HomeMy WebLinkAbout20170124 - Permit\City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests. (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:20170124
Pin #:3343O:r\
Project Address: 2122 1/2 S Shelton St
-
Assessor's Parcel. 015-204-06 Lot: 68
Unit:
Block: NA
Bldg:
Tract: 1192
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Phone.
Maria Janet Avila
2122 1/2 S Shelton St
Santa Ana, CA 927073134
(7141 878-6468
First Stop Construction
20201 Sherman Way #206
Winnetka, CA 91306
(818) 85e-6s23
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 s1603
01 1 16002 51603
01 1 16002 5160C
01 1 16002 5777C
Fee Type
New Res
FWU
Dedicated Circuit
Low Voltage/Res
Serv Meter
General Plan Update
Microfilm Records
Amount
000
000
000
000
000
0.00
000
Qty
441 .00
2.OO
100
100
100
100
1.00
Fee
$0.00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
State Lic #: 1014721
Lic Type. B
Bus. Lic #: 373691
Workers' Compensation I nsurance:Carrier: State Fund
Policy #: ga232g0
Expires. 1212212019
Building Use:
Job Type:
Nature of Work:
Accessory Dwelling Unit-D Occupancy:
New Constr Type.
ADU Code:
Date:
Date:
Date:
R-3
VB
cEc 2016 Notes: Change to contractor/replaces EP #201691O9/fees pd
on 20169109
Planning Conditions:
Planning Approva! By:
Plan Checked By:
Permit lssued By: Hernandez, Kathy
Subject to Field:
Buirdins Permit #: 1 01 1 0 2140
't1t19/2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
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.
Fee Total
Paid to Date:
Balance Due:
$0 00
$0.00
$0.00
,]
Inspector MtD#'. 201 9-149607
ELECTRICAL.INSPECTOR RECORD
()^'nQ n'7 ?^,r rr
APPROVALS DATE ID/SIG.COMMENTS OWNERBUILDERDELCARATION , ,I hoeby aflim undo poalty of perjury thar I m cxcmpt from thc ConlmctoB' Licce hw for the following r6n (Se.7031.5
Busines md Profsion Code): Any City or County which require a po'rnit to construcl. altc, improva dcrnolbh or rfinn my
structue. prior to ils issumce. also require the applicst for such peqnit to file a signcd statqnot that hc or she b licos€d pwuut
to the provisions of thc Contractor's Licoscd taw (Chapt6 9, Commcncing rvith S€tion 7000 of Division 3 of the BNin6 ild
hofsions Code) q that he or she is cxempt thsefrom ild thc bssis for thc allcgcd cxmFion. Any violation of Srtion 7031.5 by any
applicantforap€nnitsubjGtsthc applicattoacivilpenaltyofnotmorcthilfivehundrcddollus(S500).
-1.
as owner of the property. or my employees $'ith wages as their sole compensation. willdo the rvork and the structure is not
intended or offered for sale (Sec.7044. Business and hofessions Code: The Contraclor's License law does not apply to an ou,ner of
the property rvho builds or improves thereon and who does such wort hirnself or herself or through his or her own employees,
provided that such improvonents are not intended or offered for sale. lf. hou'ever. the building or improvemsrt is sold within one ]rtr
of cornplcion. the Orvner Builder will have the hrden of proving tha he or she did not build or improve the propo'ty for the purpose of
sale).
-1.
as o\r'ner of the property. am exclusively contracting rvith licensed contractors to conslruct the projea (Sec. 7044. Business
and ttofession Code: The Contractor's License Larv does not apply lo an owner of propoly rvho builds or improves thereon,
and rvho contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's License Larv).
I aln exempt under Section_. B. & P.C. for this reason.
l):rle:Orvner:___ _ _
DE(]LARA'I'ION
one of the follorving dcclarations:I hereby affinn under penalty of perjury
--t
have and will maintain a Certificate of Consent to Self-lnsure for rvorkers' compensation. as providcd for by Section 3700 of tlfr
Labor Code. for the performance of the work for which the permit is issuerJ.
--l have and rvill maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. for the performance of
the s'ork for u'hich this issued.rvorkers' compensation insurance carrier and policy number are:
Carricr:
Policy
___l certify that in the performance of the rvork for which this permit is issue<I. I shall not employ any person in any manner
so astobecomesubjecttothervorkers'compensationlawsofCalifornia.andaglrerthatiflshouldbecomesubjecttothe
rvorkers' cornpensation provisions of Section 3700 of the Labor Code. I shall. forthrvith comply rvith those provisions..
WARNTNG: Failure to secure rvorkers' cornpensation coverag,e is unlau'ful. and shall
civil fines up to one hundred thousand dollars (S100.000). in addition to the cost of
subject an onployer to and
the
Section .1076 the interest and attorney's fees.
I hereby affirrn under penalty of perjury that I arn licensed under provision of Chapter 9 (comrnencing with Section 7000) of Division 3
of the llusiness and Professions Code. and rny license is in full force and effect.
License Class:_Nurntrcr://,4?4
l)ate:Contrrcto\(
CONSTRUCTION LENDING AGENCY
I heby alfrm undr pqElty of pcrjury thal th@ is a co$truclion lmding agacy for thc psfommcc of th€ work for which this pannit b
isued (Se. 3097, Civ. C.).
[.nd6's Nmc:
Lendcr's Address:
APPLICANT DECLARATION
I hereby aflinn under penalty of perjury one of the following declarations:
Derno lit io n Perrnits-Asbestos Notil'rcat ion Federal Reg u lat io ns (T it le 40. Parl 6 )
-
Required Letter of Notification
I ccrtify that the federalregulations regarding asbestos rqnoval are not applicable to this project.
--l cerrify that I have read this application and state that the above infionnation is correct. I agree to comply with all City and County
ordinances and State [-aws relating to building construction, and hereby authorize
above mentioned property for
Applicarrt or Agerrl
Ittrlrtilt'e nir!nt
purposes.
City and to enter upon the
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltase
Fire Alarm I Dampers
Communications Cable
Building
Under Slab / Floor
Bonding I Groundins / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilings (Hard & Soffit Roush
Ceilings (T-Bar Rough)
[\Ieter Release
I
Rough t75 n DtY{n6L r[n
Service Meter I
FINAL I 25 2D Vklfle Lvkq
Notes, Remarks, Etc.I I I-/
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