HomeMy WebLinkAbout10196432 - Permit (2)City of Santa Ana
Permit Counter: (714) 647-5800
20 Civic Center Plaza (M-'19), Santa Ana, CA 92702
lnspection Requests: (7 1 4) 667 -27 38 I nspector Section: (7 I 4) 647 -5853
Building Permit #:1fl19643.2
Pin #: A246,3
Proiect Address: 403 N Susan St
Assessor's Parcel: '198-261-23 Lot: NA
Unit:Bldg: G Address Range: Buildings A-H
Historic: No
Suite Range:
Zoning: R2Block: NA Tract: NA
Building Use: Other Occupancy:
Job Type: Alteration Constr Type
Nature of Work: Ext. Door Code:
Existing Bldg. & Use: SFD w/att garage Flood Zone:
Proposed Use: Care Home (6 or less) w/no garage # of Stories.
R-3.1
V B, SPK
cBc 2016
x-0602320256J
1
1st FL Area: 0
2nd FL Area: 0
Other Areas. 0
Garage Area:
Total: 0
Patio:
T.l.Area:
Yards Req'd:
Valuation: $6,000.00
Description of Work: Replace window w/ext. door p/c fee waived per Jason Kwak
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
John Henry Foundation Care Facili Contractor:
403 N Susan St Address:
Santa Ana, CA 927033433
(714) 480-002s
John Henry Foundation Care Facili
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Engrneer
Address
Phone:
License #
Architect /
Desiqner:
Address:
Phone:
License #
John Silber IDS Group
1 Peters Canyon Rd #130
lrvine, CA 92606
(949) 387-8s00
cl 5573
Planning Approval By
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
McCann, Melanie
Kwak, Jason
Hernandez, Kathy
No
Date: 05/15/20't8
Date:05/15/2018
Date:05/15/2018
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002 57507 Permit Fee
07L76002 57672 Bldg. Stds Revolving
07776002 57600 General Plan Update
07176002 57607 lssuance
Fee Total:
Paid to Date:
Balance Due:
$154.26
$1.00
$21.25
$52.98
$229 49
$0.00
$229.49
PWA lnsp. Req'd: No Fire lnsp. Req'd: No
Planning lnsp. Req'd: No Police lnsp. Req'd: Yes
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 180 days after its issuance,or if the work authorized
on the site by such permit ls suspended o r abandoned for a period of 1 80 days after
the time the work is commenced.
Account#Total
01'116002 51600
01'116002 5't601
0'r'r'16002 51612
$21.25
$207.24
$1.00
lnspector MID#: 2015-125336
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG COMMENTS OWNER BI-IILI)ER DEI,CA RATION
I hcrchy aflirm trndcr pcnally ol fe{ury that I ililr cxcilrpt lionr thc Contrnclors Liccnsc Law iirr thc followirtg rctson (Scc.7o-]1.5
Busincss and Profcssion C(xlc): Any City or Counly which rcquilcs a Jrcrnrit lo co[slnrcl. nllcr. in]ltrovc. dcnxrlish or rcpair any
stnrcturc.priorhits issurncc.alsorequircsthcapplicrntli)rsuchfErnrilk)lilcasiSncdslatctrrcnl thrlhcorshcisliccfl\cd pulsuaDl
lo Ihc prol,isions oflhc Contractor's l,iccnsed [-aw (Chaplcr 9. Comnrcncing wilh Section 7(XI) of Division -l oflhc Business and
ProfcssionsCodc)orlhalhcorshciscxcnlFthcrclronlnndthchasisforlhcrllcgedcxcmplion. AnyviolationofScclionT0.ll.5byany
ilpplicanttbrupcrnrilsuhjeclslhc rpplicanlt)ilcivilpcnallyolnoln$rclhilnfivchufdrc(tdollars(S5(X)).
_1. as owncr of thc pi()lErly. or nly cnlployces with wilgcs rs lhe ir solc corlrpcrlsnliorr. willdo thc work and tlrc sltuclure is ilol
iilcndc(l or oflcrcd k)r salc (Scc.7(H,1. Busincss and Prolcsskrns Codc: Thc C()nlractor's Liccn\e l-aw docs D(il apl)ly lo fln osDcr ol'
thc pnlfray who builds or inrpmvcs th(E)n. afrj wh() d(rcs such rvork hintsclfor hcrscll or through hir or her own cntl)loyccs.
providcdlhstsuch iitpr(,venrilsitcnolillcndcdorollcrcdlorsrilc.lt.howcvcr.thcbuildingorinrprrvcrlrnlissoklsilhinoncycar
ofconutcliur. lhc Owncr Buiucr will halc thc hurdcn of proving that hc or \he did nol huild or inl)row thc pR)lffiy for thc puqns o[
vth).
_1. ns owncr ol'thc Jnrrpcrty. anr cxclilsivcly conlrilciirg wilh Iiccnscd c()nlrilclor\ k) con\lnrcl lhc projccl I Scc. 7(14,1. Bttsnr:sr
an(l [\]ltssi(n('odc:'fhcC()nlractor'\Liccn\c[,rwdoc\ilotnpl)lylornos[cr(!lpropcrlywhobuiklsorintprovcslhcrcoil,
in(l wh() c()[lrrcts li,r such |x()jccls wilh n Corilraclor(s) liccnsc(l nursuaill lo lhc Conlritck)r'r Liccnsc Law).
-l
rm
Dsle:
B,&thi\
()rriler
I hcrchy allirrtundcr fcnxltyol'pcrjuryonc ol lhc iotts
Lrhor Codc. ti)r thc pelli)rmancc of lhc work tirr which lhc Pcrmit is i\su(i.
_lhlvcrrdwillnlniDtiinworkcF'coirpen\ali()ninsurancc.rs rcq[ircdbyScclionJT(X)ofthc[.ah()rC(xle,li)rlhcpcrfortrrnccol'
thc work for which this pcrnlit is issucd. My workcrs' conlpdtsnlion insurancc canicr and lmlicy nunrhcr rc:
Policy Numbcr ExJ,ircs:
I (cf,ily lhrt in lhc pcrlirrnrancc o[ thc work lirr which lhis lrcr rilil i\ i\sucd. I shrll nol ctrUloy ony pcr\on in nny nlanncr
ro a\ to hcconr suhject to thc trorkcrs'coilUcn\nli()n h\'\ ol ('rlili)nrii. nn(l agrcc lhnl il l shonkl hccotrc snbjccl l{) lhc
crlil linc\ up lo (nrc hun(lrc(l ihousand dollar\ (Sl(x).o(X)). in
Sccti(nr J076 oI lhc Lltxlr (i)dc. inlcresl nn(l nll(ilrrcy's fccs.
ttarnagcs as pr0vi(lc(l ti)r thc
I )illr:6_rtrt Aptrliunl:
prcvisi(,n (tl Chal)lr'r 9 (coilrnrcncing wilh Scclion 700{)) of Division .1I hcrchy {lllrnl un(lcr pcnally ol f[rjury lhal I iln1
ol' thc llusi,lcs\ ind l)rolt\si()ns Codc. trn(l nly liccnse Iirll lincc nril clltcl.
Lirrn\c
I)nl0l
-i(cD\c Nilnrbcr:
( 0nlra(lor:
CONSTRUCTION LENDING AGFNCY
I hcrchy alfirrn undcr Jrcnally of pciury thai thcrc is r conslruclion lcnding dgency li,r lhc pcrformancc of lhc work for which this lrcrilil is
issucd (Scc. .1097. Civ. C.).
Lcndcr's Ndilrc'
I-cnrlcr's Arhlcss:
APPI ICANT DECT ARATI('IN
I IErcby nllirnl undcr lxnally ol pcrjury onc of thc folhwing dcclarations:
Dcilroliti{)n Pcrmils-Asheslos Nolificalion I'tdcrnl RcBuhtions ('l itlc 40. I'an6)
Rcquircd Lcltcr of Nolilicalior
-l
ccrtily rhal lhc lcdcral rcgulalions rcgarditrg .1hc\los rcIB)vxltrc not applicnhlc k) lhis pn)jccl.
-l
ccrtily lhnl I hrvc rcad this alplicalioil ilnd \lnlc lhal lhc lk)vc with rll City and Counly
flnd Counly lo cDtcr upon thcordiDxnccs and Slrlc l-ilws rclaling k) bu rrxl
abo!c nEnti()ncd prcpcny for
Applicant or Agrnt Signalu
l'ernrik\' trrtrre (pritrl):Ap letcg
o,,",{'18j{
Set Backs lA
Forms/Steel/Holdowns 5-2'11tr V.V-fiU
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenUl nsu lation
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
[Vasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
FINAL /--'? -tQ J /( -?t i tru l4r4
Certificate of Occupancy
Notes, Remarks, Etc.
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