HomeMy WebLinkAbout20170419 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
PermitCounter: (714)647-5800 lnspection Requests: (7141667-2738 lnspector Section: (714)647-5853
Permit #:2O17O4{9
Pin #: 25654a/
Project Address: 1313 N Spurgeon St
Assessor's Parcel: 398-134-31 Lot: 1
Unit:
Block: NA
Bldg:
Tract: 11032
Address Range: 1313-1 317"
Historic. No
Suite Range:
Zoning: R3
Owner:
Address:
Phone
Emad Ghobrial
8033 W Sunset Blvd #991
Los Angeles, CA 90046
(323) 304-60s8
01 1 16002 51603
01 1 16002 5160C
01 1 16002 51603
01 1 16002 5777C
Fee Type
Low Voltage/Comm
General Plan Update
I ssuance
Microfilm Records
Amount
35.21
22.95
57.20
3.91
Qty
1 .00
100
100
100
Fee
$35 21
$22 95
$57.20
$3 e1
*?2. ?5
192. +1,
$3,?l
$119.27
Tenant Name:
Contractor.
Address:
Owner-Builder
Phone
State Lic #.
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
BgbCh* :53494 T2/ T7 / zlt1? ID: HP INEDA
Office: CTYH Trgns*:55 I ol I
Accti: Ref *: Ztll7r't4l?
Rrpt+:02836t1? 12/17/ztrl9 3:12 F'11
Tronsocb ion Totgl $ I l9 .?-7
Ema,J 6hobr iql
.t
Generol Plnn Updnte Fee
r.rl 1 l6Lt02- 5160rJ[rr36-
Ele,:tr icnl
01 1 16t-tt:2- 516ll3u0t.t-
Il icrof ilrn & Docuttents
r_r1 1 l6rJu2- 17'7 70u0rJ-
I (:l- (:h eclt :itlStl
t
Building Use: Multi-Family (5 or more uni Occupancy:
Job Type: Misceltaneous Constr Type:
Nature of Work. Security Cameras Code'
Planning Conditions: No exposed conduits or wiring.
R-1
VB
cEc 2016
Notes: lnstall new security cameras throughout. Auth on file
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
Graham, Jeffery
Zuniga,Allissa
12t17 t2019
12t17 t2019
Account#
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
Total
Date:
Date:
Date:
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 1 6002 51 603
01116002 57770
$22 9s
$92 41
$3 e1
Fee Total
Paid to Date.
Balance Due:
$11927
$0 00
$119.27
lnspector MID# 2019-156612
ELECTRICAL.INSPECTOR RECORD
no n7 1n,t s,
APPROVALS DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hocby affm undr pcnalty of pcfjury that I m exmpt frem thc ContractoB' Licw larv for thc following lleo (Sc.7031.5
BGin6s ild Profsion Code): Any City or County rvhich requirc a pcmt to comiruct. altq. imprcvq &molish or rcpair uy
strucruc prior to its issumcc. also rcquirs thc applicilt for such pentrit to file a signqd statflmt that hc or dG is licoscd pcumt
to thc previsioN of thc Contractor's Liccnscd Law (Chapt6 9. Comencing with Setion 7000 of Division 3 of thc Busins ed
Prcfe$ions Codc) or that hc or shc is cxcmpt thqefrom od thc b6is for thc allcged ermption. Any violation of Setion 7031.5 by my
applicantforapemitsubjetsthc applicanttoacivilpcnaltyofnotmorethufivehundrcddollus($500).
- -1. as owner of the properly. or my employees with wages as their sole compensation. w'illdo the work and the struclure is not
intended or offerd for sale (Sec.7044. Business and hofessions Code: The Contractor's License Larv does not apply to an owner of
the p,ropary rvho builds or impro!'es theron and rvho does such uork himself or herself or through his or hcr own employees.
provided that such improvoncnts are not intended or offerod for sale. lf. how'wer. tlre building or improvemert is sold within onc year
of cornplaion. the Orvner Builder will have the h.rden of proving tha he or she did not build or improve the property for the purposc of
sale).
- l. as owner of the propaly. arn exclusively contracting rvith licensed contractors to construct the
and hofession Code: The Contraclor's License Law does not apply to an owner of property who
pr<rject (Sec. 7044. Business
builds or improves lhereon.
and rvho contracts for such projects rvith a Contracto(s) licensed pursuant to the Contractor's Larv).
___l am e.\€mpt under B.&a
Z
DECLARA'I'ION
I hereby affrm under penalty of perjury one of the follorving declarations:
---l have and will maintain a Cerri{icate oflConsent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
l-abor Code. for the perfonnancc of the rvork for which the perrnit is isiued.
-l have and rvill maintain u'orkers' compensation insurance. as required by Section 3700 of the labor Code. for the pcrformance of
the rvork for which this perrnit is issued. My workers' compensation insurance carrier and policy number are:
('lrrr icr :
Policy Number:-l:rpires:
I certify that in the perforrnance of the rvork for rvhich this permit is issued. I shall not ernploy any person in any manner
so as lo becorne subject to the workers' cornpensation larvs of California. and agree that
rvorkcrs' cornpensation provisions of Section 3700 of the [abor Code. I shall. forthrvith
if I should become subject to the
provisions..conrply ,'
WARNING: Failure lo scturc u'orkers' compensation coverage is unlarvful.
<r-
an onployer and
civil l-rnes up to one hundrcd thousand dollars ($100.000).compensation.for the
.)Section .1076 of the and
/-
I hereby affrnn under penalty of perjury that I am licensed provision of Chapter 9 (cornrnencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
License Class:__[.icense Nurnber:
l\., i ^.Contraclor:
CONS RUCTION LENDING AGENCY
I haeby aflirm unda pmahy of pojury that lh@ is a con$rucrion lmding agocy for the pofomilce of the work for s'hich this lumit b
issued (Sec. 3097. Civ. C.).
Lender's Name:
Lcnder's Address:
APPLICANT NECLARATION
I ho$y affu:n under penalty of perjury one of the following declarations:
Demolition Perrnits-Asbestos Notification Federal Regulations (Title 40. Part6)
-Required
Letter of Notilication
-l
certify that the federal regulations regarding asbestos removal are not applicable to
____l corify that I have read this application and state u'ith all City and County
ordinances and State Laws relating to City and County to enter
above mentioned property for
Applicrnt or Agent
l'crrrrilee na me (print):
,/
the
Site-Work
Underground
Pole Bases
Light Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm lDarxpers
Communications Cable
Buildins
Under Slab / Floor
Bonding I Grounding / UFER
Transformers
Torqueing
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Rough)
Ceilinss (Hard & Soffit Rouqh
Ceilings (T-Bar Roush)
Meter Release
Lg.D Y Dv<tvt* ?z-q.- Q- ?t Mr"$ult
Rough
Service Meter
FINAL Q-4-Zl D.r-P cl Z
Notes, Remarks, Etc.
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