HomeMy WebLinkAbout20173483 - PermitCitV of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection. (714)647-5853
Permit #:2o-173483
Pin #: 34329
/l/1/
Proiect Address: 1224 W Cubbon Sta
Assessor's Parcel: 010-272-06 Lot: POR 10
Unit:
Block: NA
Bldg:
Tract: NININGER
Address Range:
Historic: No
Suite Range:
Zoning: Rl
Owner:
Address:
Phone
Naui Huitzilopochtli
1224 W CUBBON ST
Santa Ana, CA 927034924
(7141 248-3821
01 1 16002 51603
01 1 16002 51603
01 1 16002 51603
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
Fee Type
Res Rewire
Garage Rewire
Serv Meter
General Plan Update
I ssuance
Microfilm Records
Amount
0.16
0 16
57.40
23.79
59.30
4.0s
Qty
1,232.00
400.00
1 .00
1 .00
1.00
100
Fee
$197 12
$64 00
$s7 40
$23 79
$59.30
$4 05
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Bntch*:5?53? 6/L+/'Jt-t?l IDr ELIZABETH
Office: (:TYH Trcrns*: ? 2 of' ?Accti: Fiet'*: 2tt173483
Rcpti:0331?359 6/14/2tJ?I $:57 An
Trnnsqrt i on Total $566 .4+
Nnui HuitailoporhtliBuilding Use:
Job Type:
,Nature of Work:
, Planning Conditions:
a
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Miscellaneous
Rewire
Chavez, Dave
-
Electrical re-wire and service meter
given. dwner-Builder forrn on file.
upgrade. Handout
Occupancy:
Constr Type:
Code:
Date:
Date:
Date.
R-3, U
VB
cEc 2019 Notes:
Fee Total:
Paid to Date:
Balance Due:
Lf l 1 1 61-ilj2- 3777lJt:il:rlr-
Electr i c0l
Ltl I 16ttlt2- 5 16r-r3r:tu[t-tlisn
(:(:+ : *****r** tr* * +242
$666 . ++
Authi:u3?7?C
$40s 66
$0 00
$405.66
$4 . [lI,
*,4
c,06/1 4t2021
Account#
Misc. Recerpt:
Misc. Receipt:
Misc. Receipt.
Total
Buildins Permit #: 101 106931
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 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
01 1 16002 51603
01116002 57770
$23.7e
$377.82
$4 0s
Inspector MID#'. 2021-166718
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underoround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Buildinq
Under SIab / Floor
Bondinq I Groundinq I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factorv Wired Unit
Walls (Conduit)
Walls (Roush)?- 14.Lt YrfxvC 4v
Ceilinqs (Hard & Soffit Rouqh 'l -l 4 -Ll o*t**z-
Ceilinqs (T-Bar Rouqh)
Meter Release
Rouqh
Service N/eter -a--
FINAL lC I )4/ t-l D-t) 8.,,
Notes, Remarks, Etc.-
4
OWNII.R l|t,Il,l)t,.R
I hereby affirm under lrcnalty of perjury that I am exempt fnrm the Contractors' License Law ftrr the following reason (Sec.7031.5
Business arxl Profession Ctxle): Any City or County which requires a permit to construct. alter. improve, dennlish or repair any
struclure, prilr to its issuance. also requires the applicant for such prrmit to file a signed staternent that he or she is licensed pursuant
to the prlvisions of the Contractor's Licensetl Law (Chapter 9, Commencing wilh Section 7fi)0 of Division 3 of the Business and
Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a perrnit subjects the applicant to a civil penalty of not nnre than five hundrerl dollars ($500).
_1. as owner tlf the property. or my employees with wages as thcir srh comJrcnsation, will do thc work arrl ttp stnrcture b not
intended or offered for sale (Sec.7O44, Business antl Professions Code: The Grntractor's License Law does not apply to an owner of
the property whr builds or impnrves thercon, and who does such work himself or herself or through his or her own employees,
provided that such improvenrnts are not inten<led or offered for sah. If, tnwever. the building or inpnrvenrcnt is soltl within one year
of completion, the Owner Buikler will have the burrlen of proving tlra he or she dil not build or improve 0re prugrrty for the prrynse of
sah).
-[,
asowner of the property, arn exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business
and hofessirn Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's License Law).
-l
am exempt under ftrr this
a
I hereby affirm under penalty of perjury one of the following declarations:
-l
have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation, as pruvided for by Section 3700 of the
Labor Code, for the performance of the work for which the permit is issued.
_l have and will maintain workers' compensatkrn insurance, as required by Section 3700 of the l-abor Code. for the performance of
ttre work for which this permit is issued. My workers' compensatkrn insurance carrier and policy number are:
Carrier:
Policy Number: Expires:
_l certify that in the lrcrformance of the work for which this grcrmit is issued, I shall not empk)y any frcrson in any manner
so as to become subject to the workers'compensation laws of California. and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the latxrr Code, I shall, forthwith comply with those pnrvisions..
WARNING: Failure to sEcure workers'comJrensation coverage is unlawful, antl shall
civil fines up to one hundred thousand dollars ($100.m0), in atldition to the cost of
suhject employer to and
Section 3076 of the Lahlr Code, interest and attorney's fees.
,,*, b-/ ?' 7l /w
I hereby affirm under penalty of perjury that I am licensetl under provision of Chapter 9 (comnpncing with Section 7m0) of Division 3
of the Business and Professions Code, and my license is in full ftrrce and effect.
I
License Class: License Number:
CONSTRUCTION I TNDING AGENCY
I hercby affirm under penalty of prjury that therc is a construction hnding agency for the performance of the work for which this permit b
issued (Sec. 3097. Civ. C.).
Lender's Name:
Lender's Address:
APPLICAN'I' DECLARA'I'ION
I hereby afhrm under penalty of perjury one of the following declarations:
Dernolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Require<l
Letter of Nrlifrcation
certify that the federalregulations regarding asbestos removalare not applicable to this project.
certify that I have read this application and state that the ahrve information is conect. I agree to cornply with all City and County
and State Laws relating to building construction,this City and
atxrve nrcntioned prolrcrty for
Applicant or Agent
Pernritee nanle
representatives
o
enter uJxln the
Flev. 08-07-2015
(print):-