HomeMy WebLinkAbout101103619 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: l Ol 103619
Pin #: 10468d
Project Address: 831 S Dennis St
Assessor's Parcel: 108-253-28 Lot:4
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 4258 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 Stories:
R-3
VB
cBc 2019
x-0602320256J
'lst FL Area
2nd FL Area
Other Areas:
Garage Area.
Total
Patio:
T.l.Area:
Yards Req'd
Valuation:$10,188.00
Description of Work: Tear off existing, resheath, and install 36 squares of comp roofing
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Margaret Perez
83'l S. Dennis Street
Santa Ana, CA 92704
(714177s-5667
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
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
Date:
Date:
Date: 05/16/2020
Subject to Field:
Misc. Receipt
Misc. Receipt
lVlisc. Receipt
07776002
07776002
07776002
01775002
07776002
57607
57770
51612
57600
51601
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$333.06
$3.91
$1.00
$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 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.
Fee Totat
Paid to Date:
Balance Due:
$418.12
$418.12
$0.00
lnspector MID#: 2020-158930
N/
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS owNuR Ittilt,l)t'lR t)u,t,cARA'ItoN
I hercby afnrnr under penalty of per1ury that I anr exempt lrom the Cbntractonl License Law for the following ."orJi (S...lElt.-s'
Ilusiness and Prolesri()n Codc): Any City or County which rcquircs a lfnnit lo conslrucl, ahcr, irnprovc. dcmlish or repair any
struchre.priork)its issuancc.alsorequirestheapplicantlbrsucl)pemlitmfileasignedslalemetrl thrtheorsheislicenscd pursuanl
to lh(' pmvisions of llE Contr&clor's Liccnscd lnw (Chaptcr 9. Commcncing with Seclion 7UX) of l)ivision 3 o, the Busincss and
ProtessiotrsCode)orthrtheorsheisexemplthereftonrandthebasisfbrtheallegedexenrptiur. AnyviolatiooofSectionT03l.5byany
npplicanr for a pcrmir subjecrs rhe applicant lo n civil perul(y of nol rrcre thrn five hundred dollars ($5{x)).
_1. as owncr Dl'thc proJrcny. or rny cmployees wilh wages as thcir \olc compcn$tion, will do lhc work ard thc slrcturc i{ mt
iflerxled or ollered for sale (Se.?(N4. BusiDess end Pn)fessions Code: The Conlftclor's Liccnse I"aw docs nol npply to an owner of
thepn)Fny wlx)buildsorinprowslhcHnlntlwhod@ssuchworkhimselforlErselforlhroughhisorherowtremployees,
providcdth{t such impnrverrcntseenotintcndcdoroll'credl'orsalc. ll,howcver,lhebuildingorimprovemntissoldwirhhoncycil
ofconpbli(n\ th. Owrrr Builder will havc thc burtlen ofpmving thu he or she did mt build or impruvc tlE pmp.ny for llE purpos of
sale).
_1. xs owner ofthe p()peny, am exclusivcly conlractirrg wilh liccilsed conlrachr\ lo conslrucl thc preject (Sec. 70114, Businers
and Pn)l;ssinCoderTheContract()r'sLiccnsel-awdoesnotapplytoanowncrofpropcnywhohuildsr)rin)proveslher.oil.
and who conlrilqs for such proiccts wirh a Contrack)r(s) liccnscd pursumt to thc C)ntaaclor's Licensc Law).
_l ilnr exempt under B & P.C li)r lhir rer\on.
W()llKl,lRS'( ()Nll'llNS^ l I()N
I)t.t( l_\R\,ft()N
I hcr(.hy rllirm un(lcr p.nxhy of pcrjury onc of thc ti)ll()wing dcclaralions:
_lhave andwill maintainaCc(itiuateofConsenthSelf-ln$ureforworkers'compensation,as providedforhySecrionST00ofrhe
Latx)r Codc, for rhe pcrformrcc ol thc work for which rle pcrmir i\ irsucd.
_I have and will maintain workers conlpansali()n insurancc, as required by Secliotr 3T0O ot lhc tjbor Codc, f()r thc perfomree of
thc work li)r wlich this pcrmit is issucd. My workcrs' compcnsation insuruncc cafiicr &nd Frlicy numbcr arc:
andi-.
Policy Nunrbefl Expires:
_l ccnity that in the lrcrfornuncc of lhc work for which lhis pcrmil is issucd, I shlll not cnrploy any frcrson in any nlanncr
$ as to bccorrc subjccl to lhc workcrs' coilrpensat ion laws of Calilomia, and agrcc lhnt if I slnuld trcorrc sub.iecl to the
woAers' compensalion provisions of Seclion 1700 of lhc Labor Code, I shall, fonhwilh $mply with thos provisions.
WARNINC: Failure t) scurc workcrs'compcnsation covcrogc Ls unlawful, and shall subjccl an empl()yer rc riminal pmltie md
civil lines up lo one hundred thousund dollnrs (Sl(Xl.(Xm). in addition lo thc cosl ofconrpensalion, damg.s as providcd for thc
Seclion J076 ofthe Lak)r Cbde, irilerest and att)mey's fees.
LICEN)-EDCoNTRAC-T(rR
DECLARATION
I hcrchy allirm undcr p.nally of p€rjury that I arn licensld under provision oI Chiptcr 9 (commncing wirh Sedion 7ffn) oI I)ivision 3
of lhc Busincss and Prufcssions Codc. ml my licensc is in full f(ire atul cffcct.
Liccnsc Class _Liccnic Nurnhcr: _
CONSTR(JCTION I,ENI)ING AGI]NCY
I heruhy xllirm under lEMlty of neriury thut there is a constructiotr lctrdilrB ogency f& the performance of the work firr which this permit is
issucd (Scc. :1(197, Ci\. C.).
l.cnd(r's Nnrne:
I-cn(lcr's A(lLlrcs\:
APPLICANT DECLARATION
I tErcby afiimrundcr penalty of per]rry one ofthe following dcclaratiotrs:
DenDlition Pern)ils-Asbcstos Notification Federal ReSulaliotrs (Title.l0. Pan6)
-Rcquired
lrtter of Notification
I cerrily lhxl tlrc Icderal rcgulations reSiuditrI rsheslos rcnx)\'rl rre n({ ilIpli.rblc k) rhis pi)icct.
_l ccnify thal I hiive rqrd thi\ applicalion Nxl slale thal the above infornulion is corccl. I ngr@ to comply with all City and County
(,rdilunccs and Statc Laws rchtiDg rc buildiilg construdi()r! iuil hcreby autk)rize rcprcseiltatives of this City and County to entcr uF)n lhe
atx)vc nrcnti()ncd p()pcf,y fbr inspecli()n puryDses.
Appli(unt or AScnt Signfllurc:
['rrnril( nanrr
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsulation ;.dl4t)(- C"*ck .zq
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
[Vlasonry
Pool Fence
T-Bar
Handicap Req
Deputv Final Report
Enqineer Final Report
Flood Zone Certif
FINAL k*?/L €t'1 )/q./c= Z z
Certificate of Occupancy
Notes, Remarks, Etc.
Bev.08-07-2015
INSP.O2 2013 CRC
This document moy be lound ot... http://u,r,w.santa-ana.orq/pba/
(Please use a black or blue ink ball-point pen)
Project Address:
Permit Number:0
Property Owner:V
Contractor:!License #
State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential
bu ildings.
California ResidentialCode (CRC)Section R314.1and R315.2 states in part that existing dwellings be
"retrofitted with smoke alarms and carbon monoxide alarms. CRC Section R314.3 and R314.3.3 define
the required locations.
nBoth boxes below must be checked:
E 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 required 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. I ,plso, hereby certify that I will retest the alarms per the
manufacturer's ons.
lcheck onel censed ctor P perty er
NOTE: This self-certificotion is only used for projects thot offect the EXTERIOR of the structure. This
process is applicable ONLY to projects where dccess to the interior ol the dwelling by o Santa Ana
lnspector is not required.
Have this completed form and the job-card readily available on final inspection!
Signoture:(t TM Dote:{t 72
*-SANTA
ANA-'ffi
Planning & Building Agency
20 Civic Center Plaza Ross Annex
P.O. Box 1988 (M-19)
Santa Ana, CA92702
(714) 647-5800
ww'ril.santa-a n a. orq
Smoke & CO
Alarm Affidavit
I