HomeMy WebLinkAbout101105477 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: {011o,5477
Pin #: 7'1549
Proiect Address: 2476 N Riverside Dra
Assessor's Parcel: 002-064-02 Lot: 21
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 754 Historic: No
Building Use: Single Family Dwelling
Job Type: Alteration
Nature of Work: Windows
Existing Bldg. & Use: Sfd w/det garage
Proposed Use:
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
R-3, U
VB
cBc 2019
AE-0602320144J
1st FL Area:
Znd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $6,400.00
Description of Work: Replace (9) windows, like-for-like, into existing openings.
Planning Conditions: All materials to match existing.
Owner:
Address:
Phone:
Tenant:
Ben Baginski
2476 N RIVERSIDE DR
Santa Ana, CA 927061615
(7141 745-6407
Contractor: Renewa! by Andersen Oranl
Address: 22982 Alcalde Drive, Unit 10
Laguna Hills, CA 92653
Phone: (7141 259-5120
State Lic #: 990416
Lic Type: B, D-24, C-l7, D-21
Bus. Lic #: 349936
Workers' Compensation lnsurance:
Carrier: OId Republic lns
Policy #: MWC31415820
Expires. 10/01 12021
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Graham, Jeffery
Amsden, Julie
Landscaping lnsp. Req'd:
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs issua nce,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.
Planning Approva! By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Date: 1211712020
Date:
Date: 1211712020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
07776002
07776002
s7607
57770
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$172.64
$4.05
$1.00
$23.7e
$59.30
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$23.7e
$231 .94
$1.00
$4.0s Fee Total.
Paid to Date:
Balance Due:
$260.78
$0.00
$260.78
lnspector MID#: 2020-163356
BUILDING. INSPECTOR RECORD
SITE.WORK DATE !D/SIG.COMMENTS OWNER BUTLDER DELCARATTON
I hcrchy afltm undcr pcnalty of JErjury that I am cxcmpt lirm thc Contrackns' Liccns liw tor the tbllowitrg rcasrn (Ss.7011.5
Busirrcss aul Prottssirn Codc): Any City or County which rcquircs s Frmit to construct. altcl improvc, dcmrlish or mpair any
slruclurc, pri(r lo its issuance, also rcquircs thc applicant tbr such Frmit k) lilc a signcd statcmnt that hc or she Ls liccnscd pursuant
to thc ltrovisious of llE Contraclor's Liccnsd Law (Chaplcr 9, Commcncing wilh Scctio[ 70(X) of Division .J of thc Busincss and
Pr)fcssions Codc) or th{t hc or shc is cxcmpt thercftom and thc basis tirr thc allcgcd cxcmptiul. Any violation of Sccti(r 70.1 1.5 by any
applicanl for a Jrcmit subjsls lhc applicant to a civil pcnally of nol morc th{n fivc hundrcd dou{s ($500),
_1, as owner of thc propcrty, or my employees with wagcs as their solc compcnsation, will tlo thc work and thc slructurc is not
intcrxlctl or othrcd tor salc (Sc--.7044, Business and Professions Ctxle: Thc Contractor's Liccnsc l.aw docs not apply lo an owncr of
thc pnlJrcrty wtxr builds or improvcs thcrcon, arxl who drrcs such work himsclf or hcrsclf or through his or hcr own cmpk)yccs,
providcd that such improvcrncnts arc not intenlcd or ollbrcd tbr sah. It, tnwcvcr, thc buikling or impn)vcrcnt is sokJ wilhin onc ycar
of complctkln, thc Owncr Builder will have thc burden of proving that hc or shc did not buikl or improvc thc pnrJrcrty lirr thc purprsc ol'
salc).
_1. as owncr of the propcrty, am exclusively contracting with licenscd contractors to construct thc projcct (Scc. lOM, Busincss
anl Pnrtbssion Ctxle: Thc Contractor's Licensc Law does not apply lo an owner of proJrcrty who builds rlr improvcs thcrcon,
and who contracts lilr such projccts with a Contractor(s) licenscd pursuant to the C<lntractrlr's Liccnsc Law).
-lamexcmptundcrSectitln-,B.&P.C.forthisrcasrrn.Date: Owner:
WORKERS' COTIIPENSATION
DECLARATION
I hcrcby atfirm under pcnalty of Jrerjury one of the tbllowing dcclarations:
_l havc and will maintain a Ccrtilicate of Conscnt to Selt'-lnsure firr workcrs' compcnsation, as providcd tirr by Scction .3700 of thc
Lahrr Ctx.lc, tilr thc Jrcrlbrmance of thc work for which the Jrcrmit is issucd.
E nu,"
thc work
and will maintain workcrs' comJrcnsation insurance, as rcquircd by Scct ion -1700 of the Labor Codc, lirr thc Jrcrlirrmancc of
lirr which this pqrmit is issued. My workcrs' compcnsation insurancc carricr and Jxrlicy numbcr arc:
otD Nh,qrL
vJ c-t t5 ,0.]o zlPolicy
_l ccrtity that in thc pcrlirrmancc of thc wrlrk tilr which this pcrmit is issucd, I shall not cnrpkry any pcrs()n itr any manncr
and
thc
LICENSED CONTRACTOR
DECI..ARATION
I hcrcby allrm untlcr Jrcnalty of pcrjury that I am licensed undcr provision of Chaptcr 9 (commcncing with Scction 7U)()) of Division .]
ol' the Busincss and Prol'cssions Codc, and my liccnse is in full tbrcc arx.l eltcct.
Liccnsc ct"r*' B Liccnse Number:ltov tto
?. 'l-)
Contractor:(Z>rrEnA- t.rr {po 6ogJ
{W
I hcrcby affum urklcr lEnalty of JErjury that thcrc is a custructk n hndinS agcncy for thc lrcrfomncc of lhc vork for which lhls Ismit is
issucd (Se. !(x)7, Civ. C.).
I-cndcr's Namc:
hndcr's Addrcss:
APPLICANT DECLARATION
I hcrehy allirm undcr pnalty of prjury one of the tbllowing declarations:
Dcmolition Pcrnrits-Ashestos Notitication Federal Rcgulations (Title 40, Part6)
_Rcquircd lrttcr of Notitication
_l ccrtily that thc l'edcral asbcstos rcmovalarc not applicahlc lo this projccl.
@."nily tlrat I ltavc rcarl atxrvc intirrmation is corrcct. I agrcc to comply
rcprcscntativcs ol' this City
with all City and County
arrd County to cnlcr uJxln lhcortlinalrccs irnd Statc Laws
abovc mcntioncd proJrcrty tilr
rtpplicant or Agent
Pentritee narrre
purF)ses.
antl hcrcby authoriz-c
o^r". lz. 17.1)
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nVl ns u lati on
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
FINAL Rlf-JO Ectt^'€bs "27
Certificate of Occupancv
Notes, Rernarks, Etc.
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