HomeMy WebLinkAbout10191998 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana;-SA 92702 Building Permit #: 10191998
Permit Counter: (714) 647-5800 Inspection Requests: (714) 667-2738 Inspector Section: (714) 647-5853 Pin#: 65048
Project Address: 1715 W McEvoy Ln
Assessor's Parcel:
Building Use:
Job Type:
101-531-04 Lot: 97
Single Family Dwelling
Supplemental
Nature of Work: Truss drawings
Block : NA
Occupancy:
Constr Type:
Code:
Unit: Bldg: Address Range: Suite Range : ~
Tract: 2887 Historic: No Zoning: R1
R-3, U Patio:
VB T.I.Area:
CBC 2016 Yards Req'd:
Existing Bldg. & Use: SFD w/att garage
Proposed Use:
Flood Zone: X-0602320144J
1st FL Area: O
2nd FL Area: 0
Other Areas: 0
Garage Area: Valuation: $5,000.00
Description of Work: Truss drawings
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
Thanh Vu
1715 McEvoy Ln
Santa Ana, CA 927061332
(714) 425-0852
# of Stories:
Contractor: Owner-Builder
Address:
Phone :
State Lie#:
Lie Type :
Bus. Lie#:
Workers' Compensation Insurance:
Planning Approval By:
Plan Checked By:
Permit Issued By:
NPDES lnsp. Req'd : No
Carrier:
Policy#:
Expires :
Mazarji, Zac ~
Zuniga, Alliss
Date:
Date: 02/07/2017
Date: 02/08/2017
Subject to Field:
1
•
Misc. Receipt:
Misc. Receipt:
Misc. Rece ipt:
PWA lnsp. Req 'd:
Planning lnsp. Req'd :
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd : No Account#
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 180 days after its issuance.or if the work authorized
on the site by such permit is suspended or abandoned for a period of180 days after
the time the work is commenced.
Inspector MID#: 2016-126212
N/A -No Balance
Engineer:
Address:
Phone:
License#:
Architect/
Desiqner:
Address:
Phone :
License#:
69106
Total
Total: o
Donald J Inman & Associates
Donald J Inman
5131 Fox Hills Avenue
Buena Park, CA 90621
(714) 521-0554
11888
01116002 53600 Revisi on
01116002 51612 Bldg. Stds. Revolving
01116002 51600 General Plan Update
Fee Total :
Paid to Date :
Balance Due:
$206.91
$0.00
$0.00
$206 .91
$206.9 1
$0.00
SITE-W ORK DATE ID/SIG.
Set Backs
Form s/Stee l/Ho ldowns
Erection Pads
UFER Grou nd
SLAB Fl oor
Subfl oor/Vent/lnsulati o n
Roof S heathin g
S hear Wall
Framinq
Insu lation/Energy
Drywa ll
Ext.II nt. Lath
B rown Coat
Masonry
Pool Fence
T -B ar
Handicap Req .
Deputy Fin al Report
Engineer Final Report
Fl ood Zone Cert if.
_.,.
FINAL "r'f'] I I 1i ~ I/,/ 2..:1
Ce rtifi cate of Occupancy
Notes, Remarks, Etc.
BUILDING-INSPECTOR RECORD
crnv'IMENTS
•
O WNEI{ IIUILIJl,R IJEI.C'Al{ATION
l hereby amrm und er pcnn lt y or pc1jury thm I run exempt from the Co n1rn c101-s· License Lnw fo r 1hc followi ng rc:iso n lScc. 703 1.5
Busi ness and Pro fession Code}: Any C'ity or C'ou nt)' which requires a perm it 10 co nst ruct. .ihcr. improve. dcmot~h or repair any
s1ructure, prio r t o i ts iss unnce, nl so requires t he npplirant for 5uch pennit to fil e n signed s1n1c111r 111 1hn1 he o r she is l icensed pursiAant
to the provisio ns of the Contrncl or's Licensed Law (Clrn pl er 9. C'om menci11g with Sect ion 7000 (,f Division _l t1 f the Business bnd
Pro fessions Code) or t h.it he or she is exemp t lh crcfrmn and the basis for the alkgeU e:-:cmpt km. /\ny violat ion of SecliC1n 7031.5 by any
a pp licant fo r a permit subjects t he appl ica nt to a civil penalty of not 111orc th.tit five hundred dollars ($500).
_I. ris owner of1h e propert y, or my employees with w ri ges m; their sole compensr11io n. will do 1hc work :md the s1ruct 11re is no t
intended or o ffered for sale (Sec. 7044. Business and Pro fessions Code: The C'o ntrnctor's License L.1w do(.'S no t npply lo 1111 nwner of
t he propc1ty who bu ilds or impro\·es th crron. and who does such wo rk himsel f or herself or 1hmugh his or her own employees.
provided that s uch imp rovements arc not int ended oroff1.,·ed for sale. ir: howc\·er. the buildi ng or impro\'cment ls sold wi1 hin one year
of complc1ion. the Owner Bui lder will hm·e 1hc burden of proving that he or she did not bui ld or impl'O\'C !he propt . .,1)' for the purpose of
sa le ).
_I. as owner o f the propt..'t1y, am exdusi\·ely contract ing wilh licensed co 111 n1c101-s to co11strn c1 1hc project (Sec. 7044. Ot1sincss
and Profession Code: The Contractor's Li cense Ln w docs 1101 apply to an owner fl f propc1iy who builds or impmves thcrenn.
;md who co nlrac ts for such projects with n C'ontraclor(s) licensed purs u;mt to 1he Cn ntrnctor's License Lm..,·).
_I am e:'<e mpt under Sect ion ________ . 13. & P.C. for thi s reason.
Date: __________ Owncr:~==·========~-------
WOllKEllS' CO~l l'ENSATION
IJEC LA llATION
I hereby affirn 1 under pena lty of pc1j uryonc of1l1c fo llowin g dct.·larat io1 1s:
_I hnve and will maln ta i,1 a Ce11 ilic at c of Consent to Self-Insure for workers· co mpensat io n. as provid ed for by Sect inn J700 of1he
La bor Cod e. fo r tl1c pcrfonmmce oft he work for whic h 1he perm it is issued.
_I have and wil l nm intnin workers· compc nsnt ion insurnncc. ns rc(]tti rcd by Sec1 ion J7UU of the Labor Code. for 1hc pcrfonrnlnce of
th e work for wh ich th is pcnn it is issucxl My workt..,·s· compcnsntiu n insurance CtHiicr aml 1xilicy num ber arc:
Ca11"ier: __________________________ _
Policy Numlx:r :. _____________________ E:(pircs: __________ _
_I cert ify th.it in the performance of1l1c work for wh ich this permit is iss1 1ed. I sh.ill nnt employ any person in :111 y 111:-inncr
so :-is to become s ubject to the worker s' compensatio n la ws l,f (';ili fornin. and rig.rec tlrnt if I should bccumc subject 10 the
workers' compensat ion prnvisinns of Sect io n ~700 of the Lnbn r Cod e. I shall. fm1hwi1 h i.:m nply with 1hose µrovisiim s.
WARN IN C : Failu re to secure workers' compensation coverngc is unlaw ful. and sha.11 sub,iect an employer to criminal pcrinlties and
civil fines up to one hundred tho usand dollars ($100.000). in addit ion to the cost of co111pc11~.11ion. damngcs a s proviUcd for the
Section 3076 of the Lalxll' Code. interest and attorney's fees.
Uatc: ___________ A1l plic;1111: _____________________ _
LIC ENSlcll C O NTllACTOll
IJECLAl{ATIO N
I hereby nllirm under pena lty of perjury thi11 I nm licensed under pnwision of Chapter 9 (commenc ing \\'ilh Section 7UUU ) nf Uivision 3
o f th e Business and Pro fessio ns Code. and my lice nse is in full fo rce mid effect.
L icense C tnss: ______________ Liccnsc Nu mber: _______________ _
Dn1c: ___________ Contrac1o r : _________________ _
CO NST l{UC TION LENDI NG AGENCY
I hereby affirm uml ~r pcm1lt yof perjury th at I here is a c-onslruct ion lend ing .igcncy for the pcrfon nancc of t he work fo r which this pennit is
issued (Sec. 3097. ('iv. C.).
Lendcr"s N.ime: _________________________ _
Lender"s Address: _________________________ _
A PPLICANT D ECL ARATIO N
I hereby allinn under penal ty of pe1jury one of th e following. declarations:
De molitio n Permits-Asbestos Not ification Fede ral Reg ulalions (Till e 40. Pm16)
_Rcqui,·cJ Lcttcrof Notificat ion
_I cer1 ify 1hnt the fcdcrn! regulatio ns regnrdin g asbestos remova l nre not npp!icable lo this project.
_I ccii1fy th nt I Im c rend tlus npplu.·.111011 and st nte th nt the nbg~ 1nfmnm t1on 1s con eel I ag1ce 10 comply wi th :ill C ity :iud County
01dmn nces nn d Srnt e L1\\S 1ela1,111g 10 budd111
1
~'~)11c11~11. nnl rebyJ1utl/e 1ep1ese11tnt1\es of1l11s Cit y and Counlytu t.:nler upon the
nbove mentioned p1 opcrty fo1 m ·tton pu1 (.;s/ , tr"" .-:--1 .0 Q.
Ap pli ca11l or Age111Si g1m1t11e -i Dale r-L _o~ I I
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