HomeMy WebLinkAbout20174166 - 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 #: 2o^174166
Pin #: 20871
Proiect Address: 1851 W MeadowbrookDr-a- -
Assessor's Parcel: 412-521-71 Lot: 153
Bldg: Address Range:
Tract 1631 1 Historic: No
Unit:
Block: NA
Suite Range:
Zoning. SD4
Owner:
Address:
Phone
Tenant Name:
Contractor:
Address:
Phone
Kristopher Do
1851 W Meadowbrook Dr
Santa Ana, CA 92704
(7141 234-9600
South West Sun Solar, lnc.
13752 Harbor Blvd
Garden Grove, CA 92843
(7141 582-3s09
01 1 16002 s360'
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777C
Fee Type
P lC - 650/o
General Plan Update
I ssuance
Microfilm Records
Amount
06s
23.79
59 30
405
Qty
49.78
0.00
0.00
0.00
Fee
$32.36
$0.00
$0 00
$0 00
State Lic #: 1004667
Lic Type: C-10, C-39
Bus. Lic #: 350754
Workers' Compensation I nsurance:Carrier: Starnet lnsurance Company
Policy #: BNUWCO154184
Expires. 06/01 12022
Building Use.
Job Type:
Nature of Work:
Planning Conditions:
Planning Approval By:
Plan Checked By.
Permrt lssued By:
Single Family Dwelling
Solar
Solar
Smith, Mark
Zuniga, Allissa
08t30t2021
09t07 t2021
Account#
Misc. Receipt: 75849
Misc. Receipt.
Misc. Receipt.
Total
Occupancy:
Constr Type:
Code.
Date:
Date:
Date:
R-3, U
VB
cEc 2019 Notes: Electrical for new roof mounted solar PV system - Over
10 kw
Subject to Field:
Buildins Permit #: 1 01107763
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.
Fee Totat
Paid to Date.
Balance Due:
$32 36
$32 36
$0.00
Permitee MID#: 2021-1 68416
ELECTRICAL-INSPECTOR RECORD
APPROVALS DATE !D/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby trflirm undcr pcnalty of pcrjury that I m cxctrrpt from the Contractom' Lhcns ljw for lhc following rcasn (Se.7031.5
Busincss and Profcssion Codc): Any Cily or County which rcquircs s pcrmit lo snslruct. altca improvc, dcmlish or rcpair any
slructurc. prior to its issuancc. also rcquircs thc applicant for such pcrmit to lilc s signcd sldcmnt th.t hc or she is li@n$d puEuut
to lhc prcvisions of thc Contmctor's Liccnsd t:w (Chapter 9, Comrcncing with Setion 70OO of Division 3 of th€ Busiress md
PmfessionsCodc)orth.thcorshcLscxcmptthercfromandlhcbasisforthcslhgedcxcmption. AnyviolstionofsctbnT03l.5by.ny
opplicant for s permil subtEls thc applicant to a civil penalty of nol rmrc than fivc hundrcd dollus ($50O).
-1.
as owncr of the propcrty, or my employccs with wagcs as thcir solc compcnsation. will do thc work and thc structure ls not
intendcd or offcrcd for salc (Sec.7044. Business and Professions Code: The Contraclor's License [:w docs not apply to an owner of
thc propcrty who builds or improves thereon. and who docs such work himsclf or hcrsclf or through his or hcr own employecs,
providcd that such improvcnrnts are not intcrded or offercd for salc. If. howcvcr. thc tuilding or improverrcnt is sold within one year
of complction. thc Owncr Buildcr will have the burden of proving that hc or shc dirJ not bnrild or improve the propcrty for the purpose of
sah).
-1,
as owncr of thc propcrty, am cxclusivcly contracting with licensed contr&clors to construct thc projcct (Scc. 7W, Busincss
and Profcssion Codc: The Contractor's Liccnse Law docs not apply lo an owner of propcrty who builds or improves thcreon.
and who contracts tbr such projccts with a Contracto(s) liccnscd pursuant to thc Contractor's Liccnsc l-aw).
-IamexemptundcrSection-'B.&P.C.forthisrcason.Il.. r ^.41..,-^-.
WORKERS' COMPT'NS.ITION
DECLARATION
I hcrcby alfirrn undcr penalty of pcrjury one of the following declarations:
-l
havc and will maintain a Ccrtificatc of Consent to Self-lnsurc fior workers' compcnsation. as providcd for by Scction 3700 of the
I-:rbor Codc, for thc pcrformancc of thc work for which thc ;rcrmit ls issucd.
-l
havc and will maintain workcrs' comlrcnsation insurancc. as rcquircd by Section 3700 of thc Labor Codc, for thc pcrformance of
thc work for which this pcrmit is iszucd. My workers' compcnsation insurancc carricr md plicy numbcr arc:
Policv Number: Exoires:
_l ccrtify that in thc pcrformance of thc work for which this pcrmit is issucd. I shall not crnploy anyfrcrson in any manncr
so as lo bccomc subjcct to the workcrs'compensalion laws of California, and agrcc that if I should become subjcct to the
workcrs' conrJrcnsalion provisions of Scction 3700 of the [:bor Code, I shall. forthwith comply with thosc provisions..
WARNING: Failurc to riccure workers'compensation covcragc is unlawful. and shall subjcct an cmploycr to criminal penalties and
civil fincs up to onc hundred thousand dollars ($100,000), in addition to thc cost of compcnsalion. danugcs as providcd for the
Scction 3076 of thc l-abor Code. intcrcst and attorney's fccs.
Dale:A rrnlinonl.
LICENSED CONTRACTOR
DECLARATION .
I hercby afflrm undcr pcnalty of pcrjury that I arn liccnscd undcr provision of Chaptcr 9 (commcncing with Section 7000) of Division 3
of thc Busincss and Profcssions Code, and my licensc is in full force and effcct.
Liccnse Class: License Number:
W
I hcrcby alfirrn undcr Jrmlty of prjury that therc is a onstruction bnding agcncy for thc 1Erfonrurce of lhc work for which this pemit is
issucd (Sc. 3097, Civ. C.).
lxndcr's Nam:
lrndcr's Addrcss:
APPLICANT DECI ARATION
I trcrcby affrrm under pcnalty of pcrjury one of the following dcclarations:
Demolition Pcrmits-Asbestos Notification Federal Regulations (Titlc 40, Part6)
_Rcquircd l.cttcr of Notification
-l
ccrtify lhal thc fcdcral rcgulations rcgarding asbestos removalare not applicablc to this projcct.
_l ccrtify that I have read this application and state that the above information is corrcct. I agrcrc to comply
ordinanccs and Statc [,uws rclating to building construction. and hcrcby authorizc rcprcscntatives of this City
abovc mcntioncd propcrty for inspcction purposes.
with all City and County
and County to entcr upon thc
Applicanl or Agenl
IDernrilee nutne ( prinl ):
Date:_
Site-Work
Underground
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Building
Under SIab / Floor
Bonding I Groundins I UFER
Transformers
Torqueincr
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilings (Hard & Soffit Rouqh
Ceilinqs (T-Bar Rouqh)
N/eter Release
,}e.asa,- Pcrx---r Ztr:[p -t 3-? t ftq*ir,
Rough
Service JMeter
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