HomeMy WebLinkAbout101104515 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1O11O45{5
Pin #: 56.229
Proiect Address: 2108 N Alona Sta
Assessor's Parcel: 001-091-10 Lot: 191
Unit:BIdg: Address Range:Suite Range:
Zoning. RlBlock: NA Tract. 1724 Historic: No
Building Use: Singl. Family Dw.lling Occupancy: R-3, U 1sl FL Area Patio:
Job Type Alt.r.tion Constr Type V B 2nd FL Area T.l-Areal
Nature of work Damo Pool Codq cBc 2013 Other Areas yards Reqd
Existing Bldg. & Use: SFD wr.tt Gsr.go Flood Zone X-0602320144J
p,oposed uss # of sto es: Geraqe Area valuatlon: 13'000 00
Total
Oe.crlpflon of Work Demo and lnflll pool. Handout giv.n. OK per Alvaro to lssue. lnspsctor to vodfy that unp.mittod work ha. b.€n romov.d.
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Thu Tran
2108 N Alona Street
Santa Ana, CA 92706
(7141 81s-8216
Contractor: Coastal Estates & Developn
Address: 10627 El Campo Ave
Fountain Valley, CA 92708
Phone: (7141 955-1 221
State Lic #: 945191
Lic Type: B, C-27
Bus. Lic #: 341984
Workers' Compensation lnsurance:
Carrier: State Compensation lnsurance Fut
Policy #: 9088187
Expires: 0210412021
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #.
Planning Approval By:
Plan Checked By.
Permit lssued By:
NPDES lnsp Req'd: No
PWA !nsp. Req'd: No
Planning lnsp. Req'd. No
Landscaping lnsp. Req'd: No
Khang, Kathy /
Zuniga, nfliss(
Date: 08/31 12020
Date:
Date: 0910212020
Subject to Field:
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
Fee Totat
Paid to Date:
Balance Due:
Misc. Receipt
Misc. Receipt
Misc. Receipt
0L776002
0 77760 02
07776002
07776002
0 77750 0 2
57607
57770
s7672
s760 0
57607
$34s 28
$4 0s
$1 .00
$23 79
$59 30
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 1 16002 51600
01 1 16002 51601
01116002 51612
01116002 57770
Account#Total
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days after ifs 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
$23 7e
$404 s8
$1 00
$4 0s $433 42
$0 00
$433.42
lnspector MrD# 2020-1 61 184
?
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWN I.:R IT UTI,DICR DD,LCA RATION
I hcrebl'affrnr under penalty of perjury that I am exempt from the Contractors' Licensc law for the following reason (Set'.7031.5
Business and Prol'ession Code): Any City or County which rcquires a Jrermit to construcl, alter. improve, demolish or rcpair any
structure, prior to its issuance. also requires the applicant for such permit to file a signed staternenl that tre or she is licenscd pursuant
to the pmvisions of the Contractor's l,icensed l:w (Chapter 9. Comrnencing with Section 7fiX) of Division 3 of the Business and
Prot'essions Code) or that he or she is exempt therefrom and the basis for the alleged excmption. Any violation of Section 7031 .5 by any
applicant for a pennit subjects the applicant to o civil penalty of not more than five hundrcd dollars ($5001.
_1. a.s owner ol'thc propcrty, or my employecs with wagcs as thcir sole comgrensation, will do the work and the structure is not
internlal or offered for sale (Sec.7M+, Business and Pnrfession.s Code: The Conlraclor's License Law does not apply lo an owner of
the pmperty wlxr builds or improws thermn and wlxl dtx.s such work himself or herself or through his or her own employees.
provided that such improvcrnents are mt intended or ollcrcd for sale. Il, however. thc building or inprovenrnt is soH within one )tar
of conpletiot\ thc Owner Buildcr will have thc burtlen of proving that lrc or she did not buikl or impmvc the propaty for thc purposc of
s.rle).
_1, as owner of thc propcrty, am exclusively contracting with licenscd conlraclors to construct thc project (Sec. 7O{4, Busincss
arxl hrrtesskn Code: The Contractor's License Law drrcs not apply to an owner of prolrcrty who builds or improves thereon.
and who conrracts [or such projects with a Contractor(s) licensed pursuant to the Contractor's License Law).
-IantexemptunderSection-,B.&P.C.fbrthisreason.
Dale:
WORKI.)RS' COMPENSA'IION
DECLARATION
I hercby allirm undcr Jrcnalty of perjury one of thc lbllowing declarations:
_l have ard will nrainlain a Certifrcate of Conscnt to Self-lnsure for workers' comyrnsation, as provided for by Section 3700 of thc
Labor Code. for thc Jrcrformance of the work lor which thc prmit is issued.
_l have and will maintain workers' compcnsation insurance, as required by Section 3700 of thc [:bor Code, for the performarrce of
thc work \which this Jrcrmit is issued. My workers' compcnsation insurancc carricr arxt Jxrlicy numher are:
a
Policy U-L( - L(
_l certity thut in thc Jrcrformance of the work for which this pcrmit is issued, I shall not enrploy any person in any manncr
so as to bccorr suhjcct to the workers' compensation laws of California. and agrec that if I slnuld become subject to the
workers' conrlrcnsation provisions of Section 3700 of the l-abor Code, I strall, forthwith comply with those provisions.
WARNING: Failurc to secure workers' c'ompensation is unlawful.shall subjcct an employer to criminal Jrcnahics and
civil fincs up to one hundred thousand dollars addition to of damagcs as prortrded for thc
Section 3076 of the l:txrr Ctxle, interest and
o"*,6i -2 7,
I hcrcby al'lirrn undcr pnalty of perjury that I arn liccnscd 9 (cornmencing with Section 70m) ol'Division 3
of thc Bu.sincss and Profcssions Codc, and nry liccnsc is in full tbrcc and elfcct.
a2 ILicensc
CONSTRI.'CTION I,I.:NDING AGENCY
I hercby allirnr under penalty of perjury that there is a construction lending agency tbr the Jrcrformance of the work for which this permit ls
issued (.Sec. 3097, Civ. C.).
lrnder's Name:
lrnder's Address:
APPLICANT DECLARATION
I My affrm under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6)
-Requ
ired lrtter of Notification
_l certity that the federal regulations regarding asbestos removal are not applicable to lhis pr<rjcct.
this and state that the above inlormalion is correct. I agree to conrply with all City antl County
authorize representatives of this City and County to enter uF)n thc
atxrvc mcntioncd proSrcrty lbr
Applicunt or Agcnt
Pernriler nanre
o*", €l*2-)'-
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nVI n su latio n
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
N/asonry
Pool Fence
T-Bar
Handicap Req.
Deputv Final Report
Enoineer Final Reoort
Ffood Zone Certif
t/
FINAL //-2q- a ,44-/9 ue/ldE 'ov
Certificate of Occupancv
Notesr Re.marks, Etc.t
/C I
"f'-{ /1./
Rev. 08-07-2015
orrc, €{*l-2-O