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Home My WebLink About20157732 - Permit) City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical Permit Counter: (714) 647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853 Permit #: 2o^157732 Pin #: {9OO2 Project Address: Unit: Assessor's Parcel: 005-041-20 Lot: 20 Block: NA Bldg: Tract: 1 196 Address Range. Historic: No Suite Range: Zoning: Rl Owner: Address: Phone: Tenant Name: Paul Tallman 1518 N Rosewood Avenue Santa Ana, CA 92706 Selectric Electrical Services 691 N 3rd Avenue Upland, CA 91786 (90e) 5324494 Fee Type 01 1 16002 51603 Serv Meter 01 1 16002 51600 General Plan Update 01 1 16002 51603 lssuance Amount 48.1 0 19.93 49.68 Qty 1.00 1.00 1.00 Fee $48.1 0 $1e.e3 $49.68 I Contractor: Address: Phone: State Lic #: 799824 Lic Type: C-10 Bus. Lic #: 351096 Workers' Compensation I nsurance: Carrier: Exempt Policy #: Expires: Building Use: Single Family Dwelling Job Type: Miscellaneous Nature of Work: Service meter Occupancy. Constr Type: Code: Date: Date: Date: R-3, U VB cEc 2013 Notes: Relocate & upgrade service meter/handout given. Planning Conditions; Repair any damaged stucco on exterior finishes Planning Approval By: Plan Checked By: Permit lssued By: Soto, Ricardo , Julie 08t2712015 08t27 t2015 Account# Misc. Receipt: Misc. Receipt: Misc. Receipt: Total \ Subject to Field: Building Permit #: Every permitissued shall become invalid unless the work on the site authoized by such permit is commenced within 180 days after ifs issuance, or if the work authorized on fhe sife by such permitis suspended or abandoned for a period of 180 days after the time the work is commenced. 01 1 16002 51600 01 1 16002 51603 $19.93 $97.78 Fee Tota!: Paid to Date: Balance Due: $117.71 $0.00 $117 .71 lnspector MID#: 201 5-123600 a E LECTRICAL.I N SPECTOR RECORD a a APPROVALS DATE ID/SIG.COMMENTS OWNER Bt'ILDER DET,CARATTON I hcrctry aflim undcr pcnrlly of psjury lhst I m cxcmpt from thc Contndols' Licose lrw for thc following rcaron (Scc.70.1 1.5 Busincss and Prof6sion Codc): Any City or Couirty which rcquire r pcmit to @nstnrct. altc. improvc. dcmolish or rcpcir any slructurâ‚¬. prior to ils issurncc. alrc rcquirc thc applicant for such pcmit to filc r rigncd slstcmcnt that hc or sh. b liccnsd puBuant lo thc prevhions of lhc Contr.clor's Liccnscd kw (Chapts 9. Commcncing sith Scction 7000 of Division 3 of thc Buincss and PrcfcssionsCodc)orthlthcorshciscxcmptthcrcfromatrdthcbasisforthc.llcgedcxmption. AryviolationofScaionT03l.5byany applicant fo. s pcmit subjets thc spplicant to a civil pcralty of not morc thrn fivc hundrcd dollars (9500). --1. as owner of the prope(y. or my employees with wages as their sole compensation. willdo the work and thc stnrcture is not intended orofferedforsale(Sec.T044,BusinessandProfessionsCode: TheContractor'sLicense[,awdoesnotapplytoanownerof the propetty who builds or improves thermn. and who does such wort himself or herself or through his or her own employees. provided that such improvements are not intcnded or offered for sale. I[, however. the building or irnprovement is sold within one year of cornpletion. the Orvner Builder rvill have the burden of proving that he or she did not build or inrprove the propâ‚¬fly for the purpose of sale). -1. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7M4, Btsiness and Pmftssion Code: The Contractor's License Law does not apply to an owner of propcrty who builds or improvcs thereon. and who contracts for such projects with a Contraclo(s) licosed pumuent to the Contractor's License t aw). -IamexemptunderSection--,B.&P.C.forthisreason.Dntc:- O*nert WORKERS' COITPENSATION DECI"ARATION I hereby afTirm under penalty of perjury one of the following declarations: -l have and will maintain a Certifrcate of Consent to Self-lnsure for workers' compensation. as provided for by Section .1700 of the Labor Code. for the performance of the wor* for which the pcrmil b issued. -l have and will maintain workers' compensation insurance. as required by Section 3700 of the labor Code. for the performance of the work for which this permit is issued. My workers' compc-nsation insurance carrier and policy number are: Carrier: Policy Number:_ Expires: 6(unfy that in the performance of rhe work for which this perrnit is issued. I shall not employ any person in any manner so as to become subject to the workcrs' compensation laws of California. and agree that if I strould become subject to the workcrs' compensation provisions of Section -1700 of the hbor Code. I shall. forthwith cornply with those provisions.. t WARNING: Failure to seture u'orkers'compensation coverage is unlawful. and shall subject an anployer to criminal penalties and civil fines up lo one hundred thousand dollars ($100,000). in addition to of compensation. danrages as provided for the i Section 1076 of the l.abor Code. inlerest and I hereby affinn under penalty of perjury that I arn licensed 9 (comrnencing s'ith Seclion 7000) of l)ivision l of lhe Business and Professions ('ode. and my license is in full force and effect. l,icense Class:. \ C> onrc:6-?2.\f W I h@by 8lfim undtr porlty of pqjury thrt tlsr b s oBtruc{bn kading lgcncy for thc pGforoncc of the worl for which this p6mit b issucd (Sc. !097. Civ. C.). Lcnder's Namc: l,ender's Address: _ APPLICANT DECLARATION I hoeby aftirm under penalty of perjury one of the following declarations: Dernolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6) _- Required Letter of Notification u'ith all City and County and County to enter uSron the above mentioned property for Applicent or Agent Signnlure: Perntilee n&nre (prinl): -^,,34t1-E Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Life Safety /Low Voltage Fire AIarm I Dampers Communications Cable Building Under SIab / Floor Bonding I Grounding / UFER Transformers Torqueing Sub-Panels Air Conditioners Roof Top Equipment Factory Wired Unit Walls (Conduit) Walls (Rough) Ceilinqs (Hard & Soffit Rouqh Ceilings (T-Bar Roush) Meter Release Rough Service Meter I I F!NAL Notes Remarks Etc. runrber: ('onrr""tlr, {* I certifv that the federalregulations regarding asbcstos removal are nol applicahle to this project. and State larvs relating and hereby aulhorize representatives of this ;, t "t d t ? {.I j,t n r G -i r.. -i l-trl n: 't D\ t_ \))--J J $- \rz e c) \,^ \ a oEilil , .l 'a I Iu c C\ 3l g. tul-?o--' ,r1 \l-J .: w.,, tt^ sh ,-' s .S\\\-n=fr (i I gd.\x, , i\) ,_(\._x\):\\'\) \L ,\-NV\ h\) AI Os lv, \ + x \^ r\ 0 o \SI 411) -. 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