HomeMy WebLinkAbout20170118 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 2O17O{{E
pin #: EoE{(f.f
Project Address: 601 N Jackson St
Assessor's Parcel: 198-281-30 Lot: NA
Unit:
Block: NA
Bldg:
Tract: NA
Address Range:
Historic: No
Suite Range:
Zoning: R2
Owner:
Address:
Phone:
Thuy Bui
601 N. Jackson Street
Santa Ana, CA 92703
(714!- 383-2651
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
Subpanel
General Plan Update
I ssuance
Microfilm Records
Amount
55 37
22.95
57.20
3.91
Qty
2.OO
100
1.00
1.00
Fee
$1 1 0.74
$22.9s
$57.20
$3 e1Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Entcht:52S70 LL/1/2t119 ID: PZunisn
0f f ice: (:TYH Trnnsi: 12 I of 1
Acct*: Ref*: 2l1l7l:r 118
Rcpti:02$tr1113 ll/1/?trl9 lLl:48 AI1
Tronsoction Totgl $l?4.Btt
Thuv Bu i
Gerrernl PInn UPdnte Fee
ul 1 16002- 516t-tt-r0lr0-
Electr i cnI
rll I 16r1fi2- 5160311110-
11 icr'of ilm & DocurnentE
fJ1 1 16tlr12- 5777t7lilllJ-
U isn
CC+: **rr****r*r*1565
$??. ?5
_ $167 ,?4
$3,?1
*L94. [i[r
Auth*:t:tltlSt:tcbuihing Use:
Job Type:
jlature of Work:
Single Family Dwelling
Miscellaneous
Subpanels
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-3, U
VB
cEc 2016 Notes: lnstallation of subpanels. Owner-Builder form on file.
Planning Conditions:
Planning Approval By:
Plan Checked By.
Permit lssued By: Chavez, Dave
Subject to Field: 9.c'
Buildins Permit # 10198549
11t05t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
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 site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01116002 51600
01 1 16002 51603
01 1 16002 57770
$22.e5
$167 94
$3.91
Fee Total.
Paid to Date:
Balance Due:
$1 94 80
$0 00
$194.80
lnspector MID#: 2017-1 38535
ELECTRICAL.I NSPECTOR RECORD
Hl"r', nA
^7
1/'t,tG,
APPROVALS DATE ID/SIG,COMMENTS OWNER BUILDER DELCARATION
I hoeby affirm undr pmalty of pojury that I on excmpt from thc Contraclorc' Licme Law for the following rcmn (Se.7031.5
Busines md Profeion Codc): Any City or County which rcquirc a pornit to comlruct. alta. improva danolish or rcpair uj
structurq prior to its isuocc. also rcquiro the applicant for such pemit to filc a signed statmat thal hc or shc is licdscd p$uml
to thc provisions of the Contractor's Liccnsed law (Chaptr 9. Comnencing rvith Setion 7000 of Division 3 of thc Business ud
Prcfesions Codc) or that he or she is exempt thcefrom od thc bsis for lhe allcgcd exmplion. Any violation of Selion 7031.5 by any
applicantforapnnitsubjetsthc applicmttoacivilpcnaltyofnotmorcthofivchundreddollus($500).
_1. as owner of the property. or my employees with wages as their sole compensation. willdo the work and the structure is not
intended or ofFered for sale (Sec.7044. Business and hofessions Code: The Contractor's License Law does not apply to an owner of
the property who builds or improves thercon. and who does such work hirnself or herself or through his or her own employees.
provided that such improvcrnents are not intended or ofFered for sale. lf. howo'er. the building or improvement is sold rvhhin one )€ar
of completion, the Orvner Buildcr rvill have the huden of proving tha he or she did not build or improve the pmpcrty for the purpos€ of
sale).
1$t,as owner of rhe property. am exclusively contracting with licensed contractors to construct the project (Sec. 7044. Business
and Pnoftssion Code: The Contractor's License Law does not apply to an owner of property rvho builds or improves thereon.
and who contracts for such projects with a Contracto(s) licenscd pursuant to the Contractor's l,icense Law).
-l
arn exempt under Section-. B. & P.C. for this reason.
Drt",' U- OS'lq o*n"r, ts a'urUl
WORKERS' COMPENSATION
DECLARATTON
I hereby alTinn under penalty of perjury one of the following declarations:
-_l
have and will maintain a Certifrcate of Consent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
Labor Code, for the perfonnance of the work for which the permit is issued.
-l
have and will maintain u'orkers' compensation insurance. as required by Section -1700 of the labor Code. for the performance of
the work for which this permil is issued. My workers' compcnsation insurance carrier and policy number are:
Carrier:_
Policy Number:_Expires:
T-Lrcefiiry that in the perforrnance of the work for which this perrnit is issued, I shall not ernploy any person in any manner
so as to become subject to the workers'compensation larvs of California. and agree that if I should bccome subject to the
s'orkers' compensation provisions of Seoion 3700 of the Labor Code. I shall. forthrvith comply rvith those provisions..
WARNING: Failure to secure rvorkers' compensation coverage is unlarvful. and shall subject an onployer to criminal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition lo the cost of cornpcnsation. darnages as provided for the
.1
of the Business and Professions Code. and rny license is in flull force and effect.
License
-License
Number:
Date:_Contractor:_
CONSTRUCTION LENDING AGENCY
I hcby a(fim undo parahy of ptrjury that thqe b a comtruclion l€nding ag@cy for lh€ pcfomuce of thc work for which thb p€rmit is
issucd (56. -1097. Civ. C.).
Lender's Name:
Lender's Adct'ess:
APPLICANT I'ECI-ARATION
I hctby affim undq pcnalty of po'jury onc of thc following delmtiom:
Dcmolilion PmitgAsbetos Notification Fcdml Rcgulations (Titlc 40. Pan6)
_R{uitrd ldtq of Notification
-t
csti& that thc fcdoal rcXulatiom rcguding cbctos rmoval rc not qplicsblc to this prcjcct.
191 cqti& ttra t tuvc rad thfu spplicstion od statc thst thc abovc infonnrtion is corcct. I agr to comply with all Cily ed Couty
ordimca od Stac [:rw rclaing to building coostruclion. and hocby authoriu rcpr$tdive of this City md Comty to ots upoo thc
abovc m@rioncd prcpcdy for iropoction purpos.
ApptlcrntorAsmts,r-r*X --L0uUl 4 o"t", . ll-O5-ti
permlree nnme tprintl: K Th , Y Bt- tl'
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm lDaffioers
Communications Cable
Buildins
Under Slab / Floor
Bondinq I Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Roush)
Meter Release
Rough t2.4-lg nr7$ la
Service Meter
FINAL L'65/rP DJ\s? l6z,
Notes, Remarks, Etc
-+