HomeMy WebLinkAbout20174454 - Permiti,
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1 City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:2o^174454
Pin #: 744fi,9./n-/
Proiect Address: 1239 E Martha Lna
Assessor's Parcel: 398-082-19 Lot: 39
Unit:
Block: NA
Bldg:
Tract: 9519
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone.
Tenant Name:
Contractor:
Address.
Phone.
Randy Carrillo
1239 E. Martha Lane
Santa Ana, CA 92701
(7141 235-8851
Nexgen Solar
18032 Lemon Drive, #C418
Yorba Linda, CA 92886
(7',t41 993-2011
01 1 16002 s1603
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01116002 57770
Fee Type Amount
Serv Meter 57.40
Over 10-50 HP, KW or l 49.78
Genera! Plan Update 23.79
lssuance 59.30
Microfilm Records 4.05
Qty
1 .00
100
100
1.00
100
Fee
$57 40
$49 78
$23 7e
$59 30
$4 05
State Lic #: 973276
Lic Type: B, C-10, C-33
Bus. Lic #: 377802
Workers' Compensation I nsurance:Carrier: State Comp
Policy #: 9384406
Expires: 10/01 12021
Building Use:
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelting Occupancy:
Solar Constr Type:
Solar/Service Meter/ EV OullCode:
R-3, U
VB
cEc 2019
Smith, Mark
Chavez, Dave
Date:
Date.
Date:
10t08t2021
10108t2021
Account#
Misc. Receipt:
Misc. Receipt.
Misc. Receipt.
Total
Notes:
Fee Total:
Paid to Date:
Balance Due:
lnstallation of roof mounted PV system. Worksheet
attached to plans. Seruice Meter upgrade. Handout
given. EV outleUcharger.
$1 94 32
$0 00
$194.32
Buildins Permit #: 101 108206
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.
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23.79
$1 66 48
$4.05
lnspector MID#' 2021-169327
/
ELECTRICAL.I NSPECTOR RECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DEI,CARATION .I hqeby 8[fum undq peralty of pcjury thar I m crempt from the Contracto6' Licmc lzw for the following r@n (Se.7031.J
Busins and Profsion Codc): Any City or County which rcquirs a pomit to co$truct. altc, improvq dcmolish or rcpair ay
structue prior to its issuuce, also requirc the applicet for such pennit to lile a signcd statmqt that hc or shc is licced pN6t
to the provisioE of thc Contractor's Liccnsed Law (Chapter 9. Comercing with Setiotr 7000 of Division f of thc B6in* md
Profcssions Code) or that he or she is exempt thccfrom ild thc basis for thc allcgcd exeinption. Any violation ofs(tion 703 1.5 by any
applicsntforapennitsubjetsthe applicmttoacivilpenaltyofnotmorethafivehundrcddollm($500).
_1. as owner ofthe propcrly, or my etnployees with wages as their sole compensation, willdo the work and the structure is not
intcnded or offered for sale (Sec.7044, Business and Professions Code: The Contractor's License law does not apply to an owner of
thc property who builds or improvcs theron, and who docs such work himself or hersclf or through his or her own employees.
provided that such improvonents are not intcndod or ofFcrod for sale. I[, howwer, the building or improverncnt is sold within onc ]er
of cornplaion" the Orrner Builder will have the hrden of proving that he or she did not build or improve the propoty for thc purposeof
sale).
-1,
as owner of the property, am exclusively contracting with liccnsed contractoni to construct the project (Sec. 7M4, Buiness
and Prcfession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such pirojccts with a Contracto(s) licersed pursuant to the Contractor's License l-aw).
-l
am exempt under Section-. B. & P.C. for this reason.
I hereby affirrn under penalty of perjury one of the following
_l have and will maintain a Certifrcate of Consent to SelFlnsure for workers' compensation. as provided for by Serction 3700 of the
L-abor Code, for the pcrformancc of the work for which the pennit is issued.
_l have and will maintain workers' compensation insurance, as required by Section 3700 of the L:bor Codc, for the pcrformance of
the work for which this pennit is issuod. My rvorkers' compensation insurancc carrier and policy number are:
Policv Number: Exoires:
_l certi& that in the pcrfornrance of the work for which this pennit is issued, I shall not ernploy any person in any rnanner
so as to bocome subject to the workers'compensation laws of California, and agree that if I should become subject to the
rvorkers' compensation provisions of Section 3700 of the tabor Code, I shall. forrhwith comply with those provisions..
WARNING: Failure to secure workers' compensation coverage is unlawful. and shall subject an anployer to criminal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation, danages as provided for the
Section -3076 of the Labor Code, interest and attorney's fees.
I hereby affrm under pcralty of pcrjury 3
of the Business and Profcssions Code. and my license is in full force and effect.
License Class: License Number:
CONSTRUCTION LENDINC AGENCY
I hcby affim unda pqulty of pcrjury tha th@ is I onstruction knding agocy for thc pqfotruce of thc wrt for uhich this pqmil b
isucd (Sc. 3097, Civ. C.).
Isrdq's Nmq
Lender's Address:
APPLICANT DECLARATION
I hocby alfinn under penalty of perjury one of the following declarations:
Dcrnolition Permits-Asbestos Notilication Federal Regulations (Title 40, Part6)
_Required Later of Notifrcation
-l
cdiry that thc fcdoal rcgulatiom rcgarding sbctos rmoval rc not eplieblc to this pmj€l.
-l
cqtiry that I have r@d this spplicatiotr atrd stat€ that thc abovc infomdion is coret. I sgrc to @mply with all City and Couty
ordimc6 ud Statc lrw rclating to building oNrrudioa ad hqcby authorirc rs?rMtstiv6 of this City md Comty to 6tE upon thc
abovc mationcd prcpcny for impction pupos
App[st or Ag6t Sigmturc: Drlc:_
Pernrite+ nrme (print):____
Site-Work
Underqround
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm I Dampers
Communications Cable
Buildins
Under Slab / Floor
Bondinq I Groundinq / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners I I )
Roof Top Eq uipme nt l}jlvrv l0 r2lol Wfu (fi
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Roush)
Meter Release
I I I ./)
Rough IU I l?,1il Dfh)n t%6
Service Meter ,
FINAL
Notes, Remarks, Etc.
Dnrr nA n7 nn4a
Carrier:
l)rl o'Contrnctor:_
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