HomeMy WebLinkAbout20272887 - Permitt
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Arta, CA927O2 Electrical
Permit Counter: (714) 647-5S00 lnspection Requests: (714) 667-2738 lnspector Section: gtal 647-5853
Permit #: 20272887
Pin #: {3095
Project Address: 1020 N Raitt St
Assessor's Parcel 405-1 14-13 Lot: POR 8, POR E
Unit.
Block: NA
Bldg:
Tract 521
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Cuong Pham & Hanh Nguyen
1O2O N RAITT ST
Santa Ana, CA 927032033
(7141 260-8844
01 1 16002 s1603
01 1 16002 s160C
01 1 16002 51603
01 1 16002 5777C
Fee Type
Re-Set Mtr
General Plan Update
lssuance
Microfilm Records
Amount
57.40
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
Fee
$57.40
$23.7e
$se.30
$4.05
PERMITCANCELLED
DATE: lo I rr l*,
INITIAL: bAqq
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Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Service Meter Reset
Occupancy:
Constr Type:
Code:
Date.
Date:
Date:
R.3, U
VB
cEc 2019
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By: Zuniga, Allissa
Subject to Field:
Buirdins Permit #: 1 0 2106036
03t03t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: Reset service meter. Hand out given.
Fee Total
Paid to Date:
Balance Due:
Every permit issued shall become invalid unless the worl< on the site
authorized by such permit is commenced within 360 days after its
rssuance, 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 16.70
$4.0s
$144.54
$0.00
$144.54
lnspector MID#: 2021-164648
/
N
ELECTRICAL-I NSPECTOR RECORD
APPROVALS DATE COMMENTSID/S!G
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltase
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondinq I Groundins I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factorv Wired Unit
Walls (Conduit)
Wails (Rouqh)
Ceilings (Hard & Soffit Rouqh
Ceilinqs [-Bar Rouqh)
N/eter Release
Rouqh
Service JMeter
FINAL
c€LE
Etc.
(
I
I
IUC
odN4_ -
Jl
tlhcrcby aftirm undcr Jrcnahy of perjury that I m excmpt fmm thc Contractos' Liccns hw for thc following rcasn (Ss.7031.5
Busincss and Profcssion Codc): Any City or Counly which requircs a Jrcrmit lo conslruct, altcr, improvc, dermlish or rcJuir'any
struclurc, prk r to iIs issuamc. alm rcquires the applicant for such lrcrmit to filc a sigrcd statemnt that he or she is licenscd pusant
to thc pmvisions of thc Contractor's Licen*d law (Chaplcr 9. Comrrcncing with S6tion 7000 of Division 3 of thc Business and
Pn)fcssions Codc) or lhat hc or shc is cxempt lhcrcfrcm and thc basis for thc nllcgcd cxemption. Any violalion of S6tion 70.1 I.5 by lny
applicant for a Fmit subjccts thc applicant to a civil pcnaly of not mrc lhan fivc hundrcd dollus (5500).
_1, as owncr of the propcrty. or my cmployces with wagcs as thcir vrlc comyrcnsali<ln. will do the work and thc structurc is ff)t
intendcd or offcrcd for salc (Scc.7044, Busincss and Profcssions Codc: Thc Contraclor's Liccnsc l-aw does not apply to an owncr of
thc p()pcrty who builds or inrprovcs thercon. and who docs such work himsclf or hcrsclf or through his or hcr own cmployccs.
providcd that such intprovcnrcnts arc not intcndcd orotlcrcd for salc. lf. howcvcr. thc building or irnprovcmcnt is sold withinonc year
of corrrplction. the Owncr Buildcr will have thc burden of proving that hc or shc did not build or improve thc propcrty for thc purpsc of
salc).
__1, as owncr of thc propcrty. am cxclusivcly contracting with liccnscd conlractors to construct thc projcct (Scc. 7(X4, Busincss
and l'rofbssion Codc: Thc Contraclor's Liccnsc Law docs not apply lo an owncr of property who builds or intproves thcrcon.
and who conlracls for such projccts with a Contractor(s) liccnscd pursuanl lo lhc Contractor's Liccnsc Law).
_l anr exctnpt undcr B.&.C. l'or this reason.
I hercby aflirm undcr penalty of pcrjury one of the following dcclarations:
_l havc ard will maintain a Ccrtificate of Consent to Self-lnsurc for workers' compensation, as providcd for by Scction 3700 of the
labor Codc. for thc ;lcrformance of thc work for which thc permit is issucd.
-l
havc and will maintain workers' compensation insurancc, as rcquircd by Section 3700 of the labor Codc, for the ;rcrformancc of
thc work for which this permit is issucd. My workers' compensation insurancc carrier and plicy number are:
Policy Numbcr: Expires:
_l ccrtity that in thc pcrlbrmancc of thc work for which this pcrnrit is issucd. I shall not employ any pcrson in any tnatlncr
so asto bcconrc subjcct to the workers'compensation lawsof California. and agrcc lhat if I should bccomc subjcct tothc
workers' cornpcnsalion provisions of Scction 3700 of the l-atnr Codc, I shall. forthwith conrply with those provisions..
WARNING: Failure to sccurc workers'comJrcnsalion covcragc is unlawful. and shall subjcct an employcr to crinrinal pcnaltics and
civil fincs up to one hundred thousand dollars in addition to lhc cost of compensation. damagcs as providcd for thc
Scction 3076 of thc Lrkrr Codc, intercst and
I hcrcby affirnr undcr pcnalty of pcrjury that I arn liccnscd Chaptcr 9 (commencing with Section 7000) of Division 3
of the Busincss and Professions Codc, and nry liccnsc is in full forcc and effcct.
Licensc Class: Liccnsc Numbcr:
Date:Contraclor:
W
I hcrcby aflirm undcr pcnalry of Frjury that thm is a construction lcnding 8gercy for the pcrformrce of thc work for which this lrmit is
issucd (Scc. 3097. Civ. C.).
l-crttlcr's Narttc:
[-cnder's Addrcss:
APPLIC^NT NECI ARATION
I trrcby atlirm undcr pnalty of pcrjury onc of the following dcclarations:
Dernolition Pcrmits-Asbcstos Notification Fcdcral Rcgulations (Titlc 40, Part6)
_Requircd Lcttcr of Notification
_l certify that thc fedcralregulations rcgarding asbcstos rcntovalurc not applicablc to this projcct.
_l ccltily that I huvc rcad this application and statc that thc atxlvc int'orrnation is corcct. I agrce to comply with all City and County
ordinanccs and Statc Luws rclating and hcrcby authorizc rcprcscntatives of this City and County lo cnlcr upon thc
atxlvc nrcntioncd propcrty lbr
Applicant or Agent
Pernritee nttme
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Carrier:
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