HomeMy WebLinkAbout101103384 - PermitCity of Santa Ana
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Permit Counter: Fr+l O,i
20 Civic Center Plaza (M-19), Santa n11 Cn 92702 Building
7-5800 lnspection Requests: (7i4)667-2738 lnspector Section: (714) 647-5853
Permit #: {01103384
Pin #: 86427
Proiect Address: 1014 W Pine St
Assessor's Parcel: 008-212-10 Lot: POR 11
Unit:Bldg: Address Range: 1 014-1016
Tract: BUCKINGHAM Historic: No
Suite Range:
Zoning: R2Block: A
Building Use: Ouplex Occupancy: R-3 lst FL Area: Patio:
Job Type: Reroof Constr Type: V B 2nd FL A.ea: T.l.Area:
Nature of Work Reroof codet cBc 2ol9 otherAreas. yards Reqd:
Existing Bldg. & Use: Ouplex Flood Zone: X4A02320257J
proposed use: f of storaes: Galage Area: v'luEtion: 113'500'00
Total:
D$c.lptlon of Work Raroofdupl.r -.6move existlng, replace any damaged 6hoathlng, lnBtall new rooflng systgm. GAF Timborline, colo. ia sagawood.
HandouE giv.n.
Planning Conditions: Repair all damaged eaves, rafters & fascia
Owner:
Address:
Phone.
Tenant:
KENT HARRIS
1014 W Pine St
Santa Ana, CA 92703
(s51 ) 830-e387
Contractor: Crown Reconstruction Serv
Address: 45 Vantis Dr
Aliso Viejo, CA 92656
Phone: (949) 357 -6274
State Lic #: 1051 230
Lic Type: B
Bus. Lic #: 375292
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9224420
Expires: 0313012020
Engineer:
Address.
Phone:
License #.
Arclrrtect /
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:
Khang, Kathy
sden , J ulie
Date: 0310512020
Date:
Date: 03/05/2020
Subject to Field:
Misc. Receipt.
Misc. Receipt.
Misc. Receipt:
0 77760 0 2
07776002
07776002
077L60 02
0 7776002
57607
57770
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
$333 06
$3 91
$1.00
$22 9s
$57.20
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#TotalNo
NoLandscaping 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 permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 51600
01 1 16002 s1601
01 1 16002 51612
01 1 16002 57770
$22 95
$390 26
$1 00
$3 e1 Fee Total.
Paid to Date:
Balance Due:
$418 12
$0 00
$41 8.12
lnspector MID# 2020-158275
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Bids StdE
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1i110[t[ti-
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf Ioor/VenUI nsu Iatio n
Roof Sheathino
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
N/asonrv
Pool Fence
T-Bar
Handicap Req.
Deputv Final Report
Enqineer Final Reoort
Flood Zone Certif
FINAL [21-b tL ? tS,JgtE, gLfl
Certificate of
Notes, Remarks. Etc.
owN!.tfl I LDER DELCA RAT I()N
I hereby affirnr untler penalty of perjury that l;mn exemf,lrnr the Contractors' License law for the following reasoo (Sa;.7031.5 .
Ilusiness and Prol'ession Code): Any City nr tnunty which requires a permit to construct, alrer, irnprove. demolish or rcpair any
structure, prior to its issuance. also rcquires the applicant tbr such pernrit to file a signed staternetrl that he or she ls licenscd pursuanl
to thc. provisions of thc' Contractor's l,icensed I^aw (Chaptcr 9, Commencing with Section 7fiX) of Division 3 ol'the Business and
Prot'essions Code) or that he or she is exempl therefiom and the basis tbr tlre alleged exemption. Any violation of Section 7031 .5 by any
applicant for a pennit subjects the applicant to a civil penalty of not more than live hundred dollars ($5001.
_1. as owncr ol'thc propcrty. or my ernployccs with wages as their sole compcnsation, will do thc work and the stnrcture is not
intended or offered for sale (Sec.7O44, Busincss and Pnrfessions Ccxle: The Contraclor's Licensc Law does not apply to an owner of
the prcprty wlxl builds or improves thermru arxl wtxr dtlcs such work himself or herself or through his or her own employees,
provided that such improvenrcnts are not intended or ollered for sale. Il, however, thc building or improvcnrnt is sold within one )aar
of conrplcti<lru thc Owncr Buikbr will havc the burtlcn of pnrving that lre or she dirl not buikl or impmve thc propaty for thc purpsc of
sale).
-1.
as owner of the propcrty, am exclusivcly contracting with licenscd contraclors to construct thc project (Scc. 7044, Business
aml holssirm Code: The Contractor's License Law does not apply to an owner of prolrrty who builds or improves thereon.
and who conlracts for such projects with a Contractor(s) licensed pursuant to the Contrador's License Law).
-IanrexcmplunderSection-,B'&P.C.fbrthisreason'I1... ,..
lV( )RK I,:RS' ('( )t\IPI.:NSA'l'l( )N
I)F]CI,ARATI()N
I hcrcby atlirm undcr pcnalty of perjury onc of thc tbllowing declarations:
_l have and will nraintain a Certificate of Consent to Sclt'-ln-sure for workers' c',onlpensation, as provided for by Section 3700 of the
I-,ahor Code. for the Jrcrformarrce of thc work for which thc permit is Lssued.
Code, for the Jrcrformance of
are:
poticy r.rrnlu.r'R ZZd tt 2l) -2-O rixpircs:t -t z
_l ccrtity that in thc pcrformance of the work for which this permit is issuetl, I shall not enrploy any pcrson in any manner
so as to bccorne subject to the workers' compcnsation laws of California, and agrce that if I shnuld bccorne subject to the
wodrers' comJrnsation provisions of Section 3700 of thc Labor Cotle, I slrall, forthwith comply with thosc provisions.
WARNING: Failurc to sccure workers' comlrcnsation covcmgc is unlawful. and shall subjcct an cmploycr to criminal penaltics and
civil lines up to one hundrcd thousand dollars ($ltn.(U0;, in addition to thc cost of conrpensation, damages as provided for thc
Section 3076 of the [-atnr Code, interest and attorney's fees.
V - s-zc:/\f 1...,..
DECLARATION
I hcreby al'lirrn undcr pnalty of perjury that I arn licenscd undcr provision of Chaptcr 9 (cornmcncing with Section 7000) of l)ivision 3
of thc Bu.sincss and Profcssions Code, and my liccnsc is in full lbrce and clfcct.
1oflZ?.oLiccnsc
Pernritee nanre
Numbcr:
o"r", n-5'2D Qrur^rn
coxsrntrcrlon
I hereby allrrnr under Jrenalty of perjury that there is a construction hndfurg agency lbr the Jrcrftrrmance of the work tbr which this pcrnrit is
issued (.Sec. 3097, Civ. C.).
Lender's Name:
lrnder's Atldrcss:
APPLICANT DECLARATION
I hereby affirm under pcnalty of perjury one of the following declarations:
Demolition Permits-Asbcstos Notification Federal Regulations (Title 40, Part6)
_Requircd lrtter of Notification
_l certify that thc federal regulations regarding asbestos removal are not applicable to this project.
lb certify thal I havc reatl rhis applicarion and sratc that the above informalion is correct. I agrec ro comply with all City and County
ordinance.s and State Laws relating to building constructiorL and hereby authorize representatives of this City and County to enter uJnn thc
atxrvc mcntionctl prolru-rty lilr inspection
Applicant or Agcnt \l
purposes. a"Z^^(-*h.-7 -t'za
Rev. 0B-07-201
.,",,C-?a, /B-\ License
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