HomeMy WebLinkAbout101102732 - Permit (3)Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: \714],647-5853
Unit:
Assessor's Parcel 396-'t04-59 Lol 27 Block: NA Tractr 6461 Historic. No
Suite Range:
Zoning: Rl
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, QA92702 Permit #: 1lJ11o2732
Pin #: 8,E144
Building Use:
Job Type:
Nature of Work:
Existlng Bldg. & Use
Proposed Use:
Planning Conditions:
Single Family Dw€lling
Reroof
Reroof
SFD w/att Garage
Handout given.
R-3, U
VB
cBc 2016
x-0602320164J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $8,800.00
Description of Work: Tear off existing roof material and install new comp shangle roof material. Torch-down 4 squaras, and instqll 33 squares of comp.
Rcpt:!t295631$ -
Tnonsoct ion Totql
Refil 1tl1ll1?7:J?
t/1/102rJ L141 Pf,
t721,1:
Engineer A D 6 (:FnEuruction (nd Rijclf jne
Owner:
Address:
Phone:
Tenant
Contractor: A O G Construction and Ro(
Address: 18653 Ventura Blvd #81'l
Tarzana, CA 91356
Phone: (855) 699-5959
State Lic #: 10330ts
Lic Type: C-39
Bus. Lic #: 373935
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9221338
Expires: 1111412020
6enerct1 Pl0n Updqte Fee
01 1 16002- 5l6r:rtrtrtl:r-
Buildins
011I6tttr2- 516t|1|fl:lu-
BIds 9tds R€vo 1v ins
[1116tr02- 5161?0t:ttt-
n icrof i IB .\ Do.urenls
011 160t:r2- 5;'77r:r!r:r(-
V isn
(:C+: rrxxrr**rI**2964
i21.'?i
E:l?ll.1,rrr
31 ,l:rr-r
6t. ?1
6721 .12
Authi:r:l346gG
Architect /
Desiqner:
Address:
Phone:
License #:
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
$333.06
$3.91
$1.00
$22.95
$57.20
Graham, Jeffery
Chavez, Dave
Fire lnsp. Req'd:
Police lnsp. Req'd
Flood Zone Cert. Req'd: No
lnspector MID#: 2020-156839
Date. 01lO2l2O2O
Datel
Dale: 0'llO2l2O2O
Subjecl to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipl:
Permit Fee
l\4icrofilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
No
No Account#Total
0'l 1 16002 5'1600
01 1 16002 51601
01116002 51612
01116002 57770
$22.95
$390.26
$1.00
$3.91 $418.12
$0.00
$418.12
Building
Project Address: 2118 E Twentieth St Bldg: Address Range:
Occupancy:
Constr Type:
Code:
Flood Zonel
# of Stories:
Sylvanus Matheny
2118 E 20Th St
Santa Ana, CA 927057802
(714) 542-5681
Address:
07776002
07716002
07776002
07715002
07776002
57607
57770
57672
57600
57607
Fee Total:
Paid to Dale:
Balance Due:
Evory permil issued shall become invalid unless th€ work on the slte authorized by
such pemit is commenced within 360 days aftet its issuance or if the h/o* authoized
on the site by such pemtt is suspended or abandoned fot a petiod of 360 daysafter
the time the work is commencecl .
BUILDING. INSPECTOR RECORD
SITE-WORK ID/SIG.COMMENTS OWNER AUILT}ER DFJI,CARATION
I lrrchy alrtm nn,ler pcnalry ol pcrjury rhrr I ri cr.Dnr tft,m rh. c.nrkn)n Li.cn{ L,w n)r thc loll,,wina rcxvr 1scc.70-r1.5
Bu\incss xul Ptufc$ion Cdt )r Any Cily o. Counry whf,h rcquics a tErm n' .onsrrurl- .lrcr. imti,v.. d.molish or rPlr .ny
rrucrrc. pntrro rls Nsu!tre,.1$rcquncsihcappli(anrli,rsu.hFrnnrbiLx\'gn.ns.knrnr rhnr h. or sh. i liccnsed purn'anr
b rhc [ovNnrr of rlE Cont..rois LBnrcd tjw (Chrtlcr 9, ConrmcncrnS w h Sc.ri,'n 70110 of Divisbn ] oflh. Busi.cs ,n.l
PnncsnrnsCo!c)orthathco.slrctcrcnl|,rrhcrctromr.drh.hrs\li,rrh.rllcScrlcxcmplnnr.AnyvnalnnrolS.crion?0.r1,5byuy
applicanr for l p.rn suhj(G(hc nmli(anr b aciv,lpcnilryotnor fttrc tho nvc hun'lrcd dolhn ($500)
l, rs owmr il rhc pn,F.r y, or nry cmpl,,yc\ ,i h trrsc\ i\ rh.'r vrc co'nl,cnqrtr)n, w l d. rlr { lt u.l rtE srurm is nor
i' cRlci or olidc'i t}r \alc (S!!.?(N4. Bn$n6s and Pnnassons C:,rd.: l hc Cbnrrrel(tr s Liccnsc l,!s dmr nor atrdy kt an ow ( of
rhc pn,r.ny wh t'uilds o. inlpn,vcs drE,q u'l who Jocs s!.i w)rk h'hlclf or h.r\cll or rhouth his .. h.! oen cmployccs.
B)vklcJ rh soch ihtnrvcmnB e ftr hrcnlcd oroiaed lor salc ll, hNcwr. rh. 6nil]ing or in{ftrkmnt n'ld * hm..c }er
ol .l,nPbron, rhc ow.cr Buil]tr uU hrvc rh. htrni.n of l'.vng rhar h. .r shc dkl mr tuill or inrJ,ovc lllc pnEny l(,r ih. I)urF)s uf
I..sDwncrolthcI]n)!crry,!mc\clusivclyconrra.ring*trhli(n{'l.onrrrn'cbcon{tucrrh.!n&cr(S..7044,Busucss
a.n Pn,lssi)n Ciic: -thc cl,nrrrttr's l-ic.ns. Law J(f,s noratply!, M Dwncr .l !n,pc,ly wlF huilds or inpovcs rhcR"n.
rtul who (nrncrsLrsuch pNJcels wrrh ! Cinrrm.lon, lactrr'l purtrrnr k, ihc ConMcntr t LEns tjw)
I nnrckrnpr trtrdcr Sc(ir . B. & t'( ln' rhLs rcxstri
rvoR(Em
BEC!d8AM!
I hcrcny anirm und., Fnaltyolp.riryonc otrh. Lut,wn's Jecld n,ns:
l hav. dxlwill mlmra { Ccniturrc ol Consenr k) Sclrlnsurc ,rtr qrk 6' $npcnsario,r. rs r,ovilqi lhr t'y Sccrbn lT(xl or rhc
tjhtr C,rlc,li'r lhc pcrl{mrn.c olrhc wod ltr qhiLh rhc pcm t s{EL
rnJ wrll mhrain workcs comp.nsatsn insumncc. as rcqutcd by Sccr i,)n lln of lhc tjbor Cod.. tar thc pcnimune oI
ld $h'(h rhL J*mnr F 6$cJ M) uo \.r\ (.mFnvrtun hn'r,n(c \anrr r F,liynuhh.rr.
.'iq-l€ r.^nd/c,-,..qJa 1a3E 1l /c/ 2A
_l.cn',i rhrr m rhe l].rfortuncc.f rh. work foi wh(h rlns frnnf s ssucd. I sh!l1nor cn,In'y ]n, Fr$n 'n
any nr{n,Er
y, Nrobcu,mc uijsr t,rhc wo cn d'mp.nsarn,n hwsolCal',l,nm. diJ dlRcthrr rrI dnNld n.{omc \rhjel hih.
wsrkqs dDp.n\riion povision\ ofS.cri,,n lTnof rlr blt, Cirlc,I slxl[. n]nhwirh.onl['ly wilh lhor nnlisn,nr
TV RNING: Folurc b s.u.. MrtcE ronpcnsarn,n .ovcngc ,\ unlawtul, arxl nuu ruhJl-tr r'r c Pl',yct rr unmd !.naltics mJ
eivil ,jncs up k,.nc hunlrcJ lhous,nJ JoUs ($l($.o(x)). in r'tJii(,n b rhc.o{ ol.onrFnlrlion. laroges ff ffuvi]cJ rd rhc
Scclon 10?6 or lhc ljhtrA c, mbrcn md *om.y'\ ,c.\
,a1()
DECIAEAIIO!
I hcE6y atitm untlcr Fnaltyo, leiury lhll I anr liene.l u.,lcr l)l'eti{,norChafl.r 9 (on'Encio8 with Scction ?00n)ofDi$n,n.l
of lhc Busincs Md Pftntsions Codc, &l my liccn* h in tull li)rc ul cllm!.
/a350/s
t )q)
A G 's!!N]X!(.f!!][lr!12!!!iMN1f
I hcrhy nlftm und* l.mliyolpcrjury thlt lhcrc is r.onnruclion h nu rscrey itr lhc pc.lirnufrc or rlr work tnr which lhn lrmi n
isucJ (Sq.1l)97, Civ. C )
AfILICA{LIECIJAAIIaN
I M,y aliim und.r pcnilly ol Frjuly om of lnc lhlhrvin8 dc.hr ion!:
D.mlition Pcrnfe^sb.stos Notili.rlion Fcncnl R+u,ulnN i'r(t 4). P!n6)
Rcquncd t ltcr or Nriliulion
l ..l1 irhrrrhc ltdcrilr.suhrtun\ ftEd'tirs adrros mm)vrl *. h, at'plirahlc t,'rhn p,ojc0r.
-l
ccrlilr lhdr I hvc rcrd Uis.pplioarnnr and stllc lhd lhc atDvc inhmarioo n cor.d. l rg& {,r coq)ly wlh.ll Cilyan! Counry
oilm.hccs dd sGrc uws FEriry to buildins consrdcrn'n, ! h.rhy Nrhotu. rpo\d ,h!cr dr lhs Cny Md County to cnlcr upon tlE
ah,ve m.rion.d ttup.ny rur in\p..rion puqN.s.
,4,,,,.,,, .. n*"", ..,*,nu,
l\*,**,",,".,
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Sublloor/VenVl nsu lation
Roof Sheathing
Shear Wall
Framinq
lnsulationi Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif .
/l IA /-.
FrNAL i/61 /)o)4 q
Certificate bf Occupancy
Notes Re arks, Etc.
2^,
r{
DATE
Set Backs
T-Bar
.t1, t u I 1l )-L/?)
L.nJ.i\ AJJrc$r-
,r*,-.,L-d-i.(!
I
I i-
I
CALIFOBNIA ALL-PURPOSE ACKNOWI.EDGMENT clvll coDE s 1l89
A notary public or other officer compleling this certiticate verifies only the identity oi the individual who signed the
documentto which this certificate ls attached, and not the trulhfulness, accuracy, orvalidity ofthat document.
State of California
County ot
On beford me,
Date
eared
Here Insert Name and Title af the Officer
personally app
I
Dr4>rn c-i,,/sn
Name/zfof Sionell>f
who proved to me on the basis of satisfactory evidence
sgbsgribe{ 10 the wilhin
fi sJ lrt r / tft u auth o rize d c
tFthe entity upon behalf
ovl ge.d to
a ,,axecu
lcertify under PENALTY OF PERJURY underihe laws
of the State of California that ihe foregoing paragraph
is true and correct.
WITNESS my hand and official seal.DANITLLA FARZAM
Comm. 12194055
Notary Public. California
Los Angeles County
Comm. Expkls Apr 2Z 2021
Signature
Signature of Na lc
Place Notary Seal Above
OPTIONAL
Though this section is optional, campleting this infarmatian can deter alteration of the.document or
fraudulent teattachment of this form to an unintended document.
Description of Attached D
Title or Type of Document:
oc ent
Document Date:
Nu gner(s) Other Than Named Abo
Ca er(s)
Signer's Name Signer's Name: _! Corporate Officer - Title(s):
E Partner - ! Limited E General
n lndividual lAttorney in Fact! Trustee E Guardian or Conservator! Other:
Signer ls Representing
02014 Natlonal Notary Association . www.NationalNotary.org . i,800-us NorARy (1-800-876-6827) ltem #5907
)
)
and executed
the
)
f:t7
n Corporate Officer - l'itle(s): _EPartner- DLimited. D Gdneral
n lndividual E Attorney in Fact! Trustee E Guardian or Conservator! Olher:
Signer Is Fepresenting: _
, &}fl,},
POOTINO & CONSTRUCTION
From:
Dotan Swisa, Owner.
American Developments Group Inc.
DBA ADG Construction and Roofing
18653 Ventura Blvd. Suite #811
Tarzana, CA 91355
P:855.599.5959
To:
Mayan Snir
To Whom It May Concern,
I authorize Mayan Snir, to pull city permits on my behalf for our
construction projects and provide any legal information about my company.
Thank you,ul<lt1
Dotan Swisa
ADG Construction and n8
lilr r-(/;,1, ( / ,'r.,,/
ADG Roofing
18653 Ventura Blvd'
Suite #811 i
Tazana, CA91356