HomeMy WebLinkAbout101102915 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-58Ur'h
' Permit #: 1O1l 02915
Pin #: 44489
Project Address: 4006 W Roberts Dr Unit Bldg: Address Range:Suite Range:
Zoning: RlAssessor's Parcel 108-602-26 Lot:18 Block: NA Tract:4548 Historic: No
Building Use.
Job Type
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
SFD w/att garage
Occupancy:
Constr Type.
Code.
Flood Zone:
# of Stories:
R-3, U
VB
cBc 2019
x-0602320256J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio
T.l.Area:
Yards Req'd
Valuation:$20,000.00
Description of Work: lnstall 24 new roof mounted solar PV system
Planning Conditions:
Owner:
Address
Phone:
Tenant:
Lily Ngo
4006 W ROBERTS DR
Santa Ana, CA 927042131
(714) 496-0685
Contractor: TeslaEnergyOperations
Address: 2102 Alton Parkway
lrvine, CA 92606
Phone: (702) 785-2998
State Lic # 888104
Lic Type: B, A, C-'10, C-20, C-46
Bus. Lic #: 324801
Workers' Compensation lnsurance:
Carrier: American Zurich
Policy #: WC'107458302
Expires: 'l0l31l2020
Engineer:
Address:
Phone:
License #:
Architect /
Desioner:
Address:
Phone:
License #:
Yong Heng Zhu
Yong Zhu
3055 Clearview Way
San Mateo, CA 94402
(650) 638-1028
c81774
Planning Approval By:
Plan Checked By:
Permit lssued By (->
NPDES lnsp. Req'&: ,,2 No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Ahangian, Kathy
Amsden, Julie
Date:
Date. 0212812020
Dale: 0310212020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
$450.00
$50.83
$1.00
$0.00
Account#Total
01116002 51601
0'1116002 5't612
01116002 57770
$450.00
$1.00
$50.83Every 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 ls suspended or abandoned for a period of360 days after
the time the work is commenced.
$501 83
$0.00
$s01.83
lnspector MID#: 2020-157301
Fee Total:
Paid to Date:
Balance Due:
I
BUILDING. INSPECTOR RECORD
Rev.0B-07-2015
SITE.WORK DATE ID/SIG.COMMENTS OWNITR BUILI)llR l)l),CARATION
I herehy affirnr under penalty of perjury that I mr exempt fiom llE Contractos Licensc ljw for the followirg rcaron (Sec.703 1.5
Busincss and Prolession Codc): Any Cily or County which requircs s Frmit to conslrucl. allcr. improve, deholish or rcfair any
structure. prior b ils issuancc. also requires thc applicrnt lbr such pcmril k) lilc a signed slatcmnl that hc or shc is licensed pursuanl
lo thc nrovisions of lhe Contrdctor's l-icenscd liw (Chapter 9. Comrncncin8 wilh Section 7{Xx) ol l)ivision 3 ol lhc Business and
Protes\tnlsCodc)ortharhdorsheisexempttherefronlandtlEbasistbrllEalleSedexenlpti(nr. AnyviolarbnofSectionT03l.5byary
rpplicilnt for a [Emir subjects the npplicrnt to a civil perrrlty of not nmr. thnn llve hundred dollrrs ($5U)).
_1. as owner oI thc profEny, or rny employccs with wagcs as the ir $lc cornpcnsation, will do thc work and the structue is mt
irlcrrlctl or offered for salc (Sc'.7tX4, Business and Prcfessions Code: Thc Conlrnclor's Lioensc Low does not spply lo an owncr of
theprclEfly wlsbuildsorimprovcslheren,sndwl$dessuchwo*himselforlErselforlhloughhisorherownenlployees,
proyidcd that such improvdrots e mt intcrded orollcrcd for slc. ll. krwcvcr. lh. buildin8 or irprovcmnt is old within one yee
of conrpletinr rh€ Owrcr Builder will have the burden of pmvin8 llw lE or shc did mt build or imprcve lhc pmFMy for rtE purpos of
sld).
_1, rs owrcr ofthe prof,crly, am cxclusively contrrctirlg with licenscd conlraclors 10 conslruct the project (Sec. 7044, Business
atrd Pf,)lessiorCodc:Thc(\)nlractor'sLicensel,awdoesmrtapplyt)ail(,wnerofpropef,ywhohuiklsorimprovesthereon.
and who conlracls for \uch proiccls with a Conlrach(s) licenscd pursuant to thc Contraclor's Liccnsc Law).
_l anr exempt undet Scc(ion_, B. & P.C. tbr this reasn.
woRKIIRS' COt\IPUNSA II()N
I)ECI,ARATI0N
I hcrchy allirm undcr pcnrhy ol'pcrjury onc of thc Ibllowin8 dcclarari(,ns:
_l have a8l will mintain a Cenificale of CoNcnt to Self:lNure for workers' conlpc[salion, as pnrvided for hy Saction J700 of thc
ljtnr Codc, tor the [E formrcc of thc work tor which the permil is i\sucd.
5-!.nuve ona witl maintain workers'comp€nsation insurancc, as rcquired hy Scclion 3700 ofthc l-ahor Codc, for the pcrfomBnce of
lhc wnk I(il s4licll lhis lL'rnrl ir issucd. My wrrkcts' ()nrl)cnsrti()n insurnDcc crnicr anl po[cy nunrbcr iu'c:
Pnli"y Nurrrl*r, U.*prr,*,fl ta)no
_l ccf ily lhat in the lrrti).nuncc of the work for which this pcrmil is Nsucd. I shall not cnrpk)y any pcrson in any manncr
s as lo hccorrc subjcct to lhe woakcrs'conlpcnsatiol laws ofcalifornin, a[d xgrcc that iil should bccotrrc subjcct to thc
workcrs'compeDsationprovisionsofSectionl?00oftheLaborCode,lshilll,lb(hwithcof,)plywithtlDsprovision$.
WARNING: Failurc b sccurc workcrs'compcnsilion covcrdgc is unlawtrl. an(l shall suhjcct an cmployer t) triminal Fnahies md
civil lincs up lo one hundrcd thousand doll{rs ($ltx),lxx)), in ddilion lo lhe cosl ol conrpcnsnlion, damages ax provided for lhe
Secli([ ]076 of the htrr Crxlc, intcrest and atk)rcy s fees.
D,r",712/a o fiori^n,
I,ICENSED CoNTRA(]T0R
I)I'CLARATrcN
I hcrc'hy al liiln undcr l--nalty ol pcrjury that I arn liccn$d undcr provision ol Chnptcr 9 (cornrrcncing with Section 7(XX)) ol I)ivision l
of thc Busincs\ and Profcssions Codc- md nrv liccnsc is in tull lbrcc and cllcct.
l,iccnse *",.*., 86i lO 9
,*,' 3lLl7-o
W
I heBhy aflirm under Fnaly of pcrjury rhat ihere is a construction hrilLrg ageNy for rhe lrrfomrre of the work for which rhis pemil is
issucd (Scc. 3097, Civ. C.).
lJndcr's Nnmc:
[:ndcr's Addrcss:
APPLICANTDECI,ARATTON I
I ffiy affmr under pcnahy of pcrjury onc of thc followint delararions:
Dcmlition Pcrmils-Asbestos Notification Fcdcral RcBularions (Ti(lc 40, Pan6)
_RcquLcd trttcr of Notification
,,
-l
certili that thc fcderalr.gulations rcgdding ashcstos rcmvalare nor epplicable to rlris prriar.
)>al caify rhar I havc rcad rhis applicalion aill slatc that lhc abovc infomlion is corar. I agr@ lo rcmply with all City and County
ordirunccs and State ljws rclaling to building coNtrudio[ arxl hercbyauthorize rcprc*ntativcs of this City md County to cnld upon tlr
atxrr'c mntioned propeny lirr hsprction pur;nscs.
Appli(unt or Agcnt
l'rilrikc natrr(
,r,*, ? /L/70
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsu lation
Rool Sheathinq
Shear Wall
Framinq
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
ltrlasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enoineer Final Report
Flood Zone Certif
FINAL W lolLli '/) ,1,.\{l0a*Y
Certificate of Occupancy rl
Notes, Remarks, Etc.
1 ,,./rr I
*-SANTA
NAJ}ffi!
Planning & Building Agency
20 Civic Center Plaza Ross Annex
P.O. Box 1988 (M-19)
Santa Ana, CA92702
(714) 647-5800
w'J,u../. s a nta-a n a. or-q
Smoke & CO
Alarm Affidavit
INSP-02 2013 CRC
This document may be lound at...http ://unw. sa nta-a na.o rqlpbal
(Please use a black or blue ink ball-point pen)
Project Address:
Permit Number
Contractor:License #:
State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential
buildings.
California Residential Code (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.
{rr}Both boxes below must be checked:
S 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
apPnces (i.e. hot water heater, cooktop, furnace) or a fireplace.
$Smofe 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. l, also, hereby certify that I will retest the alarms per the
manufacturer's instructions.
lcheck onel ,ed Contra tor tr Property Owner
1-
NOTE: This self-certificotion is only used for projects that offea the EXTERIOR of the structure. This
process is applicable ONLY to projects where access to the interior of the dwelling by o Sonta Ano
lnspector is not required.
Signoture -:r I
(Date
Have this completed form and the job-card readily available on final inspection!
Property Owner:
tr