HomeMy WebLinkAbout101105213 - 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 #: {O11O521 3
Pin #: 92630
Proiect Address: 501 E Russell Avea
Assessor's Parcel: 014-233-06 Lot: 8
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 2483 Historic: No
Building Use: Slngle F.mlly Ovvelllng Occupancy: R-3, U lst FL Area: Patio:
Job Type: Rgroof Constr Type: V B 2nd FL Area: T.l.Aree:
Nature ofwo*: R.roof Code: cBc 2019 Other Areas: yards Reqd:
Existing Bldg. & use: sfd wr.tt gar.ge Flood zone x46o232o27al
Garage Area: valuation: Ss,(xro.oo
Ploposed Use: # of Stories:
Totat:
D6crlptlon of Work Ro.oof hou.o t att chod g.r.go - omov. c,omp, Eplac. any dam.g.d shoathing, in.tall now comp.hinglor. H.ndouts givon.
Planning Conditions: Patio cover in rear not included.
Owner:
Address:
Phone:
Tenant:
RAMON CALLES
12812 HEWES AVE
Santa Ana, CA 927051225
(7141 615-3505
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Planning Approval By:Graham, Jeffery
Plan Checked By:
Permit lssued By:
,
NPDES !nsp. Req'd:'
PWA lnsp. Req'd:
Planning !nsp. Req'd
Amsden, Julieh"
Date: 1111212020
Date:
Date: 1111212020
Subject to Field:
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
07776002
07776002
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57607
57770
57672
57600
57607
$34s.28
$4.05
$1.00
$23.7e
$s9.30
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Landscaping lnsp. Req'd Flood Zone Cert. Req'd: No
Every permit rssued 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
$23.79
$404.s8
$1.00
$4.0s Fee Total:
Paid to Date:
Balance Due:
$433.42
$0.00
$433.42
Inspector MID#: 2020-162727
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsu latio n I
Roof Sheathinq 7,1 btra-o 7
Shear Wall I
Framing
lnsulatio nlEnerqy
Drvwall
Ext./lnt. Lath
Brown Coat
[\Iasonry
Poo! Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
.t /\.
F!NAL 1?'1 |'lr0 UWtrfI
Certificate of Occupancv
Notes, Remarks, Etc.
OWNER BUILDER DELC/IRATION
I hcrcby affrm undcr lEnalty of Frjury thst I m cxctr{rt ftom the Contraclos' Licms kw for thc following Bsn (56.7031.5
Busincss urd Prcfcssion Codc): Any City or County which rcquircs a Jrmit to constmt. altcr, imptovc, &rclish or rcJnir uy
structurc. ltrio] to its issumc. alrc rcquircs thc applicant for such pcmit to filc a signcd statcmnt lhal hc or slE is liccnsd pursuot
Io thc provisions of tlrc Contractor's Licensd bw (Chaptcr 9. Comrcing with S€tion 7fi)0 of Division 3 of thc Busircss ud
Prcfcssions Code) or that hc or shc is cxctr{,t tlEcfrcm and thc bqsis for thc allcgcd cxcmplion. Any violation of Sstion 7031.5 by my
.Jplicant far a Frmit $bjqls thc applicant to s civil pcmlty of not mrc thu fivc hundrcd dollus ($50O).
I'J
Ab. o, owrcr of thc 1mpny. or my cmplo)rccs with wagcs as tlrcil slc $mtEnstion. will do thc wtrk ard tlrc smEtrc is mt
intcndcd or ofiercd for sle (Ss.7O44. Busircss md Pmfcssions Codc: Thc Contraclor's Liccns Law docs mt alply to an owrcr of
thcpmlEny whohuildsorirpmrcstlEmtrsldwhod6srchw*himsclforhcrclforthmughhisorhcrownemployccs.
providcd that such imprcrcmnts m mt inlcrdcd or offcrcd for sb. lf, howrcr, thc buiHing or iE{,rcrcrcnt ir mH within one )qr
of cotr{,htiotr rhc Owrcr Buil+r uill haw thc htrdcn of pmvin8 llul he or shc di, rct buiH or ir{,mrc thc prcFrty fd tlE purpo* of
slc).
_1. as owner of thc property. am exclusivcly contracting with liccnscd conlractors lo construct the projc'ct (Scc. 7044, Busincss
and hmfirssion Codc: The Contractor's Licensc Law docs not apply to an owner of propcrty who builds or improves thcrcon.
and who contracts fbr such projccts with a Contractor(s) liccnscd Contractor's Liccnsc Law).
,_l am cxcrnpt urtclcr
l,
I lrercby atfirrn undcr penalty of perjury one of thc following
.--lhavcandwill nraintainaCcrtificatcofConscnttoSclf-lnsurcforworkers'cornpcnsation,as gnovidcdforbySection3T00ofthe
I-rbor Codc. for the pcrfornurnce of thc work for which thc permit is issucd.
_l havc and will nraintain workcrs' corrrpcnsali<ln insurancc. as rcquircd by Section 370O of the labor Codc, for thc performarce of
thc work for which this pcrnrit is issucd. My workers' compcnsation insurance carricr and plicy numbcr are:
workers' compcnsation provisions of Scction 37fi) of thc L:bor Codc, I shall. forthwith cnrnply with thosc provisions.
WARNIN(}: Failurc to sccurc workcrs' cornpcnsation covcragc is unlawlul.sutrjcct an crnployer lo criminal pcnaltics and
civil fincs up lo onc hundrcd thousand dollars cost of comlrcnsation. damagcs as providcd for the
Scction 3076 of thc l-.abor Codc. interest and attorrrcy's fccs.
I lrcreby al'llrrn undcr pcnalty ol'pcrjury that I anr liccnscd undcr 9 (comnrncing with Scction 7000) of Division 3
of thc Busincss and Prol'essions Codc. ard rny liccnsc is in full frrrcc and cffect.
Liccnse Class: Liccnsc Numbcr:
l)irle:
CoNSTRUCTION LM{DING AGENCY
I hercby rf,im undcr JEnalty of lErjury thol thm is a onstruction bnding agercy for thc pcrfotlrc of thc sork for w,lich this Imit is
issued (Scc. 3097, Civ. C.).
bndcr's Nam:
[.cndcr's Address:
A PPLICA NT DF'CLARATION
I hocby aflinn undcr pcnalty of pcrjury one o[ thc following dcclarations:
Dcmolition Pcrmits-Asbestos Notification Fcdcral Regulations (Title 40, Part6)
-Rcquired
lrtter of Notification
infornration is corrcct. I agrcc to cornply with all City and County
and hcrcby authorize rcprcscnlativcs of this City and County to cnter uSnn the
atrovc mcntioncd propcrty for inspcction
Applicant or Agent I
Pemritee nunre e
I
ev. 08-07 -2015
,
t(,
cerlify that in the pcrfornurrce of thc work firr which this pcrmit is issucd. I shall not crnploy any pcrson in any manncr
if I should bccorrc subjcct to thc
rl,r( 1)n
Contractor:_
-l
ccrtify that thc fcderalrcgulations rcgarding asbcstos rcnnvalare nol applicablc to this projcrct.
ccrlily that I havc rcad this
and Statc l-aws rclating to
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