HomeMy WebLinkAbout101104395 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests. (714)667-2738 lnspectorSection: (714)647-5853
Permit #: { O{ { 04395
Pin #: 69309
aProject Address: 2107 W Edinger Ave Unit:Bldg:Address Range: 2107 -2121
Historic: No
Suite Range:
Zoning: PAssessor's Parcel 407-051 -57 Lot 't Block: NA Tract: 9773
Building Use:
Job Type.
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Other
Miscellaneous
Community Pool Repairs
Multi-family Comm unity
N/A
N/A
cBc 2019
x-0602320257J
1st FL Area:
2nd FL Area:
Other Areas
Garage Area:
Total:
Patio:
T.l.Area.
Yards Req'd.
Valuation: $8,674.00
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories.
Description of Work: Repairs for community pool. Replace handrails and grabrails like for like
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
Westvale Townhomes
21Ol W. Edinger Ave.
Santa Ana, CA 92704
Contractor: B German Lopez Pools Rem
Address: 2214W. Palm Ave.
Orange, CA 92868
Phone: (7'l4l612-1813
State Lic #: 992335
Lic Type: C-53
Bus. Lic #: 375840
Workers' Compensation lnsurance:
Carrier: Falls Lake Fire and Casualty Com6
Policy #: FLA014427
Expires: 0512012021
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
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
Date:
Date:
? Dale:0812412020
Subject to Field:
Chavez, Dave
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
o7776002
07776002
071_L6002
07776002
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57607
57770
57672
57600
57607
$172.64
$4.05
$1.00
$23.79
$59.30
b
1
I
I
2
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 1 16002 51600
01116002 5160'l
01116002 51612
01116002 57770
Account#Total
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after its,ssuance,or if the work authorized
on the site by such permit is suspended o r abandoned for a period of 360 days after
the time the work is commenced.
$23.79
$231.94
$1.00
$4.05 Fee Total:
Paid to Date
Balance Due:
$260 78
$0.00
$260.78
lnspector MID#: 2020-161021
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNI,IR ItUll,l)l.lR l)III,CARATION
I hereby affirnr under pcnally of perjury thal I m exempl fronr lhe Cu{raclors License I*w for the following rcason (Sec.703 1.5
[rusrncss and Prolcssion Codc): Any City or County which rcquires a 1-*rrnit k) conslruct, altcr, irnprovc. dcrmlish or rcpair any
stnlcnlre.prior()its issuance.alsorequircstheafrplicantti)rsuchpernritt)tilcasiSncdslatemnl thatlrcorsheisliccnsd pursuant
o lh(' provisions of thc Contrdctor's l,rccnsed [-aw (Chapter 9, Comilrcncing wilh Scclion 7(XX) ol Division 3 ol-thc Busincss and
Profcssi(msCode)orthalheor(heisercnlplthereiromandthehasistirrtlEullegedexcnrption. AnyviolatiurofSectionT03l.5byany
Applicrnl for u lErmit subjecls the appliconl to n civil p.nahy ol not rmre lhan llve hundrcd dollors ($5U)).
_1. as owncr ol'lhc propcrty. or my crnployees wilh wages as lhcir solc cdrnpcnsali(]n, will do lhc work and thc slrlcture is not
iilcrxled or offered for sle (Se{.7(N.{, Business nnd PR)fesskrtr\ Code: The Contrnclor's Licensc [-aw does not apply rc aD owner of
thc p[)pcny wlx) buildr or irnprovcs lhcrdnr. aril wk) d(ts such worl hinrsell or hersell or through his or her owil cmpl()yees.
prolidcd thal snch imp(ov.rrcnls {c ml intcndcd (}rollcrcd lbr sile. II. howcvcr, t}E building or improvemnt is sold wilhin onc }rar
ofconl)lelidr, llrc Owner Buil(lcr will hnve the burden of provilg tlul he or Nhc (lid Dol build or impft)ve the pmpeny for lhc l)urF)se of
srle).
_1. ns owner oflhe proparly, rm exclusively contrecting with Iiccnsed conlractors to conslruct thc prcject (Sec. 70,14, Buriness
and [h)tesskn)Code:The(bntructor'sl-iceusel-awdoesilotapplytoanownerofpropertywhobuildsorimprovesthereon.
and who comracts for such projccls wilh a Conlmcb(s) licenscd pursurnr h tlE C(lntraclor's Liccnse t w).
-IamexemPtutrderStctilrn-'B.&I,.C.filrthisreason.
W( )RKI.IlLS' CONI I'HNSA'IION
I)ECt,ARATI()N
I hcrchy attrn undcr pcnalty of pcrjury onc of thc toll()wing (lcclffationsi
_lhaveiuxlwillnuintairaCe(ificatcofCofuscnlk]Self:lDsureforworkcm'compentation,as pnrvidedforhySectionJT00oflhc
Lntnr Codc, for the pcrforroncc ofthe work for which the pcrmit N issucd.
-l
have and will nrrintain wrrkers conrpensaliotr itr{lrrnce, n\hy Seclion 3?00 of lhc Uhor Codc. for the perfomr-c of
rhc *(nk li)r whtr lr lrcrmil is issucd.:4 My ilrxl lx)licv nuorhd ilc,ar/{ //a' ra/ /52€
Policy ALl A 7 *a-o I os-ZD -2
_l ccnity th6t in thc pcrfi)rnuncc of thc work for which this pcrnit is issucd, I shall not cmploy uny pcrson in any munncr
s as lo hecorE suhjccl lo thc workcrs' conrpensation hws ofcalifomia. and dgrcc that if I should hccorrc suhjccl to thc
worlers'conrFnsationprovi\ionsofSeclion3?00ofthet borCqle,lshall,fonhwirhcomplywithtlDsprcvisions.
WARNING: Failure to sccurc workers'compcnsation covcrrgc i\ uillawful. and shall suhjcct an cnrlhycr () dminal penalties lnd
civil liner up to one hundrcd thousxnd dollnrs ($l{X),(XXI),
Sectirnl 1076 ofrhe Latxtr Co(le, interest and attonEv s fee\.
iD rddition ro lhc damnges as provided for l\c
,r^,". -7"2a-2o
I hcreby aflifln undcr penalty ol pcrjury that I am liccn$'d 9 (commncing with Scdion 7fi)0) ol l)ivisio?rj
of thc Businrss aml Pnrlcssions Codc. and nrv liccn\c is in lull tbrce and clltct-
- ,.a-<<
Liccnsc Class: L Liccnsc J-33s
??
I hercby atllrn) under Filalty of periury lhat there is a constnrcttlr leDdilg a8eocy fbr t he perfomance of the work tbr which this pemrit is
issucd (Sec. 3(197, Civ. C.).
LrNicr'" Nrnr.'
[rn,lcr's A,ldress:
APPLICANT DECI,.{RATION
I leNby aflm undcr penally of perjury one of the followinS declarntions:
Denulitior Pcrmits-Asbestos Notification Federal Rcgulations (Tirle 40, Paf,6)
-Required
lrtrer of Notifi.ntion
I cglify lhxt llE feJeral rcaulationr rcguding asbestos rcnx)val arc no( applicahlc b lhis pmiet.IT. L;
4 onif) rhal I have reail thi\ applicalion emd sralc that lhe abovc infomalion is corccl, I aSrE to comply wilh all City and County
ordiuarrccs and Stalc Laws rehting io huildiilg auth(,rize reprcscilliltives ()[this City and Coluily lo enter upon llE
atxrvc nrcntiontrl prrpcny lor inspcct
Applicunt or Agcnt
P(nrilcc name
u*",t, 7- 7 z/-?3
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsu lation
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Eneroy
Drywall
Ext./lnt. Lath
Brown Coat
ltrlasonry
Pool Fence
T-Bar
Handicap Req
Deputv Final Report
Engineer Final Report
Flood Zone Certif
l.)^tL 2,e9l\ lt^"!r \q
F!NAL 91441+t - ?Arfi
Certificate of Occupancy \
Notes, Remarks, Etc.
4l z Zl ?. o ,. 2NI.^,
+
Rev.0B-07-2015
.
Tftl )-l*+t'