HomeMy WebLinkAbout101102845 - PermitProiectAddress: 2230W La Verne Ave
Assessor's Parcel:109-122-',t5 Lot: 28
Bldg: Address Rangel Suite Range:
Zoning: RlBlock NA Tract: 1346 Historic: No
City of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, CAg27o2 Building
Permit Counter: (714\ 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1O11o28,45
Pin #: 9337$
Building Use: Single Family Dwelling Occupancy: R-3, U 'lst FL Area
Job Type: Reroof Constr Type: V B 2nd FL Area
Nature of Work: Reroof Code: CBC 20,19 Other Areas
Existing Bldg. & Use: SFD Watt garage Flood Zone: x-o6o232o257 J
Garage Area:
Proposed Use: # of Stories:
Total
Description of Work: Reroof Wt.o.-Remove and apply comp shingles/replace sheathing as req'd/handout givel
r i,in,r , ,:,.i,i7.i
I I ._e: I.l I 11
, -,:c,i,,.
Patio:
T.l.Area:
Yards Req'd
Valuation: $6,226.00
1i 14 i )n2n I0! oiiorolpsl q
1ol'l
lul1r-r?84:jPlanning Conditions:
Owner.
Address:
Maria Elena Flores
2230 W La Verne Ave
Santa Ana, CA 92704
(71418',t8-7722
Engineer:
Address:
Phone:
Lrcense #
Architect /
Desiqner:
Address:
Phone:
License #
, ,Ar
f On:_'{1Ll lOn I O (1i $419.17
Conlractor
Address:
Owner-Builder
Phone:
Tenant
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance
Carrier:
Policy #:
Expires:
- $3?(r,16
_. $2?.91
- $1 ,(r0
_ $3.91
. $418.{ ?
Authi r g76li40
Planning Approval By:
Plan Checked By:
Permil lssued By:
NPDES lnsp. Req'd:
PWA Insp Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Orozco, lvan Dale: O1l14l2O2O
Date:
Dale:0111412020
Subject to Field:
[,4isc. Receipt
Misc. Receipt
Misc. Receipt
0177600 2
0 77760 0 2
o 71760 0 2
0 777600 2
0 711600 2
57607
57770
51672
51600
57607
Permit Fee
lvlicrofilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
\,fi\ t"rn"no"., x"tt y
$333.06
$3.91
$1.00
$22.9s
$57.20No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Flood Zone Cert. Req'd: No
Every peftnit issued shall become invalid unless the work on the site aulhoized by
such permit is commenced within360 days after ils tssuance,or if the wok authorized
on the site by such pemit is suspended ot abandoned for a period of360 days aftet
the time the work iscommencecl
Inspector MID#: 2020-157076
011 16002 51600
0't 1 16002 51601
01 1 16002 51612
01116002 57770
$22.95
$390.26
$1.00
$3.91 Fee Total
Paid to Date:
Balance Due:
$418.12
$0.00
$418.'.tz
Unit:
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BUILDING- INSPECTOR RECORD
COMMENTSID/SIG.DATE
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Sublloor/VenVl nsulation
/ot/-Za'ao
Shear Wall
Framin
lnsulation/Ene
allD
Ext./lnt. Lath
Brown Coat
Mason
Pool Fence
T-Bar
Handica Re
Final RDe ortU
ineer Final Re ortE
IFINAL-2,L-b
Certiticate of Occu anc
Notes Remarks EtC.
OlVNFII BUII-DER DI:I-('At(ATIoN
I hcrchy 6lird utulcr p.nllry or Pcrjrry Ihal I {n cr.m[ ln,m lhc Coma.b6 Ltusc lrw lo! rh' n'lbwin8 rcavr! (Scc ]l 5
Busincs dBl Pnn'csion Co.L): Any Cily or Counry qhih requici , Fm:ii b .nnslruct. altcr. inP!'v' d'molish or 6Fir 3nv '
sro.ror.. ltrir ro ns isruane, .L$ rc,tutcs rhc ,ttll*ad nn such Fmr tu ilc, vrn d natmnr rh'r ht or sh' is li"htd l'unua!'
ro rl* pnrl\ions of rhc cin rrcttr\ LiccnrJ Uw (Ch!flcr o. Connntin8 *irh S..rNn ?U)0 oi Divisntn :l ol rh' Rn(rn's n'l
Prulcsnlns Oxl.) or rhal h. orrhc il crcnpt llsclroi rnJ rh. b!si\ lirr rh. alk[cd crcmprnrn' Anv violnrbn dl Solion ?0'] I 5 hy 'nv
appli.$rtar i lcnnil subjftN rh. nflliulnr k, {c,rnFm[yolnor d rc rl[n tir. hundrcd Jollars (5500)
0(t.n. '"*,"r'r"n-xnr.,nmy.n rycc\srrr'*,3.'r\rncu \rlc, mFnsdrrr {'U'l''rr*'r[{r]rrr{duErn
Frc.r..r u"n.rc1roi *r. rie 7u14. BusN$ r.l Pn,lc$n'n\ CGlc:'Ihc ConrEck,i Lacns La* dNs trot
'Pdv
t' anow'cr oi
rhcplstEny sh) hlrlds or iryE)rcs tt R,n, ani wlY) J,f,s {ll}l u}d( himklf or hcscll or rhoulh his o' hcr owh
'mplovccsp.,viacd rlrar su.l impn,{nEnls dt rn inrcndctl or olLEJ lor salc Il. howcvci rnc tdildiry or ihlbvcmnl s sold within nc ,tr
;l cor{,ler n, rhc o*n;r BniLkr will h!rc rbc buticn.l tfti4 rld h. o, shc Jil n, ${,lI or inlmlc rhc t'n Fnv fitr rlt IntrFos ol
-1,
a\ow cro,lhcF)p.dy,, cxclu\ilcly.onk.Lli,rs wilh li(.\.tl.o r,.loF t, c nnruul rhc nn'J'cr lse..' 7044- Bnsn's
.,nl m,ls,i,n C.4", il'" Cu',r,u"rors Liccnsc Lrv d,x\ noi xpolv ro an oqncr olFrPcnv who builds or inprdvcs llrrc'tr'
rnd who co,n.cls t)r such ttoF...rs wirh a G,.hct)nO lic."rJ pu^uanl l' rhe C'nr'ciitr s Litcn* Law)
I xn,.rnrpr trnlcr Sc(rnl,. l4/./!n.n,
DECLATATION
I hc,cby ,ffirm lndcr ,]cnalry or psjury o* of lh. ti,llowine dal&tionsl
-ltdv.&rlwillminrain,CcdnElr.olCon.cnllosclt.lnslEiotmrkcBconlc.s.rbn,!sIn'lidcdtirrbvScclbnlT00'rrh'Ijlxr Co.r.. for rhc pcrlo,rlrlr! of thc m* ,or whih
'hc P.mir t L*!ctl.
I h.ve and will m,inrrin wo*.^ uomtcnsolioo inrurakc..s rcquicd bvSelion:r7oo tthc tihorG!&t, turlh€ pttlbM' of
rhc *o,k for which rhn pcmir ii i.suol. M, eoikm' omn ns.lion insurM.. .ni( ard Plicv nudbcr dc:
CMi..--
Pol!.yNumb.rr-11Ptr.\
h ccnily lhal i,r rM !.darmrNc oi rhc work rd *hi.h rhn l.nn is issr,i. I shrll nol c,npk'v rnv pcrm in ov m'lnncr
;.s l ' *...-* nrl'l.ci r, rhe wlnl(.r'$miEnslro. hw\ ol C.l,r'omr, rJ +N ll rI' I \buld hc'om hlcd torhc
w.rkcr( conrFnsrtr n toririon\ of Sc.l$n 1700 ol rhc Lfitr (iic, I rhrll. tun hwirI conPly with rlD* ltuvisn'$
WARNINC: i'ailurc b *cuc wortcn comrcnslri.n ovco3c n unhwhl a shrll suhjc'r an c'nPlovcr lo cmnrlrruhic\ MJ
c,v Un.s ut looN l,undrcd th.usanJ Jollds ($lur,llol)),
'n rldirr l,' !h. ..{ oi ctnrpco\rrion Januacs 's Fr'vklcd n)r rh'
S.rrtrnr l016.lrhc I rhtr L:txtc.0rl.m{ rRl IIorn.Y s l.cs
, t/i //9-olo *e'
r ft r,\\rr)r'()\IR\{ ]I)R
DECIARATION
lhcrbylrmundcrpcnalryorpcrjuryrharlamli..n*Jundc,pn,vNnr.lchrprc,9(.onrNnuirawirhSethnTfllo)'lDivnion:l
ot rhc Buiift* atul Pmlcsn,ns co<ic, srl my liccn{ s tr' tull n)rcc a .rlicr.
Dsle
-
Cont
gaNrucrortlEllllc-AcIEN!1
I hcmty allirm trndcr pcn.lly ot FDry lhnl rh;
^
r (,Nlfl.rm lcn,lins deckv Lr rhc I. tumnncc ol rhc work li)r *hih rhn lcmrl i!
r{d (Sc( 1097. C'!. c.).
If,nJ '-. Ninr: --
I" c, \AJJ...,
AIEIIIrINLUECBBAIIO!
I h.tr$y lllim unJcr !.nrlty ol r^_riury.nc ot rhc ti,Uowin8 J(ldauons:
D.mlii(nr Pclnn\ Adrnos Norif'caron Ecdcr{lRcSuhton\ (Tnlc 'l0 Prn6)
Rcqnn.,l l.rrcrdf N rilic{ri,n,
-l
c.nrry lhir rhc lcJcrrlrc*uhlions rcgar't rgrnEsi.sr.n$vrl,rcnorrfl]li.ahlclorhrpojc'r
)!rd,ry,hr I hr\c rcr.r rh,s,gr'(ri.n ril src
onnnrn.c\ rnJ Srrrc Lw\ Nhrim ru hui!.lin! !nndru
rhrllltr r)vc dhln dtr sconc.r I asrc. i)comnlvwilhlllCilva Cduitv
.i()n. l hcrcby rdlvtro. rcFc\cnratrrcs otrhN Cily.nJ Cou.lv lo cnrcr uf.n rlr
rbolc nrnrrnr,l prc|tdy Lr
Applionl or i\g.nl Sit .trr
-)w:^^--d
,'- )
SITE-WORK
Roof Sheathinq
Flood Zone Certif .
v
*,", )/t/2d2.,
Planning & Building Agency
Building Safety Division
20 Civic center Plaza
P.O. Box 1988 (M-19)
Santa Ana, CA 92702
(714) 647-5800
wurw.santa-ana.org
aPP-13 CBC 2016
NOTICE TO PROPERTY OWNER
Dear Property Owner:
An applicati
specifled at
on for a buildinq permit has been submitted in your name2 2^ iO-U /a ,, r, zr fi u( '9an /,.,
tist s yowsett as r9")ytl:rJ tn" property improvements
We are providing you with an Owner-Builder Acknowledoment and lnformation Verification Form to make you aware of your
responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder
We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this
form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner,
obtain the prior approval of the permitting authority.
OWNER'S ACKNOWLEGMENT AN VERIFICATION OF INFORMATON
D/RECIIOAIS: Read and initial each statement below to signify you understand or verify this information.
]-l I I t understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" build-
ing i:ermit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an
Owner-Builder, may be held liable and sub.lect to serious flnancial risk for any injuries sustained by an unlicensed person and
his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I
am willfully acting as an owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my prop-
erty.
lilL, ,understand building permits are not required to be signed by property owners unless they are responsible for the
codstruction and are not hiring a licensed Contractor to assume this responsibility.
yl.{ S. I understand as an "Owner-Builde/ I am the responsible party of record on the permit. I understand that I may protect
mybelf from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
own.
#,4+. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers
on permits and contracts.
l|-t s. t understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total
value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an
"employel' under state and federal law.
-fl1_A t understand if I am considered an "employer" under state and Federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment com-
pensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk.
Ht{-l. I understand under California Contractors' State License Law, an Owner-Builder who builds singleJamily residential
structures cannot legally build them with the intent to offer them for sale, unless a/l work is performed by licensed subcontrac-
tors and the number of structures does not exceed four within any calendar years, or all of the work is performed under contract
with a licensed general building Contractor.
A { A I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any finan-
cial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workman-
ship or materials.
l\ L S. t understand I may obtain more information regarding my obligations as an "employed'from the lnternal Revenue Ser-
vlcd, the United States Small Business Administration, the California Department of Beneflt Payments, and the California Divi-
sion of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1 -800-
321-CSLB (2752) or www.cslb.ca.oov for more information about Iicensed contractors.
S( ',0 I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the
party leg ally and flnancially reqponsible for proposed co) ) z,t i, t / a t./t ,,c,' \a nstruction activity at the followino ad-(ct 9) lo *dress a dn6
H I 11 I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern Owner-Builders as well as employers.
-[ef Z. f agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I
have provided on this form.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned
to the agency responsible for issuing the permit. /Vote : A coDv of the DroDertv owner's driver's license, form notariza-
verification acc table to the when the ermif ,s iss d
property owner's siqn atu re.
Sig nature of Property Owner
Print name of Owner v
,
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder
Permit for my project.
Project Location or Address
Name of Authorized Agent
Address of Authorized Agent:
Phone Number of Authorized Agent:
I declare under penalty of per.1ury that I am the property owner for the address listed above and I personally fllled out the above
information and certify its accuracy.
Property Owner's Signature Date o / // 1/,uO2
t/ a,l. f./", . FZxs AtuoT
Note: A copy of the owner's driver's license, form notarization, or other veification acceptable to the agency is re-
quired to be prcsented when the permit is issued to verry the propetv owner's signature.
()
Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not have a
license, the Contractors' State License Board may be unable to assist you with any flnancial loss you may sustain as a result of
a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important for you to understand
that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held
liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying
whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage.
/L/,r,-ur- - ,Z*]z-_6 Date: o/ / q, 'r02 g,
ScopeofConstructionProject(orDeScriptionofWork):
Print Name of Owner:
Planning & Building Agency
20 Civic Center Plaza Ross Annex
P.O. Box '1988 (M.'19)
Santa Ana, CA 92702
(714) 647-s800
www.santa-ana.orq
tNSP-02 2013 CRC
This document moy be lound ot...http://wvwv. santa-ana.orq/pba/
(Please use a black or blue ink ball-point pen)
Project Address:?L1o lr., tlc,nr V/Avt \an{q onq ru2L
/o /l 02 E /5
Property Owner:4", ,! o f /-o Fl,"t s
Contractor:License #:
o I
State of California requires that smoke and carbon monoxide (CO) alarms are installed in residential
bu ildings.
California Residential Code (CRC) Section R3L4.1and 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.
f,lso,tr 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. l, also, hereby certify that I will retest the alarms per the
ma n ufactu rer's instructions.
tr Licensed Contractor Property Owner
NOTE: Ihis sef-certification is only used for projects thdt afled the ExTERIOR ol the strudure. This
process is opplicable ONLY to projects where occess to the interior oI the dwelling by a Sonta And
lnspector is not rcquired.
Signdture:/4"^^-,-tL" ,7,<*C1
Have this completed form and the job-card readily available on final inspection!
*,SANTA
NA*"ffi'
Smoke & CO
Alarm Affidavit
Permit Number:
(check onel