HomeMy WebLinkAbout101102282 - Permit (3)city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA927o2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection. (714)647-5853
Permit #:1O11o228.2
Pin #: 23e3(V
Proiect Address: 409 W Columbine Ave-a
Assessor's Parcel: 410-271-37 Lot: 34
Unit Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract:7163 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
SFD w/att Garage
Occupancy:
Constr Type:
Code:
Flood Zone.
# of Stories:
R-3, U
VB
cBc 2016
x-0602320278J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Description of Work: lnstallation of roof mounted PV system. 15 additional panels added to existing solar PV system.
Patio:
T.l.Area:
Yards Req'd
Valuation:$10,000.00
Planning Conditions:
Owner:
Address:
Phone:
Tenant
RobertJ&MarieLipot
409 W Columbine Ave
Santa Ana, CA 927073907
Contractor: VivintSolarDeveloper
Address: 9847 Pioneer Blvd.
Santa Fe Springs, CA 90670
Phone: (5621 942-1270
State Lic #: 973756
Lic Type: B, C-10, C-39, C-46
Bus. Lic #: 345470
Workers' Compensation lnsurance:
Carrier American Zurich lns Co
Policy #: WC5096013
Expires: 11lO1l2O2O
Engineer:
Address:
Architect /
Desiqner:
Address:
Phone:
License #
Vivint.Solar
James Matthew Walsh
3301 N Thanksgiving Way, #500
LEHI, UT 84043
c73567
Vivint Solar Developer
Eric Curtls
9847 Pioneer Blvd.
Santa Fe Springs, CA 90670
(5621942]t270
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Ahangian, Kathy
Hernandez, Kathy
Date:
Date. 0210512020
Date: 02/06/2020
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Totat
Paid to Date:
Balance Due:
$450.00
$s4.74
$1.00
$0.00\{
No
No
No
No
Account#Total
0't1't6002 51601
01 1 16002 51612
01116002 57770
$450.00
$1.00
$54.74Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afrer lls 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.
$505.74
$0.00
$50s.74
lnspector MID#: 2019-155990
Phone:
License #:
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEL('ARATION
! hereby affirnr under penalty oi perjury thal I dn exempt from the Cortrado6' License Law for the following re6on (Sec.703l.5
Busin$s and Profsion Codc): Any Cily or County rvhich requira a pomit to conslruct. alts. improve. donolish or repair m)
slnrctrlre, prior to its issuance, also requirG the applicant for such ;rnnh to lile a signed statmrcnt thal he or shc is iicosed pursuanl
b rhe provisiom of the Contractor's Licensed Lau (Chaptcr 9. Cornmencing wilh Sstion 7000 of Division 3 of lhc Busine$ ad
Profc$ioos Code) or that he or she is cxcmpt thgeliom dd the b6is for the allegcd exemption. Any violalion of S{tion 703 L5 iy ay
applicanrforapmnitsubjststhe applicanlloacivilpenaltyofnotmorelhufivehundreddollus($500).
l.a orvneroflheproperty.ornrycrnployswithwags6theirslecontpcnsation,willdotheworkedthestruclueisnot
intoded or offscd for sle (S€.7044. Busines md hofsions Code: The Cootractor's Licrue law do6 not apply lo d ownq of
lhe prepoty u'ho builds or improvc lhq@n. md who do6 such work himself or h6elf or th.ough his or her own cmployec,
provided thai such improvmenls ee not inlffded or offqql for sle. lf, horvwa, the building or improvement is $ld within one y@
ofcompletion. the O,*ns Buildq will have the htrd6 ofproving thd he or she did nol build or improve the ympqty for the purpos of
ule).
_1. s owner of thc property. dn exclusively contracting wrth licensed contractoG to construct the prcjst (Se. 7044, Busins
md hufsion Code: 'fhc Conlractor's License Law dos not apply lo e ownq ofpropsty who builds or improvc thaon.
and \vho contmcts for such rojats rvith a Contractor(s) licenscd pursuilt to thc Conlraclor's Licme Law).
- -l m exempr undq Srtion-. B. & P.C. for this r6on.
lVORI(ERS' COMPENSATION
DECLARATION
I hoeby aflim undr penalty ofpsjury one ofthe followhg deluatioro:
_l havc md will mainlain a Ccrtificale of Consol lo Self-lnsure for workos' compwtion, c provided for by Sction 3700 of the
kbor Code. for the pafommce of the work for which the psmit is issued.
Valt havc and will mainlain workcB comp€mation iNurance. 6 required by S<tion 3700 of lhe tabor Code, for the psfomilce of
the work for rvhich this pemil is issued. My workm compflsation ins[ilce cmier ad policy numbe ae:
c*io, 4 hc r ica rt L1
Policy Numt'er:Erpircs:
_l certify that in the peformance of the work for which this ponrit is issucd, I shall nol crnploy any pcrson in any nmffi
m rotok<omcsubjecltothework6'composationlarvsofCalifomia.mdagrethatiflshouldbecomesubjcltothe
workss' compmsation provisiom ofS{tion 1700 ofthc Latnr Code. I shall, forthwith cornply with those provisions.
WARNING: Failure to wuc workers'compeNation coverage is unlawful. dd shall subject m mployo to airninal perultis od
civil fines up to one hundred thousand dollm ($100.000). in addition to the cost of compensation, dmagcs s provided for the
Scction 3076 ofthc tibor Code. interst ild attomey's fe6.
urr",t?-f-['?cr?o
I hcreby affinD under pmalty ofpcrjury thal I an licenscd 9 (connncnring $ith Seclirn 7000) ofDivisrrn -1
of the Busins md Professions (-'odc. ild my licsse is in full forcc md effet.
License LC)N urntrr:
c,
CONSTRUCTTON LENDINC ACENCY
I hoeby affim unrlo panalty of ptrjury that thq€ is a construction lending agency for the pefomance ofthe work for which this pfinit is
issued (Se. 3097. Civ. C.).
Lcndq s Namc
[-endq s Addrss:
APPLICAN T DECLARATION
I hqelry amm under penalty of po.;ury one ofthe following dcclaations:
Demolition Pfrmits-Asbcstos Notification Fedqal Rcgulations (Tillc 40. Pa16)
Rcquired l-clter of Notifi cation
-l
cffify that rhe fc'dcral rcSulations relitrding aslrestos rcmoval arc nol applicable to this projecl.
is conet. I agrc to comply with all City and County
I reprGentativ6 ofthis City ild County lo cnt6 uF)n thc
akve mmtioncd propmy for iropcstion
Apolicant or Agent
Prrnitte nanrc
\.
inl_onnation
o*"[]-lQ4e? o
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/VenUl nsu lation
Roof Sheathing
Shear Wall
Framinq
lnsulation/Energy
Drwvall
Ext./lnt. Lath
Brown Coat
Masonrv
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
I -t ,
FINAL zlzqw DIY{Y)f?:w x-/
Certificate of Occupancy ,Ir
Notes, Remarks, Etc.
Own{rl
cr-t 9) l( n
) ;- ",-: 4 ;g---,rI^_-_:,,
?f .l:',ic l-'":g.. ., a:l tci f .-.1.E,
P.O. Box t3e8 tU-19)
Sanra Ana, CA g?.70i
(7:4) 647-5S0c
S,'ricke & CO
Ala:'iii Afi"idavji
T,tis dt:u r?ir ncy Cz ltunC a!..
1l'.,1ats9 us: a )ia,ck or bl,u: i ak bai:
Pic.,'ect Aadrass o
Pern-.it l.rlmbe,.
',
IO lo
i Propeny O.s;tar:l*fL i'
C: rtra ct:,,:
-caint pe,:,
w
1(-
L,l )o
j l-icarsa #
State of Cal
bu ildings.
i1'ornia requires that smok" and carbon rnonoxide (co) ararms are instalred in residential
Dote:L-t-4 -
LJ nsed Contractor P Property owner
california Resrdentralcode (cRC)Section R314.1and R315.2 staies in part tha:existingdweirings be
;:TgJnXTjtl,',T;l'ararnis "nu .,'to. .onoxide ararn s cRC section R314 3 anai:rs: define
n Both bores below must be check-.d:
M:bon r''ron'cxid'a alarms: Are installed outside of each sleeping area in rhe immediare v:cinity ofbedroorns and aiso on each le,rel of the dvvsiling. Alarms are reccmmended in bed:conns with gas_firedappliances (i.e. hot water heater, cooktop, furnace) or a fireplace.
ff;f:::.H ffii}:[i;.;;::""' used ror sreeping, in eaci: hairway ourside oia sreeping
Retrofitted detectors may be bai:ery-operated for buildings where no inlerior aiieraiions ar.eperfo;'med combination Smokelco alarms must compry with arl appiicabre standarcs and be approvedby the Scate Fire Marshall (SFnl). Battery life must be L0 years.
I hereby cel'tify that I am the cont''actor or ihe property olv.rer of the above project. i further.certify
::1"::::=^f"Hfli.I:'rTT:?,T.1;:,,T"; h;;il;,;,,.i,u.," com0,iance with rhe governing
Signat,;rt:
icne;"k o,.re)
t,)
.
^+E
!l)r,v, =' tn
prcc zss is
tfisper!or
is s.t;'crtific*ioa is on!"1 asec fcr groj'.,s tn€t afect the ilffrRrcl a! the st*aurt. Titis:-':::i:'' .,Ar.t
y tr przle:ts wherz,f if85j rc rhe itttcriai ai titz d.trztiing bya Jsr?c..qncis rrot required.
Hlve th;s :crnpieie.i fzrn arC the job-card raadily a,;ajlab{a on finai inspecijo,n
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