HomeMy WebLinkAbout101103599 - PermitCity 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 tjJ
Permit #: 101103599
Pin #: 45207
Project Address: 1712 W Wilshire Ave
Assessor's Parcel:1 09-377-09 Lot: 31
Unit Bldg: Address Range:Suite Range:
Zoning: RlBlock. NA Tract: 2568 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Reroof
Reroof
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stones:
R-3
VB
cBc 2019
x-0602320257J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation:$7,07s.00
Description of Work: Tear off existing, install 25 squares of comp roofing
Planning Conditions
Owner:
Address:
Phone:
Tenant
Carlos Sanchez
1712W Wilshire Ave.
Santa Ana, CA 92704
(7',t4).604-6424
Contractor: Benitez Roofing
Address: 3302 S. Birch St
Santa Ana, CA92707
Phone: (714) 6964090
State Lic #: 1041404
Lic Type: C-39
Bus. Lic #: 373112
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9233191
Expires: OOl14l2O2O
Engineer:
Address:
Phone:
Licerrse #:
Architect /
Desiqner:
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
No
No
No
No
\Y
Date:
Date:
Date: 0511212020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
077L6002
0L7L6002
07776002
07775002
01"776002
$333.06
$3.91
$1.00
$22.95
$57.20
Fire lnsp. Req'd: No
Police lnsp. Req'd: No Account#
Flood Zone Cert. Req'd: No N/A _ No Balance
N/A - No Balance
N/A - No Balance
Total
Every permit issued shall become invalid unless the work on the site authorized by
such pemit is commenced within 360 days afrer its issuance,or if the work authorized
on the site by such permit ls suspended or abandoned for a period of360 days after
the time the work is commenced.
Fee Totat
Paid to Date:
Balance Due
$418.12
$41 8.1 2
$0.00
lnspector MID#: 2020-158888
57607 Permit Fee
57770 Microfilm Records
s7672 Bldg. Stds. Revolving
57600 General Plan Update
5L607 lssuance
BUILDING. INSPECTOR RECORD
Rev.0B-07-2015
SITE.WORK DATE ID/SIG.COMMENTS OWNIIR ltl.llLl)1ll{ l)I,]i.CARA'l'ION
Ih€rebyaffimrunderpcnaltyofpeaurythatIanrexenrplfronrtheCbnlra.los l-icenscL:rwforthefollowingreasn(5{.7031.5
llusincss rnd Proltsrion Code): Any Cit], or Countv which rcquircs a f*rmit !r construct, ahcr, improvc, dcrmlish or repair any
struc[rre. prior b ils issuance. also requires the applicaDt ti)r such pem)il to file a signed slrtenrent that lE or she is liccnsed pursuanl
to thc provisions ol lhc Contracto.'s l-iccnscd law (Chapler 9, Commencing wilh Scction 7(XX) ol l)ivision J ol thc Business and
ProfcssiolsCode)orrhstheorsheisexempltheretromandllEb4sisti'rtlEalle8edexenrpliql. AnyviolarionofSecttrnT03l.5byany
npplicailrfornpernitsubjectsrhc dpplicantloacivilpcnilllyoInotrnorethufivehundreddollnrs($5(X)).
_1. &\ owner ol lhc pro[r(y, or my cmployccs with wsgcs as lhcir solc compcnsation, will do thc work and lhc struclurc is mt
iileBled orofTeredforule(Se.701-l.Busincsl0ndPmfcssionsCcrlc:TheContrlctor'sLicen*Lowd@snolapplyloanownerof
theprulEny wk)buildsorimprowslheNn.ilndwhod(EssuchsorlihimselforlErsclforlhrou8hhisorherowDempkryecs,
providcdrhalsuch irnprovcrrcntsecnorinrcndcdorolfcrcdlorsale.ll,however,lhchuildingorimprovemntissoldwilhinoneled
ofconplcli(nl the Owilcr Builder will have thc burden ofpnrving tluu lrc or she clid not build or impnrve the propcny for llrc pur1x)rc of
slc).
_1. as owner ofthe propeny, !m exclusively contraclin8 with licensed conlrachrs to conslrucl lhc prcject (Sec. 704,1, Busiless
alxl f\rlissi(trrCode:ThcCoiltrack),'sLicenscLawdoesnotapplyk)anowDeroll)ropenywhohuildsorimprovesthereon.
and who contracls lbr such proicls with a Contoclo(s) licenscd pursuxnt rc lh! Coilraclor's l,icense Law).
-Ian)excmplunderSection-'B.&P,C.ti)Ithisreason,
woRKt:Rs' cot\t PUNsA'iloN
I)I]CI.ARATIoN
I hcr('hy 0llirm undcr pcnalty of pcriury onc r)l lhc lbllowinB (lcclarali('ns:
_I havc anl will nEintain a CcnitLate of Co[sent to SclLlnsure for wrrkers' conrFnsation, as prcvidcd for hySection J700 of thc
htFr Cdle, for lhc lErformmc ol lhe work for which rhL pcrmir ir isrlcd.
_thavcunrlwill nuintainworkeas'compcnsalioninsurance,as requiredbySecliolST00ofthctiborCode,forthef€rfomreeof
the work lbr which this 0crmil i9 issucd. My workers' comfE[sation insurmcc crrid and lnlicy numbcr ile:
Policy Nuntber: lixpires:
_l c('nify that in thc pcrfilrnrancc of lhe work for which this pcrmit is issued. I shall nol cnploy any person in any manner
so as lo hccorrc suhjcct to the workcrs'conlpensAtion laws ol Californir. aDd agrcc lhnt ifl should bccorrc suh.icct 1o thc
workers'conlpensrrionprovi!ionsofSection3?00ofthcLborCode,lshall,fonhwithcomplywiththo$provisions.
WARNING: Failurc rc scurc workcrs'conllEnsation covcrugc ir unlawful. anrl shall subjcct an cmployer ro oiminal lrcmhies and
civil lines up to one hundred thousand dollnrs (SI(X).(XXD. in additiorl lo the cost ofconrpcnsation. daergcs as providcd for lhc
Seclion J076 ofthe LatDr Code. inlcrest and ntk)ruy's fee\.
LI(--ENSED CoNTRACTOR
T)ECLARATION
I hcrcby al lirm undcr F-nalty of pcrjury rhat I am licensd undcr provisir)n olChanrcr 9 (cornmncing with Scclion 70(x)) ol Division 3
of thc [Jusincss and P()fcssioro Codc. frl nrv licensc is in tull lbrcc el clfect.
Licensc Clnss:-l-iccnsc Numkr:
CONSTRIJCTION T,I:NI)ING AGI:NCY
I heRby aflirnl undcr Ftnaltyofperjury thrl there is a con\truction lcndi0g agerrcy litr the perfrtrrurNe ofthe work for which this Fmrit is
issucd (Scc. 1097. Civ. C.).
l-cr(lcr's Nrntc:
hndcr's Atldressr
APPI,ICANT DECI,ARATI()N
I hereby rflimr untlcr pnnlty of perjury one of the followin8 declarntioDs:
Denrelirion Permits-r\sbestos Notification Federal ReSulrtions (Title.l0, Pn(6)
_Reqrired Letter of Notificatiu)
_l ccnity that thc fcdcral aegulatioDs rcgarding astEslos rcnDval arc not applicablc to this pmjcrct.
_l certify thal I lhvc rcad this application and state that lhc dbove infornulion is corcct. I agre lo comply with all Cily and County
ordirances and Starc bws rehtilS lo buitding corlslruction, iual hereby au(horize reprcsentalives of this City and County lo cntcr ulDn tlE
lt(rvc mntiored propc(y for iNpcction puqnss.
Applicxnl or Agcnt
PrnnltE Mmc (prlnl):
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsulation
Roof Sheathinq €ltslu bllwtu-*ry
Shear Wall t,
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
JVlasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
I i
F!NAL D?O
Certificate of Occ
Notes, Remarks, Etc
Ilet.:- Atnliont:l,'^4 z:MWil)