HomeMy WebLinkAbout10198195 - Permit (3)tr
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Building
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Permit #: {O{98{95
Pin #: 3o.292
Proiect Address: 2145 112 W Civic Center Dra
Assessor's Parcel: 004-1 53-12 Lot: NA Block: NA
Unit:Bldg: Address Range:Suite Range:
Zoning: R1Tract: NA Historic: No
Building Use Acc68ory Owelling Unit-D.t choc Occupancf R3 1st FL Area: 1199 Patio: 44
Job Type: Now Conslr Type: V B 2nd FL Area: T.l.Area:
Nature ofwork AoU code: cBc 2016 oher Arees: yards Reqd:
Existing Bldg. & use: SFD wrdet garage & barn Flood zone: x{602320'144J carage Area: vatuation: g,t2o,ooo.oo
Proposed Us€: ADu wrdet Std & det G.r.go # of Stories: , aor",, fi99
D6criptlon of Work t{ow det tched ADU with (3) bodrooms, (2) bathroom., (1r2) bathroom, l.undry, gr9.t rcom, kltchen. & ,a4 af porch. SAUSD *381?.
Planning Conditions: All materials to match existing.
Owner: Ngoc Hong Tran
Address: 9051 Belcaro Drive
Huntington Beach, CA 92646
Phone V85) 550-0181
Tenant:
Contractor: HD Engineering Constructio
Address: 1402 N Parson Place
Santa Ana, CA 92704
Phone. (7141495-0056
State Lic #: 934742
Lic Type: B
Bus. Lic #: 350983
Workers' Compensation I nsurance.
Carrier: State Fund
Policy #: 9107432
Expires: 0710112019
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
HD Engineering Construction
Hoang Dan Pham
1402 N Parsons Pl
Santa Ana, CA 92703
(71414s5-00s6
c 79089
Duc Van Tran Designer
Duc Van Tran
16436 Vernon Street
Fountain Valley, CA 92708
(7141 713-3597
Designer
Planning Approval By:
Plan Checked By:
Permit lssued
NPDES lnsp.
PWA lnsp. Req'd
Arabe, Jill Date: 1011912018 Misc. Receipt: 71732
CsE-Century Structural Engine0ate: 0212512019 Misc. Receipt.
Amsden, Julie Date: O4t3Ot2O1g Misc. Receipt:
Subject to Field:
Total
07776002
07776002
0 77760 0 2
37773002
08907007
07776002
07776002
07776002
57607
s3600
57770
5330 0
240 00
57672
57600
57607
Permit Fee
Plan Check Fee
Microfilm Records
Res. Dev. Fee - NA//
SMIP - Category 1
Bldg. Stds. Revolving
General Plan Update
lssuance/New Structu
Fee Total:
Paid to Date:
Balance Due:
$8e3.38
$1,369.92
$33 84
$5,955.24
$1s 60
$5.00
$22 08
$146 80
$8,441 86
$1,369.92
$7,071.94
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Account#
Flood Zone Cert. Req'd: No 01 1 16002 51600
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterits issuance,or if the work authorized
on the site by such permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
No
No
Yes
No
Fire lnsp. Req'd.
Police lnsp. Req'd
No
Yes
01 1 16002 51601
01116002 51612
01116002 57770
08901001 24000
31113002 53300
$22.08
$1 ,040.1 I
$5 00
$33.84
$15 60
$5,955.24
lnspector MID#: 201 8-146937
I
SITE.WORK DATE !D/SIG.COMMENTS OWNER BUILDER DEI,CARA'I'ION
I herehy affirm untler penatty of Jrcrjury that I am exempt fnrm the Contractors' License Law for the following reason (.Sec.70.l1.5
Business and Profession Cule): Any City or County which requires a Jrrmit to construcl. alter, improve, derntlish or repair any
structure. prkrr to its issuance. also requires the applicant for such permit to llle a signed staternent that he or she is licensetl pursuanl
Io the pnrvisions of the Contractor's Licensed Law (Chapter 9. Commencing with .Section 7(XD of Division 3 of the Business and
Pr6fessi6nsCode)orthatheorsheisexempttherefromandthehasisfrrrtheallegedexernption. AnyviolationofSectionT0.ll.5hyany
applicant for a permit subjects the applicant to a civil penalty of not rxtre than five hundred dollars ($5U)).
_t. as owner of the pn)frerty. or my empkryees with wages as their sole ctlmpensati()n, will do tlr wrlrk and the struclure is not
inrendetl 6rgfferetlforsale(Sec.TO44.BusinessandProfessionsCode: 'fheCirntractor'sl-icenseLawdoesnotapplytoanownerof
the pr()perty whl buikls or impmves thereon. and whr does such work himself or herself rtr through his or her own empkryees.
prrlvitletl that such impr<lvernents are not intentletl ur offered for sale. lf. however. the truiltling or improvenrcnt is srlld within one ytar
of completit)n, rhe Owner BuiUer witlhave the burden of proving that he or she ditl not huiklor improve the pnlperty forthe purprseof
sale).
_t. asowner rrf the property, amexctusively contracting with licensetl contract()rst() c()nstruct the pnr.iect (Sec. 7()44. Business
arul Pnrfessirn Code: The Contractor's l-icense Law does not apply to an owner of proJrerty who builds tlr imprtrves thereon,
and whrr contracts for such pnrjects with a Contracto(s) licensetl pursuant to the Contractor's License Law).
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amexempt under .Section-, B. & P.C. for this reason.
l):rlt. ( )rr lrt.r
*ar**r*t' coMPUNSA't'l0N
DECLARA'I'ION
I herehy affirrn under penalty of per.iury one of the frrllowing declaralions:
_l have and will maintain a Certifrcate of Consent to .Self- Insure for workers' comlrcnsation, as provided for by Section -17(X) of the
l-ahrr Cule. firr the grcrformance of the work firr which the permit is issued.
_l have and wilt maintain workers'compensation insurance. as required hy Section 37(X) of the Labor Code. for the yrrftrrmance of
the work for which this permit is issued. My workers' comp€nsation insurance carrier arxl Jxrlicy number are:
4M1/q
_l certify that in the performance of the wrrrk frrr which this permit is issuetl, I shall not
s() asto beconre suhject trr the workers'compensltion laws of California, and agree that if I
/''2\\ I I
ernpkry any person id any m#tner
should hecome subject to the
workers' compensation provisions of .Section .17(X) of the l:rtnr Code. I shall. ftrrthwith comply with those provisions.
WARNTN(): Failure to secure workers' compensation coverage
civil fines up to one hundred thrtusand tkrllars ($l(X).(XX)), in
IS shall suh.iect an employer to criminal penalties and
atltl it ion of compensation. damages ns provided for the
lo76 Lahrr interest antl attorney's fees.
I
I herehy affirm under penalty of per.iury that I am licensetl under 9 (comntncing with Section 7firu) of Divisirtn 3
of the Business and Professions C}rde. aml my license is in full firrce antl effect.
q\v1 u9
I hercby affirm under Srenalty of prjury that there is a construction
issued (Sec. 3O97, Civ. C.).
aSency perfirrntance of the work for *'hich this permit is
l.entler's Atldress:
A I'I'LICAN'I DECLAR A'T'I ON
I hereby affirm untler penalty of perjury one of the ftrllowing declarations:
Demolition Permits-Asbestos Notification F:etleral Regulations (Title 40, Part6)
-Required
Letter of Notification
_l certify that the federalregulations regarding ashestos removalare not applicahle trl this project.
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certify that I have read this application antl state that atnve information is correct. I agree to comply with all City and County
onlinances and State Laws relating to building herehy auth)riz.e representatives of this City and County ttr enter ufx)n lhe
:rhrve nrntioned property for
ul shApplicant or Agent I)ale:
T T
a 114
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVI nsu lation - l -Jl.t2-
Roof Sheathinq \Y-lb7
Shear Wall {
Framinq I l<cz
lnsu latio nlEnerqv )-2a. ;9 (?cz
Drvwall
Ext./lnt. Lath lt\-
Brown Coat \dl
Masonry a
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enoineer Final Reoort
Flood Zone Certif
I I A-t lrt
FINAL h 7 a)Prh0/l er -H67
Certificate of Occu
Notes, Remarks, Etc.
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BUILDING- INSPECTOR RECORD T
f:{ev. 0B-07-201 5
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\ermitee name f printl, 1t0 Prl ls/