HomeMy WebLinkAbout20174256 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 20174256
Pin #: 557OT
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Project Address: 1611 S Van Ness Ave
Assessor's Parcel: 013-193-10 Lot: 38, 39
Unit:
Block: E
Bldg:
Tract: 531
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone:
Carlos Marquez
161 1 S Van Ness Ave
Santa Ana, CA 92707
(909) 251-8704
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777C
Fee Type
Heat Pumps
General Plan Update
I ssuance
Microfilm Records
Amount
104.40
23.79
59 30
405
Qty
3.00
1 .00
1 .00
100
Fee
$313.20
$23 79
$s9.30
$4 05
t
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation ! nsurance:
Carrier:
Policy #:
Expires:
Eotch*:6116+
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Building Use.
Job Type.
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Alteration
Mini-splits
Occupancy:
Constr Type:
Code:
Date.
Date:
Date:
R.3, U
VB
cEc 2019
".or loE florquer
,:€rrEPOl l-'lOn up6f,f,e hE($?3 .'/'
09t08t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: (3) mini.splits
I'i icr"of'tlm fr []ctr:utrtents
ttl 1 I 6tttt2- fl777trlr[ttt-
Electr i col
ttl I l6tlLl2- 516tt3tt[ttt-
U iso
(:(:+ : t*t******* x*'/ 36?
Fee Total
Paid to Date:
Balance Due:
$/i. [lIi
$ 372 , 5[r
$989, 6[r
Aubni:[t4 14lG
$400.34
$0.00
$400.34
Amsden, Julie
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 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 7e
$372.50
$4.0s
lnspector MID#'. 2021-167431
ELECTRICAL.INSPECTOR R ECORD
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATTON
I hcrcby affrm under pcnalty of perjury that I u ercnpt ftom thc Coilracto6' Liccnse llw for thc following rcamn (Sm.7031.5
Busincss and Profcssion Code): Any City or Counry which rcquircs 8 lrrmil to construct, alts, imprcvc, &mlish or rcpair .ry
structw, prior to its issumce, alrc rcquircs the applicMt for such Frmil to filc a signcd slalorcnt thrt hc or she ir liccnEd pursanl
to thc Eovisions of thc Contractor's Licensd txw (Chapter 9. Comncing uilh Setion 7000 of Division 3 of lhe Business md
PrcfcssionsCode)orthatheorshciscxcmptthqcfrcmildthcbasisforthcallcgcdcxcmplion. AnyviolalionofSetionT0-ll.5byany
applicanl for a permit subjets thc applicant to a civil pcnalty of not mrc than fivc hundrcd dolltrs (5500).
CA
-1.
os owncr of the prcpcny, or my cmplolccs wilh wagcs as lhcir mle com;rcnsalion, will do lhc wqk ild thc strwtrc is mt
irtcndcd or offcrcd for gle (S8.7(X4, Busincss and Professions Codc: Thc Contrelor's Liccns lrw docs rcl spply lo m owrcr of
lhc pmlErty uho builds or itrprcE thc@n. aM who dc och wrk himsclf or hcrsclf or lhrcugh his or hcr own cmpk yccs,
prcvidcd that such imlrcremnts rc mt iilcrdcd or ollcrcd for eh. If. howcwr, thc building or itrprcwmnt is sld within orc )ru
of @tr{rhtiotr the Owrcr Buikkr will haw rhe burdcn of prcvisg tlul hc or shc dil rct hriH or in{mw lhc propcrty for the Jroqn* of
sb).
_1. as owncr of thc proprty, am cxclusively contracting with liccnsed conlraclors lo conslruct thc pr<ljcct (Scc. 7W, Busincss
and Profcssion Codc: Thc Contraclor's Liccnsc Law docs not apply to an owner of profrcrly who builds or improvcs thcrcon.
and who contracts for such projccts with a Contraclor(s) liccnscd pursuant lo lhc Conlraclor's Licensc [:w).
_l am cxcmpt Section-. B. & p.c. rgffir"rldn.
dt t owner: Z.-U*(\
rV r r R X n RsiCt(Tp r"r,rsf rlf i N
DECLARATION
I hereby affirm under penalty of perjury one of the following dcclarations:
_I have and will rnaintain a Certificate of Consent to Self-lnsurc for workcrs' compensation, as pmvided for by Section 3700 of thc
l-abor Codc, for the performarrce of the work for which the pcrmit is issued.
_l have and will maintain workcrs' compensation insurarrce, as required by Scction 3700 of the Labor C-ode, for the performarrce of
the work for which this permit is issued. My workers' conpensation insurarrce carrier and policy number arc:
Carrier:
Policy
C A, ccrtify that in the performance of thc work for which this pcrmit is issued. I shall nor cmploy any f,crson in any manner
so as to bccome subject to the workers' compensation laws of California, and agrce that if I should bccomc subject to thc
workers' compensation provisions of Section 3700 of the L:bor Code, I shall, forthwith comply with thosc provisions..,
WARNING: Failure lo sccure workers'compcnsation coverage is shall subjcct an cmployer to criminal J:cnaltics and
compensation. damages as providcd for thccivil fines up to onc hundred thousand dollars ($100.00O). in of
Scction 3076 labor Codc, intercst and attorncy's fecs.
q ?Lr
I hercby af firm under Slenalty of perjury that I am liccnscd under provision of Chaptcr 9 (commencing with Scction 7000) of Division 3
of the Business and Professions Code. and my liccnsc is in full forcc and effcct.
License Class: License Number:
Contractor:
W
I hcrcby afltrm undcr Fmtty of perjury that thcrc is a onstruction bnding agcncy for thc Jrcrforronce of thc work for which Ihis Jrcrmit is
issucd (S@. 3097, Civ. C.).
lrnder's Namc:
I-rndcr's Address:
APPLICANT DF'CL A ITATION
I hcrcby affrm under penalty of pcrjury onc of thc following dcclarations:
Dcmolition Pcrmits-Asbestos Notification Federal Regulations (Titlc 40, Part6)
-Required
lrtter of Notification
_l certify that the federal regulations regarding asbestos removal arc not applicablc to this projcct.
Ctr
_l certify that I have rcad this application and state that the above information is corrcct. I agree to comply with all City and County
ordinanccs and State Laws relating to building and hcreby authorizc rcprcscntativcs
atxlvc nrcntioncd propcrty for inspcction
Applicant or Agent
Permitee name (orint):CA 1S UG;1vtt Aa,.q(q 0L ?,
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab I 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 [-Bar Rouqh)
N/eter Release
Rouqh
Service N/eter t I /?
FINAL te\\)d\a VA#A Y
Notes, Remarks, Etc.lr I
.rr, nQ n7 Onlq
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