HomeMy WebLinkAbout101104841 - PermitProiect Address: 2121 S Forest Avea
Assessor's Parcel. 408448-08 Lot: 51
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract 4606 Historic: No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {01104841
Pin #: 57874
Building U8€: Slngle Famlly Dwelling Occupancy: R€, U 18t FL Area Patio:
Job Type Roroof Constr Type V B 2nd FL Area T.l.Area:
Nature of Wok Raioof Codet CBC 2019 Other Areas yards Reqd
Existing Bldg & Uss SFO wr.tt G.rage Flood Zoner X{802320259J
p,oposed use: # oI stories: GarageArea valuatlon: 3m'000'00
Totat 0
Dracription of Work T.ar otf oxlstlng roof m.to.lal and lnatall new comp shlngle root m.terlal ln prep.r.tlon for solar systeln lmt ll.tion(on peimit*
lolloilS4o H.ndout glven.
Pl.nnlng Conditiona:
Owner:
Address.
Phone:
Tenant
Sa Mai
2121 S. Forest Ave.
Santa Ana, CA 92704
(7141 622-8221
Contractor: Solartime Electrical Seruice:
Address: 14371 Euclid Street, #2F
Garden Grove, CA 92843
Phone: (626) 757-6677
State Lic #: 1051 487
Lic Type: B, C-10
Bus. Lic #: 374129
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9257733
Expires: 0711912021
Engineer:
Address:
Phone:
License #:
Architect /
Designer.
Address.
Phone:
License #:
Solartime Electrica! Services
14371 Euclid Street, #2F
Garden Grove, CA 92843
(626) 7s7-6677
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
Arechiga, Liana
Chavez, Dave
Date: 1010512020
Date.
Date: 1010512020
Subject to Field:
Misc. Receipt:
Misc. Receipt.
Misc. Receipt:
07776002
077760 02
07776002
07776002
077760 02
57607
57770
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Totat
Paid to Date:
Balance Due:
$345 28
$4.05
$1 00
$23.79
$59 30
Fire lnsp. Req'd:
Police lnsp. Req'd:
No
No Account#Total
Flood Zone Cert. Req'd: No
Every permit issued 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.
lnspector MID#: 2020-1 61902
01 1 1 6002 51 600
01 1 16002 51601
01116002 51612
01 1 16002 57770
$23.79
$404.s8
$1 .00
$4.05 $433.42
$0.00
$433.42
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby aflirm undcr lEnalty of lErjury that I am cxcmpt from lhc G)nlraclr)s' Liccnsc Law for the following rcasrn (Scc.70Jl.5
llusircss aftl Prolbssiou C<xlc): Atry City or Coutrty which rcquircs a lsmit k, q)nstrucl. altcr. improvc. dcmoli$h or rcIair any
strucluc. Fior to its issuancc. also rcquircs thc applicant tbr such Frmil k) tilc a signcd stalcmnt that hc or shc is liccn$d pursuant
to lhc pn)visions of lhc Contrsck)r's Liccnscd [2w (Chaptcr 9, Commncing sith Scction ?U)0 of DivisioD 3 of thc Busincss and
Pmfcssi(rns Cfilc) or that lrc or shc is cxcmpt thcrcli(rnr .[d thc hdsis for lhc allcgcd cxcmpti(tn. Any violation of Sccti(il 70] I .5 by any
applicant li)r a JErmil suh.i(ts Ihc applicanl k, a civil pcnalty of nol morc than fivc hundrcd dollds ($500).
_1, as owncr of thc propcrly, or my cmployccs with wagcs as thcir solc conlpcnsalion, will do thc work and thc struclurc is not
intcrxletl or ofl'ercd lilr salc (Sc.c.7M4. Busincss and Prol'essions Crxle: Thc Contractor's Liccttsc Law docs not apply to an tlwncr of
thc pnrl--r1y who huilds or inrpr)vcs tlrcrcrrn, antl who tftrcs such work himsclf rlr hcrsclf or thnlugh his or hcr own cmployccs,
prlvidcd that such inrprovcu**nts arc not intcndcd orollbrcd tirr salc. It, lnrwevcr, thc building rtr improverncnt is sold withinonc yc:u
o[comphtion, thc Owncr Buildcr will havc thc burden of proving that hc or shc dirl rxlt buill or improve thc progrrty lilr thc pur;xts;c o[
sah).
_1, asowncrof thc propcrty. amcxclusivelycontracting with liccnscdcontractomtocottstntct thc pntjcct (Scc.7044, Busincss
antl Pnrtcssrlr Codc: Thc Contractor's Licensc Law tlocs not apply to an owncr ttf proJrcrty who builds or improvcs thcrctln,
anrl who colltracts lilr such pro.jccts with a Contractor(s) liccnscd pursuant to thc Contraclor's Liccnsc Law).
-l
am cxcmpt undcr Section-, B. & P.C. for this reason.
Owner:
wonrgRs' col\tPENS
DECLARATION
I hcrchy al'l'irm undcr pcnalty of Jrcrjury one of thc tolkrwing dcclarations:
_l havc arrrl will maintain a Ccrtillcatc of Conscnt to Scll'-lnsurc lilr wrlrkcrs' comJrcnsation, as pnrvidcd litr hy Scction 37fi) of thc
[.alxrr Crxlc, lilr thc Jrcrlirrmancc of thc work lirr which thc pcrnrit is issucd.
_l havc and will maintain workcrs' cunrJrcnsation insurancc, as rcquircd by Scctirttt 37fi) of thc Lahor C<xlc. lirr thc lrcrtilrnrancc of
thc wtrrk lilr which this Jrcrnrit is issucd. My wrlrkcrs' com[rcnsalion insurancc carricr and Jxrlicy numbcr arc:
Policy Numbcr: Expires:
_l ccrtity that in thc;rcrftrrmancc of thc work tirr which this Jrcrmit is issucd, I shall not cntploy any lrcrson in any manncr
so as to hccomc subjcct to thc workcrs' compcnsation laws of Calitirrnia, and agrcc that if I shruld bccomc subjcct to thc
workcrs' com;rcnsation provisions ol'scction .1700 of thc Latxrr Crxlc, I shall, fbrthwith comply with thrlsc provisirlns.
WARNING: Failurc to securc w<lrkcrs' comJrcnsation coveragc is unlawlul, and shall suhjcct an employcr to criminal Jrcnaltics and
civil tincs up to onc hundrctl thousand dollars (S100.Uru), in addition to thc cost of compcnsalion, damagcs as providcd lilr the
Scction 3076 of thc Labor Gxlc, furtcrcst and attrlrncy's l'ccs.
LICENSED CONTIUCTOR
DECLARATION
I hcreby atlrnr undcr Jrcnalty of pcrjury that I am liccnrcrl undcr provision of Chaptcr 9 (comrncncing with Sccti<rn 7firu) of Division 3
of lhe Busincss and Prol'cssions Codc, and my licensc is in full lilrce and cltect.
Liccnse Class: Licensc Nunthcr:
Contractor:
CONSTRUCTION LENDING AGENCY
I hcrcby allirm undcr lEnalty of Jrrjury that thcrc is a construclirn bnding agcncy lbr thc lErftrmrec of lhc work for which this Jsmit is
issucd (SN. .1097, Civ. C.).
[rndcr's Nanrc:
APPLICANT DECLARATION
I lrcrehy allirnr undcr pcnalty of pcrjury onc ol'thc firllowing declaratirtns:
Dcmolition Pcrmits-Asbcstos Notilication Fctlcral Rcgulations (Titlc 40. Pan6)
_Rcqu ircd lrttcr of Notilication
_l ccrrity lhal thc fcdcral rcgulations rcgurling ashcsl(rs rcm)val arc nol applicahlc to lhis pmjcct.
_l certifi thar I havc rcad this applicarion anl statc thol lhc atnvc infomslion is coEet. I .lre to crtmply with all City.nd County
oRli[anccs and Statc llws rclating lo huilding construction, atr, hcrcby aullxrrizc rclrcrcntativcs ofthis City and County to cntq uF)tr thc
atDvc mcntioncd p()[Erly lbr inslBctiotr puqbss.
Applicant or Agent Signature:
Penrritee nanle I rrri rrl l:
l)ale:
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/VenUl ns u lation
Roof Sheathinq
Shear Wall
Framinq
Insulation/Enerqy
Drvwall
Ext./lnt. Lath
Brown Coat
[\/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
,ll cI .l -tl -t
FINAL I {/w pffI-fz /
Certificate of Occupancy
Notes, Remarks, Etc.
Flav n9,-n7 -2n I q