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Home My WebLink About20174214 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electriqd Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 Permit #:2o^174214 Pin #: 130.23 Project Address: 1521 E Twenty-First St Unit: Assessor's Parcel 396-062-08 Lol:27 Block: NA Bldg: Tract: 4167 Address Range: Historic: No Suite Range: Zoning: Al Owner: Address: Phone: Tenant Name: Contractor: Address: Phone: Patricia J Sornborger 1521 E 21st St Santa Ana, CA 927057108 (7141 5414324 Lowel! Martin Electric lnc 1411 Batavia Ste Ste 111 Orange, CA 92867 (7141 538-2504 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 59 30 405 Qty 1.00 1 .00 100 1.00 Fee $57.40 $23.79 $59.30 $4 05 State Lic #: 775598 Lic Type: C-10 Bus. Lic #: 6955 Workers' Compensation lnsurance: Carrier: OHIO SECURITY INSURANCE COMPANY Policy #: XWS2256442929 Expires: 05131 12022 tcpt*:Lts4lt1.i3 Trnnsorrt ion I iHP. Lowel l llort ir n t-l i,:.t-'of iltrt & Dr 11 16rrfi2- i77 anernl PIon I L'!-LII TLtrJ Up d, Building Use: Job Type: Nature of Work. Planning Conditions: Planning Approval By: Plan Checked By: Fermit lssued By: Subject to Field: Building Permit #: Single Family Dwelling Miscellaneous Service Meter Zuniga, Occupancy: Constr Type: Code: Date: Date: Date: R-3 VB cEc 2019 09101 t2021 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total Notes: Upgrade/Hand out given. Fee Total Paid to Date: Balance Due: Every permitissued 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 site by such permitis suspended or abandoned for a period of 360 days after the time the work is commenced. lnspector MrD#'. 2021-1 68560 01 1 16002 51600 01 1 16002 51603 01 1 16002 57770 $23.79 $1 16.70 $4.05 $144.54 $0 00 $144.54 ELECTRICAL.I NSPECTOR RECOR D Dr.., nQ n-7 On{ tr APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION I hcrcby alItrm undcr penalty of Frjury that I am exempt frcm thc CrntractoE' Liccns kw for thc following rcasq'o (Se.7031.I Busincss and Profcssion Codc): Any City or County which rcquircs a pcrmit to onslruct, altcr improvq dcmlish or rcpir anf struclurc, prior to its issuancc, also rcquircs thc applicdt for such Frmit Io file r signcd slalcrcnt thlt hc or shc is liccnsd pusuul to thc prcvisions of thc Conmctor's Liccnsd [rw (Chaptcr 9. CommrcinS with Section 7000 of Division 3 of Ihe Busincss od PrcfcssionsCodc)orthathcorshcisexcmptthmfromandthcbasisfortheallcgcdcxcmption, AnyviolationofSdionT03l.5byany applicant for 8 pcrmil subjcts lhe opplicant lo I civil penalty of not mrc thrn fivc hundrcd dollas ($500). -1, as owncr of thc propcrty. or nly employecs with wagcs as thcir sole comlrcnsation. willdo thc work and thc structurc is not intcndcd or offcrcd for salc (Scc.7044, Busincss and hofcssions Codc: The Contraclor's Licensc Law docs not apply to an owner of thc propcrty who builds or improves thcrcon, and who docs such work himsclf or hcrself or through his or hcr own cmployecs. providcd that such improvcnrcnts :rre not intendcd or ofl'crcd for sale. lf, howcvcr. thc building or improverrrcnt is soh wilhin onc ycar of complction. thc Owncr Buildcr will havc the burdcn of proving that hc or she did not build or irnprove the propcrty for thc purposc of salc). -1. as owncr of thc propcrty, am exclusivcly conlracting with liccnscd contractors to construct the project (Scc. 7W, Busincss and hofession Codc: Thc Contractor's Licensc Law does not apply lo an owner of propcrty who builds or improves thcrcon, and who conlracts for such projccts with a Contractor(s) licensed pursuant to thc Contractor's Liccnse kw). -IamcxcmptundcrScction-.B.&P.C.forthisrcason.Date: Owner: WORKT'RS' COMPF'NSATION DECI {RATION I hercby aflrm under pcnalty of prerjury one of the following declarations: _l havc and will maintain a Ccrtificate of Consent to Sclf-lnsurc for workers' cornJrcnsation. as providcd for by Scction 3700 of the [:bor Codc, for thc pcrformancc of the work for which thc lrcrmil is issued. -l havc and will maintain workcrs' comfrcnsation insurancc. as required by Scction 3700 of thc labor Codc. for thc lrcrformancc of the work for which this pcrrnit is issued. My workcrs'insurance carricr and plicy numbcr arc: i l t Policy _l ccrtify that in the performance of thc work for which this prmit is issued, I shall not employ any person in any manner so as to bcconrc subjcct to the workers' compensation laws of California, and agrce that if I should bccome subjcct to the workcrs' compcnsation provisions of Scction 3700 of thc l-abor Code. I strall. forthwith comply with those provisions. ( WARNING: Failurc to sccurc workcrs' comfrcnsalion coveragc is unlawful, and shall subjcct an employcr to criminal pcnalties and civil lincs to one hundrcd thousand dollars ($ln to thc cost of damagcs as for thc Scction intcrest and fees. DI.]CLARA'I'I0N I hcrcby af'firm under pnalty of pcrjury that I am liccnscd undcr provision of Chaptcr 9 (commcncing with Scction 7000) of Division 3 of thc Business and Profcssions Code, and my license is in full force urd effect. ,Cl ,27-tSE8Liccnsc W I hmby affrm undcr pemlty of pcrjury thal therc is E construction bnding 8gcncy for thc psformnce of thc work for which this pemit is issucd (Ss. 3097, Civ. C.). [.cndcr's Namc:a lrndcr's Addrcss: APPLICANT NT'CI.ARATION I hcrcty affrmunder grenalty of perjury one of the following declarations: Dcmolition Permits-Asbestos Notification Fcderal Regulations (Title 40, Part6) _Rcquircd lrttcr of Notification -l ccrtify that thc federalrcgulations regarding asbestos renrovalare not applicable to this project. _l ccrtify lhat I havc rcad this application statc that thc abovc inlbrrnation with all City and County ordinanccs and Statc L:ws rclating to anrl abovc- rncntiorrcd propcrty for inspcctkln Applicant or Agent I Pernritee nanre (nrint): t Z thc Site-Work Underqround Pole Bases Light Standards Spas, Pool, Fountains Sions (monument) Life Safety /Low Voltage Fire Alarm / Dampers Communications Cable Buildinq Under SIab / Floor h ? Bonding I Grounding I UFER ) (/1,Dffi>7 Transformers l- Torqueinq Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilinqs (Hard & Soffit Rouqh Ceilinqs (T-Bar Rouqh)I [/eter Release 0 9 Dfr\rtfo / Rouqh I 1 .-? Service fi/eter 0 -4 DTV6 >7 FINAL t o l' ,r,lh,l Dk#8 t Notes, Remarks, Etc.I Ir I a D \,9\d 1,0 t))\r.H -Y7 \. { as csr q,l,oa ( qlj d Eo a-â‚¬oo CLo?b a- |E c, a-r- co 0, .cr TU a- Itr ttr 3E'(!oL. 'lEl L ttr() t.cloql 0,?-+, E'tr(U ELorh E'oI(D CL Eo(, .9,?-aJ o Gl- .pEE gs -J ibC.\(JO f 12tbBi;.E Er\-trrt' .- EEoiEElrr(ul-â‚¬ TF-\E.grbt.EEl' qrEffe fiH'e< H3E-o q,ra\ .S Ei t'eqoE.3o .b *a\ EEEHtt $-t ! rr! 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