HomeMy WebLinkAbout20170634 - PermitPin #: 11 1
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Project Address: 1924 W Meadowbrook Dr Unit:
Assessor's Parcel: 412-53146 Lot: 133 Block: NA
Bldg. Address Range:
Tract: 1631 1 Historic: No
Suite Range:
Zoning: SD4
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714).647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #:2O1 70634
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Phone
Kristy Dinh
1924 W Meadowrook
Santa Ana, CA 92704
(7141 417 -2131
Tesla Energy Operations
2102Alton Parkway
lrvine, CA 92606
(7021 785-2s98
Fee Type
01 116002 51600 General Plan Update
01 1 16002 57770 Microfilm Records
Amount
22.95
391
Qty
0.00
000
Fee
$0 00
$0.00
State Lic #: 888104
Lic Type: B, A, C-10, C-20, C-46
Bus. Lic #: 324801
Workers' Com pensation I nsurance:Carrier'. Zurich
Policy #: EWS1074SB SO2
Expires'. 10/31 12020
f-.
Notes: lnstall roof mounted solar. Per Expedited Permit
Process For PV Systems Standard String System. Fees
paid on 101 102891 .
Building Use.
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Solar
Solar
02891
01t21t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Occupancy:
Constr Type
Code:
Date:
Date:
Date.
R-3, U
VB
cEc 2019
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 fhe sife by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MID#: 2020-157250
Fee Total:
Paid to Date:
Balance Due:
$0.00
$0.00
$0.00
C o.*
DAIE:lg
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E LECTRICAL-I NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underground
Pole Bases
Lisht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm lDampers
Communications Cable
Building
Under SIab / Floor
Bondins I Groundinq / UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinss (T-Bar Roush)
Meter Release
Rough
Service Meter
FINAL
Notes, Remarks, Etc.
OWNER BUILDER DELCARATION
I hrcby a(frm und6 penalty of pqjury thar I m qmpt from the Contrac{oB' LiceN kw for thc following wn (Se.7031.5
Buines ad Profwion Code): Any City or County which rcquim a po'rnit to @Gtrucl, alts, imprcvg &molish or repair uy
structure. prior to its i$umcq also requirB the applicut for such pcrmil ro file a signed statmmt that hc or she is licenscd p$uilt
to thc prcvisioro of the Contractor's Licensed law (Chaptq 9, Commocing with Seclion 7000 of Division 3 of thc Busincs ud
Profesions Codc) or that hc or shc is exempt thqefrom ad the b6is for the allcged amption. Any violation of Sslion 70-11.5 by uy
applicantforapomitsubjetsthe applicanttoacivilpenaltyofnotmorcthilhve hunclrcddollm($500).
_1, o ownq of the propsty. or my employG with wsgs 6 their el€ comp€mation, will do the work ad the stnrlw b not
intmded or offered for sle (Sc.7044, Businas ud Prcfssiom Codq The Contractor's LiccN law doB not apply to il oms of
th€propqty whotuildsorimprovcthoon,mdwhodoesuchmr*himselforhwlforthroughhborhaomcmployces,
prcvided that such imprownts e rct intqded or offqed for sale. If, howd6, the building or improvmot is $ld within one y@
ofomplaion. the Owno Buildq will havc thc hrdo ofFovirg tlld he or shc did rct build or improre the propary for the purpos of
slc).
_1, as owner of the property, arn exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business
and Profession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a Contractor(s) licensed pursuant to the Contractor's License Law).
-l
am exempt under Section-, B. & P.C. for this reason.
Date:
g9ESESLCOMPINSAIION
I hftby affm undq pcnalty of pqjury onc orru rouo*iogffiq
_I have anl will maintain a Cstificatc of Colmt to Sclf-lEre for rcrkc' ompqrs*ion s provided for by Setion 3700 of thc
Labor code, for the pqfomcc of the mrk for which thc pqmit b isucd.
y' have md will maintain workc' compcroation imuancg 6 rcquircd by Sction 3700 of thc lzbor Codc for thc pqfotlme of
fhe wrk for which this pqnit is isued. My worko' ompersdion ilsuecc ffii6 ed policy nmbe re' r-*,&//Vr't fr?Y *+ce(4
^:*
-l
@ni& that h the psforrucc ofthc work for which this pemit is issucd, I shslt not mploy ily pcmn in uy mm6
rc c to bcorc subjet to thc mrt6'@mpqBation lam of Califomi4 ad agrc tha if I should beome subjel to thc
work6' @mpostion prcvisiorc of Sction 3700 of thc labor Codc I shall, forthwith comply with tho* prcvisiore..
WARNING: Failure to secure workers' compensation coverage is unlawful. and and
civil fines up to one hundred thousand
Section 3076 of the Labor Code. interest
dollars tn the
and
I hereby affirm under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
License c.q<oq
to
I hereby affirm under penalty of perjury that there a agency of the work for which this permit is
issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
APPLICANT DECLARATION
I hereby affinn under penalty of perjury one of the following declarations:
Demolition Perrnits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Required
Letter of Notification
-l
certi$, that the federal regulations regarding asbestos removal are not applicable to this project.
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certiff that I have application and state that the
ordinances and to building the
above rnentioned
Applicant or Agent
Pernritec nanre
for inspection
information
lb1
Rev. 08-07 5