HomeMy WebLinkAbout20169842 - Permitcity of Santa Ana 2C Civic Center Plaza (M-19), Santa Ana, CA927O2
Permit Counter: (714) 647-5800 inspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
EIectE'ical Permit #:2Oi69842
Pin #: 2221 9f,
Proiect Address: 2229 112 W La Verne At'e
Assessor's Parcel: 109-l 21-15 Lot: 15
Unit:
Blcck: ltA
Bldg.
Tract: t 346
Address Range:
Historic: No
Suite Range.
Zoning: R1
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:I Carrier:
Policy #:
fxpires:
DAVID & ANGELISA MEDRAiIO
2229 W LA VERNE AVE
Santa Ana, CA 927043509
(7141 501 -7269
Fee Type
01 '1 15002 51603 Subpanel
011 160C2 5160C General Plan Update
0'i 1 16002 51603 lssuance
Amount
55.37
22.95
57.20
Qty
1.00
100
1.00
Fee
$s5.37
$22.es
$s7 20
Bntchi:52332 lr:13121r1? ID: El- IZAP,llTl{
0f f ice: CTYH Trons*: 4tt I uf' .i
Acct*: Ref *: ?r-116994,)
Rcpt*:tt277tt?71 lir/S/2irL9 Itt r57 iill
Tronsoction TotoI t13i.l:,i
DA,/ItI & AH6ELI(:A IIEDRAHO
Generql PIqn Updobe Fee
trl I 1600I- 516rJrJ00Lr-
Electr i col
0111600?- 5161130110-
V iso
(:(:+: *rr****rrr*xI I 7g
$ 1:i
Auth*: it?.d(t7l
$rr?
Building Use:
Job Type:
Nature of Work:
Accessory Dwelling Unit-C Occupancy:
Miscellaneous Constr Type:
ADU/SubPanel Code:
Date:
Date:
Date:
R.3, U
VB
cEc 2016
Planning Conditions:
Planning Approval By.
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buildins Permit #: 10198834
Every permitissued 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 the sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
10t03t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
01 1 16002 51600
01 1 16002 51603
$22.95
$112 s7
$1 3s 52
$0 00
$135 .52
Permitee MtD#'. 2018-1481 30
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWN I]R BUII,I)F]R I)F]I,CARATION
I hcrcby aff[m undcr Fnalty of lf,rjury th.t I m excmpt frum lhc Contraclo6' Licenrc Lrw for thc followhg rcasn (Scl.70]1.5
Busincss ailt Prcfcssion Cqlc): Ary City or County which n1uircs a Jrmit to construcl. alten iDprcvc, dcmlish or rcpait ay
structre, prior to its issuarec. aLo rcquircs thc applicmt for such Fmit to frle a sigrcd slatcmnl that lE or slt b liensd pwant
to rhc provisions of th. Contracror's Liensd llw (Chaptcr 9. Comrcing with Scclion 7(XX) of Division 3 of thc Busine$i md
pmfessions Co.lc) or that he or shc is crcmpt thqehom and thc basis tbr lhe allegcd eremption. Any violation of Scctbn 7031 ,5 by any
applicant for a lEmit subjcrts thc applicant to a civil pcnally of not mrc than five hutxlrcd dollils ($500).
_L as owncr of the ln [rctty. or my employccs wilh wages as thcir slc comlEnsalion. will do tlE wffk ad the structw is mt
intenlel or otfercd Is stc (3c.70&, Susif,css and Prrfcssions Codq The Controctor's Licenrc kw d@s not apply to il owmr of
thc pNpedy who builds or in{mws thcprl .nl who des sreh utk himsclf or hcEclf or thrtugh his or lrcr own cmployees,
pro;ide.l th{t such impowmnts & rot interxlql or ollbrql for eb, If. ]Dwcrcr, thc buiuiry or inlprcrcmnt ir soll within orc }44
of urmplctkrn. thc Owrcr Buillcr will hare [E hurhn of pruving thar hc or shc dil mt huill or itr{rorc thc [xotEty for the FtrFsc of
sb).
_t, asowncr of thc p()pcny, mcxclusively contretirg with liccnsd conlBctoN to q)nstrucl thc prtjsl (se. 7M4, Busircss
a[t profasix Codc: Thc Contrrctor's Licensc L.w d@s not .pply to an ovncr ofpruJErly vho builds or improvcs thereon'
anrl who sntrcts for such pf,rFcis with a Contmcto(s) liccnFd puruut lo the Contraclor's Lkensc law),
-l.mexcmpt
undcr Sccliotr-. B. & P.C. for lhis rcasn.
Dal€:- owner:
WORKERS' COIITPENSATION
DECIdEAIION
I herchy atTirm undcr pcmlty of lErjury one of the followinS dcclamlions:
_t havc 4l will mintain s Ccnifrcatc of Consent to SclElnsurc for ulrkcr' smJEnsatk n, as prcvidcd tbr by Sstbn l7m of lhc
khor Cqlc, for ltrc [rcrfomrec of lhc sr* for shbh thc ,mil is issued.
_l have and will m.inlain workcs' comFnsalion insurarcc, ss rcquircd by Scction !700 of thc ktDr Gxle, for the pcrfomc of
lhc mrk for which thls pcmit Ls isswl. My worke6' smlEnsation insuruce wicr all Jrolicy numbcr rc:
Policy Numher: ExPircs:
_l ccrtily rhat in thc Jrcrtilrnuncc of the work tor which this prmit is issucrJ, I shall not cmpk)y any Jrcrson in any manncr
so as to hccgmc sutrlcci to thc workers' compcnsation laws of Calitirrnia, and agrcc that if I shrluld bcconrc subjcct to thc
workcrs' comlrcnsation provisk)ns of Scction ]700 of thc Latxlr CrxJc, I shall, tbrthwith comply with thosc provisions.. .
WARNING: Failure to sccurc workers'comlrcnsation coveragc is unlawlul. and shall suhjcct an cmpklycr to criminal pcnalties and
civil tines up to onc hundretl thousand rlollars ($l00.Un). in arllition to the cost of compcnsation, damagcs as providcd ftrr the
t'Sectir>n 1076 ol'lhc l"-atxrr Ctxle, intercst and attorney's l'ccs.
I,I('I.]NSEI) CONTRACTOR
DI.]t]I,ARATION
I hcrcby allirm undcr pcnalty of pcrjury that I am liccnsctl undcr pr)vision of Chapter 9 (commcncing wilh Scction 7firu) of Division -l
of the Busincss and Prolbssions Code, and my licensc is in l'ull tirrcc and cttect.
Conlractor:
CONSTR,UCTION LENDTNG AGENCY
t hercby affrm undcr penalty of pcrjury that thcrc im*ructirn bnling agercy for thc 1xrfrrue of the rcrk for whfuh thir Fmit i3
issued (Sec. 3097, Civ. C.).
kndcr's Namc:
lrnder's Address:
APPLICANT DECLARATION
I hcrcby all-lrm undcr Jrcnalty of pcrjury one of the lolkrwing declarations:
Demolitkrn Pcrmits-Ashcstos Notil'ication Fedcral Rcgulations ('title 40, Part6)
-Rcquircd
[-ctlcr of Notiticatfurn
-l
cntily that thc fcdcral rcgulations rcgarding asbesk)s rcmoval rc nol applicahlc to this pNjcct.
_l certify lhat I havc rcad lhls application dxl statc that rhc atilvc inform.tion is corot. I agre to @mply with_all City and Counly
or,linanccs an.l State Laws rclating io building construction, arrl hcrcby aulk)riz rcprcsntalivcs ofthis City and County to cntcr ug)n the
abovc mnlioncd prelrcdy for hsfBution purlnscs.
Applicant 0r Agenl
P€mite mmc (prinl):
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under SIab / Floor
Bondinq I Groundins I UFER /A -?z-/,t /I*l/tt
Transformers
Torqueincr
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinss (T-Bar Rouqh)
Nleter Release
Rouqh ft -27-/g Oz,T) / lt
Service Meter I 6t\
FINAL lrLhgl 14 1-7^z- .. irL U
Remarks Etc
\t, nQ n )f\
Date:-