HomeMy WebLinkAbout20169345 - PermitProiect Address: 4926 W Kent Ave- -a- -
Assessor's Parcel: 108-373-08 Lot: 76
Unit.
Block: NA
Bldg:
Tract: 3528
Address Range:
Historic: No
Suite Range:
Zoning: Rl
city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA927o2 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853 }I Permit #i 20{69345
Pin #: 88746
Owner:
Address:
THAO NGO
4926 W KENT AVE
Santa Ana, CA 927041936
(7141 383-0002Phone:
Tenant Name:
Contractor.
Address:
Owner-Builder
Phone
State Lic #.
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
\pires:
Bntch*:51281 8/1/?ttl? I[t: ]'liir-iFii:
0ff ice: (:TYH Trnns*: 5? : of'
Acct*: Rel*: :irl16ii345
Rcpti: i12711?51 g/ii?trl? I[t:5tt Afl
Tronsgction Tobnl trlrttls.4ir
THAO HGO
Auth on file.
II??
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Addition
Addn & patio cover
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R.3, U
VB
cEc 2016
Auth * : /r6._i:i
Notes:
Zuniga,o,,,rrv 08t0512019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Total
Buildins Permit #: 101 100080
Every permit rssued 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.
lnspector MID#: 201 9- 1511 59
01 1 16002 51600
01 1 16002 51603
$22 95
$74 03
Fee Totat
Paid to Date:
Balance Due:
$e6 98
$0 00
$e6.e8
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
Fee Type Amount
125 Volt Receptacle 1 .51
Light Switches, Occ. Se 1 .64
Light Fixtures 1 09
General Plan Update 22 95
lssuance 57 .20
Qty
s00
300
400
100
100
Fee
$7 55
$4 92
$4 36
$22 95
$57 20
ELECTR!CAL.I NSPECTOR RECORD
APPROVALS DATE ID/S!G.COMMENTS OWNER BUILDER DELCARATION
I hqeby aflim und6 poalty of ptrjury that I m cxcmpt from lhe Contracton' Licruc Lsrv for the following rcon (56.703115
Busines od Profwion Codc): Any City or County which requira a pennit to construct, altq. improve. dcmolish or rcpair my
structuq prior lo its isuoce. also rcquire the applicmr for such lmit to lilc a signed statqtrol that he or slE b licmscd plNait
to the frovisions of thc Contractor's Liccnscd tarv (Chaptcr 9. Commencing rvith Sation 7000 of Division 3 of thc Busins md
Prof6sions Codc) or that hc or she is cxcmpt thqcfrom and thc bsis for thc allcgcd cxmption. Any violation of Scclion 7031.5 by any
applicant tor a permit subjcts the applicsnt lo a civil pcnalty of not morc thm fivc hun&cd dollss ($500).
_1. as owner of the property. or my employees with rvages as their sole compensation. sill do the u'ork and the structure is not
intended or offered for sate (Sec.7M4. Business and Professions Code: The Contractor's l,icense Larv does not apply to an orvner of
the progrerty who builds or improves thersrn. and who does such s'ork himself or herself or through his or her own employees.
provided that such improvonents are not intended or offered lirr sale. l[, however. the building or improvement is sold within one year
of complaion. the Ormer Builder witl have the burden of proving tha he or she did not build or irnprove the propoty for the purpose of
sale).
_1. as o\t'ner of the property. am exclusively contracting rvith licensed contractors lo construct the projecf (Sec. 7044. Business
and ttofession Code : The Contractor's License Larv does not apply to an orvner of property rvho builds or irnproves thereon.
and s'ho contracts for such projeos rvith a licensed pursuant to the License Law).
_-l am exempt under Section-
,n
-7-
-.
B. & P.C. for this reason.
DECLARA'TION
I hereby alTirrn under penalty of pojury one of the follorving declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for rvorkers' compensation. as provided for by Section -3700 of the
Labor Code. for the performance of the rvorft fior rvhich the permit is issued.
_l have and will maintain rvorkers' compensation insurance. as required by Section 3700 of the tabor Code. for the performance of
the work for which this pennit is issued. My workers' compensation insurance carrier and policy number are:
Carrier':--
Policy Number: ExPires:
_l ccrtify that in the performancc of the rvork for which this perrnit is issued. I shall not cmploy any pemon in any manner
so as to become subject to the workers'compensation laws of California, and agree that if I should become subject to the
worters' .o,np*.iion provisions of Sertion 3700 of the Labor Code. I shall. forthwith comply rvith thosc p.oritio*.. I
WARNING: Failure lo secure rvorkers' conrpensation coverage is unlarvful. and shall an onployer to and
civil fines up to one hundred thousand dollars in addition to the for the
Section 3076 of the Labor Code. interest and attorney's
g A
I hereby affirm under penalty of perjury that I arn licensed under provision of Chapter 9 (commencing with Section 7000) of Division -1
of the Business and Professions Code. and rny license is in full force and effect.
License Class:--
-License
Number:
l)nte:(lonlrnclor:
CONSTRUC'TION LENDING AGENCY
I hmby affum unds pcnalty of pdjury that thrc is a mrotruc-tion lmding agocy for thc pffomscc of thc rcrk for which this pqmh b
issucd (Se. 3097. Civ. C.).
Lender's Narne:
-
Lender's Address:
-
APPLICANT DECLARATION
I hffiby affirm under penalty of perjury one of the follorving declarations:
Demolition Perrnits-Asbestos Notification Federal Regulations (Title 40. Pat16)
-Required
Later of Notilication
_l certify that the federal regulations regarding asbestos rernoval are nol applicable to this project.
I cerrify that I have read this application and state that the akrve infonnation is correct. I agree to comply
rrepresentatives of this City
rvith all City and County
and County to enter uSnn theordinances and State Larvs relating constnrction. and hereby authoriz.c
above rnentioned propfiy for
Applicnnl or Agent
Pernrilee nAnre (print):?+ra,
oate:O-€'11
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm I Dampers
Communications Cable
Buildins
Under Slab / Floor
Bondins I Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinss (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
Rough q v4 ui Fzn,r.qc"rpn;
Service Meter u\
FINAL tt t 14 -1 W {2u
Notes, Remarks, Etc.UI