HomeMy WebLinkAbout20174016 - 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 #:2O174O{6
Pin #: 19603
,
Proiect Address: 119 N Laurel St-a- -
Suite Range:
Zoning: R2
rTwl
Assessor's Parcel: 1 98-251-34 Lot: 55
Unit:
Block: NA
Bldg:
Tract: 540
Address Range:
Historic: No
Owner:
Address.
lsis D Calvario
1 19 N Laurel St
Santa Ana, CA 92703
(714I- 884-6464
Fee Type
01116002 5160C General Plan Update
01 1 16002 5777C Microfilm Records
Amount
23.79
4.05
Qty
000
0.00
Fee
$0 00
$0 00
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Solar
Solar
Occupancy:
Constr Type:
Code:
R-3, U
VB
cEc 2019 Notes: lnstall roof mounted solar panels - fees paid on
101 107590. Letter of auth on file.
Planning Conditions:
Planning Approval By:Date:
Date:
Date:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Plan Checked By:
Permit lssued By.
Subject to Field:
Building Permit #:
Amsden, Julie 08/1 9t2021
Account#
01 1 07590 Fee Total
Paid to Date:
Balance Due:
$0 00
$0 00
$0.00
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
issuance, or if the work authorized on fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2021-168269
ELECTRICAL.I NSPECTOR RECORD
APPROVALS DATE ID/S!G.COMMENTS OWNER BUILDER DELCARATION
I hcrcby affirm undcr pcnlhy of pcrjury thrt I m cxcmpt fmm the ContmctoN' Licenrc [:w for the following rca$n (Sc.7031.5
Busincss ard Prcfcssion Cqlc): Any City or County which rcquircs a Frmit to construct. alts, improve, demlish or Epair any
structuc. prior lo its issuarcc, alm rcquircs thc spplicant for such lEnnil lo lilc a sigrcd statcmnt that hc or slrc is liccnscd puNuant
to thc prcvisions o[ thc Contractor's Licensd law (Chaptcr 9. Commcncing with Sction ?00O of Division 3 of thc Busircss atrd
Prcfcssions Codc) or that hc or shc is cxcmpt thcrcfrom and th€ basis lbr thc dhged excmplion. Any violatioo of SNtion ?03 1.5 by any
applicqrt for a pcmit subjccts thc applicant to a civil pcnalty of not mre than fivc hundred dollars ($500).
(Af S.**, *thc prcFny, or my cmployccs with waScs as thcir slc comlrcnsation. willdo the work aid thc st]rriw is mt
ilileldcd or ofIcrcd for sle (Se.7O44. Busircss and Profcssions Codq Thc Contractor's Licens bw d@s not apply to an owner of
thcpmlEny whobuildsorimprcresthcmn.srxlwhod@ssrchw*himsclforhcrslforthrcughhisorhcrowncmployccs.
providcd that $uch imprcrcmnts rc mI inrcndcd tr olIcrcd for sh. If. howcw. thc building or imprcwmnt is sld vithin onc ]au
of conrphtion. thc Owncr BuiHs will hsrc tlrc burdcn of ,mving thal lE or shc did rct buiH or imlrmre tlrc pmFaly for the pu]JDs of
eh).
-1.
as owncr of thc property, am cxclusivcly contracting with liccnscd contractors to conslruct thc project (Scc. 7W, Busincss
and Pmtbssbn Codc: The Contraclor's Licensc Law docs not apply to an owncr of propcrty who builds or improvcs thcreon,
and who contracls for such projccts with a Contracto(s) liccnsed pursuant to thc Contractor's Liccnsc kw).
_l am P.C. tbr this
x a r1 LT
DECI ARATION
I hereby affirm under penalty of pcrjury one of the following declarations:
-l
have and will maintain a Certificate of Consent to Self-Insurc for workers' compensation. as provided for by Section 3700 of the
Labor Code, for the performance of the work for which thc pcrmit is issucd.
-l
have and will maintain workers' compensation insurance, as rcquircd by Section 3700 of the Labor Code, for the performance of
thc work for which this permit is issued. My workers' compensation insurance carrier and policy number arc:
Carrier:
Policv Numbcr: Exoires:
ft-fi"nify that in thc pcrtbrnunce of thc work for which this pcrmit is issued. I shall not cmploy any lrcrson in any manncr
so as lo bccomc subjcct to thc workcrs' compcnsation laws of California. and agrcc that if I should bccomc subict lo the
workcrs' conrpcnsation provisions of Scction 3700 of thc Labor Codc, I shall, forthwith cornply with thosc provisions..
WARNING: Failurc to securc workcrs'compcnsation covcrilg,c is unlawful, and shall subjcct an employcr to criminal pcnaltics and
civil fines up to onc hundrcd thousand dollars ($100.m0). in addition to lhc cost of compcnsation. darnagcs as providcd for thc
Scction 3076 of Ccxlc. interest and atlorncy's
B (1 LI
NT'CLARATION
I hercby affirm under pnalty of pcrjury that I am licenscd undcr provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Busincss and Professions Codc, and my license is in full force and cffccl.
Liccnsc Class: Liccnsc Number:
Date: Contractor:
W
I hcrcby aIfirm undcr Fmlty of pcrjury lhat Ihcrc is a construction bnding agercy for thc JErfomrc of thc work for which this pcrmil is
issued (Se. 3097. Civ. C.).
kndcr's Narc:
lrndcr's Address:
APPT IC ANT NT'CLARATION
I Mry affrnn under pcnalty of prjury onc of thc following declarations:
Dcmolition Pcrrnits-Asbcstos Notification Fedcral Regulations (Title 40, Part6)
_Requircd lrtter of Notifrcation
_l ccrtify that the fedcral regulations regarding asbestos rcnroval arc not applicable to this projcct.
Mhty rhat I havc rcad this applicarion and state that the abovc information is corrcct. I agrcc to cornply with all Ciry ancl County
ordinanccs and State Lrws relating to authorizc rcprcscntativcs of this City and County to entcr u;nn thc
abovc rncntioncd proprty
Applicant or Agent
Pernritec nanre (A
conslruction.
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondino lGroundinq I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
N/eter Release
Rough ?q.*rL 4-?-ll E)-{^P 4t
Service N/eter
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