HomeMy WebLinkAbout20173526 - PermitProject Address: 622 W Juniper Ave
Assessor's Parcel: 410-171-14 Lot: 59
Unit:
Block: NA
Bldg
Tract: 6703
Address Range.
Historic. No
Suite Range.
Zoning: R1
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Electrical
PermitCounter: (714)647-5800 lnspection Requests. (714)667-2738 lnspectorSection. (7141647-5853
Permit #:20173526
Pin #: 60860
Owner:
Address.
Phone:
Tenant Name:
Contractor:
Address:
Phone:
Kalli & Nicholas Langsdorf
622 W Juniper Avenue
Santa Ana, CA 92707
(7141 349-1 478
Nexgen Air Conditionirg itlrr
700 N Valley Street, Suite K
Anaheim, CA 92801
(657) 208-1s87
01 1 16002 51603
01 1 16002 5160C
01 1 16002 s1603
01116002 5777C
Fee Type
Heat Pumps
General Plan Update
I ssuance
Microfilm Records
Amount
104.40
23.79
59.30
4.05
Qty
1 .00
1 .00
1 .00
1 .00
Fee
$1 04 40
$23 79
$se 30
$4 0s
t'l$ " {
t4 ,, lll
t163"'/
$566, 6
Botch* '.i?i77 6i i6/ 2ir2l ID: o,ilotrs lesi
Off ice: (:Tr'H Tr'nns*: + 1$l' 2Acct*: tier*: 20173:;26
frcpt*:0332tr66:i 6i 161 ?ttil 8:43 Aii
Inqn sclct i on Tst a i $566 . 6?State Lic #: 101 1 173
Lic Type: C-20
Bus. Lic #: 353953
Workers' Compensation I nsurance:Carrier Old Republic Gen lns
Policy #: A1CWA001 1502
Expires: 03/01 12022
l.lexgen A ir i:erd i t i on i ns nnd He
Genero I Piorr tjpoate Fee
rrl I 16ttu2- 51 altrr[r0[t-
ll icnot'ilm & DocurnentE
rtl1I6utt2- 177 7[rrrt rt-r-
Electr i cal
0l i 16u02- 51ott30r-ru-
I t:L (:heck 114556?Building Use:
Job Type:
Nature of Work:
Planning Conditions:
. Planning Approval By:
Plan Checked By:
? Permit lssued By:
Subject to Field:
Building Permit #:
Single Family Dwelling
Alteration
Heat Pump
Jacinto, Heidi
Verduzco, Vio,", $
Occupancy.
Constr Type:
Code:
Date:
Date:
Date:
R.3, U
VB
cEc 2019
06/1 6t2021
06/1 6t2021
Account#
Misc. Receipt:
Misc. Receipt:
Misc Receipt:
Total
Notes:
Fee Total
Paid to Date:
Balance Due:
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 fhe site by such permitis suspended
or abandoned for a period of 360 days after the time the work is
commenced.
lnspector MrD#' 2021-166811
01 1 16002 51600
01 1 16002 51603
01 1 16002 57770
$23 79
$1 63 70
$4 0s
$1 91 .s4
$0 00
$191 .54
ELECTRICAL-INSPECTOR RECORD
I hereby affrrm untler penalty of perjury that I am exempt from the Contractors' License Law for the following reason (Sec.7031.5
Business and Pr:fession Code): Any City or County which requires a permit to construct, alter, improve, denmlish or repair any
structure. prilr to its issuance. also requires the applicant for such permit to file a signed staterEnt that hc or she is licensed pursuant
to tlrc provisions of the Contractor's Licensed Law (Chapter 9. Commencing with Section 7000 of Division 3 of the Business and
Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant firr a permit subjects the applicant to a civil penalty of not rnore than five hundred dollars ($SttOl.
_1, as owner of the property, or my empkryees with wages as their sole comlrcnsation. will do the work arxl the struc{ue is not
intentled or offered for sale (Sec.7M4, Business and hofessions Code: The Contractor's License Law does not apply to an owner of
the pruperty wtn builds or improves thererrn. arxl whl dtrcs such wrrrk himself or herself or th,rough his or her own employees,
provided that such improvernents are not intendal or offered for sah. If, txlwever, the building or inTrrovenrnt is sokl wthin one )€ar
of completion, the Owner Builder will have the burden of prcrving that he or shc did not buikl or improve the property for the purplse of
sale).
_1, asownerof the proFrcrty, amexclusivelycontracting with licensed contracto$toconstruct thc pnrject (Sec.70.14, Business
and Pnrfesskrn Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such pnljects with a Conracto(s) licensetl pursuant to the Contractor's License Law).
_l am exempt under Section_. B. & P.C. for this reason.
Dete:
WORK h' RS' COM PENSATION
DECLA]IATTON
I hereby affirm under penalty of perjury one of the following declarations:
-l
have arxl will maintain a Certifrcate of Consent to Self-lnsure for workers' compensation, as provided for by Section 37fi) of the
I-abor Ccxle, for the perfonnance of the wo* for which the permit is issued.
4 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the lrcrfrrrmance of
work for which this prmit is issued. My workers' compensation insurance carrier and Jnlicy number are:
I'olicy
-l
certify that in the performance trf the work for which this permit is issued, I shall not employ any person in any manner
so as to becorne subject to the workers'compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of rhe l-:hlr Crxle. t shall, forthwith c,rmpty with tlxrsc pmvisions..
WARNING: Faiture to secure workers' compensation coverage is unlawfut, and shall suhject an emptoyer to criminal Jrenalties and
civil fines up to one hundred thousand dollars ($lm.Un). in addition to the cost of compensation. damages as provided for the
attrlrney's fees.
I hereby affirm under penalty of perjury that I am licensed under provision of Chapter 9 (comrnenc'ing with Section 7firu) of Division 3
of the Business and Professions Code, and my license is in full firrce and effect.
License
CONS'I'RUCTION LENDING AGENCY .I hercby affirm under penalty of perjury that there is a construction hnrling agency for the performance of the work for which this pernut is
issued (Sec. 3097, Civ. C.).
Lender's Name:
lrnder's Address:
APIDLICANT DE,C LARATION
I trreby aflrm under penalty of pcrjury one of the following declarations:
Demolition Permits-Ashstos Notification Federal Regulations (Title 40, Part6)
-Required
Letter of Notification
certify that the federal regulations regarding asbestos rennval are not applicable to this project.
I have read this application and state that the above information is correct. I agree to cornply with all City and County
and State Laws relating construction. and hereby authorize representatives of this City and County to enter uFxln the
atxrve mentioned property for
Applicant or Agent
l'ermitee nanre (print):
I
APPROVALS DATE ID/SIG.COMMENTS
Site-Work
Underqround
Pole Bases
Liqht Standards
Spas, Pool, Fountains
Signs (monument)
Life Safety /Low Voltage
Fire Alarm / Dampers
Communications Cable
Building
Under Slab / Floor
Bondinq / Groundinq I UFER
Transformers
Torqueincr
Sub-Panels
Air Conditioners
Roof Top Equipment
Factory Wired Unit
Walls (Conduit)
Walls (Roush)
Ceilinqs (Hard & Soffit Rouoh
Ceilinqs [-Bar Rouqh)
Meter Release
Rough
Service lVleter t),A &,
FINAL t FI'l,lY+{D'2
Notes, Remarks, Etc.l
Rev. 08-07-2015
Section
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