HomeMy WebLinkAbout101105300 - PermitCiW 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 #: 1O11O53OO
Pin #: 19154
Proiect Address: 919 E Catalina Avea
Assessor's Parcel:003-221-26 Lot. 106
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock. NA Tract: 1529 Historic: No
Building Use: Slngls Famlly Dwolling Occupancy: R-3, U 1st FL Area Patio:
Job Type Roroot Constr Type V B 2nd FL a,Ee T.t.Area:
Nature of Wo*: Reloof code: cBc 201 I other Areas yards Req.d
Existing Bldg. & u8e: sFo wrdot garag. Flood zone: x.o602320r83J
Garage Area v.tu.tion: 116,000.00
Proposed Use: # of stodes:
Total
Daacription of Work Re.oof wll.o.-R.mova .nd apply comp ahlnglea to lld and dct garagorroplaco ahcathlng aa Eq'drhandout givon auth on fils
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Steve Huynh
919 E Catalina Ave
Santa Ana, CA 927063047
(7141 553-3436
Contractor: Prestige Roofing
Address: 91 1 Figueroa St
Santa Ana, CA 92704
Phone: (7141 393-3620
State Lic #: 1059050
Lic Type: C-39
Bus. Lic #: 374213
Workers' Compensation I nsurance:
Carrier: State Compensation lnsurance Fur
Policy #: 9258598
Expires: 0810612021
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd.
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Guevara, Jerry
\L\ Hernan dez, KathY
Date: 1112412020
Date:
Date: 1112412020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
07776002
07776002
07776002
07776002
07776002
57607
57770
57672
57600
s7607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
$34s.28
$4.0s
$1 .00
$23 79
$59.30No
No
No
No
Fire !nsp. Req'd:
Police lnsp. Req'd
Flood Zone Cert. Req'd: No
No
No Account#Total
Every permit issued 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 permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01116002 57770
$23.79
$404.58
$1.00
$4.0s Fee Totat
Paid to Date:
Balance Due:
$433 42
$0.00
$433.42
!nspector MID#: 2020-162945
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrchy aftiril ututcr Fnrlty of Frjury that I m erempt liom lhc Conlraclors' Liccnrc ljw for lhc folbwing rcaurn (Ss.7031.5
Busincss alrl Prolbssion C<xlc): Any City or County which rcquircs a lEmit k, cor$Irucl. altcr, improvc. dcmolish or rcpeir any
structurc, fi)r b its issuancc, 0lso rcquircs the applicant lilr such JErmil to Iilc a signcd stalcm[l that hc or shc Ls liccnsd pusuant
to thc pK)visions ()f thc Cotrhct()r's l-iccnscd [2w (Chaptcr 9, Commcucing with Sccti(n 7()00 of Division .] of lhc Busincss and
PrcfcssirDs Codc) or th{t hc or shc is cf,cmpt tlrcrchom and thc hasis ti)r thc allcgcd cxcnrptiur. Any violalion of Scction 70J L5 by my
{pplicanl tirr 0 pcrmit subjets lhc applicatrt to a civil pcnally (tf not morc than tivc hunrlrcd rlollars ($500),
_1, as owncr of thc propcrty. or my cmployces wilh wagcs as lhcir solc compcnsation, will do thc work arxl thc stru!*lurc is not
furtcrx.lcd or otl'crcd lbr sale (Se.,-.7044. Busincss and Prot'cssions Crxlc: Thc Contraclor's Liccnsc [-rw does not apPly to an owner of
the- pnlpcrty who builds or impnrvcs thcrcon. alxl who drrcs such wrlrk himsclf or hcrsclf rlr through his or hcr owtt cmpkryces,
providcd that such impnrverncnts arc m)t intcnded or otlbrcd tirr salc. It. howcvcr, thc building ()r improvcrncnt is sold withitr onc ycar
of complction, thc Owncr Buildcr will havc thc hurdcn of proving that hc or shc did not huikl or improvc thc pruJrcrty lirr thc purposc of
salc).
_1, as owncr of thc proJrcrty, am cxclusivcly contracting with liccnsed contractors to construct thc projcct (Scc. 7(X4, Busincss
arxl Pnrlbssion Codc: The Contractor's Liccnse Law docs not apply to an owner of propcrty who builds or imprcvcs lhcrcon,
and who conlracts for such pnljccts with a Contractor{s) liccnscd pursuant to thc Conlractrtr's Liccnsc Law).
-l
am excmpl undcr Section-. B. & P.C. tbr this reason.
Date:
WORKERS' COIIT PENSATION
DECT,ARATION
I hcrchy all'irm undcr Jrcnalty of Jrcrjury onc of thc tilllowing tlcclarations:
.-l havc arxl will maintain a Ccrtilicatc of Conscnt to Sclf-lnsurc lilr workcrs' comJrcnsati()n, as provided fbr by Section -1700 of thc
latxrr Ctxlc. lbr thc Jrcrlbrmancc of thc work fbr which thc Jrcrmit is issucd.
_l havc anrl will maintain workcrs' conrlrcnsatiolr insurancc, as rcquircd hy Scct ion 17fi) of thc Lahor Codc, lirr thc ;rcrlirrmance of
thc work lilr which this permit is issucd. My workcrs' compcnsation insurance carricr and prlicy numbcr arc:
Canier
Policy Nunrbcr: Expircs:
_l ccnily lhat in lhc lErlormtrec of thc work tbr which lhis prmit is issucd, I shall not cmlkty sny lErson in rtry matrncr
$) as b hccom suhiel to thc sorkcrs' comlrcnsation lass of Cdliti)mia, and a8rc that if I slnruld tBu(tm suhF]-l t(t thc
workcrs' comFDsalion provisions (r[ Sccliou 37fi) of thc lahr Gxlc, I sh{ll, fonhwith comply with tk}s pruvist)ns.
WARNING: Iisiturc to scurc workcrs'compcnsation covcragc is unlawful, and shall subltrt an cmpklycr lo crimin0l [Enaltbs and
civil lincs up k) orc hundrcd thousund rlollars ($1()0,m0), in additbn to thc cost of comJrcnsation, damagcs as providcd for thc
Scction 3076 of thc Lahrr Ctxlc, intcrcst and attorncy's l'ecs.
I hcrchy al't-rrm undcr Jrcnalty of Jrcrjury that I am liccnrcd under 9 (commcncing with Scction 7U}()) of Division 3
ol' thc Ilusincss and Prol'cssiorts Codc, arnl rny liccttsc is irt litll lirrcc
Liccnsc t
W
I hcrcby sllirm undcr lEnalty of lErjury that thsc is a constructkrr lcnding agcrey for thc pcrformancc of the work for which lhis Imit L$
issucrl (Sec. .1097, Civ. C.).
Lcntlcr's Namc:
Lrndcr's Addrcss:
APPLICANT DECLARATION
I hcrchy atl-rm undcr pcnalty of pcrjury onc of thc lblkrwing rlcclaraliotts:
Dcmolition Pcrmits-Asbcstos Notification Fcdcral Rcgulations (Titlc 40, Part6)
-Rct;u
irctl [rttcr ol' Notilrcatiolt
_l ccrtil'y that tlrc t'crleral rcgulations rcmovalarc not applicahlc to this projcct.
-l
ccrtil,v that I have'read this application thc atxrve inlirrmation is corrcct. I agrcc to comply with all City and County
ordinances and Statc [:ws relating to arxl hcrcby authorize representativcs of this City and County lo cntcr uJnn thc
abovc mcntioncd proprty firr insJrcction
Applicant or Agent
Pennilee nanrc
,,,",1\ ll't/2.,
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/VenVl n s u !atio n ,^\
Roof Sheathing \z-*-vv I ulilllL F&frra lEJq
Shear Wall t)\l
Framinq
lnsu lation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
[\Iasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
n\
FINAL 12-1-ba hw),a
Certificate of
Notes, Remarks, Etc.
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Florr nR-n7-2n 1 q
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