HomeMy WebLinkAbout20170127 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Electrical Permit #:20170127
Pin #: 89340
"4Project Address: 1621 E Washington Ave
Assessor's Parcel: 400-286-06 Lot: 5
Unit:
Block: NA
Bldg:
Tract. 2648
Address Range:
Historic: No
Suite Range:
Zoning: R1
Owner:
Address:
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Richard Sanchez
1621 E Washington Avenue
Santa Ana, CA 92701
(714I- 3s3-0768
TLP Electric lntegrations db
2460 North Glassell Street, I
Orange, CA 92865
(714I- 92',1-1868
Fee Type
01116002 5160C General Plan Update
01116002 5777C Microfilm Records
Amount
22.95
3.91
Qty
000
000
Fee
$0 00
$0.00
State Lic #: 824287
Lic Type: C-10
Bus. Lic #: 343655
Workers' Compensation I nsurance:Carrier: STARNET INSURANCE COMPANY
Policy #: BNUWC01 37149
Expires: 0710112020
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By.
Plan Checked By:
Permit lssued By.
Subject to Field:
Single Family Dwelling
Solar
Solar
Smith, Mark
Hernan dez, Kathy
11t0612019
11t20t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Occupancy:
Constr Type:
Code:
Date:
Date:
Date.
R-3, U
VB
cEc 2016 Notes: lnstall roof mounted solar panels. FEES PD ON
1 01 102145
Buirdins Permit # 101 102145
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
lnspector MtD#'. 2019-155677
ELECTRICAL.INSPEGTOR RECORD
,-10 n7 ?n,t A
APPROVALS DATE !D/SIG.COMMENTS OWNER BUILDER DELCARATION
I haeby affinn unde penalty of pajury that I m erempt ftom the Contracto6' Licffi Law for the follorving rcNn (Se.70l1.5
Buines ud Profsion Codc): Any City or County which require a pei'mit to construct. alte, improvq donolish or rcpair uy
structue. pdor lo its isrilce. also requtB the applicot for such pctrnit to filc a signed statmqt thar hc or shc b licqsd pmuill
to the provisions of the Contractor's Liccnscd Larv (Chapl6 9. Commcncing with Strtion 7000 of Division 3 of thc Buins ud
Prcfsions Code) or that he or she is exonp thrcfrom ild the basis for thc alleged exmption. Any violation of Scctior 7031.5 by any
applicantforaptrmilsubj(tsthc applicanltoacivilpenaltyofnotmorcthufivchundreddollus($500).
- l. as owner of the f,roperty. or my employees with wages as their sole compensation. rvilldo the work and the structure is not
intended or offered for sale (Sec.7044. Business and hofessions Code: The Contractor's License larv does not apply to an orvner of
the progr,o'ty rvho builds or improves theron. and who does such $o* himself or herself or through his or her own employees.
provided that such improvonents are not intended or offered for sale. If. horvever. the building or imptrovement is sold rvilhin one year
of cornplaion. the O'wmer Builder rvill have the bnrrden of proving that he or she did not build or improve the propory for the purpose of
sale).
_- l. as owner of the property. am exclusively contracting with hcensed contractors to construct the project (Sec. 7U4. Business
and Profession Code: The Contractor's License Law does not apply to an ou'ner of property u,ho builds or impro!'es thereon.
and s'ho contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's License taw).
-.IamexemptunderSection-.B.&P.C.forthisreason.
Date:_Ou ner:
WORKERS' COIIPENSATION
DECLARATION
I hseby aflirm undq pcralty of pa'juryone ofthc following deluatioro:
-l
have md will maintain a Certificate of Coruol to Self-lruure for workm' compcnsation. rc prcvidcd for by Sction -1700 of thc
labor Codc for the pcfonnuce of thc wo* for which thc p6mit is i$ucd.
6avc and will rnainlain workm' compcmatiotr imumnce. c requircd by Setion 3700 of the t bor Code. for thc pqfomecc ofI thc work for which this pqmil b isucd. My workc' compcrsaion insumce cmia md policy numbo rc:
&a, " .-t lnSr n cu Cr(-aricr:
Poricy*,,*,, hV(4 LV L0 l3?lut K _E.rpires: _\
-l
cerlify that in the performance of the rvork for rvhich this perrnit is issued. I shall not employ any person in any manner
so as to become subject to the rvorkers' cornpensation las's of California. and agrc',e that if I should become subject to the
rvorkers' cornpensation provisions of Section .1700 of the l.abor Code. I shall. forthrvith comply rvith those provisions..
WARNIN(i: Failure lo secure workers' compensation coverage is unlarvful. and shall subject an employer to crirninal penalties and
civil fines up lo one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for the
Section 3076 (irtle. intercst and attorney's fces.t
g)
t)t,t('l,AtLt't tON
I hereby affinn under penalty of perjury that I arn licenscrl under provision of Chapto 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
le_l-icense
CONSTRUCTION LENDING AGENCY
I heeby alfirm unda pcrally of pqjury lhal lhqe is a consrucrion lqding agscy for tho pqfomce of thc work for which this psmil b
issucd (56. 1097. Civ. C.).
lrnds's Nanc:
Lender's Adclress:
APPLICANT DECLARATION
I hereby allinn under penalty of perjury one of the following declarations:
Demolition Permits-Asbcstos Notification Federal Regulations (Title 40. Part6)
-Required
lrtter of Notification
-l
cenify that the lHeral regulations regarding asbestos removal are not applicable to this project.
_ _l certify that I have read this application and state that the above infonnation is correct. I agree to comply s'ith all City and County
: representatives of this City and County to ent€r upon theordinances and State Larvs relating to construction. and hcreby authorize
above mentiond property for
Applicnrrl or Agcrrl Signnture: $.-
permireename(prinr): gl^EL
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm I Dampers
Communications Cable
Building
Under SIab / Floor
Bonding I Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilings (Hard & Soffit Rouqh
Ceilings (T-Bar Rough)
Meter Release
Rough t/
ServiceMeter /^ /tFINAL // {/Jo)a F*/) //
Notes Rema Etc.
License Class: C,",.,34 IS+
+- \ Contrrctor'(