HomeMy WebLinkAbout101104818 - 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 #: {O11O4E{8
Pin #: 6{758
Proiect Address: 231 0 W Flora Sta
Assessor's Parcel: 412-243-12
Unit:Bldg: Address Range:Suite Range:
Zoning: Rl
o
Block: NA Tract: 8345 Historic: No
Building Use: Slnglo Famlly Dwolling Occupancy: R3, U 1st FL Area Patiol
Job Type: Reroot Constr Type: V B 2nd FL Area: T.l.A.eal
Nature of Work Reroor code: cBc 2ol9 oher Areas: yards Reqd:
Existing Bldg. & use sFD wratt Garags Flood zone: x.o602320259J carageArea: v.tu.tion: l2o,ooo,q,
Paoposed Use # of stories:
Totat:
Oalcripllon of Work: Tsar oft exlstlng rcof mato.ial and inltell new rool lile. Bor.l Barrel V.ult Tile in Barclay ovor ons layor of Boral illstal Soal.
ESR3098.nd ESR.1783, Handout given
ar -\ -L.& r lJ'r'
f\[tLLllz r.-lO IU: LlitJSAt_tPlanning Conditions:
Owner:
Address.
Phone:
Tenant:
Veo Vu
2310 W FLORA ST
Santa Ana, CA 927045009
(e4s) 585-8228
Contractor: Popa Roofing lnc Dba Westr
Address: 13672 Onkayha Circle
lrvine, CA 92620
Phone: (7141 778-6294
State Lic #: 675902
Lic Type: C-39
Bus. Lic #: 189537
Workers' Compensation ! nsurance:
Carrier: State Compensation lnsurance Fur
Policy #: 9249035
Expires: 0 411512021
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:UIEt
14 " t..l
Graham, Jeffery
Chavez, Dave
Fire lnsp. Req'd:
Police lnsp. Req'd:
Flood Zone Cert. Req'd: No
Every permitissued 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 permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Date: 10/01 l2O2O
Date:
Date: 10/01 l2O2O
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002 SteOt Permit Fee
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds Revolving
07776002 57600 General Plan Update
07776002 57607 lssuance
Fee Total.
Paid to Date:
Balance Due:
$345.28
$4 05
$1 .00
$23.79
$59 30
$433 42
$0 00
$433.42
No
No Account#Total
01 1 16002 s1600
01 1 16002 s1601
01 1 16002 51612
01 1 16002 57770
$23 7e
$404 58
$1 00
$4.0s
lnspector MID#: 2020-161875
Lot: 18
a
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrchy affrm undcr Jrcmlty of fErjury lhal I m cxcmpt from lhc Conlracbs' Li{cns llw for thc ftrlkr*ing rcasrn (Sec.70J 1.5
Busincss anl Prulbssion Gxlc): Any City or County which rcquircs o lrrmil k) construct. altcr. imprcvc, dcmlish or rc[[ir any
structurc, prior k, its issuancc, also rcquires thc applicant lor such lrcmit to lilc a sigtrcd statcmc[t that hc or shc Ls liccnsd pusuant
lo Ihc prrvisions of thc CoDlractor's Liccnscd law (Chanlcr 9, Commcncing with Selion 7m0 of Division J of thc Business and
Prufcssions Codc) or that hc or shc is cxcmpt Ihsclrum aftl thc basis for thc allcged cxcmplion. Any violation of Sectirtn 70.}l.5 by any
applicant lbr a Fmit subjsts thc applicant to a civil Ircnalty of not morc than fivc hunlrcd dollars ($500).
_1, as owncr of thc propcrty, or my cmployccs with wagcs as thcir solc comgrcnsalion, will tlo thc work anl thc strr^"*turc is not
intcndcd or ol'tercd ftrr salc (Scc.7044, Busincss and Prol'cssions Crxlc: The Contractor's Liccnse Law does not apply lo an owner of
thc pnrJrcrty who huilds or improves llrcrcon, and who drrcs such work hirnsclf or hcrsclf or tluouglt his or her owlt cmployccs,
providcd that such imprcvcrrnts arc n()t intenJcd rlr oft'crcd lirr sah. ll, txrwcvcr, thc buikling or improvcrrcnt is sokl within ()nc ye:u
of complctkrn, thc Owncr Buiklcr will havc the burdcn o[proving that hc rlr shc did not build or improvc the propcrty for thc purp.rsc ol'
salc).
o
_1, as owncr of thc propcrty, am cxclusively contracting with liccnscd contraclors to conslruct thc pnrjcct (Scc. 7(X4, Busincss
and Pntlbsskur Codc: The Contractor's Liccnsc Law docs not apply lo an owncr of proJrcrty who builds or intprovcs thercon,
and wlrt> conlracts lor such projccts with a Contractor(s) liccnscd pursuanl to thc Contractor's Liccnsc Law).
r1
-IamcxcmptunderScctitln-,B.&P.C.forthisrcastrn'I)ate:
WORKERS' COI\TPENSATION
DECLARATION
I hcrcby allirnr undcr pcnalty of pcrjury onc ol'thc tollowing dcclaratiotts:
_l havc and will maintain a Ccrtificatc of Conscnt to Sclt'-lnsure tor workcrs' comJrcnsation, as providcd tirr by Section 3700 of thc
Latxlr Codc, tirr thc grcrlormancc of thc work trlr which thc pcrmit is issued.
_l havc and will maintain workcrs'comJrcnsation insurancc. as rcquirctl by Scctittn -1700 of thc Labor Codc, lilr thc Jrcrlilrmancc of
the work lirr which this grcrmit is issucd. My workcrs' comlrcnsation insurancc carricr and Jxllicy numbcr are:
a z 403s a 4.t{.zlPolicy
_l ccrtity that in thc pcrlirrmancc ol'thc wrlrk tor which this pcrmit is issucd. I shall not cmpkry any pcrson in any manncr
so as to bccome suhjcct to thc workcrs' compensation laws of Calilirrnia, and agrcc that if I should bccomc suh.icct to thc
workcrs' compcnsation pnlvisions of Scction 3700 of thc Lahrr Codc. I shall, lirrrhwith comply with thosc provisions.
WARNING: Failurc to secure workcrs' comJrcnsation covcragc is unlawful. anrl shall subjcct an cmploycr to crimfural Jrcnaltics and
civil lincs up lo onc huntlrcd thousand dollars (Sl00,U}()), in additkrn to thc cost of crtmpensatirtn, damagcs as providcd tilr thc
Scction
I herchy .l
of thc Busincss and Prol'essions Codc, arxl my liccnsc is in tull tirrcc arxl cffcct.
a D 6-tsrtozLiccrtscNunrbcr:
Dare')lo.l.Lo
W
I hcrcby allilm under lEnalty of JErjury that ttEe is a custruction lcndirg agcncy fur thc fqfolmNc of thc work for which this Jrcrmit is
issucd (Se. 3097, Civ. C.).
lrndcr's Name:
lrndcr's Ad&ess:
APPLICANT DECLARATION
I hcrcby allirm undcr pcnalty of pcrjury onc of thc lollowing dcclarations:
Dcmolition Pcrmits-Asbcstos Notification Fcderal Regulations (Titlc 40, Pafl6)
_Rcquircd Lcttcr of Notilication
-l
ccltify lhal thc fedcral rcgllations rcgar.ling asbeskts rcmvaluc not applicahlc to this pmj.!t.
fal cdity rhat I havc rcarl rhis application atrl strtc rhar rhc above inlormtiotr is conet. I a1rc to comply with all City and Counly
orlimnccs and Statc laws rclating to building construction, {fi| hcrcby aulhoria rclrc*ntalivcs ofthis City and County h cnts uFrn thc
abovc mcntioncrl propcrty lilr
Applicant or Agent
Pennilce rrarne ul=
x rxtu, r lO,l.ZO
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl ns u lation
Roof Sheathinq nltTkatPt q7
Shear Wal!
Framing
lnsulation/Enerqv
Drywall
Ext./lnt. Lath
Brown Coat
lt/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
=_r
FINAL ll- 29-7.v Jlr5ffi
Certificate of Occupancv
Notes, Remarks, Etc.
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