HomeMy WebLinkAbout102102598 - Permittity oi Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building Permit #: 102102598
Pin #: 9{ 811PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Project Address: 825 S Cypress Ave
Assessor's Parcel: 01 1-052-03 Lot: POR 8
Unit:Bldg: Address Range:
TTact PART OF MCFADDEI$WIL Historic: No
Suite Range:
Zoning: R2Block: NA
Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area
Job Type: Demolition Constr Type V B 2nd FL Area
Natureof Work: N/V_Demo Code: CBC 2016 OtherAreas
Existing Bldg. & Use: SFD w/ no garage Flood Zone: X-0602320276J Garage Area
Proposed Use: # of Stories:
Total
Description of Work: Demo unpermitted addition/walls and reveft back to originally permitted patio cover. Auth on file.
Planning Conditions:
Patio:
T.l.Area:
Yards Req'd
Valuation: $1 ,000.00
Engineer:Tr cr
Owner:
Address:
Phone:
Tenant
Nghiem Nguyen
54 Maywood
lrvine, CA 92602
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:*:(*t
Planning Approval By:
Plan Checked By.
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Q,lanning 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 01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
Gomez, Pedro
Zuniga, Allissa
Date: 1211712019
Date:
Date: 1211812019
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07775002
07776002
07775002
07776002
07776002
Permit Fee
Microfilm Records
lnvestigation
Penalty
Bldg. Stds. Revolving
General Plan Update
lssuanceAccount#Total
s7607
57770
57607
57607
57672
57500
s7607
$166.53
$3.e1
$100.57
$252.69
$1 .00
$22.9s
$57.20
Every pormit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs 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.
$22.9s
$s76 9e
$1.00
$3.e1 Fee Totat
Paid to Date:
Balance Due:
$604.8s
$0.00
$604.85
Inspector MID#: 2019-156556
Blt
Lrl I
Ii ir
BUILDING- INSPECTOR RECORD a
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDDR DELCARATION
I hacby affum undq pcoalty of pcrjury that t m exmpt fiom lhc Contrrcton' Licw taw for thc following ren (54.7031.5
Busincs ud Profeion Codc): Atry City or County which rcquirc a pornit to @Gtruct. altq, imprcvq ddnolish or r@ir sy
structuq prior to its isruacc, also rcquira thc applicilt for such pcrmh to filc a signcd statomt that hc or shc b licms€d p|Nmt
to thc plovisio$ of thc Contrator's Licoscd Law (Chapt6 9, Commcing with Sction 7000 of Division 3 of thc Buincs md
Prcfcsioro Codc) or that h€ or shc is crmpt thqcfrom ud thc basis for thc alleged cxmption. Any violation of Sctbn 7031.5 by ey
applicant for a pcmil subjcts thc applicant to 8 civil p@alty of nol morc tha fivc hundrcd dollffi ($500).
_-1. s oM6 of thc lropary. or my cmploye with wag6 6 thsir sle compcnsation. will do the wo* iltd thc $nrdrc b mt
intqrdod or otfqcd for slc (Sc.7044, Buine ud Profsiore Codc: Thc Codmclor'3 Licsc lrw do6 not spply lo o oMq of
thcpmpqty whobuildsorimprov6th@&edwhodo6suchwrthimsclforhwlforthrcughhisorhdomcmploye
prcvidcd rhat such imFomts rc mt intqdod or ofrqcd for sh. lf. howq. th€ building or imFovqrcnt is mH whhin onc )qr
ofcompleion. thc Ovmq Buildq will harc thc h[dor ofpoving tha hc or shc did not hrild or imprcw thc prcpaty for thc purpos of
ele).
_1, 6 omq of rhc prcpqty. m cxclNivcly contracting with licolcd cootractoE to coGtruct ihc projer (36. 7044, Buitrs
ard Proftssion Codc: Thc ContBctor's License Law dos not apply to fl own6 ofprcp€rty who builds or imprcvB th66n,
od who contrac{s for such prcj61s with I Contrclo(s) licqEcd puEuilrt to the Contrctor's Licffi Law).
__l am B. & P.C. for this reason.
t
I hereby affirm under penalty of perjury one of the
_l have and will maintain a Certificatc of Consent to Self-lnsure for workers' comp€nsation. as provided for by Section 3700 of the
L^abor Code. for the pcrformance of the work for which the perrnit is issued.
__l have and will maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. for the pcrformance of
the work for which this permit is issuod. My workcrs' compensation insurance carrier and policy numhr are:
Policy Number:- Expires:
_l cerri$l that in the performance of thc work for which this permit is issucd. I shall not employ any person in any manner
so ils to become subject to the workers'compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the l-abor Code, I shall. forthrvilh cotnply with thosc provisions.
WARNING: Failurc to secure workers' compensation coverage is unlawful. and shall subject an onployer to criminal penahies and
civil fines up to one hundred thousand dollars ($100.000), in addition to the cost of compensation. damages as provided for the
Sectron 3076 of interest and
I hercby affinn pcnaltyof pcrjury that I an licensed provision of Chapter 9
force and effect.
with Section 7000) of Division 3
of the Busincss and Professions Code. and my license is in
Licerse Class:
-License
Numbcr:
f)q I r''Contractor:
W
I hrcby alfim undo pcnalty of pqjury th8t thqc is a onstructbn lcoditrg 8g@cy for thc pqfomacc of thc work for which this pqrnit b
issued (Se. 3097, Civ. C.).
knder's Address:
APPLICANT DECLARATION
I hereby affinn under penalty of pojury one of the following declarations:
Demolition Pcrmits-Asbestos Notification Federal Regulations (Title 40. Par16)
_Required Letter of Notification
.__l certi$ that the federal regulations regarding asbestos removal are not applicable to this project.
above rnentioncd property for
Applicant or Agent
I'ermitce name
purposes.
O
t
/ct
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/Ve nUl ns u latio n
Roof Sheathinq
Shear Wall
Framincr
Insulation/Enerqy
Drrnrval!
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
I -a ,^,
F!NAL ///7 ltrfl -,-/wt/
Certificate of Occupancy /
Notes, Remarks, Etc.
a
Carier:-
and state that