HomeMy WebLinkAbout101105005 - PermitProiect Address: 2111N Ross Sta
Assessor's Parcel: 002-111-29 Lot. POR 34
Unit:Bldg: Address Range.Suite Range:
Zoning: R1Block: NA Tract: 788 Historic: No
J City 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 #: {O11O5OO5
Pin #: 42474
t
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use.
Single Family Dwelling
Solar
Solar
SFD w/att garage
R-3, U
VB
cBc 2019
x-0602320163J
1st FL Area:
Znd FL Area.
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuationr $t 8,200.00
Occupancy:
Constr Type
Code:
Flood Zone'.
# of Stories:
Description of Work: lnstall solar panels.
Planning Conditions:
Engineer: Phong Truong
Owner:
Address:
Phone:
Tenant:
Annie Burns
2111 N Ross St
Santa Ana, CA 927062507
(7141 614-7094
Contractor: Aikyum Solar
Address: 1220 Roosevelt, Suite 100
lrvine, CA 92620
Phone: (949) 705-6797
State Lic #: 986427
Lic Type: C46
Bus. Lic #: 349817
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 916732
Expires. 0712012021
Address:
Phone:
License #
Architect /
Designer:
Address:
Phone:
Lrcense #.
3000 E Birch St #201
Brea, CA 92821
(7141 269-69ss
c70784
Planning Approva! 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
Chavez, Dave
^q2.?
Fire lnsp. Req'd:
Police !nsp. Req'd
Date:
Date:
Date: 1012012020
Subject to Field.
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
01776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
$450 00
$s6 70
$1 00
$0 00
No
No Account#Total
Flood Zone Cert. Req'd: No 01 1 16002 51601
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterits issuance,or if the work authorized
on the site by such permitis suspended or abandoned for a period of 360 daysafter
the time the work is commenced.
lnspector MID#:2020-1 61590
01 1 16002 51612
01 1 16002 57770
$450 00
$1 00
$56 70
$s07 70
$0 00
$507.70
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BT'ILDER DELCARATION
I hcrcby alfrm under penslty of lEriury that I m cxempt fmm tlE Conirac{ors' Liens Liw for the following rqsnr(Ss.*031.5
Busincss and Prcfession Codc): Any City or County which rcquircs s lrcmit to construct, alts, improvc, &mlish or rctEir my r
srructre. prior to its issuilcc. also rcquircs thc applicant for such JErmil to filc a signcd stalcmnt that hc or slE is liccnsd pusust
to thc Fovisions of thc Contractor's Liccnscd lrw (Chaptcr 9, Commrcing with Setion 7000 of Division 3 of the Busircss md
ProfcssionsCodc)orthathcorshciscrcmptthcrcfromandthcbssisforthcallegcdercmplion. Anyviol.tionofsetionT03l,5byrny
applicsnt for a pcrmit subjets thc applicant to a civil pcmlty of not mrc thm ftvc hundrcd dollss ($500).
_1, as owncr of the propcrty. or my cmployccs with wagcs as thcir sole mmpcnsation. willdo thc work anl thc stnrttre is not
intcndcd or offercd for salc (Se.c.7044. Business and Profcssions Code: Tltc Contractor's Licensc law does not apply to an owncr of
thc pnrpcrty who builds or improves thercrrn. and wh<l docs such work hinrself or hcrself or through his or her own employecs,
providcd that such inrprovcrrrcnts arc not intendcd oroffcrod frrr salc. If. tnwer,cr. thc building or in5rrovcrrrnt is sold within onc )rcar
of conrphtion. thc Owrcr Buildcr will havc thc burdcn of proving thal hc or shc did not buikl or improvc tlrc propcrty for lhc purynsc of
salc).
_1, as owner of the propcrty, am cxclusively contracting with liccnsed contractors lo conslruct thc proircl (Scc. 7014. Business
and Professkm Codc: The Contractor's Liccnse Law docs not apply to an owncr of property who builds or improvcs thcrcon.
and who contracls for such projccts with a Contractor(s) licenscd pursuant to thc Contraclor's Liccnsc l-aw).
_l am cxcmpt undcr Sc.ction-. B. & P.C. for this reason.
Owner:-
WORKER.S' COM PENSATION
DFCLARATION
I hercby atTirm undcr pcnalty of pcrjury onc of the following dcclarations:
_l havc and will maintain a Ccrtificatc of Consent to Sclf-lnsurc for workcrs'cornpcnsation. as providcd for byScction 3700 of the
Labor Codc. for the pcrformancc of the work for which thc prmit is issued.
_l havc and will maintain workcrs' cornpensation insurancc. as rcquircd by Section 3700 of thc [abor Codc. for thc perfonnancc of
thc work firr is issucd. My number are:(
{Vqr>o+-Zo-Zt
O
a 1t \LoPolicy
_l certify that in the pcrforrrunce of thc work for which this permit is issued. I shall not cmploy any person in any rnnncr
so as to bcconrc subjcct to thc workcrs' compcnsation laws of California. and agrcc that if I should bcconrc subjcct to thc
workcrs' cornpensation provisions of Section 3700 of thc l-:bor Code. I shall. forthwith comply with thosc provisions.
WARNING: Failurc to sccurc workers' compcnsation coverage is unlawful. and shall subjcct an enrployer to crirninal penalties and
civil lines up to onc hundrcd thousand dollars (S100.m0). in addition to thc cost of damagcs as providcd f'er the
,::::"'f;riliT;'"*"
and altorncy's fecs.
t
I hercby affirnr undcr pcnalty of grcrjury lhat I ant liccnscd undcr
of thc Busincss and hofcssions Codc. and my liccnse is in full
Chaptcr 9 (cornrncncing with,Scction 70m) of Division 3
and effcrct.
Liccnsc
. c-ro e_ \G Nunrbcr:t
I hcrcby alfirnr undcr pcnalty of pcrjury that lhcrc is a construction perfornmnce of the work for which this permit is
issucd (Scc. 3097. Civ. C.).
l-cnder's Namc:
lrndcr's Address:
APPLICANT DECLARATION
I hucby aflirm undcr pcnalty of pcrjury onc of thc following dcclaratiotts:
Derrrolition Perrnits-Asbcstos Notification Fcderal Rcgulations (Titlc 40, Part6)
_Rerluircd Lcttcr of Notification
_l ccrtify that lhc fcdcral rcgulations rcgarding asbcstos rcnxrval arc not applicablc to this projcct.
)<-f certify thal I have rcad this application and state thar thc ls agrc'c to comply with all City and County
ordinanccs and Statc Lrws rclatirrg to building of this City and County to cnter upon thc
abovc nrcntioncd propcrty for
Applicant or Agent
Perntitee nnnre
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loo r/VenVl nsu I atio n
Roof Sheathing
Shear Wall
Framinq
lnsulation/Energy
Drvwall
Ext./lnt. Lath
Brown Coat
[\Iasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flqod Zone Certif I
>oVt,klfrhYVfif l';/,/Eo )$y,xt*.f:c,rt
FINAL dflfto )fuilooJ''Jq
Certificate of Occupancy
Notes, Remarks, Etc.
--?
Rel,. 08-07-201 5
a.a
C
,rr"'t lo / 2o f eC\ contracro'I(-
*," I plulr'.
N, ,wC<