HomeMy WebLinkAbout20173767 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:20173767
Project Address: 1224 W Cubbon St
Assessor's Parcel: 010-272-06 Lot: POR 10
Unit:
Block. NA
Bldg: Address Range:
Tract: NININGER Historic: No
Pin #:
Suite Range:
Zoning: R1
Owner:
Address:
Naui Huitzilopochtli
1224 W CUBBON ST
Santa Ana, CA 927034924
(7141 248-3821
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777C
Fee Type
Heat Pumps
Genera! Plan Update
I ssuance
Microfilm Records
Amount
104.40
23.79
59.30
405
Qty
1 .00
1.00
1 .00
1.00
Fee
$104.40
$23.79
$5e 30
$4 0s
Phone:
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
state Lic #:
Lic Type:
Bus. Lic #;
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Bstch*:5?SBl 7iI3l202I I0r ELIZABETH
0lt' i ce: CTYH TrgnEi: 66 3 or 3
Accti: ftei'*: 2017 .l'767
Ftcpti:r.13349913 7il3/2tr2i 11:56 Al1
Transaction Tsto1 tlrlt-tCI,53
Houi HuitzilopochLlt
Building Use: Single Family Dwelling
Job Type. Miscellaneous
Nature of Work:
Ptanning conditions' fA0
Generol FIctn Updnte Fee
01 I l6tltr?- 51ott[t[t[t[t-
Flicrof ilrn & Documents
Lrl 1 16tlLr2- 377 7[t[t[t[t-
Electr i c01
ul I 16utl2- 516CI311[t[t-
Viss
CC+ : *r***tt*t***7ttl I
Notes. Electrical for mini split system located at rear of
property.
$?3 .-lv
$+ . iili
$ 16Ji .'/tl,t
$1r1t-ttt,::i3
Auth*; [tt-lS:110
$1 91 54
$0 00
$191.54
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Zuniga, rulirsff
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Total
Occupancy:
Constr Type:
Code:
Date:
Date.
Date:
R-3, U
VB
cEc 2019
07 t13t2021
Account#
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 site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
01 1 16002 51600
01116002 51603
01 1 16002 57770
$23 7e
$1 63 70
$4 05
Fee Total
Paid to Date:
Balance Due:
lnspector MtD#' 2021-167398
ELECTRICAL.INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby stfirm under lEnrlty of perjury that I m excmpt frcm thc Contrrclo6' Licens hw for the following rcasn (Scc.7031.5
Busincss and Profcssion Codc): Any City or County whhh rcluircs a lrrmit to @nsiruct. ilts, imprcrc, dcmlish or rcJEir ily
srructrc. prior to its issuare, llso rcquircs thc applicant for such lErmit to filc a signcd stalcmnt that lE or slE is licensd pusuut
to rhc prcvisions of thc Contractor's Liccnrcd las (Chaptcr 9. Comrcing wilh Sction 7000 of Division 3 of thc Busircss ud
ProfcssionsCodc)orrhrthcorshciscxemptthmfrcmandthcbasirforthcallcgcdcxcrlption. AnyviolrtionofsetionT03l,5byany'
applicant for a permil subjels thc spplicanl lo I civil pcnslty of not mrc lhil livc hundrcd dolles ($500).
_1, as owncr of the propcrty, or my enrployccs with wagcs as thcir solc compcnsation, will do lhc work and thc structure is not
intcndcd or offered for salc (Scr.7044, Busincss and Professions Code: The Contraclor's Licensc law docs not apply lo an owner of
thc proprty who br,rilds or improvcs thcrcon. and who docs such work himself or hersclf or through his or her own cmployees,
providcd lhat such improvcrrcnts arc mt intcndcd or offcrcd for salc. If, howcvcr, thc building or irnprovcnrcnt is sold within onc )tar
of comphtion, the Owncr Buildcr will have thc burden of proving thal hc or she diri not build or improve the propctty for thc purposc of
salc).
_1. as owncr of thc propcrty. am cxclusively contracting with liccnscd contractors lo construct thc projcct (Sec. 7W, Busincss
and Profcssion Code: Thc Contractor's Liccnsc Law does not apply to an owncr of property who builds or improves lhcrcon.
and who contracts for such projccts with a Contractor(s) liccnsed pursuant to thc Contractor's Liccnsc taw).
_l am lirr this
I hcrcby affirm under pnalty of perjury one of thc following
-l
havc and will maintuin a Ccrtificatc of Conscnt to Self-lnsurc for workcrs'compcnsation, as providcd for by Section 3700 of thc
labor Codc. for the pcrformancc of thc work lbr which thc pcrrnit is issued.
_l havc and will maintain workcrs' comlrcnsation insurancc, as rcquircd by Scction 3700 of thc l--abor Code, for thc pcrformance of
thc work for which this pcrmit is issucd. My workers' compcnsation insurancc carricr and policy numbcr arc:
Policy Numbcr: Expires:
-l
certify that in thc pcrformancc of thc work for which this prmit is issued, I shall not cmploy any [rcrson in any manncr
so as to beconrc subjcct to thc workcrs' comlrcnsation laws of California, and agrcc that if I should bccome subjcct lo thc
workers' compcnsation provisions of Scction 3700 of the Labor Code, I shall, forthwith comply with those provisions..
WARNING: Failurc to liccurc workers' compcnsation covcrugc is unlawful. and shall an cmploycr to crinrinal pcnaltics and
onc hundrcd thousand dollars ($ I in addition to thc as providcd for thc
Latxlr Codc. intcrcst and
ITT'CI ARATION
I hcrcby aflirm under pcnalty of pcrjury that I am licensed undcr provision of Chaptcr 9 (commcncing with Sc"ction 7000) of Division 3
of thc Business and Profcssions Codc, and rny license is in full force and effect. ,
Liccnsc Class: Licensc Number:
Conlractor:
W
I hcrcby affirm undcr lrcmlty of pcrjury that thcrc is a @nstruction lcnding agcrcy for thc perfomncc of the work for which this Frmit is
issucd (Se. 3097, Civ. C.).
lrnder's Name:
lrnder's Address:
APPLICANT NECLARATION
I trrcby aftirm undcr pcnalty of pcrjury onc of thc following dcclarations:
Dcmolition Permits-Asbcstos Notification Fcdcral Rcgulations (Title 40. Part6)
_Rcquircd l.cttcr of Notification
-l
certity that the fcdcralregulations rcgarding ashstos rcmovalare not applicablc to this projcct.
_l ccrtily that I havc rcad this application and statc that thc information ls corrcct. I
ordinanccs and State [:ws rclating to
abovc nrcntioncd propcrty for
Applicant or Agent
IDernritee name
hcrcby ,Z/lhc
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
Bondino lGroundinq I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouoh
Ceilings (T-Bar Roush)
N/eter Release
Rouoh
Service N/eter .,
FINAL Ir ) /tq/zt Lu> 5q
Notes, Remarks, Etc.
fJrrr no n7 ont tr
\