HomeMy WebLinkAbout20166503 - PermitCity of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-19), Santa Ana, C492702 Electrical Permit #: 20{66503
Pin #: 67664lnspection Requests: (714) 667-2738 lnspector Section: (714\ 647-5853
Proiect Address: 121 E St Gertrude Pl Unit:
Block: B
Btdg:
Tract 284
Address Range:'119-121
Historic: No
Suite Range:
Zoning: R2
E
Assessor'sParcel: 403-154-15 Lot: POR 24
Owner:
Address
Anthony & Rachel Hovorka
2774 Mallard Dt
Costa Mesa, CA 926262234
(310) 266-3447
01 '1 16002 5160:
011 16002 5't60c
011 16002 5160:
Fee Type Amount
Demolition (includes rer 48.46
General Plan Update 22.08
lssuance 55.04
Qty
1 .00
1 .00
1 .00
Fee
$48.46
$22.08
$55.04Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
P hone Bqt':h+r4499(r - I /21/2ttt1
Off icer iiYH TronB+: ,
!,:ct+ r Rei+:hiEpt+r0?331024 - ?/24/2it1qlronsqct ion TotsI
Ill .l
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance;
Carrier:
Policy #:
Expires:
It-ll. '
SJ 1U
4nthone { i.:ilEhel HovorliR
Building Use:
Job Type:
Nature of Work
Duplex
Miscellaneous
Remove Elect
Occupancy:
Constr Type:
Code:
R-3, U
VB
cEc 2016
oenerol Plon UpdqLe Feel:Il1I600?- :t6urtu0tt-Electr i.ol
011160tr?- :1603tt0tr-ICL Che,:k l2n3
Noles
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Bualding Permit #;
w Hernandez, Kathy
Date;
Date:
Date:07t2412014
Account#
Misc. Receipt:
Misc. Receipt:
lvlisc. Receipt:
Total
Every pemit issued shall become invalid unless the wo* on the site
aulhorized by such pemil is commenced within 180 days after its
lssuance. ot if the iitork authoized on the site by such permit is suspended
ot abandonod for a peiod of180 days after the time the work is
commenced.
$22.08
$103.s0
$125.58
$0.00
$125.s8
lnspector MID#: 2018-144857
01 1 16002 51600
01 1 16002 51603
Fee Total
Paid to Date:
Balance Due:
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER I'ELCARATION
I ncahy amrd lnder penrlry,,f pctory rhll I o ci€nrr fmm rhc Conr,acrod l-i.en\c liw i(r rhc following Rrsn (sc.7011.5
Busincs and Proic$ion Cd.): Ant Cily or C.unry Bhi.h r.quircs r ,l.nnn lo .onstd.t. alrcr. i'n!rov.. dcmlish or rc,'ot any
(rucrurc. lrior ro ns ksuone. rlso rcqunes rhc imliconr for such I'emi o filc a shncd sllrcm.r rhar hcor\nc !r li.cnsd pu^n{nr
ro rhc Fovi\ions olrhr Conrractr\ l-i.cnrd ljw (Chlrrcr 9. c(,dn fting uith s..rion 7000 of Division 3 oflhc Bnsirc$ and
Piutesi.ns Codc) or rhrr hc or sh. ircxcopr rh.rcfrom od rhc lEsis rorrh.alL!.d.xcmprion. AnrviolorionofScclionT0ll.5l,yany
+!li.anlrorapcrmirstrbj.chrhc.mlica.rron.irilp.naliyornotmmihan6vchundrcddollors(S5m)
I. .s ostrn of rhc lrolrdy, oi
'ny
cflplqN! wirh wrgc\ rs rhcn v,h co rf.n.dr on. will lo rhc { (,* mJ rh. nflduru is mr
inrcndcn oroftrcd fo! slc (S( 7044. Dtrsincss.nd ProL$ioN Codcr Thc Co racroisLicen{l,rwdocsnortrPplyrornowncror
rhc poFny who huilds or iml,orc\ rlEmn. lnd *h. docs sch wo* hinNcllo! hcrclior rhrDsh hi\ or hcr own cn'tlortcs.
phvidcdrh iu.h nnln,wftnkm n imcndcd or omcd for eL lt lx)sclri rhc hiklin! or inlrx,vemnr n $kl withii onc ,qtr
ol co !,Lr [m. rh. Orftr auil]s will hrvc rhc burdcn ol prNin3 thll fu or shc did nor huild or inrrn)r rtc pmFny fir rhc puryns oi
l. aso$Dcroirhcnn|Eny. trnrcx.nNivclyconrr.dnrr wnh li.ctrscd contrrns ln drxrrud rhc proj.ci (Scc 7014, Bu\irc$
rDd rhnts{i Codc:ThcCotrtr.roasLiccn\.Lrsdocsforrlplybnn.q $.rl(,pc y uh. brildsor tnttur.s thcrc.tr.
rntl *ho conkrcr\lnr \uchpri.(r\Nirhr (inrrru(r) li.pur\unnl lo rte Contr0cnn s Liccn$ hN)
I ri,.rrnr|n undcr sccti{nr
IIEII.ABAIIAN
I herchyamrn undcr pcMl'y ot psjury onc ofrhc follosins dcclaorions
-lh!!c{dwillnunaill.CcriilhatcoiCotrscfllr.sclrlnsurcrorerkcs'compcns.rion,aspmvidcdlorhrScclbn:17(l,olrhcLabor Oodc. lor rh. t.rforfrncc ol rhc vork fd whi.h rhc Frmir i\ irsucd.
rhc work f{trrhich rhis pcrhir i\ i\\u!al Mysuic$ conrpensarion insulrn.c crric. r F)licy nu'nb$rc
l.cdily thrr in rh. p.rfonmmc olrh. work for shi.h this ltnnir t i(sud- I shall Nr cnrploy ony lcnon ir atry mrnnc,
n r b lf,om su$jd b rhc rorkcn' conrr.nsarn,n hw\ olCulifoni!. aad ogrcc rld irI should bccoft \ubtcr t, rh.
(orl.ri co'np.n\rrionpfl,visn,n\ofS(rin17ff)otrhrlntxtrCode.lshrll.n,nhwirh.o lllywrihrhoscpn'visions..
WARNINC: lailurc to surc rorkcn' conp.Darion
civil fincs u0 ro onc hundrcd thousond dnllm ($lOU
Setion.1076 ofthc L$or Codc. inrcrcst lnd 4nomy s
Dde: Appllcnl:
I rn cmnl,),cr n) rifri',alF-mlric\ n
nrllc,srii,r drn g.! r\ fnirnlcd lnr rh.
DECI.AEAUAN
I h.rby nmrd undcr ri.nak, ol p.riurr rhar I ad licenEd undcr EovnionolChrprd 9(conmRing *nh sft'htr r0tn) olDivision 1
of dc Ausim$ nnd Poti$ions Codc. ud my licrns ir tull lorcc md cifcd.
COISIBIJCtrON.LE DINGACDNCI
I h@hy aftirn lnder p.nahy ol Frjury rhd rh@ i* a ..nnrudi.n hnding rgcfty lor ln. penonum ol rh. so* for which lhis Frmil is
isslcd (Scc. 309'r, Civ. C.)
AIIIICANLDECLBA.II!]N
lMy.fmlnd pemllyof pc,jlryoncorltcfollowin8dcclaErions:
lxnblilion Pcrmns.AsiEslos Norificalion Fcdcrsl R.Eulnlio.s Onlc 40. Pan6)
-Rcquncd
Lcllcr ol Notiarc ion
I ccnilyrhrr (hc f.d.nl r.guhrt)n\ mg&li',g nsbc{os rcRxrl rr. norrpFli.nhlc b rht UojLrr
-l
ccnilylhll lhrvc rcodlhh rnplicllion ihd thc r6ovc nrn)nn ior i\ cor.cr I i8rm h co ,tl
. rcn,r*nrrri!.\or rhn ( irordirtrtrccs lnd Srorc Lnwsrlrin8 ro bu
rlhlc nrnrioncd ptupcny i(tr insDccr
ADplacanl or AA.nl SiAMhrre.
ral
){ h rll 9t y Jn'l C/td y
vd corrhyro.nrlr unon Lh(
$u(ct
Un derground
Pole Bases
Light Standards
S pas, Pool, Fountains
Signs (monument)
Lile Safety /Low Voltaqe
Fire Alarm i Dampers
Communications Cable
Building
Under Slab / Floor
Bonding / Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rouoh
Ceilings (T-Bar Rouoh)
It/eter Release
Rouoh
,t
FINAL filqr llK 'thty**)?*,T_T-tr -----------_Notes Remarks, Etc
Site-Work
Service IVleler
l
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