HomeMy WebLinkAbout101104894 - PermitProiect Address: 1039 N Custer Sta
Assessor's Parcel: 398-193-03 Lot: 6
Unit Bldg: Address Range:
Tract: HAWKIN'S ADD
Suite Range:
Zoning: SD84Block: B Historic: No
City of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {01104894
Pin #: 42474
Building Use: Commercial Occupancy: B 1st FL Area
Job Type: Reroof Constr Type: V B 2nd FL Area
Nature of work: Reroof code: cBc 2019 other Areas
Existing Bldg. & Use: Commercial Flood Zone: X-0602320163J Garage Area:
Proposed Use: # of Stories:
Totat
Description of Work: T/O existing roof and install new hot mop roofing system to commercial building. Hand out given.
Patio:
T.l.Area:
Yards Req'd
Valuation: $16,175.00
Planning Conditions:
t
Owner:
Address:
Pl,bne:
Tenant
David Gregory
1039 N Custer St
Santa Ana, CA 92701
(7141 835-8676
Contractor: HD Roofs, lnc.
Address: 5022 W sth St
Santa Ana, CA 92703
Phone: (7141 554-0267
State Lic #: 908238
Lic Type: C-39
Bus. Lic #: 325094
Workers' Compensatron lnsurance:
Carrier: State Fund
Policy #: 9052886
Expires: 0110112021
Engineer:
Address.
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
t/9,/?ff
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:
Graham, Jeffery
Zuniga, Allissa
Date: 1010812020
Date.
Date: 1010812020
Subject to Field:
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
077760 02
07776002
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
$433.42
$0 00
$433.42
No
No
No
No
Fire Insp. 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.
lnspector MID#: 2020-162017
01 1 16002 51600
01 1 16002 51601
01116002 51612
01116002 57770
$23.79
$404.58
$1 .00
$4.05
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrchy affirm undcr lEndlty of pcrjury lhat I am excmpt lirrm thc Conlrack)rs' Liccnsc law for thc lirlbwing rcnsotr (Scc.7OJ 1,5
Busincss ant Profcssi<ln Crxlc): Any Cily or Counly which rcquircs a lErmil lo conslrucI. allct impnrve. dcmr)lish (rr rc[uir atry
structurc, lrior to its issuancc, alsr rcquircs thc applicant for such Jrrmit to lilc a siglcd stalcmnt that hc or shc k liccNcd pursu{nt
k) thc pfl)visions of thc Conlract(rr's Liccnsd tiw (Chaptcr 9, Comrcncing with Scction 7u)0 of Division -l of lhc Busincss and
Prufessions C'(xlc) ()r that hc (rr shc is crcmpt thcretiom and thc basis for the allcgcd cxcmpti(tn. Any violation of Setion 70J 1.5 by atry
applicant tbr a JErmit subjBls thc applicant to a civil pcmlty of nol morc than five hundrcd dollars ($5fi)).
_1. as owncr of thc propcrty, or nry cmployces with wagcs as lhcir solc compcnsation, will do thc work atil thc slrur'turc is not
intcndcd or oll'cre'd lilr salc (Scc.7(X4, Busincss and Pnlt'cssions Ctxlc: The Contractor's Liccnsc Law docs nol apply to an tlwncr ttf
the pK)pcrty who builds or improvcs thcrcon, and who drrcs such work himsclf or hcrscll'or thnrugh his or hcr own cmployccs,
providcd that such impnrvenrcnts arc not intcrxlcd or otl'crcd lbr sah. It. lxrwcvcr. thc huikling or impr<lvcmcnl is srtkl within onc ycar
ol'complction, lhe Owncr Buildcr will havc tlre burdcn o[proving that hc or she did not build or improvc the pnrpcrty lirr the pury)osc ol'
sah).
_1. as owncr ol'thc propctly, anr cxclusivcly contracting with liccnscd contraclors to construct thc pnrjcct (Sec. 7(X4, Busincss
and Pnrfbssirln Codc: Thc Contraclor's Liccnse Law drrcs not apply to an owncr of proJrcrty who builds or improvcs thcrcon,
and who contracts lirr such pnljccts with a Contractrlr(s) licorscd pursuant to thc Contraclor's Liccnsc Law).
-IanrcxcmptuntlcrScctitllt-'B'&P'C'fitrlhisrcastln.
}VORKERS' (:ONI PENSATION
DE(ILARATION
I hcrcby atTirm undcr pcnalty of Jrcr.iury onc of thc lirlkrwing dcclarations:
_l havc aml will maintain a Ccrtilicate of Conscnt to Sclt'-Insurc ttlr workers' comSrcnsation, as pnlvidcrl lilr by Scctittn 17fi) of thc
Latxrr Culc, lirr thc pcrklrmance2l'thc work tbr which thc pcrmit is issucd.
_l havc antl will maintain wrlrkcrs' comfrcnsatkln insurancc, as rcquircd by Scction 37fi) of the Lahor Codc, tilr thc pcrlirrmancc of
the work tilr which this Jrcrmit is issucd. My workers'insurancc carrier and Jxrlicy nunrhcr arc:-
F
l- t-?\Policy
i
_l ccrtify that in thc Jrcrkrrmancc of thc work lirr which this Jrcrmit is issucd, I shall not cmploy any pcrson in any manncr
so as lo bccomc subjcct to the workcrs' compcnsation laws of Calilirrnia, and agrec that if I should bccomc suhject to thc
workcrs' compcnsation provisions of Scction 3700 of thc l-^atxlr Crxlc. I shall. klrthwith comply with thosc provisions.
WARNING: I;ailurc to sccurc workcrs'
civil lincs up to onc hundrcrl thousand
compcnsation is unlawlul, and shall subjcct art to crirri.ral Jrcnaltics and
dollars ($ I in addition to tltc as providctl lor thc
Scction 1076 of intcrcst l'ces.
t-
I hcrcby allirrn undcr pcnalty of Jrcrjury that I am liccnscd pnrviskrn of Chaptcr 9 (comrrcncing with Scction 7U)()) ol'Division -]
of thc Busincss and Prof'cssions Codc, and my liccnsc is in tull tbrcc and cll'ect.
-
Liccnsc Nunrbcr:
I hercby aflrm undcr pcnalty of frcrjury that thcrc is a construction
issucd (Sec. 3097, Civ. C.).
[.cndcr's Namc:
agency Jrcrtormancc of thc work frrr which this Jrcrmit ls
lrndcr's Addrcss:
APPLICANT DECLARATION
I lrcrcby all-rm undcr pcnalty of ;rcrjury onc of thc ftrlklwing dcclarations:
Dcmolition Pcrmits-Asbestos Notification Fcdcral Rcgulations (Title 40, Part6)
_Rctluircd l,cttcr of Notilication
/etccrtilyhO" I'crlcratrcgulations rcgarding asbcsto.s rcmoval arc not applicablc to this pnrjcct.
_l ccrtity that I havc read this and statc that thc ahrvc inlilrmation is corrccl. I agrcc to comply with all City and County
ordinanccs and Statc laws rclating construction. and hcrcby authorizc rcprcscntativcs of this City and County to crttcr uJxrn thc
atxrve mcntioncd propcrty for
Appiicant or Agent
I'crnrilec nanrc
PUrrx)scs.A-\\-
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVI ns u Iatio n ,
Roof Sheathing /o.l'slzrzD *dti\
Shear Wall (,v
Framinq
lnsu lation/Enerqv
Drywall
Ext./lnt. Lath
Brown Coat
[\Iasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
|t,rt; I / I
FINAL
of
Notes, Remarks, Etc.
Elorr nP.-n7 -2n 1 q