn th. pdmn ir isNd.
I h^.and \r,lln,ainrai. \$rk.6.ornpcnsarion iNuBnce.6 requirsl by S(r
'on
I700 orr hc l4or Cod.. lor rh. p6fonne.. of
rlt work tu whirh rht p@n t isudi My rortcn compqer ion iNurance c@{ dd policy numbs d.
PohcyNu'nbo Eipis:
lcdriaylhd inthcpdaofln.nccolrhc trork lor lhrh thipdmn is tsucd.I sh.ll nor mploy any F.Mn in anymMn6
g, as lo b..otrE subjdl Io lhc N!,k6' compe.sal ion laws olcaliiomia, ud asre lhal il I should b.cor€ iubjd to
'he*0116 compqexon previsioN olScclion 1700 ollhe L,bor Code.l shall. fonh\ilh conply *irh rhospovisioro
WARNINC: Faihre lo sur. $0r[6 conpcnsarn)covdr!€ $ u.lawful, dd shrllslbler e mplord lo aimin.l penhiB od
clvil tincs u, to onc htrndrcd rhoNd dolla {$l n lo rhc coe oaconpensalion. dama86 6 provid€d aor th.
Sc.ri,r 1076rlrhr Lrlrtr (,x1., ducna d
!-[(! l!!U9!
! hcreLry aifi fln under rlnallyolperjtrryrhar prolision olChaptd 9 (com,nscins wilh Sation 7000) otDivisio! l
of thcBusinNdd P'ifsiodCoi., dd try licdk E in lullforca^leal€cr
I hreby 6mrh undr Dcnalty ol psjury $al I
issu.d (S( ]097. Civ. C )
l€odins ascncy 6r th. p€rfomd.e ofrhc \ork aor \yhi.h rhis Frnir b
ATII,ICANLDECIAAAIIO!
I I'oriyltfmunds p.tuhy ofrdjury on of lh€ fol los ins d.c lral ions
Doolirioo Pmirs-AsbcsrG Notiic.tion F.d6al RcSoldiom (Tirl. 40. Pan6)
-R.quir.d
L.lt6 of Nolilicalion
ab6ros r6n \.1&€ nol apeli.abl.lo this proidt
r.d srat. rhar th. atFve infoft!.rion B coftst IaercrocomplysnhaUCityandCoxflry
io( and hcrcby aurhod. rcpi.sGrtc ofrhi Cny.nd Counryto 6t6 upon rhc
^Dplicitrl
or r0t SlEnrl'l
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APPROVALS
l\rleter Release ri
Lndea3 ad&s
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