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City of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA 92702 Building <br />Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853 <br />Permit #: 1()192934 <br />Pin #: 515{8 <br />Assessor's Parcel 109-441 -06 Lot 4 <br />Unit Bldg: Address Range Suite Range: <br />Zoning: Ri <br />,r <br />Block NA Tract: 3353 Historic No <br />Building Use: Singlo Family Owelling Occupancy: R-3, U 'l st FL Area: Patio: <br />Job Type: Reroof Constr Type: V B 2nd FL Area: T.l.Area: <br />Nature of Work: SFD watt Garage code: cBc 2016 other Areas: yards Req,d: <br />Existing Bldg. & Use: Flood Zone: X-0602320257J Garage Area: Valuation: t6,000.00 <br />Proposed Use: # of Stories: <br />Total: <br />Description of Work: Tear off existing roof material and install new comp shingle roof. Approx. 20 squares. Handout given. Owner-Builder form on file. <br />Planning Conditions: Replace any damaged wood members, fascia, eaves, etc. prior to final approval. <br />Owner: <br />Address <br />Phone: <br />Tenant; <br />Engineer: <br />Address: <br />Phone: <br />License #: <br />Architect / <br />Designer: <br />Address: <br />Phone: <br />License #: <br />Minh Chau Kieu <br />5651 Ocean Terrace Drive <br />Huntington Beach, CA 92648 <br />(7'.t41716-6201 <br />Contractor: Owner-Builder <br />Address: <br />Phone: <br />State Lic #: <br />Lic Type: <br />Bus. Lic #: <br />Workers' Compensalion lnsurance <br />Carrier: <br />Poliry #; <br />Expires: <br />Planning Approval By: Orozco, lvan <br />Plan Checked By: <br />Permit lssued By: Chavez, Dave <br />NPDES lnsp. Req'd: No <br />PWA lnsp. Req'd: No <br />Planning lnsp. Req'd: No <br />Date: 05/09/2017 <br />Date: <br />Date: 05/09/2017 <br />Subject to Field: <br />$298.50 <br />$'t.00 <br />$20.56 <br />$51.26 <br />07776002 51601 Permit Fee <br />07776002 57612 Bldg. Stds. Revolving <br />07776002 57600 General Plan Update <br />O7776002 51601 lssuance <br />Fire lnsp. Req'd: <br />Police lnsp. Req'd ffi Account#Total <br />Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No <br />Every pennit issued shal become invalid unless the wo* od lhe sile aulhoized by <br />such peinit is commenced wihin 180 days aftet its issuence.or if the wo* authonzocl <br />on the sile by such ponnl is suspenclad ot abandoned lot a penod gf 180 daysaftat <br />the lime the wod< ts commenced <br />$371 32 <br />$0 00 <br />$371.32 <br />lnspector MID#: 2017-136053 <br />01 1 16002 51600 <br />01 1 16002 51601 <br />011 16002 51612 <br />$20.s6 <br />$349.76 <br />$1 00 <br />Fee Totall <br />Paid to Oate: <br />Balance Due: <br />Project Address: 21 10 W McFadden Ave <br />tvlisc. Receipt <br />Misc. Receipt <br />Misc. Receipt