HomeMy WebLinkAbout20222496 - PermitCity of Santa Ana
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Electrical Permit #: 20222496
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 k
Project Address: 932 W First St Suite:
Block: P
Bldg:
Tract: HEIL
Address Range: 928-932 *
Historic: No
Suite Range:
Zoning: C2Assessor's Parcel: 008-1 44-03 Lot: POR I, POR I
Owner:
Address:
Angela Rodriguez
1615 Dewey St
Santa Monica, CA 90405
(31 0) 4s24700
Fee Type
Light Fixture
lssuance
Amount
0.75
23.50
Qty
1.00
1.00
Fee
$o.zs
$23.50
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder o
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Type of Work:
Nature of Work:
Single Family Dwelling - Dc Constr Type
Alteration Occupancy:
NV Code:
VN
R3&U1 Notes: Legalize light fixture.
Planning Conditions: Place Shield On Light Fixture.a
Planning Approva! By:Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Plan Checked By:
Permit lssued By:
Subject to Field:
$)c"rares,Janet 1111412002
Building Permit bl Fee Total:
Paid to Date:
Balance Due:
$24.25
$0.00
$24.25
This permit shall expire by limitation and become null and void if the work authorized by this permit
is not commenced within 180 days from the date of this permit, or if the work authorized by this
permit is suspended or abandoned at any time after the work is commenced for a period of 180 days.
Before such work can be recommenced, a new permit shall be first obtained to do so.
Account #: 01 1-01-5913 lnspector
t
ELECTRIGAL.I NSPECTOR RECORD
APPROVALS DATE lD/slG.GOMMENTS Owns-Buildd Dccluation
I hacby affim und6pcndty of pcrjury that I m cxmpt fm thc Contrrcon'Liccnsc Law for thc following rcuon (s@.7031.5 Buins
md Profssion Codc): Any City or Conty which rcquitc a pcmit to @nstruct, altcr, improvc, &molish or rcpair ily structurc, prior to its
isuurc, also rcquirc thc appliot fd such pcmit to filc a signcd Etat@mt that hc ff shc is licmscd pmuut to thc provisions of thc
Confe-tor's Licmcd L8w (Chapta 9, Cmmcing with Setio 7000 of Divisiff 3 of thc Bwins sd Prcfsiffs Codc) or thar hc or
shc is cxop thcrcfrcm ud thc bsis ftr thc allcgcd cxmprion .Any violarion of Scction 703 t . 5 by uy applicut ftr a Fmil subjccb thc
applicmt to I civil pflalty of not morc ths fivc hundrcd dollm (t500).
_1, c omo of rhc Fopcrty, or my mploye witb wags u thcir solc mpqralio, will do thc work md rhc smctw ir not intadcd
or offccd fc salc ( Se.70,14, Bwitre ud Prcfdims Cod!: Thc ConErctry's Lic@c Law dm not apply to u omr of the propcrty
who buil& or improve thcrcq ud who dG such wort hiruclf tr h6€lf 6 thrcugh his o hcr own cmploye, providcd tha! such
improvmqts e not intcndcd q offcrcd fo salc. If, howcva, thc building or improvoar is sold within onc yca of @mplction, thc
Owna-Builda will havc thc burda ofproving thar hc u shc not build q improvc for thc purpcc of salc).
_1, s owncr of thc prcpcrty, m €xclsivcly cmredng with limscd contrrcton to @nstruct thc prcjcct ( Scc. 7044, Bsinss md
Profsion Codc: Thc C-ntretor's Licsc lsv ds not apply to u ownq of prcpcny who builds q irnprovs thmn , md who
contrels fq such prcj@B wi$ 8 Contreto(s) licascd pmmt ro thc Cotrrctor's Liensc Law.).
_l un Section & P.C. for this reason.
Date:
I hercby affirm und6 pcnalty of pcrjury onc
_t havc md will mintain a CdtifiBtc of Crnscnt o SclfJnsurc for workc6' compcnsation, o providcd fa by Scction 3700 of lhr
Labor Codc, for thc pcrfmue of thc wqk for which thc pmir is issucd.
_l havc ed will mainuin wqkm' compemation iroume, a rcquircd by S4tion 3700 of thc Labq Codc, for thc pcrfommcc of thc
work for which ttis pqmit is iisucd. My wq&6' compqrsalion insurue cuia md policy nmbq sc:
f"#.,.
Policy Number Expires:
(This section nr or less)
{cettitythat in the pcrformancc of the work for which this pcrmit is issued I shalt not ernptoy Bny pcrson in any manner so as to
bccame subject to the workcrs ' compensation laws of California, and agrec that if I should bccomc subject to the workers'
of Scction 3700 of the Labor Codc, I forthwith comply with thosc provisions..
Failurc to secure workers'coverage is and shall subject an employer to and civil
fincs up to onc hundrcd thousand dollars ($ 100,000),in addition to thc cost of compcnsation, damages as providcd for
the Labor Codc, interest and anorney's fees,
Scction 3076 of
LICENSED CONTRACTORS DECLARATION
I hcrcby aflim undo pcnalty ofpcrjury thar I m lienscd unda provision of Chapts 9 (commcncing wirh Scction 7000) of Division 3 of
thc Bwircs ild Profsions Codc, ud my liccnsc is in full fre od cffct.
Liccnse /-t ^...Liccnsc Numbcr
Date' Contractor:
W
I hmby afhm und6pcnalty of pojury thd thsc is a mtruction lodinS agocy fcthcpcrfoma@ of thc work forwhich this pcmit is
i$ucd (Se. 3097, Civ. C.).
Lad6's Nmc:
lrnder's Addrcss:
APPLICANT'S DECLARATION
Dcmolitio Pcmits-Asb6tc Notifi€tion Fc&ral Rcgulations (Titlc 40, PsIt 6)
_ Rcquircd L.tt6 ofNotificatim
I crniry thst thc fcdcral rcgularios rcgddinS abcsts rcmovd uc not 8pplicablc ro $is prcjcct.
{t **y tt.ttt rtc rud thir applicaio ed ststc u..t thc $ovc infmatim is cmcr t agr* ro ffiply with i.ll City dd County
ordinances and State Laws reluing ro building
above mentioned property PurPoscs.
and hereby authorizc rcprscntativcs of this
I
and to enter uPon thc
Site-Work
Underground /
Pole Bases ,L4- /T)1,/tUn l,fr ND
Lightg a*{/r/4"2 (L/-4/\;-..,-
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Eromunications Cablert
Building
Under Slab / Floor
Bonding I Grounding / UFER
Transformers
Torquing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilings (Hard & Soffit Rough
lings (T-Bar Rough)
Release
Rough
Service Meter -- ./,/,
FINAL ffi,<,
^))Notes, Remarks, Etc.J.\---l