HomeMy WebLinkAbout101103367 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Building Permit #: { Ol { 03367
Pin #: 814{9
Proiect Address: 600 W Dver Rd
Assessor's Parcel: 410-023-10 Lot: NA
Unil: .Bldg: G Address Range:Suite Range:
Zoning: MlBlock: NA Tract: NA Historic: No
Building Use: Commerciel Occupancy: B 1st FL Area: Patio:
Job Type: Roroof Const. Type: V B 2nd FL Area: T.t.Area:
Nature of Work Roroof Code: cBc 2019 otherAreas: yards Reqd:
Existing Bldg. & User Mini-Warohouse Flood Zone: X-0602320259J
prcposed user # of stories: r Garage Area: Valuation: $18'000 00
Total:
Ooscriptlon of Worki Tearofl cap .h.el & epply 42 3q3 of Carlble TPO roofing mat.rial. iIOTE: ROOFING MATERIAL TO BE APPROVED BY THE COOL
ROOF RATING cOUNclL. Handout givon.
Planning Condition3:
Owner:
Address:
Phone:
Tenant:
Dyer Road Mini
18552 MACARTHUR BLVD 495
lrvine, CA 926121271
(9s1) 68s-9499
MiniU
Contractor: Hull And Sons Roofing lnc
Address: 89ti0 Jurupa Rd
Riverside, CA 92509
Phone: (951) 685-9499
State Lic #: 554747
Lic Type: C-39
Bus. Lic #: 165323
Workers' Compensation lnsurance:
Carrier: American Zurich
Policy #: WC018974802
Expires: 1213112020
Engineer:
Address:
Phone:
License #,
Architect /
Designer:
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp
PWA lnsp. Req'd
, Jerry
Teri
Fire lnsp. Req'd:
Police lnsp. Req'd
Date: 03/04/2020 Misc. Receipt:
Date: Misc. Receipt:
Date. 03104t2020 Misc. Receipt:
Subject to Field:
No
No Account#
01 1 16002 51601
01 1 16002 51612
01116002 57770
07776002
07776002
07776002
07776002
07776002
57607
57770
57672
57600
57507
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$333.06
$3.91
$1.00
$22.95
$57.20
$41 8.1 2
$0.00
$418.12
No
No
No
TotalPlanning lnsp. Req'd:
Landscaping lnsp. Req'd Flood Zone Ce(. Req'd: No 01116002 51600
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 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.
$22.9s
$390.26
$1.00
$3.91
lnspector MID#: 2020-158130
Fee Total:
Paid to Date:
Balance Due:
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS owNt:R lrutl,Dt]t( l)ut,cARA't'toN
I hereby affirn under penalty of perjury that I anr etenrpt fronr the (:ontraclos Licensc tjw for the following rcaen (5(.701 1 .5
llusincss and Prolbssion C()de)r Any Cily or County which rcquircs a lErinil k) conslrucl, allcr. irnprovc. deralish or rcpair any
slnrcture, prior k) its issuance. also requircs the applicaill fbr srch fEmit t() fih a sigilad slatemtrl lhat lt or she is licatrrd purjuant
to thc nmvisions of the Conlractor's l-iccnsed lrw (Chaptcr 9. Commcncing wilh Scction ?(Xm ol Division 3 ol-thc Busincss and
ProlcssiousCode)orlhatheoriheisexempttherehomandlhebasislbrtlrcalleSedexemptbtr. nnyviolatioilofSectionT03l.5byatry
rppliclot for l permit subjects lhe npplicailt to a civil pendlty of nol more than llve hundred dollars ($5lx)).
_1, as owncr ol thc profrny, or my cmployccs with wagcs ds lhcir solc compcnsation, will do thc wo,* and lhe lMturc is mt
interxled oroffcrerlforule(Se.T044,BusincssandPrcfessknisC(xle:TheConlrrcbr'sLicenscL{wdocsnotspplylotnowncrof
the pn)pny wk) huilds or inprows thcrm[ axl wlm docs such work hinrself or lErself or tlrough his or lrr owl enrployees.
proYid('d rhat such improvcrEnrs dc 8n htcnded orolLrcd ft)r $le. ll, howevcr. rhc building or improvcmnt is sold wilhin one ycar
ol conuletitu. the Owrrer Builder will hrve thc burden of provirrg thfll lE or she did ftn build or imprcve the pmtEny for thr puqnsc of
sale).
_1, as owncr ofthe propef,y, am exclusivcly cootrscling wilh liccnsed conlraclors 10 con\lrucl the p()jed (Sec. 7044, Businass
arxl Pn)tl\si(nrCr)dc:TheContractrr'sLicenseLawdoe\notapplyloanownerofpr(!pertywhobuildsorinlprovesthcrcon.
and who contracls for such proiccls wilh a Conlraclor(s) liccnNcrl pursuaot h thc Cootrlc(tr's l-iccnsc Law).
_l anr exempt under Section-, B. & P.C. lbr this reason.
Drle:_
W()RKI,IRS' ( ( )IlI'UNSA'I l( )N
t)E('t.,\R,\1 t()N
I hcrchy atlirm undcr plnaly of pcrjury onc ot lhe lbllowing dcclarations:
_lhoveuxlwillnuinlaina(c(ilicateofConsenlk)SelllDsuref(rrworkers'conrpensation,as pmvidedforhySccti(]n3700ofthe
Lnk)r Codc. Ibr thc lcrformtncc ol-lhc work li)r which thc pc,mil is issucd.
_lhaveandwillnraintainworke6'comp€Nalionirsurance,as requiredhySection3T00ofthetihorCode,fortheperfomurccof
thc work lbr which lhis IErmil is issuql. My workcrs' conrpcNation insurnncc cmicr iuxl lnlicy numhcr trc:
Policy /z/tr,/z-,.t
j(l ('nily rhd
,---7
in lhc lrrli)r nnncc ol thc w(nk ,i)r whirh lhis l)ctrril is issuc(|, I shall not cnrpby uny pcr\,rn in dily nranncr
so aslohcco,msuhjccllolheworkcrs'compcnsalioDlaw\ofCxliforniil,andil8rccthntifIshouldtacorrcsubjccttothc
workers'coDrpensalionprovisionsofSectionlT00oftheLaborCode,lshilll,f(,nhwithcomplywithtlp*pruvisions.
WARNING: Failurc (r securc workcrs' compensili()n covcrdgc unlawful, and shall suhjcct m cmploycr tr oiminal 1rcMLies Md
civil llnes up to one hundrcd thousaM to the of conrpcnsalion. darmges fls provided for tha
Secli()n 1076 of [jtDr Cqle. intercst fees.
I hcrcby allirrn und('r pcnalt], of pcrjury lhat I arn liccns!-d Chaptcr 9 (cornrroncing wilh Scqion 70ff)) ol Division 3
o, rhc Bu\ines\ and Pnrtrssions Codc ml nrv liccnsc is in tull fircc and cllict
I 7l,iccnstr Nunbcr:
I hercby aflrm undcr Fnalty ofpedury tlrat there is a constnlctiur lcndirg ageilcy for I
issu(d (Scc. .11)97, Civ C.).
Lcndcr's Nxmc:
perfi)matrce of thc work tbr which this pemrii is
Ixn(lcr's A(l(lrcss:
APPI-ICANT DECLARATION
I tmby uffmr under penalty of perjury onc of thc following declardlions:
Demolirion Permils-Asb€rtos Notification Fcdcral ReSulations (Tille,l0, Pan6)
-Requircd
lf,lter of Notificalion
_l ocdily lhat tlE federal rcsulatiorE rcgarding asbcslos rcnpval arc Dot applicablc to rhis pmlxl.
nnd slrle lhal lhe rh)ve irrfonralion is correct. I tgrcc lo conrply wilh rll City and Counly
constnrcti(nr. ilil herchy authorize representntives of thls City and County to entcr uF)n llE
Applicf,nt or Agcnt
['rrrDiler
lo
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsu lation ,.1,,
Roof Sheathinq 1 dzt laoTr,
Shear Wall
Framinq
lnsulation/Enerqv
Drywall
Ext./lnt. Lath
Brown Coat
[t/asonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
I
,A
FINAL ttll/zo Dfl lt i)
Certificate of Occupancy .l
Notes Remarks Etc.
Rev.0B-07-2015