HomeMy WebLinkAbout20174247 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927o2
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (7141647-5853
Electrical Permit #: 20,174247
Pin #:II4i127
R/v'
Project Address: 2841 N Auqusta Wav Unit:
Block: NA
Bldg:
Tract: 15648
Address Range:
Historic: No
Suite Range:
Zoning: RlAssessor's Parcel:232-111-25 Lot: 1
Owner:
Address:
Huy Ngo
2300 S. Sycamore Ave.
Santa Ana, CA 90016
(626) 625-5202
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
Serv Meter
General Plan Update
lssuance
Microfilm Records
Amount
57 40
23 79
59 30
405
Qty
100
1.00
1.00
1.00
Fee
$57.40
$23 79
$59.30
$4 05
Phone:
Tenant Name:
Contractor:
Address:
Power Electric & Construction
2300 S Sycamore Ave
Los Angeles, CA 90016
(800) 310-7510Phone:
State Lic #: 942023
Lic Tvpe: C-10
Bus. Lic #: 378712
Workers' Compensation lnsurance:
Carrier: Everest Premier lnsurance Co.
Policy #: 7600017664211
Expires: 0610112022
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
E !ectrica I
Occupancy:
Constr Type
Code:
R-3
VB
cEc 2019 Notes. E lectrical
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field.
Building Permit #:
web_user
Date:
Date:
Date.09t07t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit rssued shall become invalid unless the work on the site
authorized by such permit is commenced within 360 days after its
rssuance, or if the work authorized on fhe site by such permit is
suspended or abandoned for a period of 360 days after the time the work
is commenced.
N/A - No
N/A - No
Balance
Balance
Fee Tota!.
Paid to Date:
Balance Due:
$ 1 44.54
$ 1 44.54
$0.00
lnspector MID#: 2021-168641
INSPECTOR RECORD
SITE.WORK DATE ID/S!G.COMMENTS OWNER BUILDFR DT'I CARA'TION
I hereby aflirm under penalty of periury that I am exempt form the Contractors' License Law for the following reason (Sec.703 I .5 Business
and Profession Code): Any City or County rvhich requires a permit lo construct. alter. imp,rove. demolish or repair any structure. prior to its
issuance. also rcquires the applicant for such pennit to file a signed statement that he or she is licensed pursuanl to the provisions of the
Contractor's l.icensed l-arv (Chapter g. Commencing rvith Section 7ffX) of Division ]l of the Busincss and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 70-l I .5 by any applicant for a pcrmit subjects the
applicant to a civil penalty of not more lhan five hundred dollars ($500).
!1f . r. owner of the propetty. or my enrployees with rvages as their sole compensarion. rvill do the wort and rhe stnrcturc is nor intended
or oflered for sale (Sec.7044. Business and Professions (.ode: The Contractor's License Larv does not apply to an owner of the property
u,ho builcls or inrproves thereon. and rvho does such rvork himself or herself or through his or her orvn employees. providcd that such
imprcvonents are not intended or offeted for sale. lf. horvwer. the building or improvement is sold within one year of complaion. the
(hvner Builder s,ill have the burden of p,roving that he or she did not build cr improve the propertv for the purpose of sale).
!!i. ,-r owner of the property. am exclusively conffacting with licensed conhactors to conshuct the p,roject (Sec. 7044. Business and
hofession Code: The Contractor's License Larv does not apply lo an owner of property u,ho builds or improves thereon. and
rvho contracts for suclr pro.jects rvith a Contracto(s) licensed pursuant to the Contractor's License Law).
!!l .rn exempt under Secrion B. & P.C. for this reason.
WORKT'RS' ('OMPFNSATION NF'CI ^ RATION
I hereby affinn under penalty of perjury one of the follorving declarations:
*! t n.*," and rvill maintain a Certificate of Consent to Self-lnsure for rvorkers' compensation. as provided for by Section 3700 of the
l-abor C'ode. for the performance of the rvork for u'hich the permit is issued.
YES
._ I have and u'ill maintain rvorkers' compensation insurance. as required by Section 17fi) of the Labor Code. for the performarrce of the
work for which this pennit is issued. My u'orkcrs' compensation insurance carrier and policy number are:
. Everort Premlor lnrurance Company
Carrier:
7C0017CC.1211 l0lll0112022
Policy Nurnber: Expires:
NO
_l cerrifu that in the perfonnance of the rvork for rvhich this permit is issued. I shall not employ any p€rson in any manner so
as to become sub.iect to the rvorkers'compensation larvs of California. and agree that if I should become subject to the rvorkers'
compensation provisions of Section 3700 of the Labor ('ode. I shall. forthrvith cornply with those provisions..
WARNING: [;ailure to secure rvorkers'cotnpensation coverage is unlarvful. and shall subjecl an employer to criminal penalties and civil
fines up to one hundred thousand dollars ($100.000). in addition to the cost of comp€nsation. damages as provided for the Section -3076
of the l.abor ('cxle. intetest and attomev's fees.
LICFNS['N CONTITACTOR NT('I AR A'TION
I hereby'affinn under penalty of per.iurl'that I am licensed under provision of Chapter 9 (commencing rvith Section 70m) of Division .1 of
the Business and Professions Code. and mv license is in full force and effect.
c-10
l.icensc ('lass:042023
[,icense Number
CONSTRIICTION I TNNING AGFNCY
I hereby aflinn under penalty of per.iury that there is a construction lending agency for the perfonnance of the rvork for which this permit is
issued (Sec. 3097. Civ. C.).
I-endcr's Narne:
l.cnder's Addrcss:
APPI ICINT NFCI ARATION
I herehr allimr under pe.nalty of perluw one of the followrng declarations
[)enrolrlron Perrnrts-Asbestos Notrficalron Federal Regulatrons (Trtle 40, Part6)
N! Require<l I-etter of Notification
ttt , cerlify rhat the federal regulations regar<ling asbestos removal are not applicable to rhis project.
YEs I ceflib that I have reacl this application and state thar the above information is correct. I agree to cornply with all City and County
ordinances and State l-au's relating to building constnrclion. and hereby authorize representatives of this City and County to enter upon the
above mentioned property for inspection purposes.
Reroof
Roof (Diaphragm Sheathing/Frame)
Structural Final
Plumbing
Under FIoor I Under SIab
Rough
Shower Pan / Tub Test
Water Service
Sewer / Sewer Cap
Gas Air Pressure Test
Plumbing Final
Electrical 0
Service (Meter I Panel)q- lul ' /r \c
Grounding / Bonding g-t'l'tr{\r
Rough 1-l{ -l (La'\v
Electrical Final 9-14 -l\- t ,/
Mechanica!
Gas Air Pressure Test
Rough
Piping (HW, CW, etc.)
Exhaust Ducts
Mechanical Final
Notes, Remarks, Etc.