HomeMy WebLinkAbout20174176 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (7'14) 667-2738 lnspector Section: (714) 647-5853
Permit #= 20174176
Pin #: 28647
J,
Proiect Address: 1024 N Olive Sta
Assessor's Parcel. 405-283-20 Lot. 34
Unit:
Block: NA
Bldg
Tract: 354
Address Range:
Historic: No
Suite Range.
Zoning: Rl
Owner:
Address:
Salvador Ramtrez
1024 N OLIVE ST
Santa Ana, CA 927032334
(7141 884-24s4Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone.
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Pclicy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By.
Subject to Field:
Single Family Dwelling
Alteration
New Bathroom
Zuniga
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3
VB
cEc 2019 Notes.Etectricdl for closeUbathroom conversion
Visn
CC+: *r*rr*r**r**8819 Auhh
08t25t2021
Account#
Misc. Receipt.
Misc. Receipt.
Misc. Receipt:
Total
Buirdins Permit #: 1 01107772
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 the 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 7e
$66 s3
$4 05
Fee Total
Paid to Date:
Balance Due:
$94.37
$0.00
$94.37
01 1 16002 51603
01 1 16002 51603
01 1 16002 5160-2
01 1 16002 5160C
01 1 16002 5160;'
01 1 16002 5777C
Fee Type Amount
125 Volt Receptacle I .57
Light Switches, Occ. Se 1.70
Light Fixtures 1 .1 3
General Plan Update 23.T9
lssuance 59.30
Microfilm Records 4.0S
Qty
100
200
200
100
100
100
Fee
$1 s7
$3 40
$2 26
$23 7e
$5e 30
$4 05
Bqtr hi
0f f ir:P
Ac,:t * :
Rcpt*:
Tr sn so
bener B J.
[1 I 1600
EIectr'i
u 1 I 16110
t,/27/?tt7
f 869e5
Rel*:
21/2it71
$84
io I vod uf i{ctts
Fee
lnspector MID#: 2021-168434
ELECTRICAL.INSPECTOR R ECO R D
Dn., nO n7 Dnl tr
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcreby aflirm undcr lrcnalty of Frjury that I m cxempl frcm thc ContractoF' Liccns ljw for lhc followin&rcasn (Scc.70ll.5
Busincss and Prufcssion Codc): Any City or County which rcquircs a Ismit Io construcl. altca improvc. dcmolish or rcp4ir any
structurc, prior to its issuancc, als rcquircs thc applicml for such lEmit to filc a sigrcd stutcmnt thal hc or shc is licensed pusuant
lo thc prcvisions of thc Conractor's Liccnrcd law (Chaptcr 9. Commencing with Scction 7000 of Division 3 of lhe Busincss snd
PrcfcssionsCodc)orthathcorshciscxemptlhcrcfromandthcbosisforthcallcgcdcxcmption. AnyviolationofSethnTO3l.5byany
applicrnt for a [rc]mir subjects thc applicant to a civil pcnrlty of not mrc than fivc hundrcd dollus ($500).
_1. as owncr of thc propcrty, or my cmployccs with wagcs a.s thcir solc compcnsation. willdo thc work and thc structurc Ls not
intendcd or olTcrcd lbr salc (Scr.7044, Business and Profcssions Culc: Thc Contraclor's Liccnse law does not apply to an owncr of
thc proprty who builcls or improvcs thcrcon. and who docs such work himsclf or hcrsclf or through his or hcr own cmployees.
providcd that such inrprovcnrcnts arc not intcnded or offcrcd ftrr salc. lf. howcvcr. thc building or intprovcnrcnl is sold within onc ycar
of completion. tlrc Owncr Buildcr will have thc burdcn of proving that hc or she did not build or improve the proprty for the purpose of
salc).
-1,
as owncr of thc propcrty. am cxclusivcly contracting with liccnscd contractors to construct the propct (Scc. 7W, Busincss
and Profcssion Codc: Thc Contraclor's Liccnsc Law docs not apply lo an owncr of propcrty who builds or improves thercon.
and who contracts for such projects with a Contracto(s) liccnscd pursuant to lhc Contractor's Liccnse l-aw).
_l am cxcmpt ts.t
Z z,
1VORKERS' COt\I PUNSATION
DECI ARATION
I hercby affirm undcr pnalty of perjury onc of the following dcclarations:
_lhaveanclwill rnaintainaCertificatcofConscnttoSclf-lnsurcforworkers'compensation,as providedforbySection3T00ofthc
Labor Codc. lbr thc pcrformance of the work ftrr which thc pcrmit is issucd.
-l
have and will maintain workers' comlrcnsation insurance, as rcquircd by Section 3700 of the l-abor Codc, for thc grcrformancc of
thc work for which this pcrmit is issued. My workers' compcnsation insurance carrier and plicy number arc:
Carricr:
Policy Numbcr: Expircs:
_l ccrtify that in thc pcrformancc of thc work fbr which this permit is issucd. I shall not cnrploy any pcrson in any nranncr
so as to bcconre subjcct to the workers' compcnsation laws of California. and agrce that if I should beconrc subjcct to the
workcrs' compcnsalion provisions of Scction 3700 of thc l-atnr Codc. I shall, forthwith cornply with thosc provisions..
*
WARNING: Failurc to liecure workers' compcnsation covcragc is unlawful. and shall subjcct an entploycr lo cripinal pcnaltics and
civil fines up lo onc hundred thousand dollars in addition to the cosl corrtpcnsation, damagcs as provided for thc
Scction 3076 tt
LIC I.]NS F:I ) CON'tRA C"I'O R
DECII\RATION
I hcreby affirrn undcr pcnalty of pcrjury that I am licenscd undcr provision of Chapter
of the Busincss and Prof'cssions Code. and my liccnse is in full forcc and effect.
9 (comnrcncing with Section 7000) of Division 3
License Class: Licensc Number:
I)ate:
W
I hcrcby alf[m undcr tEmlty of perjury that thcrc is a construc,rion lcnding agcncy for lhc pcrfomnce of thc work for which this pcmil is
issucd (Se. 3097. Civ. C.).
hnder's Namc:
lrnder's Address:
APPLICA NT DF'CLARATION
I trcrc'byafinnundcr pnalty of pcrjury one of thc following dcclarations:
f)crnolition Perrnits-Asbcstos Notification Fcdcral Regulations (Titlc 40. Part6)
_Rcquircd lrt tcr o f Notification
-l
certify lhat the
_l ccrtify that I have
feOcru\Iffphtions rcgarding asbcstos renrovatarc not applicablc ro this project.
rcad this application md state that thc atnvc infortnation with all City and County
ordhanccs and Statc l-aws rclating to building
above mcntioncd propcrty tbr
Applicant or Agent
aPernritee
and lo cnter
Z/
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bondinq I Groundinq 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
tl .-{)
Rough I lU l'fl o I MN
Service N/eter I
F!NAL tolTt ,l)^lCr^Notes, Remarks, Etc rl \LJ
I
r P
Conlractor:_
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