HomeMy WebLinkAbout101103545 - PermitI
t city of Santa Ana 20 civic center Piaza (M-19), santa Ana, cA927o2
Permit Counter: (714)647-5BCO lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Building Permit #: 1O1103545
Pin #: 57927
Proiect Addressi 5402 W Ballast Avea
-
Unit:Bldg: Address Range:Suite Range:
Zoning: RlAssessor's Parcel:1 08-587-06 Lot: 24 Block: NA Tract: 455-q Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Farnily Dwelling
Reroof
Reroof
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
R-3
VB
cBc 2019
.A-0602320252J
1st FL Area
2nd FL Area
Other Areas
Garage Area:
Total
Patio:
T.l.Area:
Yards Req'd
Valuation: $9,905.00
Description of Work: Tear off existing, install 35 squares of comp roofing
Planning Conditions
Owner:
Address:
Phone:
Tenant
Nguyen Vuong
5402 W Ballast Ave
Santa Ana, CA 92704
(714) 647-69s5
Contractor: Sal-NB Roofing
Acldress: 3702E- Chapman Ave #C
Orange, CA 92869
Phone: (714) 345-8745
State Lic #: 1044963
Lic Type: C-39
Bus. Lic #: 371134
Workers' Compensation I nsurance:
Carrier: State Compensation lnsurance Fur
Policy #: 9160583
Expires: 06/09/2020
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:
Date: Misc. Receipt:
Date: Misc. Receipt:
Date. o4t28t2,2l Misc. Receipt:
Subject to Field:
No
No Account#
N/A - No Baiance
N/A - No Balance
07716002
077L6002
07776002
01,7L6002
07776A02
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57507
57770
57672
57600
57607
$333.06
$3.91
$1.00
$22.9s
$57.20
web_user
No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd Total
Flood Zone Cert. Req'd: No N/A _ No Balance
Every permit issued shall become invalid unless the work on the site autinrized by
such permit is commenced within360 days after its issuance,or if the work auth<trized
on the site by such permit ls suspended or abandoned for a period of360 days after
the time the work is commenced.
Fee Total
Paid to Date:
Balance Due
$41 8.1 2
$418.12
$0.00
MID#: 2C2A-158733
:r/
t\-
lnspector
BUILDING- !NSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNIIR BLill,l)l:lt t)llt,CARA'l'lON
I hereby affirm under penalty ofperjury that I m excmpt fronr the Contraclo6' License L1w for the followinS rcasn (S6.70J1.5
llusincss and Profcssion Crldc): Any Cily or Couily which rcquires a fErmit lo conslrucl. nllcr, improve, dermlish or rcpair any
stnrcture. prttr () ils issuance. allo reqnires the applicant tba such pcrmil to filc a signed slatemnt that lE or shc is liccn*d pursuant
lo thc pmvisions o[ the Conlraclor's Liccnsed [,aw (Chapter 9. Cornrrcncing wilh Scction 70(n of l)ivision J ol the Busincss and
PrclessionsCr)detorthutheor\heiserrmptthereliomandtltbasislbrthcallegedexempti(nr. AnyviolatiotrofSectionT03l.5byany
dpplicrDr lbr a pcrmil subjects the npplicanr ro a civil pcoalt), of nor rmre thrtr five hundrcd dollars ($5(x)).
_1. $ owner d,'lhc prortny, or my crnployecs wilh wagcs as thcir solc cornpcnsation, will do lhe work and thc structrtrc is not
iileDded orofferedforsle(Sa.7044,BusinessandP()fessionsCodc:TheCoDltrrclor'sLicensekwdocsnolapplyloanowncrof
the pft)fE(y wlx) tNilds or improws thcr<nl ud wlD d(Es such work himself or lErsell or through his or her own cmployecs.
prolidcd lhal such imprevcrrents de mt intcnded or oll'crcd for slc. ll, howcvcr, thc building or ifprovcrrcnt is sH wilhin one yd
ofconplerior, lhe Owner BuiIJcr will have thc burdcn ofpmving tlul lE or she did not build or inrprove thc pft)peny for lhc purlnse of
sale).
_1. as owner ofthe propeiy. am exclusively contraclinS with liccnsed conlrdck)r\ lo conslruct tlt pmject (Scc. 704,1. Busincss
arxl [\ot*sitrlCode:ThcCortr!c(or'sLicenseLawdoesnotipplytoanowilcr{)fprope(ywhobuildsorimprovcslhercotr.
rnd who contracts for such proiects with n Contraclor(s) liccnsc(! pursuanl lo thc Conlrac(tr'r Licensc Law).
-lrmerem|rtunderseclion-.B,&P,C'lilrthrsreasrrn'
woRKuRs' cot\rPB,NsA't IoN
DT]CLARATt()N
I hcrcby allirm undcr pcnilhy of perjury onc of thc lirllrwing dcclerations:
_l have arul will nraintah a Ccrtiricale of Consent to Self:lnsure tirr workers' comperNillion, as prcviderl trrr bySccti()n 1700 of thc
Lak)r Codc, for thc lrcrformmc of rhe work for which lhc pcrmil is i\sucd.
_l have and will nrrintrin workers conrpeNalion insurance, as rcquired by
(hc w(,rk ti)r which this pcrnlit is issucd. My workcrs' compensation insuruncc
Scal()n 3700 of lhe tibor Codc, for thc pcrfotrurec of
: crnicr and lxrlicy numbcr uc:
Policy Numbcr: lixpires:
_l cralify that in the lErli)rnuocc otlhc work for which this pcrnril is issucd. I shall not cnlpby any pcrson in any manner
s as lo bcconE subject to thc workers' conTensation laws of Califonlia. and aSrcc thnt if I stnuld bccorrc suhjcct to thc
worlcrs'conllEnsationprovisionsofSectiillST00oftheLaborCode,Ishall,lirnhwithcomplywilhtlpsprovision!.
WARNING: Fdilure to sccurc workers'conrpensali()n coveragc is unlawful. and slull suhjccl an enrploycr to qiminul pcnaltiB and
civil fines up to one hundrcd thousand dollars (Sl(X),uXD, in addition to the cost ofconrpcnsdtion. damges &s providcd for thc
Sccli[ ]076 of rhe btx)r C(xle, intere$t and attorcy's fees.
Datc:-
UCI,NSE.CTINIBACIgE
DECLARATION
I hcrcby allirm undcr ttnally of pcrjury that I am licensld undcr provision ofChapts 9 (comrcncing with Sccthn 7ffx)) ofDivision ]
of thc Busincss and Pmfcssions Codc, and my liccnsc is in full fore iuxl etfect.
Liccnsc Numbcr:
ll"'-
CONS'TRT)CTION I,I:NI)INC AGENCY
I hcehy aflirnr under lEnrlty of periury th0t there is s constructiur leudirg agerEy lor the perfomarEe oflhe work fi)r which this p€mil is
issucd (Scc. 3097, Cir. C.).
[.ndcr's Nnn]e:
APPLICAiYT DECLARATI0N
I hentryaffm undcr penalty ofperjury onc ofthe following d*hralions:
Dcmolition Permils-Asbeltos Notification Federal ReSulations (Title 40, Pan6)
-Requfed
lf,tter of Notification
_l ceniti lhar the fadcralrcgulntions rcSarding asbesbs removal are not applicnblc to this projert-
_l ccnify rhal I have read this applicalion and stalc thnl lhe above irfomnlion is corecl. I aSrce to crmply wilh all City and County
ordirrNes and Shtc kws rctrtirrg to buildirrg coNtructi(n\ ilrl hetehy aulhorize reprcseDtalives of this CIy atrd Coutrty to cntcr upon thc
atx,vc mnlioncd pro1r(y for inspcction purF)ses.
Appllcsnl or Agcnl Signutum: Dotc:_
l,cmlte nante (Drint):
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsulation
Roof Sheathinq WnOc wffi
Shear Wall I l-r
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
JVasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
I .l ^ r)-
FINAL 5tu .Z uth^il 6-V ry
Certificate of Occupancy I 'rl'
Notes, Remarks, Etc.
Rev.08-07-2015
[xndcr's AJ(lrcs\:
-
,--SANTA
ANA,'*liilffi
(Planning & Building Agency
20 Civic Center Plaza Ross Annex
P.O. Box 1988 (M-19)
Santa Ana, CA92702
(714) 647-s800
www.santa-ana.orq
Smoke & CO
Alarm Affidavit
Project Address:51 o :- rr) . ''l t\lzik Luo,.
Permit Number:lot r\rlgr{t
Contractor:fnv -
JtJB &o,'c.--.a License #:
This document moy be found at... http://www.santa-ana.orq/pbai
(please use a black or blue ink ball-point pen)
State of California requires that smoke and carbon mono xide (CO) alarms are installed in residential
buildings.
California Residential Code (CRC) Section R314.L and R315.2 states in part that existing dwellings be
"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R3L5.3 define
the required locations.
nBoth boxes betow must be checked:
EI Carbon monoxide alarms: Are installed outside of each sleeping area in the immediate vicinity of
bedrooms and also on each level of the dwelling. Alarms are recommended in bedrooms with gas-fired
appliances (i.e. hot water heater, cooktop, furnace) or a fireplace.
E Smoke alarms: Are installed in each room used for sleeping, in each hallway outside of a sleeping
room, and on each level of the dwelling.
Retrofitted detectors may be battery-operated for buildings where no interior alterations are
performed. Combination Smoke/CO alarms must comply with all applicable standards and be approved
by the State Fire Marshall (SFM). Battery life must be 10 years.
I hereby certify that I am the contractor or the property owner of the above project. I further certify
that smoke alarms and carbon monoxide alarms have been installed in compliance with the governing
Codes and have been tested to be functional.
lcheck onel Licensed Contractor Property Owner
NOTE: This self-certificotion is only used lor projects that offect the EXTERIOR of the structure. This
process is applicoble ONLY to projects where occess to the interior of the dwelling by o Sonta Ana
lnspector is not required.
Have this completed form and the job-card readily available on final inspection!
Signoture:S n\u e,l.,.- **.v; .r 6.r'si: I z'ruo
I erop"rty owner: I * ,\ , i {,ra.. \r,r ),r q
I
io Yi{ 9 r-'( I
I Dote:
I