HomeMy WebLinkAbout101105354 - Permit (2)I
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 #: {01105354
Pin #: 3{ 111
Proiect Address: 622 S Harbor BIvda
Unit:Bldg Address Range: 622-666
Historic. No
Suite Range:
Zoning: SP2Assessor's Parcel: 188-071-22 Lot: NA Block: NA Tract: NA
Building Use: Commercial Occupancy: B 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: Commercial Flood Zone: X-0602320256J Garage Area:
Proposed Use: # of Stories:
Total:
Description of Work: lnstall Firestone 60 mil TPO single ply roof system over 1 existing layer (85 squares). Handouts given.
Patio:
T.l.Area:
Yards Req'd:
Valuation: $+8,080.00
Planning Conditions:
Engineer:
Owner.
Address:
Tom Chou, LLC
3 Whatney
lrvine, CA 92618
(7071 88e465s
China King
Contractor: AII Surface Roofing & Water
Address: 923 N Logan St
Santa Ana, CA 92701
Phone: (7141 834-1 462
State Lic #: 729505
Lic Type: B, C-39
Bus. Lic #: 0002991
Workers' Compensation I nsurance.
Carrier: State Fund
Policy #: 9159984
Expires: 06/01 12021
Address:
Phone:
Tenant:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Planning Approval By Graham, Jeffery Date: 1210212020
Date:
Date: 1210212020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
07776002
07776002
57607
57770
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$863.20
$4.05
$2.00
$23.79
$se.30
I
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA !nsp. Req'd:
q:msden , Julie
,No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Planning Insp. Req'd:
Landscaping lnsp. Req'd
Tota!
Flood Zone Cert. Req'd: No 01 1 16002 51600
01 1 16002 51 601
01 1 16002 51612
01 1 16002 57770
$23.79
$922.50
$2.00
$4.05
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs issua nce,or if the work authorized
on the site by such permit is suspended or abandoned for a period of 360 days after
the time the work is commenced.
Fee Total:
Paid to Date.
Balance Due:
$952.34
$0.00
$952.34
lnspector MID#: 2020-1 63037
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/S!G.COMMENTS OWNER BUILDER DELCARATION
I hcrcby allirm uftlcr 1Emlly of Frjury that I am cxcmpt from thc CoNracklrs' Liccns Law tbr thc li)lk wing rcartn (Scc.70.ll.5
Rusilcss anl Prolcssion CGlc): Any City or County which ]cquires a JErmit kr conslruct, altcr. improvc, dcm]lish or rcpair any
structurc. [rirr to its issuarec, al$ rcquircs thc applicant tbr such Jrcmit b l'ilc a signcd slrlcmnl that hc or shc is liccn$d pursu{t
to thc pn visions of thc Contractor's Licenrcd law (Chaplc] 9, Comcncing with Scction 70U) of Division 3 (tf the Busincss and
Pnrfcssions Codc) or that hc or shc is crcmpt thcrcfrom and thc basis for thc allcgcd cxcmpti(rn, ADy violation of Section 70J 1.5 by any
applicant li)r a JEmit subjccts thc applicant to a civil pcnalty of not morc than livc hundrcd dollars ($50O).
I
_1. as owncr of tlrc propcny, or my cmployccs wilh wagcs as thcir eh comFlsation, willdo thc work uxl lhc slrulurc is ml
intcn Nl or ollcrcd lilr Mh (Se.7(N4. Busincss and PKlfcssions Cdc: Thc Contrdclor's Liccn$ kw docs nol aplly lo an owncr of
rhclmllrcrty wlx)buildsorimpmrcstlrcB)n,arxlwhod(rssuchw)rkhimsclforhcrsclforthroughhisorhcrowncmployccs,
proviJcd that such imlmrwmnls re ft)t inlcffl,ql or ollircd lbr slc. Ii lx)wcwl thc huiLling or inlrcrcmnt is vrll within orc )84
ol $nplction, lhc Owncr Buil.lq will havc lhc bunlcn of Frving thlt hc or she did mt buiLl or imJrorc ilrc Jmrls(y lbr (hc purlDs of
sh).
_1. as ()wnc.r ol'thc pn)pcrty. ant cxclusivcly contracting with liccn.scd conlraclors lo construct thc prc.icct (Scc. 7044, Busilress
and l1ot'cssiln Codc: Thc Contraclor's Liccnsc l-aw drrcs nol apply to an owner of propcrty who builds or improvcs thercott,
and who contracts filr such pr)jects with a Contractor(s) liccnscd pursuant to tltc Grntraclor's Liccnsc Law).
-l
amcxcmpt under Scction-, B. & P.C. lbr this rcason.
WORKERS' CONIPENSATION
DECLARATION
I hcrchy all'irnr undcr Fnalty of pcrjury one of thc tirlklwing dcclarations:
/
_l havc arxl will maintain a Certiticatc of Conscnt t<l Sclt'-lnsurc li)r wrlrkers' comgrcnsation, as providcrl tilr by Section -1700 of thc
Latxlr Grdc, lirr thc Frcrli)rmance o[ thc work l<lr which thc pcrmit i.s issucd.
6 nuu"and will maintain wrlrkcrs' comJrcnsatiorr insurance, as rcquircrl by Secrion 37il) of thc l.-abor Codc, tirr thc Jrerlirrmance of
\ thc work lirr which this Frcrmit is issued. My wrlrkcrs' c()mpcnsation insurancc c.uricr and;xllicy numbcr
Oyr ,q L
lron.y s -L
_l ccrtity that in thc Jrcrtirrmancc of thc work lilr which this Jrcrmit is issuctl, I shall not cntploy any pcrs()n in any manncr
so as to hcconrc subjcct lo thc workcrs' compcnsation laws of Calililrnia. and agrce that il'I should bccomc subjcct to thc
workcrs' comJrcnsation provisions of Scction 1700 ol'lhc Latxlr Crxlc. I shall. li)rthwith comply with thosc prtlvisiolts.
WARNING: I;ailurc to sccurc workcrs'conrpcnsatiot't covcragc is unlawful, and shall suhjcct art cntploycr to criminal Jrcnaltics and
civil lincs up to onc hundrcd thousand dollars (S100,Uru), in additiort to thc cost rtl'com[rcnsation, damagcs as providcd lilr thc
Sccti<ln 1076 ofthc [-ahrr Crxle, inlercst and attrlrtrcy's l'ccs.
4r1 {L^o e
I.I C]ENSEI) CONTITACTO R
I)ECI,ARATION
I hcrcby atlrnr untlcr Jrcnalty of Jrcrjury that I am liccnscd undcr provision of Chaptcr 9 (commcncing with Scction 7firu) of Division .l
of the Busincss and Prolbssions Codc, and my licensc is in lull tirrcc and ell'cct.
Kn,,"l tosCNumbcr:
C v\T
tN rn ,fi^l
I hercby allrm untlcr pcnalty of pcrjury
issucd (Scc. 3097, Civ. C.).
kntlcr's Namc:
CONSTRUCTION LENDTNG AGENCY
that therc is a construction lcrrdingt agcncy lirr thc Jrerlilrmattce o[ thc work tbr which this pcrmit Ls
t
[,cndcr's Addrcss:
APPLICANT DECLARATION
I hcrcby atl-rm under pcnalty of grcrjury onc of thc lirlkrwing dcclarations:
Dcnxrlitiorr Permits-Asbcstos Nolilication Fcderal Rcgulations ('l'itlc 40, Part6)
-Rcqu
ircd lrttcr ol' Notilication
I
-l
ccnily that lhc tbdcral rcgulatbns rcgddin8 ashcst()s rcmlval arc not applicahle k, this pRljet.
-(fccrtity rhar I havc (cad this alplicati(rr uxl st{tc that thc ah}vc inli)rmation is coret. I agre k) comply with all City and County
ordinanccs and StaIe llws rclaling k, building construction, anl hcrcby aullxrrirc rcprcscilativcs of lhis Cily and C(tunty to cntcr uFln thc
ahrvc mc-ntioncd proprty tirr inspcclion
, Applicant or Agent
\ Penrrilee nanre
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf Ioor/VenVl nsu lation
Roof Sheathing
Shear Wall
Framinq
lnsu lation/Enerqy
Drywal!
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
tl \-r1 .l -<-a
FINAL us w )[T J U
Certificate of Occupancv t
Notes, Rgmarks, Etc L I
-t )l\--+
Elorr fiP*n7 -2n1q,
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