HomeMy WebLinkAbout20171929 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, C,A927O?- Electrical
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 2o^171929
Pin #: 98536
lit
Proiect Address: 1811 N Greenleaf Sta
Unit:
Block: B
Bldg:
Tract: 256
Address Range:
Historic. No
Suite Range:
Zoning: RlAssessor's Parcel: 002-104-26 Lot: POR 1
Owner:
Address:
Janna Middel
1001 W Stevens Ave #408
Santa Ana, CA 92707
(7141 356-2734
Fee Type
01 1 16002 51603 FWU
01 1 16002 51600 General Plan Update
01 1 16002 51603 lssuance
01 1 16002 57770 Microfilm Records
Amount
26.71
23.79
59.30
4.05
Qty
1.00
1.00
1.00
1.00
Fee
$26.71
$23.7e
$59.30
$4.05
Phone
Tenant Name:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Alteration
FWU
Occupancy:
Constr Type
Code:
R-3
VB
cEc 2019 Notes: for a/c & furnance - owner/builder on file
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Verduzco, Violet {r
Date:
Date:
Date:09t22t2020
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
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
01 1 16002 51603
01 1 16002 57770
$23.79
$86 01
$4.05
Fee Total:
Paid to Date:
Balance Due:
$t t 3.85
$0.00
$1 13.85
lnspector MID#:2020-1 61221
NSPECTOR RECORD:LE,U T FT
APPROVALS DATE ID/SIG.COMIIIENTS
Site-Work
Underqround
Pole Bases
Lisht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltaqe
Fire Alarm / Dampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding I Grounding I UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouoh)
Ceilinss (Hard & Soffit Roush
Ceilinss (T-Bar Roush)
N/eter Release
Rouqh
Service [Vleter rl ,l ,,,
FINAL tOltl/2 iff
Notes, Remarks, Etc.
()wNltR
I hereby affrnr under penalty of perjury that I arn exenrpt from the Contractoru' License Law for the following reason (Sec.7031.5
Business and Prolbssion Code): Any City or County which rcquircs a permit l,o construct, alter. itnprove, demolish or rcpair any
structure, prior to its issuance. also requires the applicart for such pernrit to file a signed statement that he or she is licensed pursuant
to the pmvisions of thc Contractor's l.icenscd l,aw (Chaptcr 9, Cornmcncing with Section 7000 of Division 3 of the Business and
Professions Code) or that he or she is exempt therefrom and tlre basis for the alleged exemption. Any violation of Section 7031.5 by any
appticant for a pennit subjects the applicant to a civil penalty of not more than llve hundred dollars ($5Otl1.
_1, as owner ol'the property. or my employces with wages as their sole compcnsation, will do the work and the structure is not
interrrled or offeretl ftrr sale (Sec.7(Xa, Business and Professions Code: The Contractor's License Law does not apply to an owner of
the prcpeny wlxr builds or inrproves thereorl ad who does such work himself or herself <lr through his or her own entployees,
providcd that such improvcnrcnts arc not intcnded or ollered for salc. I[, howevcr, t]re building or improvemcnt is sold within one year
of completion, tlre Owner Builder will have the burden of proving that lre or slrc did not build or improve the properry for the purpose of
sale).
_1, as owner of the property, am exclusively contracting witlr licensed conlractors to conslrucl the project (Sec. 7044, Business
and Bnrfession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and Who confacts lor such projccts with a Contractor(s) licensed pursuant to thc Contractor's License Law).
_l anr exempt B. & P.C. tbr tltis reason.n
I hcrcby aflirm under penalty of pcrjury one of tlrc
-I
have and will nninlain a Certilicate of Conseltt to for workers' conrpensation, as provided for by Section 3700 of the
Labor Code, for the performancc of thc work for which the pcrmit is issued.
_I have and will nraintain workers'conpensation insurance, as required by Section 3700 of the Labor Code, for the perfonnance of
the work for which this permit is issued. My workers' compensation insurance carrier and policy number are:
Policy Nurnber: Expires:
_l cerrify that in tlrc lrcrfornunce of thc work for which this pcrmit is issued, I shall not cmploy any [rcrson in any manncr
so as to becornc subject to the workcrs' contpensation laws of California, and agree that if I should bccomc subject to the
workers' conrlrcnsation provisions of Section 3700 of the Labor Code, I slrall, forthwith cortrply with those provisions..
WARNING: Failure to secure workers' cornpensation coverage is unlawful, and shall subject an employer to crirninal penalties and
civil fines up to oue hundred thousand dollars ($100,000). in addition to tlrc cost of competnation, damages as provided for the
attorncy's
I hereby affrrn under penalty of perjury that I anr licensed of Chapter 9 (cournrcncing with Section 7000) of Division 3
of the Business and Profiessions Code. and my license
License Class: License Number:
Date:
CONSTRUCTION LENDING AGENCY
I hcreby allirrn under pcnatty of perjury that there is a construction lending agency for thc pcrlbrmance of thc work ltrr which this perrnit is
issued (Sec. 3097, Civ. C.).
knder's Name:
[rnder's Address:
APPI,ICANT DECLARATION
I tmeby affirm under pcnalty of perjury one of the following dcclarations:
Demolition Permits-Asbcstos Notification Federal Regulations (Titlc 40, Part6)
-Required
lrttcr of Notification
_I ccrtify that the federal regulations regarding asbestos removal are not applicable to this project.
_l certify tlrat I have read this application and statc that the abovc information is correct. I agrec to comply
ordinances and State Laws rclating to building construction, and hereby authorizc representatives of this City
with all City and County
and County to entcr upon thc
above nrcntioned properry for
Applicant or Agent
Pcrnrilce nanlc
r
Flev. 08-07-201 5
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