HomeMy WebLinkAbout20172233 - 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 #:20172233
Pin #: 98985
Proiect Address: 241 8 112 W Elder4ye-a-
Assessor's Parcel: 109-1 23-04 Lot: 81
Unit:
Block: NA
Bldg:
Tract: 1346
Address Range.
Historic: No
Suite Range:
Zoning. Rl
Owner:
Address:
LDM PROPERTIES LLC Fee Type
New Res
New Garage
General Plan Update
I ssuance
Microfilm Records
Amount
0.16
0 16
23.79
59 30
4.05
Qty
s58.00
441 .00
100
1 .00
1.00
Fee
$8e 28
$70 56
$23 79
$59.30
$4.05
Phone:
Santa Ana, CA 92703
(7141 501 -726s
01 1 16002 51603
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777CTenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier.
Policy #:
Expires:
.a
Building Use Accessory Dwelling Unit-D Occupancy:
New Constr Type:
ADU w/att Garage Code:
R-3, U
VA
cEc 2019
Job Type:
Nature of Work:
Notes: Electrical for new detached ADU
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Zuniga,
Date:
Date:
Date:11t03t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Buirdins Permit# 101102820
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.
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23 79
$2 t 9.14
$4 05
Fee Total
Paid to Date:
Balance Due:
$246 98
$0 00
$246.98
lnspector MID#: 2020-157031
t
t
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDIiR DI',LCARATION .
I hereby affrnr under penalty of frlury that I aru exempt from the Clontracton' License law for the foll<lwing reason (Sec.7031.5
Busines.s and Profcssion Crxle): Any City or County which rcquircs a perrnit to construct, altcr. irnprove, dcrmlish or rcpair any
slructure, prior to its issuance. also requires the applicurt for such grernrit to fih a signed staternenl that lr or she is licerrscd pursuant
to the provisions of thc Contractor's Licenscd law (Chapter 9. Cornmencing with Scction 7fi)0 of Division 3 of thc Busincss and
Professions Code) or that lrc or she is exempl therefrom and tlre basis for tlre alleged exenrption. Any violation of Secti<ln 7031.5 by any
applicant for a pennit subjects thc applicant to a civil penalty of not nrcre than fivc hundred dollars ($500).
_1. as owner ol'thc propcrty. or tny crnploycc.s with wagcs a.s thcir solc compcnsation, will do the work and thc structure is not
interxlcd or offercd for salc (Sec.7O$4. Busincss and Professions Code: The Contractor's Licensc l-aw tloes not apply to an owner of
the pruperty wlxr btrilds or inproves threon, urd who does such work himself or lrerself or through his or her own employees,
provided that such irnprovcnrcnts are not intcndcd or ol'fered for sah. Il. howevcr, the building or furprovenrcnt is sold wilhin one ycar
of completioru thc Owner Buil&r will havc the burden of prcving that hc or she did rpt buikl or inrprovc Orc propaty for thc purposc of
sale).
_1. as owner of the propeny, am exclusively contracting with licenscd contraclors to conslrucl thc project (Sec. 7(X4. Business
and Protbssion Code: The Contractor's License lxw does not apply to an owner of prope(y who builds or improves lhereon.
and who conlracts for such projccts with a Contractor(s) licenscd pursuant to the Contractor's License Law).
_l anr exempt under P.C. lirr this
o,r", tllDllro
I hcrcby aflirnr undcr pcnalty of pcrjury one of lhc lirllowing
-l
have and will nnintain a Certificate of Con.sent to Self-lnsure for workers' compensation, as prcvided for by Section 3700 of thc
l-abor Code, for the performance of thc work for which thc perrnit is issued.
_l have and will nraintain workers' conryrensalion insurarrce, as required by Section 3700 of the l-abor Code, for the Srcrfornunce of
the work for which this Jrcrmit is iszucd. My workcrs' conrpcnsation insurance carrier
"n
l foli.y number are:
Policv Number: Exoires:
_l ccrtity that in thc lxrlirrnuncc of thc work frrr which this Jrcrnrit is issucd, I shall not cnploy any pcrson in any manncr
so as to bccornc subjcct to lhc workcrs' compcnsation laws of California. and agrce that if I shcruld bcconrc subject to thc
workers' conrlrnsation provisions of Section 3700 of the Labor Cotle, I shall, forthwith conrply with those provisions..
WARNING: Failure lo secure workers'
civil firrcs up lo one hundretl tlmusand
is unlawful, and shall subject an cmployer to criminal penahias and ,
adr,lition to llre cost o[compersation, danuges as provided frlr lhe
Scction 3076 of thc [:bor Code, intcrcst and
o^.", * lll Dl)..o a
DECT.ARATION
I hereby affrnr under pnalty of perjury that I anr licens:ed under provision of Chapter 9 (conmrncing with Section 7000) of Division 3
of the llu.siness and Professions Code. and my license is in full forcc and elTect.
License Class: License Number:
Contrectorl.
CONSTRUCTION LENDING AGENCY
I hcreby afl'irm undcr pcnalty of pcrjury that therc is a construction lcnding agcncy for thc pcrlbrmance of thc work lbr which this pcrmit is
issued (Sec. 3097. Civ. C.).
lrnder's Address:
APPI,ICANT DECI,ARATION
I trreby affrm undcr pnalty of perjury onc of thc following dcclarations:
Demolition Perndts-Asbcstos Notification Fedcral Regulations (Tillc 40, Pan6)
-Rcquired
l,cttcr of Notificatio, \
_l ccrtily that thc fedcral rcgulations rcgarding asbestos rcmoval are not applicable to this profixt.
_l ccrtify that I havc rcatl this application turd stalc tlnl with all City and County
ordinanccs and Statc Laws rclating to and County to cntcr upon the
above rncntioned propcrty for
Applicant or Agent
I'crnritcc
D,'", il/)f Lo
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under SIab / Floor
Bondinq I Groundinq I UFER
Transformers
Torqueinct
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Roush
Ceilings (T-Bar Rough)
l\Ieter Release
Rouqh
Service lVleter I
FINAL ol-zY-A \\L\T
Notes, Remarks, Etc.U \
Bev. 08-07-201 5
n
lrnder's Name:
and hcrcby authorizc rcpresentativcs