HomeMy WebLinkAbout20168543 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:20{68543
Pin #: zslffu
Project Address: 123 N Jackson St
Assessor's Parcel: 198-25242 Lot: 147
Unit.
Block: NA
Bldg:
Tract: 540
Address Range:
Historic: No
Suite Range:
Zoning: R2
Owner:
Address:
Phone:
Alexander Dantes LLC
17300 Redhill
lrvine, CA 92614
(e4e) 383-830e
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
Fee Type
Air Conditioner
FWU
Serv Meter
General Plan Update
I ssuance
Amount
96.90
24.79
53.28
22.08
55 04
Qty
1.00
2.00
1 .00
1.00
1 .00
+
Tr
t es t-LC
Fee
$96.e0
$49 s8
$53.28
$22 08
$55 04
-*,?? nq'Ij 'i"rl t i-l U
$?5 4 , iill
$,*fl I /r $[t , f_,I
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
,/?-i,/ZirL? I0: qmornns*: 51 3 ,
Ref{: ?t-t1695
1/ ??j,/?[t 19 I : 32 F i11 $8 r /r80 .
,Poleslliaf6
+3
il
41
fienernl Plnn Uprtnte
01. 1 l6rrrJ?- 516{n_r0t;U-
F J e':tr' i ,:n I
tJ1 1 16ur:r:- 516rJ3!100-
I : L ,Ih e':k I?6?
Fee
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
W Hernan dez, Kathy 04t25t2019
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes:
Fee Totat
Paid to Date:
Balance Due:
Single Family Dwelling
New
Single Family Dwelling
Occupancy:
Constr Type.
Code:
Date:
Date:
Date.
R-3
SPK
cEc 2016
Buildins Permit #: 1 0197831
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 the site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01 1 16002 51603
$22 08
$254.80
$276 88
$0 00
$276.88
Botlrr
lnspector MID#: 2017-136574
ELECTRICAL.I NSPECTOR REGORD
f),..,fio rl-, fln { r:,
APPROVALS DATE ID/SIG,COMMENTS O1VNER BUTLDER DEI,CARATION
I hreby aflim unda pdalty of pdjury that I m cxmpt from thc ('ontncto.!' Liccnsc hw for thc followilg wn (Sa:.fr31.5
Busincs and Profesion Codc): Any City or County which rcquirc a psrnit to comtruct. alro, improvc, danoliJh or rcpair an'y.
sruduq prior to its issumcc. also rcquirc thc eplicilt for such pcmit to filc a signcd statmot thd hc or $c b licqEcd puslatn
to thc provisios of thc Contractor's Licenscd Law (Chaptd 9, Commencing with Sction ?000 of Division 3 of thc Busins ud
Profsions Codc) or that h€ or she is cxmp thqcfrom md the basis for th€ allcgcd exmption. Any violation of Sction 7031.5 by my
applicmt for a pcnnit subjets thc applicmr to a civil pcnally oftrol morc thm five hundrcd dollm ($500).
-1.
as owner of the prop€rty. or my employees with wages as their sole compemation. will do the work and the structure is not
intended or offerd for sale (Sec.7044, Business and hofcssions Code: The Contractor's License Larv does not apply to an orvner of
the property who builds or improves thereon and who does such wort himself or herself or through his or her own employees.
provided that such imp,rovonents are not intendcd or offcred for sale. If. howwer. the building or improvemslt is sold within one year
of complaion. the Orvner Buildcr will have thc hrden of proving thd he or she did not build or improve the property for the purpose of
sale).
-1,
8s owner ofthe property. am exclusively contracting with licensed contractors to construct the project (Sec. 7044. Busincss
and hoftssion Codc: The Contractor's License Law does not apply to an owner of property who builds or improves thereon.
and who contracts for such projects with a Contractor(s) liccnsed pursumt to the Contractor's License l-aw).
-l
am exempt under Section-. B. & P.C. for this reason.
l)rtlc: Orr rtcl':
WO RKE ITS' CONT PEN SATION
DECLARA'[ION
I hereby affrrm under penalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for rvorkers' conlpensalion, as provided for by Section 3700 of the
Labor Code. for the performance of the work for which the pennit is issued.
-l
have and rvill maintain workers' compensation insurance. as required by Scction 3700 of the l.abor Code. for the per-formance of
the work for which this permit is issued. My workers' compensation insurance carrier and policy number are:
Policy Number: Expires:
_l certify that in the perfonnance of the work for which this permit is issued. I shall not employ any person in any manner
so as to becomc subjcct to the workcrs' compcnsation laws of California. and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code. I shall, forthwith comply with thosc provisiotls..
WARNING: Failure to secure rvorkers' compensation coverage is unlawful. and an anployer criminal penahies and
civil fines up to one hundred thousand dollars ($100.000). in addition to the as provided fcrr the
Section 3076 of the Labor Code. interest and attorney's
Ior,..t-, -ZS -2c) ,)
I hereby afl'irm under penalty of perjury that I am licensed under Chapter 9 (cornrnencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
License
S'D)c
W
I hcby allim unda Fnalty of psjury that thqc is a @nsructbn lcnding agacy for thc psfomcc of thc mrk for which this pqmit is
issued (Se. -1097, Civ. C.).
Lender's Name:
Lender's Address:
APPI ICANT NECLAIL{TION
I hoeby affurn under penalty of perjury one of thc following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
-Required
Lettcr of Notification
-l
certify that the federal regulations regarding asbestos removal are not applicable to this project.
-l
certi& that I have read this application and state that the is I agree to comply rvith all City and County
ordinances and State Laws relating to building construction.of this City and County to enter upon the
above mentioned property for inspecrion
Applicant or Agent
Pernritee nttnrc D
authorize
l\^r ^.
t-l - 75-7o)1
Site-Work
Underground 65'e)lcc v r)
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm I Dampers
Communications Cable
Building
Under SIab / Fjqar
Bondins I C#undlnq / UFER '"-l ? ,? rs tuv 7
TransformeiH
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinss (T-Bar Rouqh)
Meter Release b-{1 4D tucz7 >/D J9=22 /-i z2
Rough
Service Meter 61f,3 14z /
F!NAL t-Z.Otl rLQ')re@)-)rl
Notes, Remarks, Etc.