HomeMy WebLinkAbout20170105 - Permita City of Santa Ana
i
20 Civic Cente r Plaza (M-19), Santa Ana, CA 92702 Electrical Permit #:2O17O{05
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853 Pin #:59294. l!\t
Project Address: 2629 W Occidental St-
-
Unit:
Block: NA
Bldg:
Tract: 2511
Address Range:
Historic. No
Suite Range:
Zoning: RlAssessor's Parcel: 408-073-02 Lot: 47
Owner.
Address:
Lazaro Espinoza
2629 W Occidental
Santa Ana, CA 927044046
(7141 e55-7071
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01116002 5777C
Fee Type
Serv Meter
General Plan Update
I ssuance
Microfilm Records
Amount
55.37
22 95
57.20
391
Qty
1.00
1 .00
1 .00
1 .00
Fee
$55 37
$22.95
$57.20
$3 91
Phone
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone Bnt,:lii:5
tlf'f ice!
83r
TYI
/ 4,t?ti
ntr s.* :
R
11/rr
I D : t':{:[
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
[icp L*: Lt?Stu:1753
tn e0c t
I flr'cr t
lrrclnt q
5I 6t-tt-u:u:u-]
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Service Meter
Occupancy:
Constr Type:
Code:
R-3, U
VB
cEc 2016
t I 1,5tJrJ?- 5 16tJ;jrlt-tr-r-
i crof i im L Documerit
1 I l6r:[J?- fi777rir-rrrr:r-
Notes:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field.
Building Permit #:
Hernan dez, Kathy
Date:
Date:
Date:11t0412019
Account#
Misc. Receipt.
Misc. Receipt:
Mrsc. 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 fhe sife by such permit is suspe nded
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 s1600
01 1 16002 51603
01116002 57770
$22.95
$1 12 57
$3.e1
Fee Total
Paid to Date:
Balance Due:
$1 39 43
$0 00
$139 .43
lnspector MID#: 2019-155644
i x * x8{17
ELECTITICAL.I NSPECTOR RECORD
f,} c"rl0. n'7 ')n-, fi
APPROVALS DATE ID/SIG,COMMENTS OWNER BUILDER DEI,CARATION
I h6cby amm undo pemlty of pctjury thst I m ercmpt ftom the ContmctoE' Licm Law forthc following rcmn (Sc.70-11.5
Buinqs ud Profession Code): Any City or County which rcquira a pcnnit lo coEtrucl. alta, improvc dmolish or npair uy
structuc. prior to its isuance. also requirG the applicdt for such pennit to lilc a signcd statmcnt thal hc or shc b licoscd pNuilt
to thc provisioB of the Contractor's Licenscd llw (Chapta 9. Commcing rvith Sation 7000 of Division 3 of thc Buins a{
Prof*sions Codc) or that hc or shc is cxcmpt thccfrom md thc b6is for thc alleged cxmption. Any violation of Scction ?031.5 by an!
applicantforapmitsubjslsthe applicanttoacivilpcnaltyofnotmorcthmfivehundreddollm($500).
_1. as owner of the property. or my employecs with wages as their sole compensation. will do the rvork and the structure is not
intended or offered for sale (Sec.7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of
the poperty rvho builds or itnproves thereon. and rvho does such wort himself or herself or through his or her own employees.
provided that such improvanents are not int€nded or offered for sale. lll hou'ever. the building or improvemcnt is sold within one )€ar
of complaion, the Or,r,ner Builder will have the burden of proving that he or she did not build or imp,rove the propoty for the purposc of
sale).
_1. as owner of the propeny. am exclusively contracting rvith licensed contractors to construct the project (Sec. 7044, Business
and hofcssion Code: 'l-he Contractor's License Law does not apply to an owner of property rvho builds or improves thereon.
and u'ho contracts for such projects rvith a Contraclo(s) licensed pursuant to the Contractor's License Law).
_l arn exempt under Section_B. & P.C. for this reason.
o*e, l('V - I 1
DECLARATION
I hereby alhrm under penalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for workss' compensation. as provided for by Section 3700 of the
Labor Code. for the performance of the work for which the perrnit is issued.
_l have and will maintain workers' compensation insurance. as required by Section .3700 of the Labor Code, for the performance of
the work for which this permit is issuecl. My workers' compensation insurance carrier and policy number are:
Carrier:-
Policy Number: Expires:
_l certi& that in the performance of the work for which this perrnit is issued. I shall not anploy any person in any manner
so as to become subject to the workers' compcnsation laws of California and agree that if I should become subject to thc
u'orters' compersation provisions of Sertion 3700 of the labor Code. I shall. forthrvith comply with thosc provisions..
a
WARNING: Failure to sccure workers' cornpensation coverage is unlau'ful. and shall subjecr an onployer to criminal penalties ar.?
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as providcd for the
Section -1076 of the Labor Code, interest and attorney's fees.
.2 I
DECI.,ARATION
I hereby affirm under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and cffect.
_License Number:License Class:
Date:Contractor:_
(:0NS'l'RU("!'ION l,llNDIN(; A(;llN('Y
I hreby affm undtr pcnalty of pcrjury that th6c is 8 construction lending agcncy for thc psfommce of lhe uork for u'hich this pqmit b
issued (Sec. -1097. Civ. C.).
Lender's Ad&ess:
APPI ICANT DECLARATION
I herelry affirm under penalty of perjury one of the following declarations:
Demolition Perrnits-Asbestos Notification Federal Regulations (Title 40, Pafl6)
_Required Lrtter of Notification
-l
cqliry that the fedral regulatiou regoding sbestos moval re not applicable to this projat,
-l
cdiry that I have md this application ild state thst the abovc infomation is corccl. I agc to comply with all Cityand County
ordhaocc trd State Laws rclating to building comtruction. and hscby authoriz reprcutativa of this City md County to 6t6 upon thc
o*u, f l- Lf -l 7
above mentioned property for inspectign purposes.
::'*:,**#:-eg,?t'*oz4
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltase
Fire Alarm I Dampers
Communications Cable
Building
Under Slab / Floor
Bondins I Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Wails (Roush)
Ceilinss (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
Rough t/// z/rQ D$ttoa-,*En
Service Meter I
^-l
ll
I
FINAL f/4v<1 /0v
Nofes, Remarks, E{c
?-
q *H-
I
///)11 l7
lr