HomeMy WebLinkAbout101105037 - PermitCity 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 #: {O11O5O37
Pin #: 4E{56
Proiect Address: 806 E Occidental Sta
Assessor's Parcel: 014-214-12 Lot: 2
Unit Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 2239 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
Sfd w/
R.3, U
VB
cBc 2019
x-0602320276J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $20,000.00
Occupancy:
Constr Type:
Code:
Flood Zone'
# of Stories:
Description of Work: lnstall solar panels. Per checklist.
Planning Conditions:
Owner.
Address:
Phone:
Tenant:
David Dai Pham
806 E Occidental St
Santa Ana, CA 92707
(7141 722-9361
Contractor: Solartime Electrical Seruice:
Address. 14371 Euclid Street, #2F
Garden Grove, CA 92843
Phone: (626) 757-6677
State Lic #. 1051 487
Lic Type: B, C-10
Bus. Lic #. 374129
Workers' Compensation lnsurance:
Carrier. State Fund
Policy #: 9257733
Expires: 0711912021
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
BDP Engineering, lnc
Bau D Pham
13302 Century Blvd, #A
Garden Grove, CA 92843
(7'.,41 909-6060
c60087
Planning Approval By
Plan Checked By:
Permit lssued By:
NPDES Insp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
J ulie
Date.
Date:
Date: 1012212020
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds. Revolving
07776002 51600 General Plan Update
Fee Tota!.
Paid to Date:
Balance Due:
$450 00
$48 60
$1 00
$0.00
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd Account#
No
No Total
Landscaping lnsp. Req'd:Flood Zone Cert. Req'd: No 01116002 51601
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterifs issuance,or if the work authorized
on the site by such permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 51612
01116002 57770
$4s0 00
$1 00
$48 60
$499 60
$0 00
$499.60
lnspector MID# 2020-162324
a
a
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OVYNER BUILDER DELCARATION tI hcreby affirnr undcr penalty of frcrjury that I am cxempt from the Contractors' License l-aw for thc following rcason (Scc.7031.5
Busincss arrl Profcssion Code): Any City or County which requires a prmit to construct, altcr. improve. dcmolish or rcpair any
structurc, prior lo its issuance, also requircs thc applicant for such pcrmit to lilc a signed statcnrent that hc or shc is licenscd pursuanl
to thc provisrons of thc Contractor's Licensed I-:w (Chaptcr 9. Commcncing with Section 7000 of Division 3 of the Busincss and
Professions Codc) or that hc or she is exempt thercfrom and thc basis for thc allcgcd cxcrrtption. Any violation of Section 703 I .5 by any
applicant for a permit subjccts the applicant to a civil pcnalty of not more than five hundrcd dollars ($500).
_1. as owre*r of the propcrty. or my cmployecs with wagcs as thcir solc compcnsalion. willdo lhc work and thc structunc is rnt
intcndcd or oft'ercd for salc (Scc.7044, Busincss and Pnlfcssions Code: 'l'he Contractor's Liccnse [:w does not apply to an owncr of
thc propcrty who builds or irnprovcs thercrrn. arxl who does such work hinrsclf or hcrsclf or through his or hcr own cmpkryecs.
providcd thnt such inrprovcrncnls arc not irrlcndctl oroffcrcxl for salc. If. howcvcr. thc buikling or irrqrrovcnrcnt is sold within onc ycar
of comphtion. the Owncr Buildcr will have thc burdcn of proving that hc or shc did nol buikl or improvc tlrc prof,crty for thc purJnsc of
salc).
-1.
as owncr of thc prcpcrty. am exclusivcly contracting with liccnsed contractors lo conslruct the projcrct (Scc. 7U4. Busittcss
and holbssirn Codc: Thc Contractor's Liccnse Law docs not apply to an owner of proJrcrty who builds or improves thcreon.
antl who contracts for such projccts with a Contraclor(s) licensed pursuant to thc Conlractor's Liccnsc Law).
_l am cxetnpt undcr Scction_, B. & P.C. for this rcason.
I)nte:Owner:_
WORKERS' COMPENSATION
DF'CLARA'I'ION
I hcreby affirrn undcr pcnalty of rlcrjury onc of thc following declarations:
_l have and will maintain a Ccrtificate of Conscnt to Self-lnsure for workcrs' conqrensation. as povided for by Scction 3700 of thc
Labor C-ode, for thc performance of thc work for which the pcrmit ls issued.
4 havc and will rnaintain workcrs' compcnsation insurancc. as rcquircd by Sectiott 3700 of thc krbor Code. for thc perfornuncc of'
work lbr which this prmit is issucd. My workcrs' compcnsation insurancc carricr and plicy nunrbcr are:
e-J--* e- f ut,^l
poricyNurt*r, 42 C7 -l 3'? Expires: 1 f u-ho>l
_l ccrrify that in the Jrcrformance of thc work for which this pcrmit is issucd. I shall not employ any pcrson in any rnnncr
so as to bccorrrc subjcct to thc workcrs' compensation laws of Calilbrnia. and agrce that if I should bcconrc subject to thc
workcrs' compcnsation provisions of Section 3700 of the Labor Code. I shall. forthwith comply with those provisions.
WARNING: I.hilurc to sccure workcrs'compensation coveragc is unlawful. and shall subject an cmployer to criminal pcnaltics and
civil fincs up to onc hundred thousand dollars ($100,000), in addition to
Scction 3076 of thc Labor C-ode, intercst ard atlorrrcy's fecs.
cost of compcnsation, damages as provided for thc
Applicanl:tvL/,
LICENSED CONTRACTOR
DTCI-ARATION
I am licenscd undcr provision of Chaplcr 9 (comnrcncing with Sc.ction 7Un) of Division 3
my licensc is in full force and cffcrt.
I hcreby affirm undcr pcnalty of pcrjury that
of thc Busincss and Professions Code. ard
License
Date:
Nurttbcr:
to /t t 1>.o tz/
W
I hcrcby aflirm urder Fnalry of pcrjury thal theE is I @nstruction lcnding agercy for thc perforMc of the work for which this ]Emit is
issued (Scc. 3G)7. Civ. C.).
[.cnder's Namc:
Lrnclcr's Addrcss:
ATEIJCANI.DECI.AMTON
I hqEby.mmundcr Fnolty of ]rcrjury onc of thc following dccloolions:
Dcmlithn Pcrmits-Asbcstos Notification Fcderal Rcguldions (Titlc 40, P8rt6)
-Rcquircd
Lrttcr of Notifrcation
-l
ccnify thlt thc fcdcnl rcgulations rcgarding asbcstos rcmvrlilc mt upplicable to this prcirt.
Il:l cedify thot I havc rcad this applbation dd stalc thst thc abovc informlion is coRrl. I agrc lo cort{,ly wirh 8ll City 8nd County
o-rdinan@s ard Statc trws rclaling lo building conshrctiorl ard h€reby aulhorirc rcIrcsntatircs of lhis City and County lo ents ulnn thc
atxrvc rncntioncd proprty ltlr
I'ernritec nanre
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf Ioor/VenUl ns u Iatio n
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
[\ilasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif .
I , l-Ot
FINAL It lq\1?IrlY LY1 I
Certificate of Occupancy I
Notes, Remarks, Etc
Rev. 08-07-201 5
Ort",
Applicant
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