HomeMy WebLinkAbout10122865 - Permit615 N. BRISTOL STPRO.'ECT
AOORESS:
SUITE #:JoBrypE: IIULTI/AL
RANGE;
ADDRESS 611-563 DECK WORKNATURE
OF WORK:
1 NA
Bl@k;
LEGAL
DESCRIPTION: Lot:
CONDOS I.I/DET GARAGESNO. OF EXISTING
BUILDINGS & USE:
rncr 10861 VNTYPE OF
CONSTRUCT]ON:
R1/U1@CUPANCY
GROUP:
I haroby .ffim undcr p.nalty of p.rjury that I am cxGmpt Irom th. ontFcloE'
liccn$-lr{v ior thc iollffing rca$n:
V(*on7O44A. l, as mr ot ths pop.rty, or my .mploy6 with mgcs as
thcir $1. comp.netion, will do thc mrk, and l,l. structurc is not intcndod or
ofi.r.d ,or sl..
contracting withamthe
405-08L-23ASSESSOR'S
PARCEL *:
TENANT IMPROVEMENT
AND / OR REMODEL AREAI
x-oFL@D
ZONE:
owNER: sHA,DoI{ wooD HoA
NEW / ADDL.
1st FLR, SQ, FT
NEW / AOOL,
OTHER SO. FT,
ADDRESS: 611 N BRrsroL sr NEW / AOOL
2nd FLR. SQ. FT
NEW / ADDL.
GARAGE SO, FT
zoNlNG: R- 1 t500.ooVALUATION:SAI{TA AI{A, CA 927O3
7L4/542-3s2sPHONE LLPLANNING
APPROVAL BY;DATE:LL /02 /ee
CONTRACTOR:BLDG. SAFETY
PLANCHECKA DATE:
[=#[.",( ft1.rxeADDRESS:Lt /02 / eeDATE:
H&?IET'*lJ N NLANOSCAPING
REQUIRED:
PHONE:
OYINERSTATE
LICENSE #:TYPE:
SANTA ANA
BUSINESS LICENSE #:
I hcrcby .tlim under p.nalty ot poriury ona of th. lollming DcclaEtions:
lha6 and will maintain a Certiticat! Ot Cons.ntto Sclt-lnsurc torWork6s'
ffipansation, as pBidsd for by Scction 37OO ot tho Labor Codc, for thc
p.rform.ncc of tha rcrk tor which this Pcmit is issuod.
_l haw and will maintain WorkrB' Compcnstion lnsuEnce, as rcquircd bykion 3700 ol the Labor Codc, tor the pcrfomancc of thc mrk tor which thisp€mit is issucd. My Worke6' Compcnsation lnsuranca canicr and policy number
arc:
Policy Number:_
(this iection nua
or ls$).
in the performance of the rcrk for which this pcrmit is issued, I
any p€Bon in any manner rc as to become subject to the Worke6'
shall
that
not
ol Calilornia, and agree that if I should bocome subject to tho
of th6 Labor Codc. I shallprwisions ol Section 37@
Failure to
prryided tor in Section
with tho* Prdisions
ENGINEERYARCHITECT:
ADDRESS:
PHONELiccn$ Class:_ Licensc
of Division 3 of the
is in tull and effcct.
Oat6:_Contractor:
prwisions of
Businass and
LICENSE #:
/WEATHERPROOF DECKS.Ivnn.
IJOB DESCRIPTION:
RESURFACE
HAI{DOUT G
City of Santa Ana
Building Safety Div. M-I9
P.O. Box 1988
Santa Ana, Ca.927Ol
206 W. 4th. Street
2nd Flmr
(714) 647-s8OO
@o
oo
FEE TOTALPAID TO DATE
BALANCE DUE
FEES:
oo
@o
oo
5
2 1
PERMIT FEE
ISSUAI{CE
so
2L
7L
o
7L
I hcrcby af{im under p.nalty o, pcrjury that ther. rs a @nstruction landing agoncy
tor thc pcrfomanc. ot tha rcrk for which this permit is issued S*. 3097, Civ. C.)
D6mdition Pcmits.Asb.stos Notification Fcdcral Rcaulations Oide 40, Pan 6)
_Requircd L.tbr ot Notifiation.
is
I,
Applicant or agcnt sig.
Pcmitto nama (prino:
Lcndc/s
Lcndc/s
OWNER-BUILDER DECLARATION
WORKERS COMPENSATION DECLARATION
LICENSED CONTRACTORS DECLARATION
CONSTRUCTION LENDING AGENCY
APPLICANT'S DECLARATION
Mailing Address Puhlic Counter
This permil shall expire by limitalion and b€come null and void if the work aulhorized
by this pemil is nol commenc€d wilhin 1E0 days from lhe date of lhis permil, or if the
work aulhorized by this permil is suspended or abandoned for 180 days, al eny time
affer r rork was commencad, ln such case a n€rv permil shall lirsl be oblained before
such work can be recommenced.
BUILDING PERMIT PERMIT NO.LOL22865 aq
Account No. 011-01-5911 - Pemit Valdation
5A1151110299S060 371.tXIs{_ rlrsPEcroB coPt _
cs-60s
Qa4/\/
City of Santa Ana
lsurre
I Raruce,
|
,r,,o,"o o,
9TY
1
1
UniUSuite
Notes, Remarks, etc
I hereby affirm under ponalty of p€rjury lhat I am exempt from lhe Contractors' License Law for lhe following reason
(Sec. 7031.5 Business and Professions Code): Any City or County which roquire6 a permil lo conslrucl, aller,
improve, demolish, or repair any slructuro, prior to ils issuance, also roquiros lh6 applicanl for such permit to lile a
signed statement thal he or she is licensed purcuant lo the provisions of lhe Contraclors' License Law (Chapter 9,
commencing with Seclion 70fl) of Division 3 of the Business and Professions Code) or thal h€ or she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjecls lhe applicanl lo a civil penalty of nol more than fle hundred dollare ($Sfi)).
_1, as oumer of lhe prop€rty, or my employees wilh $/ages as their sole compensation, will do the rvork, and lhe
slructure is nol inlended or oflered for sale (Sec. 7(X4, Business and Professione Code: The Conlraclors' Liconso
Law does nol apply lo an o$rner of lhe property wfio builds or improves lhereon, and wtro does such work himsslf or
hersalf or lhrough his or her orrrn employees, provided lhal such improvemonts are nol intended or ofiered for sale. lf,
however, the building or improvement is sold wilhin one year of complelion, the Oivner-Builder will have lhe burden
of proving lhat he or she did not build or impro\re for th6 purpose of sale),
_1, es onrner of the property, am exclusively conlracting with licensed conlraclors lo conslrucl lhe proiocl (S6c.
7(X4, Businees and Profcssions Code: The Contraclors' Licenso Law dose not apply lo en orvner of pioporty who
builds or improves thereon, and who contracts for such projects wilh a Conlracto(s) licens€d pursuanl to the
Conlrac,lors' Licsnse Law.).
Site Work Remarks Date Signature l.D
Setbacks
Forms/Steel/Holdowns
UFER Ground
Slab Floor
Steel
Pool Fence
Masonry
I
Building Remarks Date Signature l.D.
Under Pinninq (floor ioistl
Foundation Ventilation
Roof Sheath
lnsulation / Enerqy
Dry Wall I I't^
Exterior Lath h/:q/-tlllffh7,/-
TSar
Handicap Requirernents
I
bltldb:
I /lrn
FRAMING /$14127
FINAL (Shell only)"7 t .L,
FINAL {Tenant lmorovementl Le/3 ,yry /,9, --,7(
_l am exompt und€t
O,vner:
B. & P.C. for lhis reason.
BUILDING ... !NSPECTION RECORD
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Brown Coat
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