HomeMy WebLinkAbout101105203 - Permita
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 #: 1O11O52O3
Pin #: 21096
Proiect Address: 3301 S Ross Sta
Assessor's Parcel: 410-1 62-20 Lot: 61
Unit:Bldg: Address Range:Suite Range:
Zoning: R1Block: NA Tract 7089 Historic: No
Building Use: Single Family Dwelling
Job Type. Miscellaneous
Nature of Work: Windows/Doors
Existing Bldg. & Use: SFD w/ att garage
Proposed Use:
Occupancy:
Constr Type:
Code:
Flood Zone.
# of Stories:
R-3, U
VB
cBc 2019
x-0602320278J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation:$5,500.00
Description of Work Replace (4) windows and (2) sliders. Like for tike.
Planning Conditions:
Owner.
Address:
Phone:
Tenant
Eleanor Migues
3301 S Ross St.
Santa Ana, CA 92707
(7141 540-6779
Contractor: Renewal by Andersen Orang
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 I nsurance:
Carrier: Old Republic lns
Policy #: MWC31415820
Expires: 10/01 12021
Engineer:
Address:
Phone.
License #:
Architect /
Designer:
Address:
Phone:
License #:
(TTI
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping !nsp. Req'd: No
Gomez, Pedro Date. 1111212020
Date:
Date: 1111212020
Subject to Field.
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.Zuniga
07776002
07776002
07776002
07776002
07776002
57607
57770
s7672
s7600
s7607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Totat
Paid to Date:
Balance Due:
$172.64
$4.0s
$1.00
$23.79
$5e.30
$260.78
$0.00
$260.78
Fire lnsp. Req'd: No
Police Insp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
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 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$23.79
$231 .94
$1.00
$4.0s
lnspector MID#: 2020-162709
BUILDING- INSPECTOR REGORD
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hereby affirrn undcr pcnalty of perjury that I am excmpt from the Contractors' Licensc l-aw for thc following reason (Sec.7031.5
Business and Profession Codc): Any City or County which requires a pcrmit lo construct. alter. improve. dcmolish or rcpair any
struclurc. prior to its issuancc, also rcquircs thc applicant for such pcrmit to filc a signcd statenrcnl that he or shc is liccnscd pursuant
to thc povisions of the Contractor's Liccnscd hw (Chaptcr 9, Commencing with Scrction 7000 of Division 3 of the Busincss and
Profcssions Code) or that hc or shc is exempt thcrcfrom and the basis for thc allegcd excmption. Any violation of Scction 7031\5 by any
applicant lbr a pcrmit subjccts thc applicant to a civil penalty of not morc than five hundred dollars ($5001.
_1. as owncr of the propcrty, or my employecs with wagcs as their solc comJrcnsati<ln, willdo the work and thc structure is not
intcndcd or offcrcd for sale (Sec.7044. Busincss and Profcssions Codc: The Contraclor's Liccnse Law does not apply to an owncr of
the propcrty who builds or improves lhcrcon. and who docs such work himsclf or hcrsclf <lr through his or her own cmployces, -
providcd that such improvenrcnts are not intcndcd or offcrd fior sale. If, howcrar. the building or inprovcnrcnt is sold within one ),car
of complctkrn. lhc Owncr Builder will havc thc burden of proving thal tE or shc did not build or improve thc propcrly for thc purynsc of
salc).
_1. as owncr of thc propcrty. am cxclusivcly contracting with liccnscd contractors lo conslruct thc projoct (Sec. 70tl4. Busirrcss
and Prrofisskln Codc: Thc Contractor's Licensc Law docs not apply to an owncr of proJrcrty who builds or improvcs lhcreon.
and who contracts ftrr such projects with a Contracto(s) licensed pursuant to lhe Conlraclor's License Law).
-lamexcmptundcrScction-.B.&P.C.forthisreason.I1.,. ^.
WORKERS' COM PET{SATION
DECLARATION
I hcrcby alfirm undcr pcnalty of perjury one of thc following declarations:
_l havc and will maintain a Certificatc of Conscnt to Sclf-lnsure for workcrs'compensalion, Bs provided for bySectkrn 3700 of thc
I-:bor Codc. for the perfornunce of thc work for which thc permit is issued.
_l have and will maintain workers' comJrcnsation insurarrce. as required by Scction 3700 of the Labor Code, for the performance of
thc work for which this pcrmit is issuccl. My workcrs' compcnsation insurance carricr and plicy number are:
Rlr3u.t <-
Mlwa l5 o t.u
Policy
_l ccrtily lhat in thc pcrformancc of thc work frrr which this pcrmit is I shall not cmploy any pcrson in any manncr
so as lo bccomc subject
workcrs' cornpcnsation
to the workers'conrgrcnsation laws agrce that if I strould bcconr subjcct to thc
provisions of Scction 370O of thc Code. I those provisions.
WARNING: Failurc lo sccure workcrs' corr4rcnsation ts employer to criminal pcnaltics and
civil lincs up lo onc hundrcd thousand
Section 3076 of ttrf I-at$r C-odc, interest
r)sre: *.-J+hzl 1-b
dollars ($100.m0).thc cost of compensation. damagcs as providcd for the
and att<lrrrcy's
I hereby affirm undcr pcnalty of perjury that
of thc Busincss and Professions Code. and
LICENSED CONTRACTOR
DECLARATION
I arn liccnsed undcr provision of Chaptcr 9 (comnrcncing with Section 70m) of Division 3
my licensc is in full force and effcct.
-qqN\L
Liccnsc b Nurrthcr:
tJ
I hcrcby allirrn undcr pcnalty of pcrjury that
issucd (Scc. 3097, Civ. C.).
CONSTRUCTION LEI{DING {GENCY
thcrc is a construction lcnding agency ltlr thc pcrformance of thc work for which thi*,rcrmit is
Lrndcr's Namc:
[.cndcr's Address:a
APPI ICANT DECLARATION
I hcrcby affrnn under pcnalty of pcrjury onc of thc following dcclarations:
Dcrnolition Pcrrnits-Asbcstos Notification Fedcral Rcgulations (Titlc 40. Part6)
_Rcqu ircd lrttcr of Notification
asbcstos rcmovalarc not applicablc to this project.
abovc nrcntioncd proJrcrty for
Applicnnt or Agenl
Pernritee nanre
to
lhal
I
Date:tl 'i7.1-D
thc
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenU! nsu latio n
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Enerov
Drywall
Ext./lnt. Lath
Brown Coat
Jt/asonrV
Poo! Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif .
FINAL lzl t1 l>o Dft+ryq
Gertificate of Occupancv I
Notes, Remarks, Etc.
Rev. 08-07-201 5
,
Owncr:
Date:
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