HomeMy WebLinkAbout20166815 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, CA92702 Electrical Permit #: 20{ 668{ 5
Pin #: 24980
l nspection Requests: (7 1 41 667 -27 38 I n spector Section: (7 1 4) 647 -5853
Project Address: 11 15 S Shelton St Unit:
Block: NA
Bldg:
Tract: 557
Address Range:
Historic: No
Suite Range:
Zoning; R1
br
Assessor'sParcel: 013-061-06 Lot: 59
Owner:
Address:
Graciela Lopez & Sergio Arargon
l1l5 S Shelton
Anaheim, CA 92802
(714) 398-6342
01 1 16002 51603
01 1 16002 51603
011'16002 51603
01116002 51603
01116002 51603
01 1 '16002 5'1600
01 1 16002 51603
Fee Type Amount
125 Volt Receplacle 1.45
Light Switches, Occ. Se 1.58
Light Fixures '1.05
FWU 24.79
Serv Meter 53.28
General Plan Update 22.08
lssuance 55.04
Qty
4.00
3.00
4.00
1.00
'1.00
't.00
1.00
Fee
$s.80
$4.7 4
$4.20
$24.79
$53.28
$22.08
$55.04
Phone:
Tenant Name
Contractor
Address:
Phone
Building Use: Single Family Dwelling Occupancy:
Job Type: Alteration Constr TYPe
Nature ofWork: Fire Damage Repa;d5grv lvlgCode:
R.3, U
VB
cEc 2016 Notes: Fire damage repair to hallway & (1) bathroom.
Remove/replace (e) electrical fixtures. Upgrade serv
meter/handout given.
Planning Conditions: lnterior work only
Planning Approval By Date:
Date;
Date:
lvlisc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Plan Checked By
Permit lssued By
Subject lo Field:
Building Permit #
efl 08/30/2018
Account#
0197569 $22.08
$147.85
$169.93
$0.00
$169.93
Every perfiit issued shall become invalid unless the wo* on the site
authorized by such pefinit is commenced wilhin 180 days after its
issuance, ot if the wotu aulhoized on the site by such perrnit is suspended
or abandoned tot a peiod gf 1 80 days after the tima the work is
commencecl.
lnspector MID#: 2018-145780
01116002 51600
01 116002 51603
Fee Total:
Paid to Date:
Balance Due:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensalion lnsurance;
Caffier
Policy #:
Expires:
Owner-Builder
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Acct+:
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ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Salety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq / Groundinq / UFEFI llr I 4r\tuheVt >b)
Translormers I U I
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduil)
Walls (Rouqh)
Ceilinos (Hard & Soflit Rouqh
Ceilings (T-Bar Rough)vr)lvleler Release ry
I ,^lrt)Rough tr I I q4ufi
"rffi)Service lvleter Ir
FINAL I /:#tr
Notes, Remarks, Etc.,r\
OWNER AUILDER DELCARATION
I hcrcbt af6nn utrdcr pcnllry of lcrJury rhar I ut €renfl fon rh. conkr.k,^ Ltctrr bw lo,lhc lououine rcnsn lsec.7o.ll.5
Businc$ and Profcsion Co.l.): Any cny or Counry whkh r.qutcs a Pcirnil to .on{tucr. dr.r, imrorc, dc."l"h ". .1,"" ";yddcrurc. orb ir{ irsx n.c..l$ rcquircs thc spllica nlr sucn [Ennil io liLa si8trcd sarcmnl th hcot shc h li&n\cd ruAU,
k,lhe pmvkions of llrc Conlmcror\ Licc.sd tiw (Ch!p(tr 9. ConrmNins wirt Secrion ?fix) or Divirion ] ollhc Businc\s aid
ProrcssbnsC.d.)orrharlrorshciscxcmptlhcEfrnmandlhcboshforlneullescdcrcnprion.AtrrvnnntionofS<rirn70:llshyrni
trppli.n tur , Nrnrn suhj.ch thc rrllicontloocivilFnolryofnolhorerhr.,lvchuMrendolhrslS5U))
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a\ ownerolrhc pnp.ny, {, my.mplorcs qnh waScs.s lhcir wlc co'npcnurn,n. will do rh. work ond lhc slnxruE n tun
i.tcndcd or ofcr.d i{tr elc (Sc.?o44. Busirc$ and Pretcsions Codc:-rhc Cuntadols Liccnsc Ls{ doer oor uPply to rtr o*rcrof
rhc Dmpcny wh, buikls or inlpn*.srh.en,a i uho dos such sd( himsclf or hcrcla.r rhmngh his or hcr own cmploFcs.
,n,vidcd rhd su.h i'nfmw$ e dn iolend or otrcEi tar sk I ll h.*e\rr. rh. boildin8 or in{mvcmnl is n,ki wirhin uic tor
otcompbrbn, rhd Owtur Buildd sill h.vc rtE hunlcn olprcvir8 rhor hc o, shc did mr huild d iqmvc rh. nm!.nr lor ih. Putbs.f
l. r\o*ncrofrhc rmp.dy, nDcxclu\rvcl, contnctins sirh licctred conrr.ttrsro cotr{nrcr rtE Proiccr (sN.701.,1, 3unrc$
rd PniL\sion Coitcr ThcConlrrcktr s t-i.tn* l-rw do$ norrt plyi.0nowncrofpropc ysh(, huildsot nnntolcs thcrcor
rnd slb co h.F ror such poic.G sirh r Conrmcbn 9 liccnsd puhurnr k, r ht (in rlcrois l.i.cnsc lf,w)
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will nBinrrin s Ccnifcdr of Conscrr lo Scli lNurc lor $ortcn $hpcis nrn. as Frvidcd lbr by S(rion :17{X) of th.
tilior C.dc. for Inc pcrfortuncc orrh. *$* foi *hich
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will frrinrah w.rkcB comrnsrlion insuroncc. rs rcquircd byscctdrlTmol th. Lshot Codc. f.rrhc t'c.fonn0ncc of
rhc sort ir which rhisp.rn r i\ issucd. My workcr' comt'cnsation insu.Mcc c,nid,.d r.licy nu.rbcr rc:
l.cnilyrh,r inrh. ncnbflmncc ('irhc sork fitr which rhnrennir is i$u.d.Ish.ll nolcmploy !nylc oninrtrymrtrncr
h .s ro hccom subjd ro rhc woik ri.dmp.nsrtnnt hws ol Caliloarid. ond r3re rh3r if I shonld t!.otm sublccr lo llE
*ol(cm coarpcnr ion pm!i\n,n\ of S*rion lT0O of rhc tntrtr Codc. l shsll. thdh*irh .o'nply *irh rhos fovGions
W,\XNINC Frilurc r' {cur. rorkcrJ c.nvLrs,lion orcrrlc is unlxstul. rnd \hrll \!bic! dr cnrl,loycr lo di'nir'd p.r'lric\ ttrd
civil incs up l,) onc htndrM rhous0nd dolla^ (X)). in i(ldirion b rhc co! of.otrfcn\dridr. drnuacs r( p(,vidcrl l(n rhc
Scctiu.llrT6 ofrhc I-ntrrCodc. inrcrcs rnd ull ro,.re\"r lpf e,Z-
I hcrcby dllrnr undcr pcmlryorFrjury ihai I am li.cn{d undcr pmvhion ol(hrprcr9(mnnxi.n€sirhSc.rionTlxx))otDni\n .l
CONSTRIICTION I FNDIN(I A(iENCY
I hcrchy ainm undcr rEnahyorp€iuryrhar rh.rc r..onsrd.rion hndinaascnc, for Ihc FrrornDmc ofrh. work tr *hich rhi\ Fmir il
i\sucd (sft. 1097. civ. c.).
AIILICANLIIESTTBAID!
I hltr,y rfim undcr pcn.hyofpcd!ryonc oalhe roU.*ing dc.ldarions:
ftmlirnr Pcrnrirs AsrEsos Nolificalion Fcdeml R.8u lat ions (Tirlc ,10. Pdn6)
_Rc+irtd btrcr of Ndiff,dion
! ccnilyrrlr !hc lcdeul'csul,rrnlreardrnS,.bc{.,.r.'tu\aldrc n.r,nnli$hr. r' rhr I,mKl
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r u* *,a,r^ JDnl'c,rnn 0,r1$n,c thd rh. liovc inromrion ir.olmr. I r8e ro.omply wlth alr (iry0nd loutrr,
ordinJnccsA\SErcb*.Eld'ngroburldrnScon{rucriotr.ndncrcbylurhdrizcrdpidc.nrariv.sollhisCilyandColnryt,cnlrunonlh.
ah^. nEi{iurctrnNny rnr in\Fcrinn DurD.e{;;:;#;;;c^""*-Oq fae-' - ,.,.,rlrchY -Grt..ie\a Lonez
Site-Work
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Policy NumlEr:-ElpiE*r
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of rh. Bx\incs,nd Prolt$ioN Codc- ffilmr licctrk i\ in llrll loN nnd cfitd.
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