HomeMy WebLinkAbout101103378 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 101103378
Pin #:23937
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Proiect Addressi 218 N Susan St
Assessor's Parcel:198-251-16 Lot: 26
Unit Bldg: Address Range:Suite Range:
Zoning: R2Block: NA Tract: 540 Historic: No
Building Use: Singl. Family Owolling Occupancy: R-3, U 'lst FL Area: Patio:
Job Typer Reroof Constr Type: V B 2nd FL Area: T.l.Area:
Nature ofwork: Roroof code: cBc 2019 other Areas: yards Req,d:
Existing Bldg. & use Sfd ryrno garage Flood Zone: X-0602320256J
proposed us". # of stories: Garaoe Area valuationi $3'600 00
Totali
Deacdptlon ofWork: Raroof houge - rsmove comp shinglea, replaco any damaged sheathing, install class A comp shlnglga,light gray color& bur.
Handouts given.
Plannlng Condltions: Rqpalr anal rcpalnt any damaged oave6, fascla, ratte6, etc as needed.
Owner:
Address:
Phone:
Tenant:
Raul Duron Garza
218 N Susan St
Santa Ana, CA 92703
(818) 254-67s0
Contractor: RDG Roofing
Address: '14202 Hamlin Stret
Van Nuys, CA 91401
Phone: (818) 254-6750
State Lic #: 925352
Lic Type: C-39
Bus. Lic #: 352683
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 1957339
Expires: 0610112020
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
r_r.t f .t oLrL
P'rtiirlin
Lr1 1 1 ,5tr[
Blris SL
ti1116Ut
ll i ,:t'st r
Llill6i-il-
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning.lnsp. Req'd:
Pezeshkpour, Ali
Amsden, Julie
Landscaping lnsp. Req'd
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.
Date: 03/04/2020
Date:
Date: 03/04/2020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
07776002
07776002
57607
57770
57572
57500
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Total:
Paid to Date:
Balance Due:
$333.06
$3.91
$1.00
$22.95
$57.20
$41 8.1 2
$0 00
$418.12
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
01 1 16002 51600
0'1116002 5'1601
01116002 51612
01116002 57770
$22.95
$390.26
$1.00
$3.91
lnspector MID#: 2020-158253
BUILD!NG- !NSPECTOR RECORD
Bev. 0B-07-201 5
SITE.WORK DATE ID/SIG.COMMENTS oWNllR Iltlll,l)llR l)lll,CARA'IIoN
I hereby affirnr under penahy of perjury rhal I anr exempl fronr rhe Conlncloc l.iceose Lrw for thc followirg rcason (Scc.703 1 .5
llusincss nrd Prol'cssion Code): Any City or Counlv which rcquircs a l^-rrnil h constnlcl, allcr. irnprovc. dermlish or rcpair any
stilc[rre. prior rr) its issuance. also requires the applicant 1()r such p€rnri( rr file a siSned statemetrt that lE or she is licensed pursuant
to th(' prevision\ of lhc Contraclor's l-icenscd liw (Chaptcr 9, ComrncncinS with Scclion ?UX) of l)ivirion 3 o[ lhc Business and
ProftssionsCodc)orthathcorshciscxemplthercfion)oDdlhcbasistirrtlrcallegedexenrpti(nr. Anyviohti6ofSectionT03l.5hyany
rpplicailt for r pcnnir \ubjects lhe npplicanl to n civil pdnilty of nol more thatr fivc hundred dollnrs ($5(x)).
_I. as owner ol tlE prolrny. or rny cmployces with wages as thci solc cornpensation, will do thc wtrk and thc stMturc is mt
irleulerl or offercrl for sle (54.7044. Busirtcss and Prrfesskrns C(xle: The Cunnclor's Licensc Inw d@s nol apply to an owncr of
lhe popeny who build$ or inrprovcs therc[ a[d who d(Es such work himsell or hcrself o( through his or her owu enrployees,
providcd rhal such improvcrEnls arc mr inlcnded or ollcred for salc. Il. howcvcr, rhc building r)r improvcmnl is sH wirhin one )rff
ofconrlrleri(xr, rlrc Owner Builder will have thc burden of prcvirg thdt lt or she did not build or impmve the pnpcny for the purlFse of
sb).
_1. as owner ofthe prop€fly, am exclusively contracting with lic.n*d conlroctoft to conrlrucl the pNject (Scc. ?04.{. Business
and ftotlssknCode:'lheCoiltrrctor'cI-icetrseLawdoesnotapplytoanowneroIpropertywhobuildsoriDprovesthcreon.
nnd who conlracts lor such pr(ticcts with a Conlracto(s) licen$d plr\uail (r lhc Contracloas Liccnse [iw).
-IanlexemItundcrsection-.B,&P-C,lbrlhisreasoil.
W0RKI]RS' C()MPI:NSATION
DT]CLAR{TION
I hcrchy atlirm undcr pcnnlty ofpcrjury onc ofthc tbllowing dcclararions:
)y'llfirtsuemlwlllnuinlairaCenili(atcofConsenttosel[hrsurcforworkers'compemation,as pruvirlerlforbyScuion]700ofthc's(utf,r Coac. tor rhc l^-rformncc ol lhc work lbr which thc pcrmit is i{surd.
_[haveandwillnraintsinworkcrs'compensationinsurancc,as rcquiredbySeclfun3T0OofthebborCode,forthepcrfomrceof
thc work li,r whrch this FErmil is issuql. My workers'cunicr ml nunrhcr iue:
Policy 5 o I -o( -7910
_l ccnity rhrt in thc lNrlormrnce of lhc work ,r,r which this pcrmil is issuc(!, I shilll not cnrpby rny pcrson in any nranncr
so as lo bccorrc suhjccl to thc workcrs'compcnsation laws ofCilil-ornia. aDd agrcc thdt il l slnuld bccoila suhjcct lo lhc
workers' conlpen\atioD provi\ions ofSection 1700 ofthe Latbr Coile, I shall, fof,hwith con)ply with tlDs provisions.
WARNING: Failurc k, scurc sorkcrs'compcnsation covcrage is unlawful. and shall subjcct an cnrploycr h ainrinul Jtftthies and
civil llnes up rc one hundred thousilnd dollnrs (Sl(X),(XX)), in rdditior to lhe cosr ol'coilrpensalion, damrgcs ts trovided for the
Section 1076 ofthe trlnr Codc, inerest and allorrcy s fees.Y)o
LICENSED CONTRACT0R
DECI-ARATION
liccnscd undcr prcvision ol Chaptcr 9 (commcncing with Section 70tn) ol Division 3
liccnsc is in full li)rcc ud ellcct.
I hcrcby al'lirm undcr pcnalty ofpcrjury lhat I arn
of thc Business and Prcfcssions Crxlc, and my I
l-iccnsc L Numltr:55L
CONSTRT'CTION I,I.]NI)TNG AGI]NCY
I herhy aflirm under Jrnallyof periury that there is a con{tilcrioil bndiug agemy lirr the prfr)rmrce of the work fbr which ihis Fmrir is
issucd (Sec. 1097, Civ. C.).
l-cndcr'\ Nnnrc:
hndcr's A(l(lressi
APPI,ICANT DECLARATI0N
I heEbv affmr under penalty of pcr.iury one of the following dcclilrtions:
Denrolition Permils-Arbeslos Ndification Federal Re8ulations (Title.l0, Pan6)
_Required Lctter of Notificalion
@
r"tifV Wt the fedcral regulations regarding asbcstos rcnroval arc not applicahl. rc this Frojeu.
I f,ffcenrfy rhat I hxve rcild rhi\ applicnt
{irJirnrrces and Starc Laws rehtrrg tr hur
ion iuxl stnte thal the ahove infornution i\ core.l. I aSre to comply wilh all City and County
,reprcsenlrlives oflhis Ciry and Couilly lo cnter ulDn tlEaulhorize
atx^'c nrnli(,ncd prolEny lbr
Applicant or AEcnl
l'(nliler nanre G,
o94L(Zo
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsu lation
Roof Sheathinq
Shear Wall 7,4 /zd kul
Framinq t/
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
lMasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
FINAL Vrr/zaeo ZcrE lv e ,Z-o9 2rl
Certificate of Occupancy /
Notes, Remarks, Etc.
,^", 03 '0140