HomeMy WebLinkAbout101103217 - Permit (2)Project Address: 1901 N Fairview St Unit:Bldg: B Address Range:Suite Range:
Zoning: PAssessor's Parcel: 399-031-23 Lot: NA Block NA Tract: NA Historic: No
@ City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter. (714)647-5800 lnspection Requests. (714)667-2738 lnspector Section: (714)647-5853
Permit #: { Ol 1o3217
Pin #: 6e231V
Building Use: Othar Occupancy: I{rA 1st FL Area: Patio:
Job Type: Reviaion Consk Type: NrA 2nd FL Area: T.t.Area:
Nalure ofwork OT lnspection code: cBc20{9 otherAreas. yards Reqd:
Existing Bldg. & Use: Flood Zone: X-0602320,t44J
proposect lJsei # of stories: Garage Area: Valu'tion:
Total 0
Description olWork Ovedlme ln.pection for Flida\!,A2!2020, oN por John Pham. Reference 10'198191 fo. scratch coat lnspsctorwillbe Oanny
Nguyen, 7'14{57{175; contact ia Rami,o Vargaa, 949-279-1527.
ptanning condition.: ila:':, irr,. :L''-;:.'r1., Irr rrill
Engineer
Address
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #
ltronsewc'od I uundctt icin
Owner:
Address:
Phone:
Tenant:
Orangewood Foundation
1575 E Seventeenth St
Santa Ana, CA 92705
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
B.Lrildirrs
Lrl I 1 6L[-r?.. :, I 6iri t:lr:u:r-
11 irr'af i lrrr & Dacumerrt
Lll 1 1 0r-r_t?- i i 77r.1r-titir-
i (:L i:h erk t:r:_i 1r:16
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd
PWA lnsp. Req'd:
Julie
Date:
Dale:
Dale. 0212012020
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002 57770 Microfilm Records
07776002 s7607 O/T lnspection
07776002 57600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
$3.91
$666.1 2
$0.00
$670.03
$0.00
$670.03
o
Planning lnsp. Req'd:/No Fire lnsp. Req'd. No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: NoLandscaping lnsp. Req'd: No
Every permit issued shall become invalid unless fhe work on the site authorized by
such permit is commenced within 360 days after its issuance,or if the work authorized
on the site by such permit rs suspended or abandoned for a period of360 days after
the time the work is commenced.
lnspector MID#: 2018-147219
No
Account#Total
01'116002 51601
01116002 57770
$666.1 2
$3 91
BUILDING. INSPECTOR RECORD
tlev. 08-07-201 5
SITE.WORK DATE ID/SIG.COMMENTS owNER ltull,l)1lR l)ut.cARATIoN
I h€reby affirnr under peDalty of perjury that I anr exenrpl from lhe ('ontrack,n' l-icense Lap for the following reaton (Sec.7031.5
Busincss and Prolcssion Codc): Any City or Counly which requires a ltrmil k) constnrct, allcr. irnprove, dcmlish or rcpair any
slruclurc. prior to its issurnce. also requircs thc applicant tbr such ncrnit r, filc a signcd slalenrnl lhat hc or she is licenkd pursuanl
lo thc'nrovisions ol'lhc Conlraclor's l,iccnscd lrw (Chhptcr 9. Cornrncncing with Scclion 7(Xn ol Division 3 ol lhe liusincss and
Prolessioils Code) or that he or she is exempt therekom and the basis tbr the ulleged exenrptitD. Auy violation of Section T0S l .5 by any
applicant for a pernrit subjccts rhc applicnilt ro n oivil penillty of nol more thrn llve hundred dollars ($500).
_1, as owncr ol lhc profrly, or my cmployces with wagcs a\ thcir solc cornpcnsation, will do thc work and thc stMturc is mt
irlendetl or offcred for sale (Se.7Gl4. Busirrcss nnd Pmfcssions Codc: The Conlraclor's Licensc I-sw does nol spply to sn owncr of
theprupefly whotf,lildsorimprowslherd)trufilwk)dftssuchworkhinrseltorlrcrsclfortlrou8hhisorltrownenrployees.
providcd that such impmvcrrcnts dc nor inlended or olLred for ML'. II. howcver. thc building or inprovcmnt is sld wirhin onc yce
ofconrdelion, the Owner Builder will lnvc the burden of prcvin8 lhd lE or she did not build or improve the pn)peny for lhe puryrse of
slc).
_1. asownerolthe pn)peily, unrcxclusivelycontractitrg with licensed conlraclors!) conslrucl lhc project (Sec.7(Hrl. Dusiness
aNl [\{)ti\\ionCodc:TheContrrctor'sl,icense[-awdocrnotapply&ranownerofpropenywhi)buildsorinrprovesthcrcon.
nnd who conrraclr lbr $uch prqiccts with a Conlrach(s) liccnsdl pur\uant kr thc Contrlclor's l-iccnse ljw).
_l anr e\empt under Sectirrn-. R. & P.C. fbr this rearrn.
WoRKl.:RS' ('ONIPENSA'I l()N
DECLARATI0N
I hcrchy allirm undcr pcnalty of lcrjury one of lhc Ibllowing dcclurtio[s:
_l have and will nuhtain a Cedificate ofConsent to Seltlllsurc f<)r workcrs' compensation, as provided for by Section 3700 ofthc
Latpr Codc, for lhc perforroncc oflhc work li)r which lhc pcrmit i\ i\sued.
_lheveaMwillnlaintairworkem compensaliotrirsurance,as requiredbySectiol3T00oftheLaborCode,fortheperf()rnuNeof
thc work li,r which rhis lcrnrit is issucd. My workcrs' compcnsati()n insurancc cunicr ul lxrlicy oumhcr uc:
Policy Nunrbci F:xpircs:
_l ccnity thilt in lhc Frfbrnunce of thc work fi)r which this pcrnlit is issucd. I shrll ftx cnuloy any Frcrson in any manncr
so as Io bcconr subjcct to thc workcrs' compcnsat ion law\ ol Crlilbrnia. aDd a8rcc thal if I should bccorre subjcct to thc
wodiers' .onrlrnsation pruvisions of Section ]700 of the l,ahx Code, I shnll, fo(hwith comply with tlDE provisioos.
WARNING: |ailurc Io $curc workcrs'conpcnsati{)n covcrrgc is unhwful. xnd shall subjcct an en)phycr b simind lEmhiqs ud
c,vil fines uI to onc hundred lhouxand dollilrs ($l(nl.(Xx)), in nddiliur h lhc cosl ol conrpensrlion. dnrnages rs providcd for lhe
Secti([ :]{)76 of the trh)r (ixle. interest and otlorrey s fee\.
Datc!-
LIC-ENSED CoNTRA(:ToR
DECLARATION
I hcrcby al lirm undcr plnahy of pcrjury that I am liccn*d undcr provision ol'Chaplcr 9 (commncing wirh Section ?000) of I)ivision 3
of thc Busincss and Pmfossions Code, arxl nly liccnsc is in full fbrcc md clfcct.
l-irr'nrc Nurnhcr:
CONSTRI.]CTION I,1]NDING AGI]NCY
I heEhy alllrD undcr penalty of perjury that lhee is a construclion Lrtdiog aSerEy fbr the perfo@rcc of the work for which this pemril ir
issued (Scc. 1097. Civ. C.).
[Indcr's Nhmc:
kndcr's Addrcss:
APPLICANT DECI,ARATION
I hcrcby affim !nder penalty of perjury onc of the followinB dalilntions:
Denrelitiotr Permits-Asbestos Notification Federal ReSularions (Tille.l0, Pnn6)
_Required Irtter of Notification
_l cerlily lhilt rhe lederrl re8ulnlioils resudin8 il\bcsk)s renx)villrre ftn applicahle k, rhis proiecl.
-l
cenify thrt I h^vc rcrd this applicalion and stntc lhat thc atDvc infomralion is concct. I agre to mmply
) rcPrerntalivcs ofthis city
with dll City and County
ordiilances and Statc lnws rckling co$lructtD and herchy authorize ylo cnler
atxrvc nrcntioncd propcny firr
Lppliconr or Agcnt
/Prmritee name 77t (^r
ud
o
llE
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsulatio n
Roof Sheathing
Shear Wall
Framinq
lnsulationi Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
lMasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
I I
FINAL vlqlT,o -fkhil4 etJ
Certificate of Occu
Notes, Remarks, Etc.
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