HomeMy WebLinkAbout101105125 - PermitProiect Address: 2001 E Fruit Sta
Assessor's Parcel: 400-171-53 Lot: 51
Unit:Bldg: Address Range:Suite Range:
Zoning: R4Block: NA Tract: 9208 Historic: No
Cify of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
Permit Counter. (714) 647-5800 lnspection Requests: 014) 667-2738 lnspector Section: (714) 647-5853
Permit #: {01105125
Pin #: 361 {9
Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area
Job Type: Alteration Constr Type: V B 2nd FL Area
Nature of work: New Bedroom code: cBc 2019 other Areas:
Existing Bldg. & Use: SFD w/aft Garage Flood Zone: X-0602320164J
Garage Area:
Proposed Use: # of Stories:
Total
Description of Work: Legalize conversion of dining room into a bedroom and remove living room double door. Auth on file
Planning Conditions:
Patio:
T.l.Area:
Yards Req'd
Valuation: $2,000.00
Owner:
Address:
Phone:
Tenant
Betty Fanhui Kong
1233 S. 8th Ave.
Arcadia, CA 91006
(626) 623-0s45
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 #:
MH Drafting
1129 Sullivan
lrvine, CA 92614
(7171 728-3416
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning !nsp. Req'd: No
Landscaping lnsp. Req'd: No
Arias, Fernanda
Lee, Wayne
Zuniga,
Date: 1110312020
Date: 1111312020
Date: 1112012020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
74912
Total
07776002
07776002
07776002
07776002
07776002
07776002
57607
53600
57770
57672
s7600
57607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
Fee Totat
Paid to Date:
Balance Due:
$345 28
$478.68
$20.25
$1.00
$23.79
$se.30
$e28 30
$478 68
$449.62
Fire lnsp. Req'd: No
Police lnsp. Req'd: No Account#
Flood Zone Cert. Req'd: No Ol 1 16002 51600
Every permitissued 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 permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
Inspector MID#: 2020-162577
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$23.79
$404 58
$1.00
$20.2s
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby affrrm undcr penalty of frcrjury that I am cxempt from thc Contractors' Licensc [-aw for thc following reason (Sec.7031.5
Business and Profcssion Code): Any City or County which rcquircs a Jrcrmit to construct. altcr, improve, dcmolish or rcpair any
structure. pnclr to its issuancc, also rcquircs thc applicant for such prmit to filc a signcd statcrncnt that he or shc Ls licenscd pursuant
to thc yrovisions of thc Contractor's Liccnsed l-aw (Chaptcr 9, Comrnencing with Scction 7000 of Division 3 of the Business and
Profcssions Code) or that hc or shc is cxcrnpt thcrefrom and thc basls for thc allcgcd cxcmption. Any violalion of Section 703 I .5 by any
applicant for a pcrmit subjcrcts the applicanl to a civil pcnalty of not morc than five hundred dollars ($500).
_1. as owtrcr of the propcrty, or my enrployccs with wages as their solc conrpensation. will do the work and the surrtunc is ncrt
intcnded or olTcrcd for salc (Sc.c.7044. Business and Profcssions Codc: Thc Contraclor's Liccnsc l-aw docs not apply to an owncr of
the proprty who builds or irnproves thcrccln, and who docs such work hirnsclf or hcrself or through his or her own employees.
providcd that such inrprovcnrcnts arc not intcndod oroflcred for salc. If, howerrr. thc building or improvcrrcnt is sold within one ycar
of complctiotL thc Owrcr Buildcr will havc thc burden of proving that hc or shc did not buih or intprovc tlrc propcrty for thc purpose of
salc).
_1. as owncr of thc pmpcrty. am exclusivcly contracting with liccnscd conlraclors to construct the projcct (Sec. 7(W. Busincss
and Protbssion Codc: The Contractor's Liccnsc Law docs not apply lo an owncr of property who builds or improves thcrcon.
and wh<l contracts for such projccts with a Contracto(s) liccnscd pursuant to lhc Contractor's Liccnse taw).
_l arn cxcnlpt B. & PC.this
,
I hereby affirrn undcr pcnalty of pcrjury one of thc following de.clarations:
_l havc and will maintain a Ccrlificatc of Conscnt to Sclf-lnsurc for workcrs' compcnsation, as providcd for by Scction 3700 of the
Labor Codc. for thc performance of thc work for which the permit ls issucd.
_l havc and will maintain workers' compensation insurarrce. as required by Scction 3700 of the labor Codc, for thc performancc of
thc work tbr which thls permit is issued. My workcrs' compcnsation insurance carricr and policy numbcr arc:
Policv Number: Expircs:- -J
_l ccrlily that in the pcrlbrrnarce of thc work t'or which this pcrnrit is issucd. I shall not employ any pcrson in any nunncr
so as lo bcconrc subjcct to thc workcrs' conUrcnsation laws of California. and ugrce lhat if I should bcconrc subict to thc .
workers' comJrcnsation provisions of Scction 37fi) of thc l-,:rtnr Code. I dull. forthwith comply with those provisions.
WARNING: Failurc to riccure workers' conrpcnution covcragc is unluwful. and shall subject an cntployer to criminal pcnaltics and
civil fincs up to one hundrcd thousand dollars ($1(X).UX)1. in addition to thc cosl of comJrensation. darurges as providcd for thc
atlorney's
I hcrcby atfirrn under penalty of perjury thal I am licenscd undcr provision of Chaptcr 9 (comnrncing with Scction 7000)
of thc Busincss and hofcssions Code. and my liccnsc is in full force and cffctct.
3
Liccnse Class: Licensc Numbcr:
I)tte:Conlractor:_
W
I hcrcby aflirm undcr pcnalty of Frjury th0t lhcrc is a @nsruction lcnding agcrcy for thc lErforlrcc of thc rcrk for whbh lhis pcrmit is
issued (Sec. 3097, Civ. C.).
kndcr's Norc:
lrndcr's Address:
APPI ICAT\TT DT.CLARATION
I hcreby aflirm undcr pcnalty of pcrjury one of thc following dcclarations:
Dcmolition Pcrnrits-Asbcstos Notification Fedcral Rcgulations (Titlc 40, Part6)
-Rcquircd
lrttcr of Notification
-l
certify that thc fcdcralregulations rcgarding asbestos rennvalare not applicablc to this projc'ct.
-l
certify that I have read this application and state that the atnvc information is corrccl. I agree to comply with all City and County
ordinances and State laws rclating to building construction. and hcreby authorize reprcscntatives of this City and
abovc rncntioncd propcrty for
Applicrutt or Agent
Perntilee nanle
//
cntcr u1rrn thc
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVI ns u I atio n
Roof Sheathino
Shear Wall
Framing
lnsulatio nlEnergy
Drvwall
Ext./lnt. Lath
Brown Coat
[\Iasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
,l l,l rl
FINAL I 'Lu\ U wurw WJ
Certificate of Occupancv I
Notes, Remarks, Etc.
Rev. 08-07-201 5
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