HomeMy WebLinkAbout20174357 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #:20174357
Pin #: 24459
Project Address: 1001 N Westwood Ave
Assessor's Parcel: 405-231-28 Lot: 3
Unit:
Block: NA
Bldg:
Tract: 1558
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address.
Phone:
NICOLE VERMILION
1OO1 WESTWOOD AVE
Santa Ana, CA 927032239
(949) 422-6404
Donald F Holly & Sons lnc
209 S Richman Ave
Fullerton, CA 92832
(7141 32e-s832
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777C
Fee Type
Serv Meter
General Plan Update
lssuance
Microfilm Records
Amount
57.40
23.79
s9 30
405
Qty
100
100
100
100
Fee
$57 40
$23 7e
$s9 30
$4 0s
Bnt,ch*:6ttBoi
Ul'i' I Ce: i:T yH
rt--rArtlLL [, ] r
Rcpti I tt34 t+7'i
I nonsflcL r on
f / t+/ tt-ttt'rfin E* : g
Ref *:
it t'i t t it tT'
I D: NF, I NEDf1of1
2rr 1 '7 +317
1t:r; 39 AH
ri+4.11
State Lic #: 814223
Lic Type: C-10
Bus. Lic #: 336239
,Workers' Compensation lnsurance:Carrier: Truck lnsurance Exchange
Policy #: C09441240
Expires: 1110112021
lon0ld l' HoIlv
Upgrade/Hand out given.
T2J
rl16
t1
tt11
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Building Use:
Job Type:
Nature of Work:
Planning Conditions
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Zuniga, Allissap 09t24t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes.
Fee Total
Paid to Date:
Balance Due:
Single Family Dwelling
Miscellaneous
Service Meter
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cEc 2019
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 sife 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
01 1 16002 57770
$23.79
$1 t 6.70
$4 0s
$144.54
$0 00
$144.54
lnspector MID#: 2021-16902 1
C
ELECTRICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEITARATION
I hrcby allirm undr pcnalty of pajury thar I m cxempt fipm thc Conusctoo' Licoc Law for thc following rcon (Se.7031.5
Bsincs illd Profsion Codc): Any City or County which rcquirc a ponit to @Ntruc1 alta. improvq donolish or rcpair oy
structu.q prior to its isumcc. also rcquirc thc applicat for such pcmit to filc a signcd stat@cnt that he or shc b licoscd pt$mt
to thc provisiore of the Contractor's Licoscd taw (Chspts 9, Commcing with Sation 7000 of Division 3 of thc BBins md
PrcfcsionsCodc)orthatheorshcisqanptthrefromedthcbssisforthcallegedcxmpion. AnyviolationofSetionT03l.5byany
applicant for a pemit subjets thc applicut to a civil pcnalty of not morc thm livc hundred dollrs ($500).
--1,
as owner of the property, or my cmployecs with wages as their solc compensation, will do thc work and the structure is not
intcnded or offered for sale (Sec.7044. Business and hofessions Code: The Contractor's License l-aw does not apply to an owncr of
the propcrty who builds or improves thcron, md who does such wort hirnself or hcrself or through his or her own employees,
provided that such improvanents are not intcnded or ofFood for sale. If. howerrer. the building or improvemcart is sold wilhin one )€zr
of cornplaion, the Orvner Builder will have the burden of proving tha he or she did not build or improvc the propoty for the purposeof
sale).
-1.
as owner of the propcrty. am exclusively contraciing with licersed contractors to con$ruc1 thc project (Sec. 7044, Busiricss
and hoftssion Code: The Contractor's License Law does not apply to an owner of property who builds or irnproves thereon,
and who contracts for such projects with a Contracto(s) licenscd pursuant to the Contractor's License t aw).
-l
am exempt under Sc<tion-, B. & P.C. for this reason.
rloto.
WORI(ERS' COMPEI\ SATION
DECLARATION
I hereby affrrm under penalty of perjury one of the following declarations:
-l
have and will maintain a Certifrcate of Consent to Self-kxurc for workers' compensalion, as provided for by Section 3700 of the
I-abor Codc, for the pcrformance of the work for which the pcrmit is issued.
-l
have and will maintain worksrs' compcnsation insurancc, as requircd by Section 3700 of the Labor Codc, for the performance of
the work fqg which this permit is issued My workers' compensation insurance carrier and policy number are:
Policy ./l 3o -zr
_l cerri$ that in the perforrnancc of the work for which this pcnnit is issued. I shall not employ any pcrson in any manne{
so .rs to becorne subject to the workers' compensation laws of California, and agree that if I should becorne subject to the
workers' cornpensation provisions of Section 3700 of the labor Code, I shall. forthwith comply with thosc provisions..
WARNING: Failure to secure workers' compensation coveragc is unlawful, and shall subjcct an anployer to crirninal penalties and
civil fincs up to one hundred thousand dollars ($100.000), in addition to thc cost of cornpensation, damages as provided for the
Section 3076 of the Labor Code, interest and attorney's
I)ECI,AITA'I'ION
I hereby affurn under penalty of perjury that I am licensed under provision of Chapter 9 (comrnencing with Seqion 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
License
I hereby aflirm undcr penalty of perjury that thcre
issued (Sec. 3097, Civ. C.).
l,ender's Name:
aSency performance of the work for which this po'rnit is
Lender's Address:
APPLICANT DECLARATION
I hcreb}/affinn under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
-Required
Lettcr of Notification
_-l ccrtify that the federal regulations regarding asbcstos removal are not applicable to this project.
-l
certify that I have read this application and state that the above information is correct. I agree to comply with all City and County
ordinancqs and State Laws rclating to construction, and hereby authorizc representatives of this City and County to ent€r upon the
above mentioned property for
Applicant or Agent
Permitce nnme
J*",3q-llzt
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm I Dampers
Communications Cable
Building
Under SIab / Floor
Bonding I Groundins / UFER l*'?-zl c>-4 4t
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilings (Hard & Soffit Roush
Ceilinqs (T-Bar Rouqh)
Meter Release lo-2-? t D-P {.,1_
Rouqh t D -', -2t <l.l.-.gl ttl
Service Meter lo- 7 -2 t \;
FINAL lo -? -2- //{ r{z
Notes, Remarks, Etc.
Dr.rr na n7 nnltr,
c*,io, 7M frXss I
oerc: 7-? /-2-,/
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