HomeMy WebLinkAbout20170093 - PermitProiect Addresa
Unit:
Block: N
Bldg:
Tract: HEIL
Address Range:
Historic: No
Suite Range:
Zoning: R2Assessor's Parcel: 008-21 1-04 Lot: 10
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
eertpfcoulteft$ 647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 2O{7OO93
Pin #: 89{9\-\
Owner.
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
State Lic #: 1020158
Lic Type: B, C-16
Bus. Lic #: 374251
Workers' Compensation I nsurance:Carrier: Exempt
Policy #:
Expires:
Jim Colombo
1030 W. Walnut
Santa Ana, CA 927033949
(7141 914-7094
Ventmart Hoods Master
1800 E. Garry Ave. Suite #1C
Santa Ana, CA 92705
(7141 866-7210
01 1 16002 s1603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
125 Volt Receptacle
General Plan Update
I ssuance
Microfilm Records
Amount
1 .51
22.95
57.20
3.91
Qty
2.00
1.00
1.00
1.00
Fee
$3.02
$22.95
$57.20
$3.e1
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Alteration
Vehicle Damage Repair
Chavez, DaveVc'
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-3, U
VB
cEc 2016 Notes:
Botch*:52836 Il/+/2019 ID: (:(:Ur-.l
tlff icel (:TYH Trnns*: 4[l 3 ulAcct*: Rel*: 2tll7tlt-t?3
Rcp t,* : L'2$tttt3g5 lI / 4 /?itLV l tt : 54 Al'1
Trnnsoct ion To[01 $613, ?tt
Ilnr io Bor'undo
Ventmarb Hoods lloEter
Electrical repair at bedroom due to vehicle damage.
$87 08
$0.00
$87.08
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By.
Subject to Field:
Buirdins Permit # 101 102116
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 permit rs suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 201 9-155619
11104t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
01 1 16002 51600
01 1 16002 s1603
01 1 16002 57770
$22.95
$60.22
$3 e1
Fee Total:
Paid to Date:
Balance Due:
ELECTRICAL.I NSPECTOR RECORD
t\Q n7 '>^a r;
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltase
Fire AIarm I Dampers
Communications Cable
Building
Under Slab / Floor
Bonding I Grounding / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Wails (Roush)
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
/\
Rough -F-11 Vr,t#%
Service Meter U \J
FINAL \,*tMx
Notes Remarks Etc.
-+
I hseby affirm undo penalty of pcrjury that I m cxempt from thc Contractos' Licme taw for thc following re$n (Sc.70-t1.5
Businos and Profsion Code): Any City or County which requirs a ponit to construct. alta. improve. donolish or rcpair uy
structurq prior to its isuucc. also requiB the applicilt for such pemit to lile a signed statmot th.t lE or shc b licased plNilt
to thc provisioc of thc Contractor's l,iccnsed larv (Chaptq 9. Commcrcing rvith Setion ?00O of Division J of thc Bsins dd
Prcfc$ions Codc) or that hc or shc is excmpt thoefrom and thc basis for thc alle8ed ermption. Any violation of Sation 7031.5 by 8ny
applicantforapennitsubjetsthc applicanttoacivilpenaltyofnotmorelhilfivehundrcddollm($500).
-.1.
as owner of the property. or my employees with wages as their sole compensation. rvill do the work and the structure is not
intended or offered for sale (Sec.7044. Business and hofcssions Code: The Contractor's License l-arv does not apply to an orvner of
the property rvho builds or inrproves theron. and who does such w'ork himself or herself or through his or her own employees.
provided that such improvonents are not intended or offered for sale. l[, horvever. the building or improvement is sold within one year
of cornplaion. the Orvner Builder rvill have the burden of proving tha he or she did not build or irnprove the propo'ty for the purpose of
sale).
_1. as owner of the propeity. am exclusively contracting with licensed contractors to construcx the project (Sec. 7044. Business
and Pnoftssion Code: The Contractor's License Larv does not apply lo an o$,ner of propcrty who builds or improves thereon.
and rvho contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's License Law).
_l arn exempt under Section_. B. & P.C. for this reason.
Date:_Owner:_
}VORKERS' CONT PENSATION
DT,CLARATION
I hcreby affirm under penalty of perjury one of the follorving declarations:
-l
have and rvill rnaintain a Certificate of Consent to Self-lnsure for rvorkers' compensation. as provided for by Section -3700 of the
Labor Code. for the pa'formancc of the work for rvhich the permit is issued.
_l have and will maintain rvorkers'insurance. as by Section 3700 of the Labor Code. for the performance of
,carrier and policy number are:the rvork for which this pennit is issued.
Carrier: '
Policy Number: '
a
_Expires:
-l
certify that in the perforrnance of the work fur which this perrnit is issued. I shall not ernploy any person in any manner
so as to becorne subject to the rvorkers' compensation larvs of California. and agree that if I should become subject to the
rvorkers' cornpensation provisions of Section -3700 of the Labor Code. I shall. forrhrvith comply rvith thosc provisions..
WARNING: Failure to secure s'orkers' compensation coverage is unlarvful. and subject an onployer to crirninal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the of comlrcnsation. damages as provided for the
Section 3076 of the Labor Code. interest and attorney's fees.
l)1,.('1.,\ll.\ l'loN
I hereby affrnn 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 effect.
License Class: '_l-icense a [c, zs I
orrr,- ll 44 Contractor,(--
CONSTRUCTION LENDING ACENCY
I hmby alfim undo penalty of pcjury that thqe is a orotruaion bnding agocy for thc pcrfommcc of thc wrk for which this p€nnit b
isued (Sa. 3097, Civ. C.).
l.crrrlcr 's Niurrc.
Lender's Address: _
APPLICANT DECLARATTON
I herelry aflinn under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Titlc 40. Part6)
_Required Letter of Notification
rernovalare not applicable to this project.
above infonnation w'ith all City and County
and
above rnentioned property for inspection
Applicant or Agent Signature: >L l)ate: -
qPernritee nRnre (print):
LT
hereby County to enter upon the
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aa
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