HomeMy WebLinkAbout101103592 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building Permit #: 1O1{03592
Pin #: 74996,Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 2042 N Victoria Dr Unit:Bldg
Assessor's Parcel:002-111-37 Lot: NA Block: NA Tract: NA
Address Range: 2042-2044
Historic: No
Suite Range:
Zoning: R1
Building Use: Single Family Dwelling Occupancy: R-3 1st FL Area
Job Type: Reroof Constr Type: V B 2nd FL Area
Nature of Work: Reroof Code: CBC 2019 Other Areas.
Existing Bldg. & Use. Flood Zone: X-0602320163J Garage Area:
Proposed Use: # of Stories:
Totat
Description of Work: Tear off existing, resheath, and install 40 squares of comp and 5 squares of built-up roofing
Planning Conditions
Patio:
T lArea:
Yards Req'd
Valuation:$12,570.00
Owner:
Address:
Phone:
Tenant
Linda Matzkin
2042 N Victoria Drive
Santa Ana, CA 92076
(213) 434-0883
Contractor: WeatherlineRoofing,lnc
Address: 633 W Katella Ave #F
Orange, CA 92867
Phone: (7'141731-3425
State Lic #: 933810
Lic Type: C-39
Bus. Lic #: 349134
Workers' Compensation I nsurance:
Carrier: Zurich American
Policy #: 475869108
Expires: OGl01l202O
Engrneer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
*"0-u."S/
Date: Misc. Receipt:
Date: Misc. ReceiPt:
Date: 05/1 1/2020 Misc. Receipt:
Subject to Field:
No
No Account#
N/A - No Balance
N/A - No Balance
07776002
0LLL6002
07776002
07776002
07775002
57601
57770
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$333.06
$3.91
$1.00
$22.95
$57.20
Fire lnsp. Req'd:
Police lnsp. Req'd:Total
Flood Zone Cert. Req'd: No N/A _ No Balance
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after lts lssuance,or if the work authorized
on the site by such permit ls suspended or abandoned for a period of360 days after
the time the work is commenced.
Fee Total
Paid to Date:
Balance Due
$41 8.1 2
$418.12
$0.00
lnspector MID#: 2020-158870
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/S!G.COMMENTS OWNI]R BUII,DI]R I)I]I,CA RATION
I hereby aflrnr undcr pcnelty of pcrjury that I m cxcmpt frcnr lhc Contractos' Liccnsc law for thc following reaen (SN.7031.5
lrusincss and Proltssion Codc): Any City or Countv which rcquircs 6 permit to construcl, altcr. improvc. dermlish or rcpair any
structure. prior to its issuailce. also requiEs the applicant tor such ltmil h file a signed stalcrenl thd hc or shc is licc[td pursuailt
lo rhc pmvisions of lhc Contraclor's l-icensed liw (Chaprcr 9, Comrncncing with Scction 7(XX) ot Division 3 of the Busincss and
ProtissionsCode)orthithdorshcisexcmpttherefronrlrldrlEb$rstilrllEallcgedexemflioil. Anyviolali()nofScclionT03l.5byany
npplicrntforo[Ermitsuhjectsthd {pplicanttoncivilpcnnltyofnotrmrethanfivehundreddollilrs($5(x)).
_1. &\ owncr ol thc prolEny. or rny cmployccs wilh wagcs As lhcir solc compcnsrlion, willdo (hc work and lhc slructfc is nol
iilended or offered for srle (Se.7(X4, Business and Pn)fessions Code: The CoDtrrc(tr s l,icensc l-nw docs not epply lo an owner of
thc prcperty wh{, builds or imDroves therrcu md who does such w()rk hinrsclf or herself or llrou8h his or lEr own employees.
providcd thal such improvcrrcnts de nol intended or oll'cR'd li)r srlc. ll. howcvcr, lhc building or irnprovcrrcnt is sld wilhin one ycar
ofcompleti(u rlr Owncr Builder will luve the burden of proviDs lhilt lE or shc did Dot build or impn>ve thc Propcny for lhe purlDsc of
$le)-
_1. as owncr ofthe propa(y, am ciclusively contractinS with liccnrcd contrrclors to con{rual lhe prujcct (Scc. ?044, Businers
anl ProtlssbtrCode:ThcContractor'rLicenseLawd@snotapplybanownerofpropeflywhobuildsorimp,oveslhercon.
and who conlracts for such projccts with a Contmcb(s) liccnscd pursumt lo lhe G)nlraclor's Liccnsc [rw).
_l am exempt under Section-. B. & P.C. lbr lhis reason.
WORKtI,RS' ('OMPI.INSA'II()N
I)DCI,ARATrcN
I hc'rcby allirm undcr p!'nnlty ol pcrjury onc oflhc lbllowinB (l.clxralions:
_l have and will nEiNaiD a Cedificate of Corsent to Self:lnsurc for workers' lsmpensation, as prcvided for by Section 3700 of thc
Labor C(dc, for thc tErforrorcc of thc work fot which lh! lffmil is i-ssucd.
_lhaveandwillnraintainworkcs conpensationinsurance,as requircdbySection3T00ofthclaborCode,forthcperfomBrrccof
thc work tbr which this pcrmit is issucd. My workers' compcnsilion insurdncc cmicr ml [Dlicy nunrtrcr de:
, -*i-. _
l'olicy
_l cc(ili that in thc lrrtbrnuncc of the work for which this lErnrit is issuc(j, I shrll not cnrploy any pcrson in any manner
I as to bccorrc subjccl to thc workcrs' conlpensalion laws of Calilonria. and agrec lhal i[ I slmuld bccorm suhjcct lo thc
wodiers' comfrnsarion prcvisions of Section 3700 of thc ljbor Cqle, I shall, fonhwith rumply wilh tlN* prcvisions.
WARNING: Failurc rr xcun'workcrs'compensation covcrJgc is lnlawful. and shrll suhjcct an cnDloyer to dminal rtmltix Md
civil tlnes ul to onc hundred thousand doll3rs ($l(X).(l(Xl), in rddition lo the cost ofcompcnsation, damgcs as providcd for lhc
Section J076 oflhe trlxx (lxle, intercst and allofty s fcc\.
I,ICENSED CONTRACTOR
I)I]CI,ARATION
I hcrcby al lirm undcr r*nalty ol pcrjury that I arn licenscd undcr provision o, Chaptcr 9 (cornrrcncinS wirh Scction 7000) ol Division 3
of the Busincss an(l Prrfcssions Codc, md my liccnsc is in full fi)rcc and clfccl.
Liccnse Class:-Liccnsc Numbcr:
Conlmclor:
CONSTRI,]C1'ION I,I,]NI)ING AGENCY
I hcreby allirm under Ftralty of perjury lhat fhere is a constnr(ti(tn lendilg agercy ti)r thc perfornurrce of the work for which this pemrit is
issucd (Sec. 3097, Civ. C.).
lrndcr's NAnrc:
lrn,Icr's Ad.lress:
APPI,ICANT DECI,ARATION
I hercby affmr under [Enxhy of pcrjury one of the followi[g declaratioDs:
DenDlition Pernrits-Asbcstos Notificntion Federal Relulations (Title.l0, Pafl6)
_Required [itler of Notification
_l cefrity thal tlrc lederal reSulatiors regilding astEsk)s rcnx)val are not lpplichble o this projcct.
_l cerlify lhal I lilve rcad thi\ {pplical ion and stale th.l lhe atnve iDfornration is corecl. I ngrE lo comply with all Cily and CouDty
(,rdiilances and Stale Laws rclat ing to huilding coilslructioil, and herehy authorize rcpresettalives of this City and CouDty lo eiter uF)n the
rtxlvc mcntionc(l nropcny lirr inspcction purposes.
Applicont or AScnt l)nlc:_
Pemlle mme (prlnl):
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsulation l,r
Roof Sheathinq 1/tt looa 7,M
Shear Wall v./
Framinq
lnsulation/Enerqv
Drvwall
Ext./lnt. Lath
Brown Coat
[\4asonry
Pool Fence
T-Bar
Handicap Beq
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
tl tA
FINAL 7fL"1/+t fl -4ffit t/
Certificate of Occupancy | -l
Notes, Remarks, Etc.
Rev.08-07-2015