HomeMy WebLinkAbout101102886 - Permit (3)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Building
Permit Counter: (714) 647-5840 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 101102886
Pin #: 8ee(l
Proiect Addressi 2315 N Santiaqo St
Assessor's Parcel: 003-092-23 Lot: 'i 5
Unit Bldg: Address Range:Suite Range:
Zoning: RlBlock: A Tract: 378 Historic: Yes
Building Use. Single Family Dwelling Occupancy: R-3, U 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: Sfd w/det garage Flood Zone: X-0602320163J Garage Area:
Proposed Use: # of Stories:
Totat
Description of Work: Reroof house only - remove wood shakes & hot mop & install new***ICC-ESR #1410***
Patio:
T.l.Area:
Yards Req'd
Valuation:$30,500.00
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Andrew Thorne
2315 Santiago St.
Santa Ana, CA 92706
(6s0) 863-2281
Contractor: HD Roofs, lnc.
Address: 5022 W sth St
Santa Ana, CA 92703
Phone: {7141 554-0267
State Lic #: 908238
Lic Type: C-39
Bus. Lic #: 325094
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9052886
Expires: 0110112021
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone.
License #:
1il
lds
111
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
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Graham, Jeffery Dale. 0112112020
Date:
Dale: 0112312020
Subject to Field:
Misc Receipt:
Misc. Receipt:
Misc. Receipt:
071-L6002 51601 Permit Fee
07775002 57770 Microfilm Records
07776002 57672 Bldg. Stds. Revolving
01L76002 51600 General Plan Update
07776002 5760L lssuance
Fee Totat
Paid to Date:
Balance Due:
$333.06
$3.91
$2.00
$22.95
$57.20
$419"12
$0.00
$419.12
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 issuance,or if the work authorized
on the site by such permit is suspended or abandoned for a period of360 days after
the time the work is commenced.
01 1 16002 51600
011'16002 51601
01 1 16002 51612
01116002 57770
$22.95
$390.26
$2 00
$3.91
lnspector MID#: 2020-157217
Zuniga, AllissM
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG..COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/Vent/l nsu lation
Roof Sheathino /-31-2o kftalo3
Shear Wall
Framinq
lnsulation/Eneroy
Drywall
Ext./lnt. Lath
Brown Coat
lt/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
FINAL ,'Ul-",Ds?-tl l6:',
Certificate of Occupancv
Notes, Remarks, Etc.
OWNER BUIt,DER DELCARATION
I hcrchy afllrm undcr pcnulty of pcrjury that I am cxcmpt from lhc Conlrack)rs' Liccnsc hw for thc folk)wing rcasn (Scc.70.11.5
Busincss lnd Prolbssion Code): Any City or Counly which rcquircs a pcnril lo constntcl. allcr, irnprrvc. dcmolish or rr;lair any
slruclurc. priork, its issuance. also rcquircs lhe applicant li)r such pcrmil to lilc a signcd strlctrrcnt lhal lreor she is liccnsc(l pursuant
k) lhc provisions of thc Conlrack)r's Licenscd hw (Chaptcr 9. Conlncncing with Section 7(Xn of Division -l of Ihc Busincss and
ProltssionsCodc)orthalhcorshciscxcmpllhcrcf()mandthebrsislbrthcallcgedcxcmption. AnyviolnlionofScctionT0-ll.5byany
applicilnt li)r a pcnrit subjccls thc applicant lo a civil penillly ol'not rnorc lhon llvc hundrcd dollars ($500).
_1. as owncr ol thc proFny. or ilry cilrployccs wilh wages as Ihcir \olc conrlxnsalion. will do tlrc work and lhc strclurc is nol
intcild orofTcrcdf()rsle(sN.7(!,l.Busincs\andProfcssir)nsCodcrThcColtrrctor's[-iccnscLjtwdocsnotapplytornowncrof
thc pR)pcny who builds or improvcs thcmn. md who d@s such srrrk hirnsclfor hcrscllor lhr)ugh his or her own enrpk)yces.
provi(lcd thal such itrrprovenrcnls ffc not intendcd orollcrcd tbr salc. ll. howcvcr. thc huilding or inrprovcmnt is sold within (ilrc ycnr
ofconllction. thc Owncr Buildcr will havc thc burdcn of provirg thill hc or shc dtl nol huild or inuovc the pnrpcfty for thc purF)r of
qlc).-
l. as owncr of thc propcrly. ilnr cxclusivcly contricting with liccnscd conlr ack)rs l() conslrucl lhc froicct (Scc. 7()1.1. Busirtcss
and l1\r'cssiolCodcr'lhcConlrrclor'sl-icensc[,awtlocsnolilpplylontrowncrofpropcrlywhohuildsoririlprovcslhcrcon.
anrl whi) coDtrrcls lbr such p(,iccls wilh r (i)rilrrcbr(s) liccDscd pursun0l l() lhc Conlrilclor's l-iccnsc l,rw).
lJmcxcmpluildcrscclion-.B,&P.C'forlhistcuson'
l)nlr:()rvnrr:
WORKERS' COMPENSATION: IIECIIISAIIQN
I hcrcby aflirm uldcr pcnaltyof pcrjuryone of rhc li)lk)wing dcclarationsl
_l havc and will ilrriltilin a Ccrlilicxtc ofCoilscill t) Sclf-lnsurc li)r workcrs conlpcnsution. rs providcd li)r hy Seclion .17(X) ofthc
lntx)r Codc. for lhc pcrli)rnunce ol lhc work lbr which thc pcrtrtil is issucd.
thc
havc and will nrainlain workcrs' cotrqEnsation insurance. as rcquircd by Sccli()n
which this pcrmit is isrucd. My wrrkcrs' comlcn\alion iil{urancc cafiicr
.: i,r1\ t atffL\
-17([ ofthc lahor Codc. for thc pcrlbriluncc of
md Jxrlicy numbcr are:s1)rk lor
rzl3rCrrricr:LL(/
Policy Nu
_l ccrlifythrti[thcpcrfornunccollhcworkli)rwhichthislcrnlitisissucd. Ishall nolenrlk)ynnypcrsoninanymililncr 4
so xs lo bcconle suhjccl k) lhc workcrs'cornpcnsation laws ofCalili)inia. and agrcc lhal if I shorld bccomc suhjccl lo thc
workcrs'coilrpcnsillionprovisionsofScclion-17(X)ollhct{htrCodc.lshdll,lorlhwilhconlplywilhlhosprovi\ions.
IVARN]NG: Frilurc to rcurc workcn'colrpcnsnlion covcrrgc is unlawful. antl shall suh.iccl an cmplo;cr lo nimiilal ftnullics aBl
civil llncs up to onc hundrcd llt)usnnd dollars (S itr rdd lhc cosl of con{Ensrlion. danragcs as providctl fot the
Sccl')n ol Codc. intcrcsl
I)tlt:L?Z 1tj
I hcrchy afurm undcr pcnalty of pcrjury Ihat I am liccnrcd undcr Jrovision of Chuplcr 9 (commcncing wilh Scction 7000) of Division ]
of thc Business and Prolessions Codc. md nry liccnsc is in full li)rcc and cllccl.
\[-iccrrsc N u nrl_--r:
W
I hcrchy aulrm undcr frcnillly of pcrjury lhat lherc is il construction lcnding rgcncy lor the pcrli)nnuncc of the work lbr which this prrttil is
issucd (Scc. 1097. Civ. C.).
Lcndcr's Namcl
I-cndcr'( A(ldrcs\
ATIIJCANLD&CLABAII9N
I hrcby alfinn undcr pcnalty of pcrjury one of lhc folkrwing dcclaralions:
Dem)lition Pernlits-Ashcslos Nolification Fcdcral Rcgulalions (Tillc 40. Pan(r)
-Rcquircd
kttcr of Notificalion
-l
ccrtily thrt lhc lcdcral rcSulalions reguding 0\bcslos rcrnov0l rrc Dol applicahlc lo lhis projccl.
this appliculion irnd stntc that thc atx,vc inli)rnlxli()n is (orrccl. I ilgrcc lo c()nll)ly with all Cily and Counly
buildiilg cotrslruclion. dnd hcrchy iluthorizc rcprcscntrlivc\ oI lhis Cily ilr(l County h cnlcr upon lhc
abovc ilrcntioned propcrly
Applicsnl or Agent
I'errrilrr trrmc (
PUrJtscs.
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