HomeMy WebLinkAbout20172199 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 2o^172{99
Pin #: 6{ tla
Proiect Address: 3705 S Ross Sta
Unit:
Block. NA
Bldg:
Tract: 6702
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel: 410-142-15 Lot: 18
Owner:
Address:
Beniamin Huang
3705 S Ross Street
Santa Ana, CA 92707
(949) 885-8180
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
Air Conditioner
General Plan Update
lssuance
Microfilm Records
Amount
104.40
23.79
59 30
4.05
Qty
1.00
1 .00
1 .00
1 .00
Fee
$104.40
$23.79
$5e 30
$4.05
Phone:
Tenant Name:
Contractor:
Address:
Phone:
RK lndustries Group lnc
1301 S Beach Blvd #D
La Habra, CA 90631
(7141 7234658
State Lic #: 996175
Lic Type: B, C-20
Bus. Lic #: 376539
Workers' Compensation !nsurance:Carrier: State Fund
Policy #: 91 1 02TT -2020
Expires: 0812312021
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling Occupancy:
Alteration Constr Type
F u rnace/Com pressor Gom 51Code :
R-3, U
VB
cEc 2019 Notes:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #.
Enriquez, Gissel Date:
Date:
Date.
10t29t2020 Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
verduzco. Vior"J
..1
10t29t2020
Account#
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23 7e
$163.70
$4.05
Fee Total:
Paid to Date:
Balance Due:
$191 .s4
$0.00
$1 91 .54
lnspector MID#: 2020-162497
4
ELECTRICAL-!NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq I Groundinq I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouoh)
Ceilings (Hard & Soffit Roush
Ceilings (T-Bar Roush)
l\Ieter Release
Rouqh
Service lVleter I
FINAL tt lfo hn 0ffwd 7
Notes, Remarks, Etc.lt
OWNE,R BUTT,DER DIiI,CARATION !
I hereby affirnr untter penatry of perjury that I arn exernpl from the Contractonr'Licensc l-aw for the following reason (S...203t.5'
Busincss and Profcssion Code): Any City or County which requircs a pcrmit to conslruct, aller, irnprovc, dcmolish or rcpair any
structure, prior to its issuance. also requires the applicant for.such pernril to file a signed staternent that lre or she is licenscd pursuanl
to thc pmvisions of thc Contractor's l.iccnscd law (Chapter 9, Commcncing with Scction 7000 ol' Division 3 of thc Business and
hofessions Code) or that hc or she is exempt therefronr and the basis for tlre alleged exenption. Any violation of Section 7031.5 by any
applicant for u perrnit subjects the applicant to a civilpenaltyof not more than five huntlred dollars ($500).
_1. as owncr ol'thc property. or my cmployees with wages as thcir sole compcnsalion, will do thc wcrk and thc structure is rxrt
intendcd or offered for sale (Sec.7Ot+, Business and Professions Codc: The Contractor's Licensc l-aw rloes not apply to an owner of
the prcperty wlrcr btrilds or improves thereorL and wlro does such work himself or lrcrself or through his or her own entployecs,
provided that such improvcrmnts arc not intended or oflcrcd for salc, Il. however, thc building or inprovcrncnt is sold within onc year
of completion, the Owner Buikler will have the burtlcn of proving ttrat lre or she did not buikl or improve Orc propaty for thc purposc of
nale).
_1, as owner of the propefly, um exclusively contracting with licensed contraclors to construct thc projcct (Sec. 7044, Busirrcss
arxJ hrofesskxr Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon.
and who contracts for such projccts with a Contractor(s) licensed pursuant to thc Conuactor's License Law).
-IantexernptunderSectit,tt-'B.&P.C.fortlrisreason.
WORKERS' COMPENSATION
DECLARATION
I hercby affirm undcr Srcnalty of perjury one of thc tbllowing de-clarations:
I
J I hu", and will nuintain a Certiticate of Consent to Self-lnsure for workers' compensation, as prcvidcd for by Se,ction 3700 of thc
labor Codc, for the pcrformarce of the work for which thc pennit is issued./
Vli hor. anrJ will nuintain workers' conryrcmalion insurance, as required by Section 3700 of the Laborv-
thc work for which this pcrnrit is issucd. My workcrs' conqrcnsation insurancc carricr arxl plicy numbcr
fn
Code, for lhe perfonnarrce of
are:
TI osf z=[ z*z r
irr thc pcrtirrnunce o[ thc work for which issucd, I shall not employ any pcrson in any manncr
and agrce that if I should bccotnc subjcct to thc
shall, forthwith comply with thosc provisiotu..
this Jrcrmit is
of California.so as to bccornc subjcct to thc workcrs'cornpensation laws
workers' conqrcnsation provisiorrs of Sectiott 3700 of the Labor Cbde, I
WARNING: Failure to secure workers' compensation coverage is unlaw[ul, and shall subject an employer to criminal penalties and
civil firrcs up to one lrundrcd thousand dollars ($100,W0). in addition to lhe cost of compersation, danuges as provided for lhe
Section 3076 of thc [:tnr Cotle. intcrcst and attorncy's [cc's.
io[tQ[mI)ete:
I l- LTcENSEpcoNTRACToR
DECLATTATION
I hercby affirm under pnalty of pcrjury that I ant licensed undcr provision of Chapter 9 (commencing with Section 7000) of Division 3
of thc Busincss and Professions Code. and my license is in full force and effect.
Nunrber:
qc(u117
License
Dnte:nl?A lbo
CONSTRUCTION LENDING AGENCY
I hcrcby aflirrn undcr pcnalty ol'pcrjury that thcrc is a construction hnding agcncy for thc pcrl'orrnance of thc work lbr which this pcrrnit is
,issued (Sec. 3097, Civ. C.).
l.cnder's Name:
L.cnder's Address:
APPLICANT DECI,A RATION
I r-brcby aftirnr under p-nalty of pcrjury onc of thc tbllowing dcclarations:
Dcnxrlition Pcrnrits-Asbc'stos Notification Fcdcral Regulations (Title 40. Pan6)
-Rcquircd
l-cttcr of Notification
_l certity that thc fcderal rcgulations rcgarding asbcslos rcmoval arc not applicablc to this project.
_l ccrtily tlrat I lurvc rcad this application uxl statc that thc abovc inlornution is corrcct. I agrc'rc to comply with all City and County
ordinanccs and State Laws rclating to building construction, and hcrcby authorize representativcs of this City and County to entcr upon ttr
above rnenlioned property for
Applicant or Agent
lrcrnritee trunlc
!
08-07-2015
ll
Dare: Iol2A[l O
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