HomeMy WebLinkAbout102101148 - Permita.a,
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #:1021 O1148
Pin #: 25205
Proiect Address: 2425 W California St-a-
Assessor's Parcel: 408-061-33 Lot 40
Unit:Bldg. Address Range:Suite Range:
Zoning: RlBlock C Tract: 506 Historic: No
Building Use: Slnglo Family Owolling Occupancyi R-3, U 1st FL Area Petio:
Job Typq Alt.r.tion Conslr Type V B 2nd FL Area T-l.Area:
Nature of work: Nrv - Addition code: cBc 2016 other Areas yards Reqd
Existing Bldg. & Use: SFD wr.tt c.rport .nd det lhed Flood Zone: x{602320257J
proposed use: # of sro es: "
Garage Area vtlurtion: $l'000'00
Total
O6crlptlon ot Work R.movo unpermitted eddltlon to exlsting permlttod.to6gs 6hod (pormlt nl9735) and r.stojs sh.d b.ck to original p.rmittod
condition.
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Tracy Nguyen
2425 W CALIFORNIA ST
Santa Ana, CA 927044013
Contractor: H L Home
Address. 11071 Dune St
Norwalk, CA 90650
Phone: (562) 412-1818
State Lic #: 812009
Lic Type: B
Bus. Lic #: 354204
Workers' Compensation lnsurance:
Carrier: Exempt
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
I'jr-.P L* : Ll2
TrnFrstrrrt
Ht,n sr
H L Hane
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
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Guevara, Jerry
Zuniga, Allissa
Date 08/19/2019
Date:
Date: 0910412019
Subject to Field:
Misc Receipt:
Misc. Receipt:
Misc Receipt:
0 777600 2
077760 0 2
07776002
0 77760 0 2
07776002
0 7776002
Permit Fee
Investigation
Penalty
Bldg. Stds. Revolving
General Plan Update
I ssuance
57607
57607
57607
57572
57600
57607
Fee Totat
Paid to Date:
Balance Due
$166 s3
$1 00 s7
$2s2 69
$1 00
$22 9s
$57 20
$600 94
$0 00
$600.e4
Account#Total
01116002 51600
01116002 51601
01116002 51612
$22 95
$s76 99
$1 00Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterifs issuance,or if the work authorized
on the site by such permit ls suspe nded or abandoned for a period of 360 days after
the time the work is commenced
.l
lnspector MID#: 2019-153761
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1d irrg
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BUI RECORD
SITE-WORK DATE !D/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nVl ns u lation
Roof Sheathinq n
Shear Wall ^ /t\
Framinq '--1 ^4 )-J1-14
lnsu lation/Energy (J \r
Drywall l,11-7-k)
Ext./lnt. Lath fiao-7A Y')CrE(
Brown Coat c -25'.7o \ilryx1
WJ{}'+rtlhr{asgnrv l0n *\L^f a '-1-h
Pool Fence Yl\ I
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif \/
It \\
FINAL )rWY\
Certificate of
Notes, Remarks, Etc \,
)o I'v
OWNER BUILDER DEI,CARATION
I hcrcby aflirm undcr pcnalty of pcrjury that I am cxcmpt frnm thc ConlEclors' Liccnsc law for thc following rca$n (SN.70-!1.5
Busincss and Protcssion Codc): Any City or County which rcquircs 0 [Ermil lo conslrucl. .llcr. imp]orc. dcmoli(i or rcpair any
structurc. pri)r to ils issuarce. also rcquircs the applicant for such Jrcrmil lo filc a signcd statcrrcnt that hc or she ir liccnscd frBuanl
to lhc pmvisions of thc Contrrctor's Lhcnscd hw (Choptcr 9. G)nnncncing wilh Sslion 7000 of Division 3 of thc Busircss ind
ProfcssionsCodc)orlhathcorsheircxcmptthscfromandthcbusisforlhcallcgcdcxcmplion. AtryviolalionofSationT0.3l.5byany
upplicanlforapcrmilsuhj$tslhe upplicnnlk)acivilpentrltyofnolmorclhanlivchurdrcddollars($5fi)).
-1.
as owncr of the proJrcrty. or my crnployccs with wages as thcir solc compcttsatiolt. willdo thc work and the structurc is not
intcndcd or olTcrcd for s.rte (Scr.7O44. Busincss and Professions Codc: Thc Contractor's Licensc l-aw docs not apply lo an ou'ncr of
thc prolrcrty who builds or improles thcrcrrn. and who docs such wort hirnsclf or herself or through his or hcr own cmployecs.
providcd that such inrprovenrcnts arc not inlcrrdcd orofl'crcd lirr salc. lf. howcver. thc building or irnproverrent is sold within onc year
of comphtion. thc Owncr Buikler will harc thc burden of proving that hc or shc did nol build or improve the propcrty for thc purynsc of
salc).
_1. as owncr of thc property. arncxclusivcly contracting with licenscd conlractors lo conslruct thc projcct (Scc. 7044. Business
and hofcssion Codc: Thc Contractor's l-iccnse Law does not apply to an owner of propcrty who huilds or itnproves thcreon.
arrd who contracts for such projccts with a Contracto(s) licenscd pursuanl to lhc Contractor's l-icensc Law).
-larnexclllplunderSection-.B.&P.C.forlhisrcason'
l ):rtc. ( )u ltt'r:
}V()RKF RS' C0I\ I P}'NSA'I'ION
I)IiCI,ARAI'I(}N
I hcrcby allirrn urrdcr pcnalty ol'perjury onc of lhe following declaralions:
_l havc and will maintain a Ccrtificate of Consent to Sclf-lnsure lirr workcrs' cotnpensation. as providcd for by Section 37fi) of thc
l-ahor Code. for the pcrfornrance of thc work lor which the Jrcrmit is issucd.
_l havc and will ntaintain workers'compensalion insurance. as rctluired hy Section 37(D of thc l-abor Code. for the Jrcrforltunce of
thc work frrr which this pcrrnit is issucd. My cornpcnsation insuraltcc carricr and Jxrlicy numbcr are:
Policy
_l ccrlily that in the pcrforrnance of thc work for which this pcrnrit is issued. I shall nol cntploy any pcrson in any munncr
so as to bcconrc subjcct to the workers' compcnsation laws of California. and agrce lhal if I should bcconrc subjcct to the
workcrs' corrrpensation provisions of Scction 37ff) of the Lalxrr Crxlc. I shall. lbrthwith corrrply with thosc provisions.
WARNING: Failurc to sccure workcrs' conrpcnsation covcrage is unlawful. and shall suhjecl an entployer to crirninal Jnnalties and
civil fincs up to one hundrcd thousand dollars (SlU).0rX)). in addition to lhe cost of cornpcnsation. damagcs as provided for the
Scction 3076 of the Lahrr Codc. intcrcst and allorney'lE.*.- nofuDate:
LICENSED CONTRACTOR
DECLARATION
t hcrchy atfirnr urrcler pcnalty of perjury that t anr liccnscd undcr provision ol'Chaptcr 9 (comnrcttcing with Section 7Un) of Division .3
of thc Busincss and Professions Codc. and rny liccnsc is in l'ull f<rrcc and cfl'ect.
Liccrrsc I
Da6 b q
I hcrcby allirrn undcr pcrtalty ol'pcrjury lhal llrcre is a coltslruction
issucd (Scc. -1097. Civ. C.).
agcncy lirr thc ol'thc rvork for u'hich this prrnit is
l.cntlcr's Nalnc:
[,cndcr's Addrcss:
AI'PI ICANT DI.'CLARATION
I lrcrcby allirrn unclcr pcnalty of pc{ury one o[ lhc folkrwing dcclaralions:
Dcnrolition Pcrmits-Asbcstos Notillcalion Fcdcral Rcgulations (Titlc .10. Part6)
-Requircd
Lrttcr of Notification
_l ccrtify that the fcdcral rcgulations regarding asbcstos rcmovalare nol applicablc lo this project.
_l cerlity that I have rcad this application and state that the ahrve inlormatiott is correct. I agrce to comply with all City and County
0r
6 I*
orrlirranccs and Slatc Lau's rclating to construction. and hercby authorizc
ahovc rncrrlioncd propcrly for
Applicnnt or Agenl
cnter uJnn theIrqg
Pernritee nanre $
1
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