HomeMy WebLinkAbout20173905 - Permita
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Electrical
Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714) 647-5853
Permit #:20173905
Pin #: 86354
Proiect Address: 1636 E Stafford Sta
Assessor's Parcel: 400-295-09 Lot: 42
Unit:
Block: NA
Bldg:
Tract: 2648
Address Range:
Historic: No
Suite Range:
Zoning: R1
Owner:
Address:
Phone:
Tenant Name:
ROBERTO BORDA
1636 E STAFFORD ST
Santa Ana, CA 927013232
Clean Energy Solutions
417 W. Allen Ave. Suite 105
San Dimas, CA 91773
(800) e94-1 134
Fee Type
01 116002 5160C General Plan Update
01 116002 5777C Microfilm Records
Amount
23 79
405
Qty
000
000
Fee
$0 00
$0 00
Contractor
Address:
Phone.
State Lic #: 998787
Lic Type: B, C-10
Bus. Lic #: 349544
Workers' Compensation I nsurance:Carrier: State Fund
Policy #: g2gZ1G1
Expires: 0210612022
Building Use:
Job Type:
Nature of Work
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Single Family Dwelling
Solar
Solar
Smith, Mark
Zuniga, Allissa
09/1 3t2021
10t05t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Occupancy:
Constr Type:
Code:
Date:
Date:
Date:
R-3, U
VB
cEc 2019 Notes: Electrical for - Add to existing roof mounted solar
panels.
Buildins Permit #: 101 106576
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 permtt,s suspended
or abandoned for a period of 360 days after the time the work is
commenced.
Fee Total
Paid to Date:
Balance Due
$0 00
$0 00
$0.00
lnspector MtD#' 2021-165882
OWNER BUILDER DELCARATION
I h6cty affm und6 pcnalty of pojury that I m qemfl fiom thc ContracloN' Licce lrw for thc following r@n (56.70]1.5
Buine od Profsion Code); Any City or Couty which rcquirc a polnil to @nstruct, altq, imprcvg danolish or rrpair uy
structue. prior to its i$@cc. also requirc thc applicet for such pcnnit to filc a signcd statmqt that h€ or shc b licaucd pmuut
to thc provisioN of thc Contractor's Liccnsed law (Chaptq 9. Commencing with Selion 7000 of Division 3 of ahc Bsin6 ed
Prcfessions Codc) or thal he or shc is exempt thG€from ud thc basis for thc allcgcd aonption. Any violstion of Setion 7031.5 by any
applicanlforspmitsubjetsthc applicanttoacivilpmaltyofnotmorcthefivehundrcddollm($500).
_1, as owner ofthe property. or my ernployees with wages as thcir mle compensation. willdo the work and the structure is not
intendcd or offered for sale (Sec.7044. Business and Professions Code: The Contractor's License l-aw does not apply lo an orvner of
the propo'ty who builds or improves thereon. and r*'ho does such wort himsclf or herself or through his or her own employees,
provided that such improvonents are not intended or offered for sale. If, howet/€r. the building or improvcmort is sold wilhin one year
of complaion, the Orvner Builder will have the hrden of proving tha he or she did not build or improve the propaty for the purposc of
sale).
-1,
as owner of the propeny. arn exclusively contracting with licensed contractors to construct the project (Sec. 7U4, Business
and Profession 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 arn exempt under Section_. B. & P.C. for this reason.
Dete,
WORJ(ER^S' COM PENSATION
DECLAIIATION
I hereby affrrm under penalty of perjury one of the following declarations:
_l have and will rnaintain a Certificate of Consent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
Labor Code, for the perfonnance of the work for which the permit is issued.
-l
have and will maintain workers' compensation insurance. as required by Section 3700 of the labor Code. for the po'formance of
the rvork for which this pennit is issued. My workers' compensation insurance carrier and policy number are:
-l
certify that in the perforrnance of thc work for which this permit is issued, I shall not onploy any person in any manner
so :rs to becornc subject to the rvorters'cornpensation laws of California. and agree that if I should become subject to the
rvorkcrs' cornpensation provisions of Section 3700 of the Labor Code. I shall. forlhwilh comply with those provisions..
WARNING: Failure to secure workers' cornpensation coverag,e is unlawful. and shall subject an onployer to criminal poralties and
civil I'rnes up to one hundred thousand dollars ($100,000), in addition to the cost of compensation. damages as provided for the
Section -3076 of the Labor Code, intcrest and attorney's fecs.
Date:Annlinrnt.
LICENSED CONTRACTOR
DECI."ARATION
I hereby alTirm under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Codc, and my license is in full force and effect.
Policv Number: Exoircs:
License Class: Liccnse Number:
Date: Contractor:_
W
t hrcby aflim undo pcnalty of pcrjury that th@ is a @nstructbn loding ag6cy for thc pGfollme ofthc wort for which this pqrnit b
issucd (Se. 3097, Civ. C.).
Iadd's Nmc:
Lender's Address:
APPLICANT DECLARATION
I herelry affurn under penalty of perjury one of the following declarations:
Demolition Pennits-Asbestos Notification Federal Regulations (Title 40. Parr6)
-Recluired
Letter of Notification
-l
cdify that thc Gd6al rcgulatioE ntrding 6b6tos rmoval rc not eplieblc to this prcj61.
-l
cdiry that t have ud this application {d state that thc abovc information is cor€t. I agrc to comply with all City ud County
ordinancG ud Statc laws relating to builditrg construclio.r, dd h6cby authorizc rcpreqtativc of this City od Couty to @tq upon thc
abovc mcntioned prcpaty for imp€tion purpos6.
Applicant or Agent
Perrnitee nRme (print):____
APPROVALS DATE ID/SIG COMMENTS
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm lDampers
Communications Cable
Buildins
Under Slab / Floor I I ,,a
Bondinq I Groundinq / UFER 0lr tN 0,@1ru w
Transformers
Torqueing
Sub-Panels
Air Conditioners l-t/,tlJ -a,
Roof Top Equipment lm6(lalil ltr Ututh >v; w
Factory Wired Unit I t,
Walls (Conduit)
Walls (Rough)
Ceilinqs (Hard & Soffit Rouqh
Ceilings (T-Bar Roush)
Meter Release
Rough
Service Meter It It -aureh*FINAL tolulat ?V6
rlNotes, Remarks, Etc.
no n7 r)n{ tr
ELECTRICAL,I NSPECTOR RECORD
Owner:_
t