HomeMy WebLinkAbout20172232 - Permitr-Proiect Address: 241 8 W Elder Ave-a
Assessor's Parcel: 109-1 23-04 Lot. 81
Unit:
Block. NA
Bldg:
Tract. 1346
Address Range:
Historic: No
Suite Range:
Zoning: Rl
City 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 #: 20172232
Pin #: 37691
-t/ -rt I
Owner.
Address:
Phone
LDM Properties LLC
909 W Walnut Street
Cerritos, CA 90703
(7141 501 -7269
t
t
Tenant Name:
Contractor:
Address.
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Addition
Addn/Remodel/Demo
Zuniga,Allissa
Occupancy:
Constr Type:
Code:
Date:
Date:
R-3, U
VA
cEc 2019
11t03t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Total
Notes: Electrical foraddition/remodel.
Fee Total
Paid to Date:
Balance Due:
Buirdins Permit #: 1 0110281 9
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 fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2019-152268
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23 79
$2e5 60
$4.05
$323 44
$0 00
$323.44
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 1 6002 51 60C
01116002 5160:
01 1 16002 5777C
Fee Type
125 Volt Receptacle
Light Switches, Occ. Se
Light Fixtures
Air Conditioner
Low Voltage/Res
Serv Meter
General Plan Update
I ssuance
Microfilm Records
Amount
1 .57
1 .70
1 .13
104.40
39 56
57.40
23 79
59 30
4.05
Qty
10 00
600
800
100
100
100
1 .00
100
1 .00
Fee
$15 70
$10 20
$9 04
$104 40
$3e 56
$s7 40
$23 79
$59 30
$4.05
APPROVALS DATE ID/S!G.COMMENTS
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildins
Under Slab / Floor
Bondinq I Groundinq I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilinqs (Hard & Soffit Rouoh
Ceilings (T-Bar Rough)
Nleter Release
Rouqh ,^..
Service N/eter
FINAL Q-71 4t ttil 03
Notes, Remarks, Etc.
\
OWNI,R BUILDER DIiI,CARATTON
I hereby affirnr under penalty of perjury that I am exenrpt from the Contractors' License [:w for thc f<rllowing, rcason (Sec.7031.5
Business and Prol'c.ssion Codc): Any City or County which rcquires a pcrmit to construct, alter. irnprovc. demolish or rcpair any
structure, prior to its issuance. also requires the applicant for such Srcrmit to fih a signed statemcnl that lre or she Ls licerrscd pursuant
to thc provisions of thc Contractor's Liccnsed law (Chaptcr 9, Commcncing with Section 70fi) of Division 3 of thc Business and
Professions Code) or that lr or she is exenrpt therefronr and tlre basis for tlre alleged exenrption. Any violation of Section 7031.5 by any
applicant for a pennit subjects thc applicant to a civil penalty of not nnre than five hundred dollars ($5ttO1.
_1. as owner ol'thc. propcrty. or my crnployccs with wagcs as thcir sole compcnsation, will do thc work and the structurc is not
interxled or offeretl for salc (Scc.7(X+, Business and Professions Codc: Thc Contractor's License Law docs not apply to an owner of
the propreay wlxl builds or inrproves thereorl arxl wlro dtrcs such work himself or lrerself or through his or lrer own employees,
providcd that such irnproverrcnts are rrlt interxlcd or olTcrcd for salc. Il. howevcr, thc building or inprovennnt is sold within onc )ear
of completion, tlrc Owner Builder will have the burden of proving that lr or slrc did not buikl or inprove 0re propary for the purposc of
sale).
_t.Busincss
ard tltereon.
and
_l anr exenlpt under B.
I hercby aflirm under penalty of pcrjury one of tlre tirllowing
_l have and will nuintain a Certifrcate of Consent to Self-Insure for workers' compensalion, as provided for by Section 3700 of thc
I-abor Code, for the performance of the work for which the permit is issued.
_l have and will maintain workers' conpensation insurance, as required by Seclion 3700 of the l-abor Code, for thc pcrfonrunce of
the work for which this pcrmit is issued. My workers' comJrcnsation insurance carrier and policy number are:
Carrier:
Policv Numbcr: Exoires:
_l ccrritythat in thc lrcrfornuncc of tlrc work frrr which this Jrcrmit is issued, I shall not cmploy any pcrson in any manner
so astobccomc suhjcct tothc workcrs'cornpensation lawsof California. and agree that if I should becotnc subjcct tothc
workers' conrlrcnsation provisions of Section 3700 of the Labor Cbde, I shall, forrhwith contply with those provisiotts..
WARNING: Failure to secure workers' compensation coveragc is unlawful, and shall subject an employer to criminal penalties and
civil fines up to one lrundred thousand tlollars in addition to tlrc danuges as provided for thc
Scction 3076 of the Codc, intcrcst and
4,,,
DI.]CT-ARATTON
I hereby affirnr under penalty of perjury tlut I anr licensed under provision of Chapter
of the llusiness and Professions Code. and my license is in full force and e[fect.
9 (conmrcncing with Sectbn 70m) of Division 3
License Number:
CONSTRUCTION LENDING AGENCY
I hcreby al'lirm undc'r pcnalty of grcrjury that thcrc is a construction hnding agcrrcy for thc performance of the work lbr which this pcrmit is
issued (Sec. 3097. Civ. C.).
Lender's Nanre:
[rnder'.s Address:
APPI,ICA NT DECI,ARATION
I hctcby afl-rm undcr pcnalty of pcrjury onc of thc folkrwing dc'cleuations:
Dcnplition Pcrnrits-Asbcstos Notification Fctlcral Rcgulations (Titlc 40, Part6)
-Rcquircd
lrttcr of Notification
_l certily that thc fedcral rcgulations rcgarding a-sbestos rcnnval arc not applicablc to this prolxt.
_l ccrtify tlral I havc rcad this applicatitxr and stalc thal lhc atxrvc infrrrnulion is corcct. I agrc.e to conply with all City and County
ordinanccs and Statc Laws rclating and hcrcby authorizc rcprcscntativcs oflhis City and County to entcr upon thc
above mentioned property for
Applicant or Agcnt
Pcrntilec nanlc
*,", tllAf an
ELECTRICAL.INSPECTOR RECORD
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for
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