HomeMy WebLinkAbout20173130 - PermitProiect Address: 5132W First Sta
Assessor's Parcel: '108-74243 Lot. 42
Unit: B
Block: NA
Bldg
Tract: 8939
Address Range:
Historic: No
Suite Range:
Zoning: R2
City 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^173{30
Pin#: "W
Owner:
Address:
Phone:
Tenant Name:
Contractor.
Address:
Phone:
David O'Brien
5132 W. First Street
Santa Ana, CA 92703
(7141 22743s2
Semper Solaris
10713 Norwalk Blvd
Santa Fe Springs, CA 90670
(61e) 7154054
01 1 1 6002
01 1 1 6002
01 1 16002.
01 1 1 6002
51 603
51 600
51 603
57770
Fee Type Amount
Air Conditioner 104.40
General Plan Update 23.19
lssuance p,cr ?, ,: h # : :.i g iJ :,1 _i sq?q 4 ,r
,,f
t-i,")
Microfilm RH&ids: i l /[] 4:OSris* i
Ar._,-L f : l;lr:firrit:?:!:i32:"/6!'!.i 4./14,i
Qty
100
100
100
100
Fee
$1 04 40
$23 79
$s9 30
$4 05
iernp er So l nr
State Lic #: 978152
Lic Type: B, C-10, C-39, C46
Bus. Lic #: 365759
Workers' Compensation I nsurance:Carrier. Midwest Employers Casualty
Policy #: BNUWCO1 SZ4BI
Expires'. 1011012021
Senernl PI nn Updnte t
Jl I 16r-rriZ- 5160$JUL|-
il ect,r i cn l
t1 I 16lttr2- 516Lt3r:t0t:r-"licrolilm & Document:
I1 1 1,1t]tt2- 577 7t-tt-t0tl-
I (:1. [:hec]l 11345
Building Use:
Job Type:
' Nature of Work
. Planning Conditions:
Planning Approval By
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Condominium
Miscellaneous
HVAC
Orozco, lvan
Occupancy:
Constr Type
Code:
Date:
Date:
Date:
R-1
VB
cEc 2019
04t1412021
04t14t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Notes: HVAC system. AC condenser at rear
Fee Total:
Paid to Date:
Balance Due:
Chavez, Dave
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.
lnspector MID#: 2021-165517
01116002 51600
01 1 16002 s1603
01 1 16002 57770
$23.79
$163.70
$4.05
$191 .54
$0.00
$191 .54
ELECTRICAL.I NSPECTOR R ECOR D
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrcby amrm undcr Fnilry of perjury that I u exempt from thc ContractoE' Licenrc l:w for lhe following rc&$n (Ss.703ir5
Busincss and Prcfcssion Codc): Any City or County which rcquircs a fsmit to construcl, trlter, improvc, demlish or qBir uy
structuc. prhr to its issuqncc, also rcquircs the .pplicot for such Frmil to filc a sigrcd st.tcrent that he or shc k liccn*d pmmt
to the prcvisions of the Contractor's Licenrcd l"rw (Chaptcr 9. Commencing wilh Setion 7000 of Division 3 of thc Busincss and
PrefcssionsCodc)orthathcorshciscrcmptthercftomandthebasisforthclllcgcderemption. AnyviolalionofSctionT03l.5byany
epplicant for I lErmit $ubjccts the applicant to r civil penalty of not mre than five hundrcd dollus ($5fi)).
_1. as owncr of thc propcrty, or my employces with wagcs as thcir sole conrpcnsation, will do thc work and thc stnrcturc is not
intcndcd or otTcred for salc (Scc.7044. Busincss and Professions Code: Thc Contraclor's Liccnsc law does not apply lo an owncr of
thc proJrcrty who builds or improves thcrcon. and who docs such work hinrself or hcrsclf or through his or hcr own cmployccs.
providcd that such inrprovcnrnts are not intcrxlcd or offcrcd for sah. If. howcver. thc building or improvcnrcnt is rcld within onc ytar
of complction, the Owncr Builder will havc thc burdcn of proving that he or shc did not build or intprovc thc propcrty for thc purynse of
'uh).
_1, as owncr of thc propcrty. am cxclusivcly contracting with liccnscd contractors to conslruct thc pnljcct (Scc. 7W, Busincss
and Profcssion Codc: Thc Contraclor's License Law does not apply lo an owner of property who builds or improves thercon.
and who contracts fbr such projccts with a Contractor(s) liccnscd pursuant to thc Contractor's Liccnsc taw).
-IatncxenrplundcrScction-'B.&P.C.forthisrcason.
Owner:
wo Rxn' ts' cour pn'rrLsl rro) x
DECI ARATION
I hcreby affirm under Srenalty of pcrjury one of the following declarations:
-l
havc and will maintain a Certifrcate of Consent to Sclf-lnsurc for workcrs' compensation. as providcd for by Section 3700 of the
l,abor Code, for the performancc of the work for which thc permit ls issued.
_l havc and will maintain Section 3700 of thc labor Codc, for thc pcrformance of
thc work for which this carricr and number arc:
o ,rS CA ea Con?
Policy (F o o
_l ccrtify that in thc pcrtbrmancc of the work for which this pcrrnit is issucd, I shall not crnploy any person in any manncr
so as to bccomc subjcct to thc workcrs' comgrcnsation laws of California. and agrec that if I should beconrc subjcct to the
workcrs' cornpcnsation provisions of Scction 3700 of the labor Codc, I shall. lbrthwith cornply with thosc provisions..
WARNING: Failure to stcurc workcrs'compcnsation covcragc is unlawful. and shall subject an cmployer to criminal pcnaltics and
civil tines up to one hundrcd thousand dollars ($100,000), in addition to thc6ost of comgrcnsation, damagcs as provided for thc
Scction 3076 of thc Labor Codc, intercst and attorrrcy's t'ccs,
D,,"., Lr-\Lt -L[ ffi,'* 8", [) f, '
I hcreby affirm undcr pcnalty of pcrjury that I arn liccnsed undcr provisit of Chaptcr 9 (commcncing with Section 7000) of Division 3
of thc Busincss and Profcssions Codc, and nry liccnse is in full force and cffect. .
Liccnsc
,a Qtnlt)
D",.. r L.l -lL{-21 rt ciY \a
W
I hcrcby affrm undcr lEnllty of pcrjury that thcrc is a constructbn lcnding agcncy for thc perforlmce of thc work for which this permit is
issued (56. 3@7. Civ. C.).
lxndcr's Namc:
[.cnder's Addrcss:
APPLICANT DECLARATION
I trcrcby affrnn under penalty of pcrjury onc of thc following declarations:
Dcmolition Pcrmits-Asbestos Notification Fcderal Regulations (Title 40, Part6)
-Requircd
l.cttcr of Notification
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Siqns (monument)
Life Safety /Low Voltaqe
Fire Alarm lDampers
Communications Cable
Buildinq
Under Slab / Floor
Bonding I Grounding I UFER
Transformers
Torqueinq
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rouqh)
Ceilinqs (Hard & Soffit Rouqh
Ceilinqs [-Bar Rouqh)
JMeter Release
Rough 4 -t?-2t Wt?L/a
Service Nleter
FINAL 9-19-?,tu{42
Notes, Remarks, Etc.
-s,
Dr.rr nO n7 Onl tr
Date:_
-Expir"#-
rcmovalare not applicablc to this projcct.
intbrnutio:r is corrcct. I agrce to conrply with all City and County
rcprescntatives of this City and County to cnter upn thc
abovc mcntioncd property for
Applicant or Agent
Pernritee nanre @ H,p+t.ra
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