HomeMy WebLinkAbout101103640 - Permitcity of Santa Ana 20 civic center Plaza (M-19), Santa Ana, c492702
Permit Counter: (714)647-5800 lnspection Requests (714)667-2738 lnspector Section: (714)647-5853
Building
b/
Permit #: 1O1103640
Pin #: 69289
Project Address: 1229 S Arapaho Dr Unit:Bldg: Address Range:Suite Range:
Zoning: RlAssessor's Parcel: 109-674-21 Lot:121 Block: NA Tract 3855 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
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
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
Ana ohe
1229 S Arapaho Dr
Santa Ana, CA 92704
(7141472-3816
Contractor: Premier Roofing Pro lnc dbi
Address: 20614 Saticoy St
Winnetka, CA 91306
Phone: (818) 571-0991
State Lic #: 1055453
Lic Type: C-39
Bus. Lic #: 375545
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9256808
Expires: OllO3l202O
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
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
Date:
Date:
Date: 0512012020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
0L776002
07776002
07776002
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57601"
57770
51672
57500
57607
$333.06
$3.91
$1.00
$22.95
$57.20
web_user
No
No
No
No
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 Total
Paid to Date:
Balance Due:
$41 8.1 2
$418.12
$0.00
lnspector MID#: 2020-158995
t-
BUILDING. INSPECTOR RECORD
Rev,0B-07-2015
SITE-WORK DATE ID/SIG.COMMENTS OWNI]R BT'II,D1:R I)1:I,CARA'TION
IherebyrffirnrunderpetraltyofpcriurythalImrexcmptf@mtheContractoN LicenseLawforth.followinSreason(Sec.7031.5
llusinc\s rnd Prolcssion Codc): Any Cily or Counlv which requircs a fErmil to conslrucl, altcr. improve. dcmolish or rcpair any
structure.priort)its issuance.lLsorcquirestheapplicanllorsuchlEmitbfilcasiSnedslalcnEnl lluthcorsheisliccnsd pursuant
h lhc pmvisions of Ihc Contraclor's l-iccnsed [,aw (Chaptcr 9. Cornrncncing with Scction 7fi)0 o[ Division 3 of thc Business and
Piotls$i('nsCodc)orrharheorshciscxenrpllherefronrandllEbasistorthcallegedexenrprion. AnyviolalionofSectionT03l.5byany
npplicnnl for a pcrmit suh.iecrs the xpplicint ro a civil pemlry of not more thn[ five hundred dollilrs ($-5{)0).
_1. as owncr ol lhc pro[r(y. or rny employccs with waScs as lheir s)lc comFrcnsalion. will do lhc work and tha stMlurc i$ mt
intcnded oroffercdforsalc(Se.T044,Busin.ssandPmfessionsCoderThcConlraclor'sLicenscLawdocsnolapplytoanownerof
the prcpcf,y wlb huilds or improves lhdrcn. ud wlx) does such work himself or lrcrself or lhrough his or hcr own cmployees.
proridcd rhar such impmvcrrnts ee mt iNcrded orollcrcd for Mle. ll. howcvc{, rtE tililding or improvemnt is $H within one }cr
ofcompleli(nl lhe Owrrcr Builder will luvc the burden ofprovinS llut hc or shc did mn build or improvc thc pmpeny for lhe purposof
sale).
_1, as owner oflhe propeily, am cxclusively con(racting wilh licensed conlrack)rs lo coilslruct the pmject (Sec. 7044. Business
ard Pnrllssbn Corle: Thc Contracl()r's License Law d(Es trot rpply lo an owiler oI propeny who builds or improvcs thercon.
and who contracts for such proiccts with a Contrack)(s) liccn$d pursumt lo rhc Coilracktr's Licensc llw).
-IanreIemplundcrsection-.B,&P'c,lbrlhisrcsson,A.----.
WORKI:lLS' COMPI.INSATION
DECLARATION
I hcrcby allirm undcr penalty ofperjuryonc ofthc lbllowing declaralions:
_lhavcardwillnEintainaCcnificatcofCorenttoSelf-lnsurcforworkers'comFnsation,as prcvidcdforbySectionJT00ofth.
Lahor Code, for thc perforronce ofthe work lbr which thc pcrmit is issued.
_l havc and will maintain workcr' conrpcnsalion insurance, as rcquircd by Scction 3700 of the [:bor Codc, for lhc lErfotlrwc of
thc work for which this pcrmil is issucd- My workers' compeosation insurmcc cariff ud plicy numbcr ue:
Policy Numb€r: Erpircs:
_l cenify thal in thc pcrlormancc of tlre work for which this pcrmil is issucd. I shall not employ uny pcrson in uny manner
$ as lo bclsm suh.jcct lo thc workcrs' compcnstion laws of Califomia. and agrce that if I stnuld becom subjecl to thc
workcrs'compcnsationprovisionsofSection3T00of(heLaborCode,Ishall,fonhwith$mplywiththosprcvisions.
WARNING: Failurc tr sccure worken'compensation covcngc is unlawfill. and shall subject an cmployer to oiminal penaltis and
civil fincs up toone hundrcd thousand dollars ($l00,UX)). in addition lo lhc cost ofconrpcn$tion. dam8cs as providcd for lhc
Scction 1076 of the Lltbr Cele, intcrest and sllorcy s fees.
Ilclc:_ ApDli@nl,
I,ICENSED CoT{TRACTOR
DT]CLARATION
I hcrcby allirm undcr pcnally of perjury tha( I am liccn*d undcr provision ol Chaplcr 9 (comrcncing with Secthn 7ff)0) ol Division l
of the Business and Profcssions Codc, affl my liccnsc is in full tbrcc ind eutct.
l,iccnsc Class:-l,iccnsc Numhcr:
CONSTRUCTION I,I:NDING AGI]NCY
I herehy aftirm under lEnulty of perjury that there is a constnrctkxr lenrling agerrey for the Jxrforurce of lhe work for which this lEmil is
issued (scc. 3097, Civ. C.).
[4nd('r's Nrmc'
a
APPLICANT DE(:LARATION
I her€by affm under p€nally of perjury one of the followinB d{ldationsl
Dcnblirion Pernrits-Albestos Notification Federal Regulations (Title.l0, Pan6)
-Rcquired
ktt.r of Notifi.ation
_l ccrtify lhal the federal rcgulatiotrs reg[ding ilsheslos renroval ure not alplicable t) this p()icct.
_l cenify thnt I havc rcad this application iud statc thal the above infornralkrn is corect. I agre lo comply with all Cily and County
ordinances aild State Laws relating r) buildiuS construction, drl h€reby suthorize reprcscnlalives of this City and County to enler ulrn the
atxrve mntioncd propeny li)r inspeclt)n purF)ss.
Applicunl or Ag(nt Dater-
Prmlle. mme (Drlnt):
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsu lation
Roof Sheathing 5 zdzo Dffi)A1 #*
Shear Wall
Framinq
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
lvlasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
I
FINAL (t 7,lu Wo A,J 4n
Certificate of Occupancy -l \r
Note.s, Remarks, Etc.
I PW
I
tn//rn -
Carier:
l)ete:- Conlrrclor:
knder's Addrcss: