HomeMy WebLinkAbout101104879 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (7'14)667-2738 lnspectorSection: (714)647-5853
Permit #: 101104879
Pin #: 94708
Proiect Address: 305 E Vi rqinia Ave
Assessor's Parcel: 396433-06 Lot: 13 & POR 14 Block: NA
Unit:Bldg: Address Range:Suite Range:
Zoning: RlTract: 1473 Historic: No
Building Use.
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Reroof
Reroof
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
R-3
VB
cBc 2019
x-0602320163J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation: $9,056.00
Description of Work: Tear off existing, install 32 squares of comp roofing
Planning Conditions:
Owner: Pedro Guillen
Address: 305 E. Virginia Avenue
Santa Ana, CA 92706
Phone . V14l 380-2657
Tenant
Contractor:
Address.
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance.
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
Architect /
Designer.
Address:
Phone.
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
_user
Date:
Date:
Date: 1010712020
Subject to Field:
Misc. Recerpt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
07776002
07776002
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57607
57770
57672
57600
s7607
$345.28
$4.05
$1.00
$23.79
$59.30
web
No
No
No
No
Account#Total
Balance
Balance
Balance
N/A - No
N/A - No
N/A. NoEvery permitissued shall become invalid unless the workon the site authorized by
such permit is commenced within 360 days afterifs issua nce,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.
Fee Totat
Paid to Date:
Balance Due:
$433.42
$433.42
$0.00
lnspector MID#: 2020-1 61993
BUILDING. INSPECTOR RECORD
COMMENTSSITE.WORK DATE !D/SIG.
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenU! nsu latio n I L
Vlqzuilt#,Roof Sheathinq lot'221?,t ,^
Shear Wal!I
Framinq
lnsu lation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
JVasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
tl I
FINAL IU rLfr1tr/0 vM;hru nft
Certificate of Occupancy
NoteS, Remarks, Etc. r r t Itr(
oM-- I
EtruvtilaS atc WVa /W +ut( (W,ttiLUrL&[
rl
OWNER BUILDER DELCARATION
I hcrchy allirm undcr Fnalty of lErjury that I am cxcmpt t(rm thc GrntrackrN' Liccnre kw for lhc folkrwing rcsvtn (Se-.7031.5
Busincss anl Profcssion Cqlc): Any City or County vhich rcquircs a Jrmit k construct, alls. improvc. rtcmolish r\rcpair any
structurc, [trbr to its issuancc, slso rcquircs Ihe applicanl for such lrmit k, filc . sigred stalcmnl that hc ot slE is liccr*llrffag!
kr thc pnrvl\ions ()f lhc Contractor's Liccnscd l:w (Chaptcr 9, Comrereing eilh Sclion 70fl) of Division -l of thc Busincss and\
Prulb$siotrs Cqlc) or that lrc or shc is cxempt thsclirm and thc brsis for tlrc allcgcd exemgion. Any vttlation of Scctim 703 1.5 by any
applicant for a Frmit suhjccts lhe applicant lo a civil pcnally of not mtrc than fivc hundred dollrs ($5@).
_1, as owncr ol'thc propcrty, or my cmployees with wagcs as thcr solc compcnsation, will do thc work and the slruclurc is not
intcndcd or oll'crcd tilr salc (Sct.7044, Busfuress and Prolcssions Crxle: Thc Contractor's License Law dtrcs not apply to an owncr of
thc pr)pcrty who huiltls rlr improvcs tlrcrcun, and who d<rcs such work hintsclf or hersclf or tlrntuglt his rlr hcr own cmployccs,
provitlcd that such inrpnlvcnrcnls arc not intcndcd or <lll'crcd lilr salc. Il, howcvcr, thc buildirtg or improvcnrcnl is sold within ottc ycar
ol'comphtion, llrc Owncr Buildcr will havc the burdcn ol'proving that hc or shc did not build or impnlvc thc propcrry lirr lhc purJxrse ol'
salc).
_1, as owncr of thc proprty. am cxclusively contracting with liccnscd contraclors to construct thc projcct (Sec. 7M4, Busincss
and ttot'esskrn Code: Thc Contractor's Licensc Law docs not apply t() an owncr of proJrcrty who builds or imprtlvcs lhcrcon.
and who conlracts tilr such projccts with a Contractrlr(s) liccnscd pursuant to thc Contractor's Liccnsc Law).
-IarncxcmptunrlcrScctirln-.ts.&P.C.lirrthisrcastln.
Date:Owner:
wonxg
DECLAR/tTlON
I trcrcby allirm undcr Jrcnalty o[ Jrcrjury one of the tolkrwing tlcclaralions:
_-l havc and will nraintain a Ccrtiticatc of Conscnt to Scll-lnsurc lilr workcrs' contJrcnsation, as providcd lilr hy Scction J700 of thc
Latxrr Crxlc, lilr thc pcrlormancc ol'thc work lilr which thc pcrmit is issucd.
_l havc and will nraintain workcrs' compcnsation insurancc, as rcquircd by Scct ion 3700 of thc Lahor Ctilc, lirr thc Jrcrlirrmancc of
thc work lor which this Jrcrmit is issucd. My workcrs' comlrcnsation irtsuratrcc carricr and plicy numbcr arc:
Policy Numbcr: Expircs:
_l ccrtity that in thc grcrlilrmancc of the work tilr which this Jrcrmit is issucd, I shall not cmploy any lrcrson in any manncr
so as to bccomc subjcct to thc workers' compcnsation laws of Calilirrnia, anrl agrcc that if I strluld bccome subjcct to thc
workcrs' comJrcnsation pnlvisions of Scction 37ffi of thc Lahlr Ctxlc, I shall, tbrthwith comply with thosc prtlvisiotts.
WARNING: Failurc to sccurc workcrs'comgrcnsation covcragc is unlawful. and shall subjcct an cmploycr to criminal pcnaltics arrd
civil lrncs up to onc hundrcd thousanrl tlollars ($100,Uru), in additiott to tlrc cost of com[rcnsatiott, damagcs as providcd tilr thc
Scction -3076 ol'thc Lahlr Crxlc, intcrcst and attorncy's l'ccs.
LICENSED CONTR/TCTOR
DECLARATION
I hcrchy atlrm under pcnalty of pcrjury that I am liccnscd undcr proviskrn of Chaptcr 9 (commcncing with Sectkrn 7m0) of Division 3
of thc Busincss and Pml'cssions Code, arxl my licensc is in full titrcc arxl cffcct.
Liccnsc Class: Liccnsc Numbcr:
l\.,I ^.
W
I hcrcby aflirm under Fnalry of pcrjury that thcrc is a custructi)n hnding agcncy tbr thc lrcrfbmncc of thc uo(k for which this Imit is
issucd (Scc. .1097, Civ. C.).
I-cndcr's Namc:
[.ender's Addrcss:
APPLICANT DECLARATION
I trcrchy allinn undcr Jrcnalty of Jrcrjury onc of thc lolkrwing dcclarations:
Dcmolition Pcrmits-Asbcstos Notification FerJcral Rcgulations (Titlc 40. Part6)
_Rcqu ircd [.c'ttcr of Notilication
-l
cc(ify lhal thc lbdcral rcgulations rcgarding astrskrs rcmrval arc nol applicrblc lo this prujcct.
_l ccnily that I havc rcad this application md statc that lhc alhvc intbrmtidr is corcct. I agre to clrmply with all Ciiy and G)unty
ordtruNcs and StnIc llws rclating k, building construction, anl hcrcby autluizc reprcgntativcs of this City and CouDty to cntq ul[n thc
abovc mcntioncd pnllrcny lirr irslrcctbn puF)scs.
Applicant or Agcnl
l)cnttitec nrull('(rrrirrl l:
Date:-
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