HomeMy WebLinkAbout101104939 - 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 #: 1O1104939
Pin #: 29915
Proiect Address: 1901 W Moore Avea
Assessor's Parcel. 412-281-08 Lol:22
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract. 8517 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
Sfd w/att garage
Occupancy.
Constr Type.
Code.
Flood Zone'.
# of Stories:
R-3, U
VB
cBc 2019
x-0602320259J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio.
T.l.Area:
Yards Req'd.
Valuation: $S,435.00
Description of Work: lnstall roof mounted solar panels. Per checklist.
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
Alicia Bermudez
1901 W Moore Ave
Santa Ana, CA 927046151
(7141 s81-1 580
Contractor: Vivint Solar - lrvine
Address. 2500 White Rd #A
lrvine, CA 92614
Phone: (951) 496-2292
State Lic #: 973756
Lic Type. B, C-10, C-39, C46
Bus. Lic #: 345470
Workers' Compensation lnsurance:
Carrier: American Zurich
Policy #: WC509601305
Expires'. 1110112020
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Vivint.Solar
James Matthew Walsh
3301 N Thanksgiving Way, #500
LEHI, UT 84043
c73567
Planning Approval By
Plan Checked By:
Permit lssued By.
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Amsden, Julie
Date:
Date.
Date: 1011412020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
$4s0 00
$1 09 3s
$1.00
$0 00
No
No Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#TotalPlanning lnsp. Req'd: No
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every permitissued 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 permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 51601
01116002 51612
01 1 16002 57770
$4s0.00
$1 .00
$1 09 35
$560 35
$0 00
$s60.35
Inspector MtD#'. 2020-162143
BUILDING- INSPECTOR RECORD
SITE-WORK DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hercby afftrm undcr pcnalty of perjury thlt I m cxctrpt fmm thc Contraclotr' Licmp llw for thc following rqsn (Sc.7031.5
Busincss and Pmfcssion Crxlc): Any City or County which rcquircs 8 tmit lo conslrucl, alts, improrc, &mlislf or rcIEir uy.
srrcturc. prk r to its issuucc, alrc rcquircs the applicant for such lEmit to filc a signcd statemnl that hc or shc ir liccnsd pursuut
io the Fovisions of tlE Contrclor's LLTn*d tlw (Chaptcr 9. Comncing wilh S$tion 7fi)0 of Division 3 of thc Busimss ud
PDfessbnsCodc)orthathcorshcisexcmpttlmfromandthcbasisforthe&llcgcdcxmption. AnyviolationofScdionT03l.5bymy
applicant for a Frmit subjEts thc applicant to a civil pcmlty of not mrc lhu fivc hundrcd dollds (S500).
_1, as owrrcr of thc propcrly. or my cmployees with wagcs as their solc crlmpcnsalion, will do thc work and thc stnrcturc is mt
intended or ofTcred for salc (Sec.7Ul4. Business and hofcssions Codc: Thc Contraclor's Liccnse [:w docs not apply lo an owncr of
thc property who builds or inrprovcs thcrcon, and who docs such work himself or herself or through his or her own employces.
provided thal such irnprovcrncnts arc not intcnded oroflerctl lbr salc. If. howcvcr. thc buikling or improvenrcnt is sold wilhin onc ycar
of completion. thc Owncr Buildcr will have thc burdcn of proving that hc or shc did not build or improve tlrc proprty for lhc purynsc of
sale).
_1, as owncr of thc propcrty. am cxclusively contracting with licenscd contraclors to construct the projcct (Scc. 7W. Busincss
and hofessbn Codc: Thc Contractor's License Law docs not apply lo an owncr of propcrty who builds or improves thcreon,
and who contracts for such projccts with a Contractorls) liccnscd pursuant to thc Contractor's Liccnsc [:w).
I am cxcmnt undcr Sc.ction . B. & P.C. for this rcason.
Date:_Ormer:
wo
DECLARATION
I hcrcby affirm undcr pcnalty of pcrjury one of the following declarations:
_lhaveandwillmaintainaCcrtificateofConscnttoSclf-lnsurcforworkcrs'conr;rcnsation,as providcdforbyScction3Tfi)ofthc
Labor Codc, for thc performance of the work for which the pcrrnit is issucd.
Tta have and will rnaintain workers' compcnsation insurance. as rcquired by Scction 3700 of thc Labor Codc. for thc pcrformatrce of
the work which this;rcrrnit is issuctl. My workers' comlrcnsa!' and plicy numbcr are:"7i
ffirfi'""ranccca'irrcr
Policy \\' t 'LC
&""rrify ,U, in thc [rcrformmc of the vo]k for which this pcrmir is issucd I shlll not etrpby any pemn in ey mnncr
$ as to becom sbjcct to thc wqtsd omlrcnslion laws of Califomis, Md agre that if I should becom subjst to llE
work6s'mmJrNstionprcvisionsofScction37mofthchborCode.lslEll.fonhwithotrplywiththospEvisions.
WARNING: Failure lo $curc workcrc cotrpcnstion covcmgc is unlawirl. ard shall subjLTt il mplo)€r to oiminal lEnaltics od
civil fincs up to onc hundrcd thousand
Section 3076 ef thc L;rlxrr Codc. interest
Dare: lclt* lzo
dollars ($l in addition to the providcd for thc
and
I hereby affirm undcr pcnalty of pcrjury that I am licensed 9 (cornrncncing with Scction 7fin) of Division 3
of the Busincss and Professions Codc, and my license is in full tilrcc and eff'cct.
Licensc C.\O Nurrthcr:
q1 R"l 5G,
I\ ^.6.ro'I v VI
W
I hercby 8ffirm undcr lEnaltyof Frjury that therc is a @nslruction hnding agcrcy for lhe pcrforme of thc work for which lhis Frmit is
is$ed (Sec. 309?. Civ. C.).
[,cnder's Namc:
Lcndcr's Adclless:
APPLICANT DIICLARAT'ION
I hoeby affurn undcr pcnalty of pcrjury one of thc following declarations:
Dcmolition Permits-Asbcslos Notification Fcderal Rcgulations (Titlc 40. Part6)
-Rcquircd
lrttcr of Notification
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenUl nsu latio n
Roof Sheathinq
Shear Wall
Framinq
Insulatio nlEnergy
Drywall
Ext./lnt. Lath
Brown Coat
JVlasonry
Pool Fence
T-Bar
Handicap Req.
Deputv Final Report
Engineer Final Report
Flood Zone Certif .
FINAL tt I L\ltto Dfr+ffi
Certificate of Occupancy
Notes, Remarks, Etc.
Rev. 08-07-201 5
I ccrtifv that thc
Nh ccnity rhat I have
fcdcralrcgulations rcgarding asbcslos renrovalarc not applicable to this propct.
rcatlthis
abovc nrcnti<lncd propcrty ltrr
Applicant or Agent
Pcrnrilee nanre
construction. and