HomeMy WebLinkAbout10189247 - Permit.. City of Santa Ana 20 Civic Ce nter Pl a za (M-1 9), Santa A na, CA 92702 Bu ilding Permit#: 10189247
Permit Co unter: (7 14) 647-5 8 00 Inspection Requests: (714) 667-2738 I ns p e ct o r Section: (7 14) 64 7-5853 Pin#: 78281
Project Address: 4010 W Mcfadden Ave Unit: Bldg: Address Range: 4010-4026
Hist ori c: No
Suite Ran ge: Bf
Ass essor's Pa rce l: 108-601-25 Lot: 25
Building U se:
Job Type:
Single Family Dwelling
New
N ature of Work : New SFD
Ex isting Bldg. & Use: Vacant Lot
Proposed Use:
Block: NA
O ccupa ncy:
Constr T yp e:
C o d e:
Flood Z o ne:
# o f Stories:
Tract: NA
R-3 , U
VB , SPK
CBC 2013
X-0602320256J
Zonin g: A1
1st FL Area: 682 P a tio: 181
2 nd FL A rea: 795 T.I.Area:
Other A r eas: Y ard s Req'd:
G a rag e A rea: 483 Valuation : $198,496 .00
Tota l: 1477
Description of Work: See "Harmless letter on. file" New 1499 sq ft 2-story SFD with 3 bedrooms, 2 1/2 baths , laundry, 181 sq ft front porch and 483 sq ft
attached garage. GGUSD paid on #4578./Fees due paid on M-68892
Plan ning Conditions:
Ow ner:
Address:
Phone:
Tenant:
Habitat for Humanity of OC, Inc
2200 S. Ritchey
Santa Ana , CA 92705
(714) 434-6200
Planning App;oval By: Pezeshkpour, Ali
Contractor:
Address:
Phone:
State Li e #:
Li e Type:
Bus. Lie #:
Habitat for Humanity of Ora1
2200 S Ritchey Street
Santa Ana , CA 92705
(71 4 ) 4 34-6200
843208
B
186231
Work ers' Co mpensa tion In sura nce :
Ca rrier: Dept of Industrial Relations
Poli cy#: NPUWCG001
Expires: 01/01/2017
Date: 11/14/2016 Misc. Rece ipt:
Plan Checke d By : Maza rji, Zac ~ / Date: 11/22/2016
Permit Issued By: .-Zunig a, Alli ss ~ 1 Date: 11/23/2016
Misc. Receipt:
Misc. Rece ipt:
Eng in eer:
Address:
Phone:
Li cense#:
Arc hitect I
Des iqn er :
Add ress :
Phone:
Li ce nse #:
6 7 994
68892
NPDES lnsp. Re q'd : / --~ Su bj ect to Fi eld:
f .WA ln sp. Re q'd : Yo . e lnsp. Req'd: @, Tota l
Pianning lnsp. Req'd : No Poli ce lnsp . Re q'd: es _A_c_c_o_u_n_t# _______ _
LE!ndscaping l nsp. Req'd: No Flood Zone Ce rt . Re q'd: N/A _ No Ba lance
Every permit issued shall become invalid unless the work on the si te authorized by
such permit is commenced within 180 d ays after its issuance,or if the work authorized
on the site by such permit is suspended or abandoned for a peri od of180 days after
the time the work is commenced.
NIA -No Ba lance
NIA -No Bala nce
N/A -No Bala nce
Structural Design Group Inc.
Philip Som a Jr.
17780 Fitch , Suite 185
Irvine, CA 92614
(949) 252-7660
C46231
KTGY Group Inc.
Jill Diane Williams
17922 Fitch
Irvin e, CA 92614
(949) 851-2133
C22315
01116002 5 1 601
01116002 5 3 600
01116002 57770
08901001 24000
01116002 5 1 612
01116002 5 1 600
01116002 5 1 601
Permit Fee
Plan Chec k Fee
Microfi lm Reco rds
SM IP -Category 1
Bld g. Stds. Revo lving
Ge neral Plan Update
Issuan ce/New Structu
Fee Total:
Paid t o Date:
Balance Due:
$1 ,102.34
$3,50 3.2 1
$199.50
$2 5.80
$8.00
$20.56
$136.72
$4 ,996 .13
$4 ,996 .13
$0.00
'---...
,.._______
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MID#: 2014-112538
BUILDING-INSPECTOR RECORD
SITE-WORK ID/SI~ COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/Vent/lnsulation
Roof Sheathing 6 t1,../ /1"
I
/0 I ll Ir~ 5 . 7r..v I r-::11.i ~
Insulation/Energy f I~ I /t i 5 -~ l0f1.I ~
Ext.lint. Lath l
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif.
FINAL
Certificate of Occupancy I I vv 'I-"'
Notes , Remarks, Etc.
OWNER BUI LDER OELCARATION
1 hereby affirm under penalty of pc1jury that I run exempt from the Con1rac1ors· License L1w for the following re!~•mn (Sec.7031.5
Business and Profession Code): Any City or Comuy wh ic h requires a pennit to construct. alter. improve. dem olish or rej>air any
structure. prtOr to i1s issuance. also requires the applicant for such pennit to file a signed statemen t that he or she 'is lic'ensed pttcs~an t
to the provisions of the Contractor·s Licensed Law (Chapter 9. Commencing with Section 7000 of Division 3 of the Business and
Professions Code) or that he or she is exempt 1hcrcfrom and the basis for the alleged exemption. An y violation or Section 703 1.5 by any
applica nt for a pennil subjects the applicant to a civi l penally of not more than five hundred dollars {$500).
_I. as owner of the prope11y. or my employees with wages as their sole compensation . will do the work and the structure is not
intended or offered for sale (Sec. 7044. Business and Prorcssio ns Code: The Contractor·s License Law does not apply to an owner or
the prope11y who builds or improves thereon. and who does such work himse lr or hers elr or through his or her own employees.
prov ided that such improvements are 1101 intended or offered for sale. If. however. the building or im provement is sold within one year
or completion. !he Owner Builder will have the burden of pro\~ng th at he or she did not build or improve the propaty for 1he purpose of
sale).
_I. as owner of the property. am exclusively contracting wilh licensed co ntractors to co ns1111ct the project (Sec . 7044. Bus iness
and Pmfcssion Code: The Conlrn ctor·s License Law does not apply 10 an owner o f proper1y who bu ilds or irnpro\·es 1hcreon.
and who contracts for such projccls wit h a Contrnctor(s} lic ensed purstrant lo the Contractor·s License Law).
_I am exempt under Sec tion, ________ . 8. & P.C. for this reason
Dnte: __________ Ow ner:_~--~~--~~~~------------
WORKERS' COMPENSATION
DECLAllATI ON
I hereby affirm under penalty o f perjury one of the following declarations:
_1 have and wi ll maintain a Cert ifi cate of Consent to Self-Insure for workers· compensation. as pro vided for by Section 3700 of the
Labor Code. for the pcrfom1ance o f the work for which the pen11it is issued.
..,
_I ce11ify tha1 in the performance of the work for which this permit is issued. I shall no I employ any person in any manner 4
so as to become subject to the workers' co111penso.1ion laws of Cali fornia. and ag ree that if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor Code. I shall. fo11hwit h comply with those provisions.
WARN I NG: Failure to secure workers' compensation coverage is unl awful. and shall subject an emp loyer to ffiminal penalties andJ
civil fines up to one hundred thousand dollars lli l 00.000), in addit ion to the cost of compensation, dmnages as provided for the
Section 3076 of th e Labor C~e. interest and att~mcy· ~v} jJ fX /L
Ontc:--A \ -!22-lb A pplic t: JI ( A / l~ { I
\IJE, LAl!A T ION
'
4 ~ . u ,,Ns1 D l"'olhT!AY'T( R V \.I\) \,i,
I hereby affirm under penalty of perjury thnt I am liccn St."CI l~cr provision ofClw1ptcr 9 (commencing w11I cction 7000) of Division 3
of th e Business and Pro fessions Code. and my license is in full force and effect. '"
License((llms: ~ • <icenscNumbcr: B 4-3'1--0'fl;.J
On te t , -:· '2.---5 ~ i ~ Co nt m tXf ):} /1 /1 -,,., /V' a '\ '
, r·nNsTnu~1L ~~,: • :Jr-cvV \A) \ /
I hereby affirm under pcr1 alt yof pc1j ury 1lia1 there is a constnictN lending agency for the perfom1ance of th~o1\.; for whi ch this permit is
issued (Sec. 3097, Civ. C.).
Lender"s Name: _________________________ _
Lendcr·s Address: _________________________ _
A PPLICANT DEC LARATION
I hereby affi rm under penalt y o f pe1jury one of th e follow ing declarations:
Demol ition Penn its-Asbestos No1 ilica1ion Federal Regulations (Title 40. Pa116)
_Requi red Letter of Not ification
_I cenify that th e rederal regulations reganling asbestos removal are not applicable to this project.
J
'
_1 cC111fy thilt I have read th1s appl1cat1o n and state that th e above 1nfo1 111at1011 1s concct I ag1ee 10 com ply \\ 1th a ll Cny amt County
ordmances nnd State Laws relating to buildin g constnact10n. and hcr(\1o/1'?r:e rep1esentat1ves oftlus C it y and C'ount y to e nler upo n the
above mcn11oncd property for mspecho~n· A 11 I\ I J ,
Appli cant or Agen t Signntnr.J / LI //'vV V ) / 1) l Onie 1 l .-1,_,' ' l (,c;
Pcrmitcc name (p rint): ~· /i') \f"Y? P I <'J .--, ,), I A1/'I /} J -I .. ·-1 -