HomeMy WebLinkAbout101103917 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Building Permit #: 1O1103917
Pin #: {4566Permit Counter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Proiect Address: 1657 W Wisteria Pl Unit:Bldg: Address Range:
Assessor's Parcel: 109-352-36 Lot: 150 Block: NA Tract: 2355 Historic: No
Suite Range:
Zoning: Rl
Building Use: Single Family Dwelling Occupancy: R-3 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: Flood Zone: X-06023202S7J Garage Area:
Proposed Use: # of Stories:
Totat
Description of Work: Tear off existing, install 1900 squares of comp and 1900 squares of built-up roofing
Planning Conditions:
Patio:
T.l.Area:
Yards Req'd
Valuation:$1 ,012,700.00
Owner:
Address:
Phone:
Tenant
CENTRAL PROPERTY MGMT
1657 W WISTERIA PL
Santa Ana, CA 92703
(714).270-9074
Contractor: RAYMUNDO PEREZ ROOFIt
Address: 10862 Rustic Ln
Anaheim, CA 92804
Phone: (7141 290-3337
State Lic #: 1060627
Lic Type: C-39
Bus. Lic #: 375470
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9212641
Expires: 0611712021
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
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
web user
Date:
Date:
Date: 06/2512020
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
0LLL6002
07776002
07776002
07776002
07776002
57607
5777 0
57572
57600
57507
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$333.06
$3.91
$41.00
$22.95
$57.20No
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No N/A - No Balance
N/A - No Balance
N/A - No Balance
Account#Total
Every permit issued shall become invalid unless fhe work on the site authorized by
such permit is commenced wilhin 360 days after its issuance,or if the work authorized
on the site by such permit is suspended or abandoned for a period of360 days after
the time the work is commenced.
Fee Totat
Paid to Date:
Balance Due:
$458.1 2
$458.1 2
$0.00
lnspector MID#: 2020-159760
fiY
BUILDING. INSPECTOR RECORD
Rev.08-07-2015
SITE.WORK DATE !D/SIG COMMENTS OWNER BUILDER DELCARATION
I hcrcby allirm undcr penalty ol Frjury that I anr cxcilrpt ftom lhc Conlraclors' Liccnsc [aw for lhc following reason (Scc.7031.5
BustDcss aNl Prolession Crxle): Any City or County which rcquircs a Jrcmit lo conslrucl. altcr. irnprove, dcmolish or rcJnir uy
structurc, prior lo ils issumcc. nlso rcquircs ihc apJ,liqnl for such [Ermil lo filc a siSncd slatcmf,t that hc or shc is liccnsd pursumt
k) lhc Jrovisions of llE Contraclor's Licensed Law (Chapter 9. Comtrrcncing with Scclion 7000 of Division 3 of the Busircss md
ProfcssionsCodc)orthathcorshciscxemptthcrefromrndthebasirforthcallcgcdcxcmption. Anyviolulio[ofscctionT03l.5byany
applicantlorapcrnlitsubjcclsthc 0pplicanlhacivilpcnaltyofnotmolcthmfivchundrcddollus($5url).
_1. ils owNr ol-lhc proJrcny. or nry cnrployccs with waScs as lhcf \olc coilllEnsalio[. willdo the worl and lhe stnEtuc is rnt
inlcndcd oroflcrcdli)rslc(Ser.7()4,l.Busincssandltotcssk)nsCodc:'l'hcConlracbr'sLiccnse[nwdocsDolapplytoanowncrof
thcproFrly whobuild\oriiurovcstlrcBntadwhodoessuchworkhintsclforhcrsclforthrcughhisorhcrowncmployces.
provdcd that such improvcnrcnts arc not inlendcd oroflbrcrl for salc. I[ howcvcr. thc buildiog or in]provcnrcilt is sold wilhif otrc ]Ee
ol conlplction. lhc Owncr Buildcr will have thc budcn ofproving that hc or shc did nol build or improvc lhc pmIrcfly for thc purJx)s of
$lc)
__1. as owncr ollhc prcpcny. atrr cxclusivcly conlrilcting with liccn$d conlraclors k) c()nslruct thc pmlrt (Scc. 7044. Busirrss
dnd ftofcssiorCodcrThcConlractor'sLiccnscLawdocsnotapplyk)anowncrofprolrcrtywhobuildsorimprovcsthercon.
and who contracls lbr such projccts with n G)nlrdctor(s) liccnscd pursuant to thc Conlrucbr's Licensc Lflw).
_l am cxcrnpl undcr Setion-. B. & P.C. for lhis reapn.
Drte:-- Omer:-
WORKERS' COMPE{SATION
DECI.AEAIION
I hercby alTirm undcr fEnalty of pcrjury one of thc following deluat ions:
_l havc and will rointain a Ccnifrcatc of Con*nt to Sclf-lnsurc l<)r workc.s'compcnsalion. as Frovidcd for by Scctbn 3700 of thc
tibor fue, for thc pcrfomncc of the work for which thc permil is issucd.
thc work li)r which lhis pcrillil is issuc\l. My workcrs cotrrl)cnsilti{rn iosurulcc can'icr rrxl l)olicy nunrh(r ilrci
Policv Numbcr: Exnircs:
_l ccaily lhat iil thc fErlbilmncc olthc work for which this pcrmit is issucd. I shall nol cmploy any FErson in any manncr
so as lo bcconrc subjcct lo lhc workcrs'compen$lion laws ofCllilbmia. imd agree thut il l should bcconr subjcct lo thc
workcrs'cotrlpcnsationprovisionsofScction.lTfi)oflhctatnrCodc.lshall.fonhwithLrmplywilhthospovisions.
I{ARNING: fiilurc to scurc workcrs compcn$tion covcragc is unlawful. and shall subjcct an cmploycr b ffirninal Fnaltics and
civil fincruploonchundrcdthousdnddollars($l0O.0m).inaddiliontothccostofcompensation.danugcsasprovidcdforthc
Scctiril 307(r ol lhc l-ilt$r C-odc, inlcrcsl and altorncy's lbcs.
Dote:
-
Appliont:
LICENSED CONTRACTOR
DECI,IIRATION
I hereby affirm undcr Jrcnalty of fErjury that I am liccnscd undcr provision ofChaplo 9 (conrnrcncing wilh Scclion 70fi)) ofDivision 3
of thc BusiDess and Profcssions Codc. arrl my liccnsc is in full forcc and cff(t.
Licensc Class
Dale:-
Nu illhcr.
_ (-onlrarlor: _
CONSTRUCTION LF]]\DING AGENCY
I hcrcby affirm undcr lEnally of JErjury that thcrc is a conslruclif kndin8 a8crcy for lhc pcrfortMcc of lhc work for which this Frmit is
issucd (Scc. 3097. Civ. C.).
lrndcr's Addrcssl
APPLICAM DECLARATION
I lmby alfinn undcr penalty of pcrjury onc of thc folkrwing dcclaralions:
Dcmolition ['crmits-Asbcstos Nolification Fcdcral Rcgulalions ('l illc 40, Pan6)
-Rcquircd
lxllcr of Notilicalion
_l ccnify th{t thc lcdcralrcgulalions rcgitrding rsbcstos reff)vrlarc nol applicablc to this projccl.
__l ccnify thal I luvc rcad this applica(ion od stale that thc atnvc inlbrnutknl is correct. I ogr@ to comply wilh all Cily trnd County
ordindnccs and Slalc ljws relating to building construction. illd hcrcby aulhorize reprcsentalivcs ofthis Cily and County lo cntcr upon the
ntnvc rEnIioilcd pmpcny for inspection purposcs-
Applicfl nt 0r,\gcDl Sigualurcl Dsle:_
l'(rnrilee notrre (prinl):
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsulatio n
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
I
FINAL /.t*/ent ^r^Adt I
Certificate of Occu
Notes, Remarks, Etc.
kndcr's Narc: