HomeMy WebLinkAbout20173853 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
PermitCounter: (714) 647-5800 lnspection Requests. (714)667-2738 lnspector Section: (714)647-5853
Permit #:20173853
Pin #: 71777
N,N
Proiect Address: 2366 N Riverside Dr-a-
Assessor's Parcel: 002-133-27 Lot: 111
Unit:
Block: NA
Bldg:
Tract: 425
Address Range:
Historic: Yes
Suite Range:
Zoning: Rl
Owner.
Address:
Michael Mustafa
2366 N Riverside Drive
Santa Ana, CA 92706
(eoe) 615-8666
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777C
Fee Type
Serv Meter
General Plan Update
I ssuance
Microfilm Records
Amount
57.40
23 79
59.30
405
Qty
1 .00
100
100
1 .00
Fee
$s7 40
$23 79
$5e 30
$4 05
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field
Building Permit #:
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
lssuance, or if the work authorized on fhe srfe by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Electrica I
web_user
Occupancy:
Constr Type:
Code:
Date:
Date:
Date.
R-3
VB
cEc 2019
07 t23t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Total
Notes: Electrical
Fee Total
Paid to Date:
Balance Due:
N/A - No
N/A - No
Balance
Balance
$144.54
$144.54
$0.00
lnspector MtD# 2021-167629
ELECTRICAL.INSPECTOR RECORD
Dr'.r nO n7 On1tr
APPROVALS DATE !D/SIG.COMMENTS OWNERBUILDERDELCARATION - I,
I hercby affirrn under penalty of prjury that I an cxempt frcm the Conteto6' Liccnrc [aw for thc following rcarcn (Ss.7031.5
Busincss afll Profcssion Codc): Any City or County which rcquires a ;rmil to construct. allcl improvc, dcmlish or rcJtrir aoy
structurc, Irior to its issuancc, ds rcquircs lhc applicmt for $uch pcrmit to filc a sigrcd stltcmnt lhat hc or slrc is liccnrcd pumant
to thc povisions of thc Contr{ctor's Liccnsd [jw (Chaptcr 9. Commncing wilh Sstion 7000 of Division 3 of thc Busincss rnd
ProfessionsCodc)orthathcorshciscxcmptthrcfrommdthcbasisforthcallcgcdcxcmplion. AnyviolstionofscctionT03l.5byany
applic8nt for a pcrmil subjels Ihc applicant to a civil pcnalty of not morc th.n fivc hundrcd dollars ($500).
_1. as owncr of lhc propcrty. or my employecs with wagcs as thcir solc comlrcnsation. will do thc work and thc stnrtue is not
intcndcd or ofl'cred for salc (Scc.7M4. Busincss and Profcssions Codc: The Contractrlr's Liccnsc Law docs not apply to an owncr of
thc propcrty who builds or improvcs thcrsrn. arxl who docs such work himsclf or herself or througih his or hcr own cmployces.
providcd that such improvcrncnts arc not intendcd or offcrcd for sah. If. howcvcr, thc building or improvcrrcnt is mld within one )tar
of complction. the Owncr Buildcr will have tlrc burdcn of proving that hc or shc did not build or inrprove the propcrty for thc purprse of
sale).
-1.
as owncr of the propcrty, am cxclusivcly contracting with licenscd conlraclors lo construct thc project (Scc. 7W. Busincss
and [lofcssion Codc: The Contraclor's Licensc Law does not apply to an owncr of propcrty who builds or improvcs thcreon,
and who conlracls for such projccts with a Contractor(s) liccnsed pursuant to thc Contractor's Liccnsc Law).
-lamexcmptundcrSection-,B.&P.C.forthisrcason.Dale:--0wner:_
wortKF rts, coMPENsATroN
DECLAITATION
I hereby affrm undcr pcnalty of perjury one of the following dcclarations:
-l
havc and will maintain a Certificate of Consent to Self-lnsure for workers' compcnsation, as providcd tbr by Scction 3700 of thc
Labor Codc, for the lrcrformancc of thc work for which the pcrmit is issucd.
-l
havc and will maintain workers' comSrcnsation insurance. as rcquircd by Scction 3700 of thc l-abor Codc. for thc Jrcrformance of
the work for which this permit is issucd. My workers' compensation insurancc carricr and plicy number are:
Policy Number: Expires:
-l
ccrtily that in thc perforrnancc of the work for which this permit is issucd. I shall not cmploy any pcrson in any manner
so as to bcconre subject to the workcrs' cornpensation laws of California. and agrce that if I should becomc subject to the
workcrs' compcnsation provisions of Scction 3700 of thc l-:bor Codc. I shall. forthwith comply with thosc provisions..
WARNING: Failure to sccurc workers' comF,cnsation coveragc i.s unlawful. and shall suhjcct an crnploycr to criminal pcnaltics and
civil fincs up to onc hundrcd thousand dollars (S100.m0). in addition to lhc cost of comfrcnsation. darnages as providcd for the
Scction 3076 of thc [:bor Codc, intcrest and attorncy's t'ccs.
Date: Applicant:
LICENSED CONTRACTOR
DT'CLARATION
I hercby affrm under penalty of pcrjury that I am liccnsod under provision of Chapter 9 (comrnencing with Section 7000) of Division 3
of the Business and Professions Code. and my liccnsc is in full forcc and effect.
License Class: License Number:
It..r^.
W
I hcrcby afftrm under pcnalty of Frjury that thcrc is a @nstructhn lcrding agcrcy for thc lErformrcc of thc wmk for which this tEmit i!
issucd (Se. 3097. Civ. C.).
Lcndcr's Narnc:
lrnder's Addrcss:
APPLICANT NECLARATION
I hcreby allirrn under pcnalty of perjury onc of thc following declarations:
Dcrnolition Pcrmits-Asbcstos Notification Fedcral Rcgulations (Title 40. Purr6)
_Rccluircd Lrttcr of Notification
-l
ccrtify that thc fcdcralregulations rcgarding asbcstos renroval arc not applicablc to this project.
_l ccfrify thnt I hvc rcad this application ild srotc th.t thc above infonmtion is corccl. I agrc lo comply wilh all Cityand CouDty
ordinanccs ond Statc laws rclating to building construction. and hcrcby aulhorizc rcprcrcntativcs ofthis Cilyond Counlyto cnlcr ulnn thc
abovc nrcnlioncd prcpcny for insfEtion purtDrcs.
Applicant or Agent Dule:
I'rrurilt c nltnr ( llrint):
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under SIab / Floor lt l, t A"
Bondinq I Groundinq I UFER ulVlLr wa/e\0ra
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinss (Hard & Soffit Rouqh
Ceilings (T-Bar Roush)^t I ,A
N/eter Release TTbt tutfu&fi)
I
Rough fl A/^aService N/eter 'v{12,:w ^a
FINAL I Tm,h &y'nt Ylm6
Notes, Remarks, Etc lt
Carrier: