HomeMy WebLinkAbout10190953 - PermitCity of Santa A n a 20 C iv ic Center Plaz a (M-1 9), S anta Ana, CA 92702· Building Permit #: 10190953
Pe rmit Counte r: (7 14) 647-580 0 Inspection Re quests: (714) 6 67-2 738 Ins p ect o r Sectio n: (7 14) 6 4 7-5853 Pin#: 13472
Project Address: 619 E Virginia Ave Unit: Bldg: Add ress Ra nge: Suite Ra nge :
Assessor's Parcel: 003-032-14 Lot: 18, PORS 19, 20, Block: NA
Building Use:
Job T ype:
Single Family Dwelling
Alteration
Nature of W o rk: Interior remodel
E xisting Bldg. & U se: SFD
Pro p osed U se:
Occupa nc y :
Co nstr T ype:
C o de:
F lood Zo ne:
# o f St o ri e s:
Tract: 705
R-3, U
VB
CBC 2013
X-0602320163J
Histo ric: No Zoning: 1
1st FL A rea: P atio:
2nd FL A rea: Tl.A r ea:
O the r A r eas: Yard s Req'd:
G ara g e A re a : Valuation: $4,500.00
To t a l: 0
Description of Work: Interior kitchen remodel , new 4 x 12 beam between dining room and kitchen, new partition lll(ijll~,.new 24" x as:· _opening. Batcn;:jolU8 -11/2/1Ul~ Iu: NCARCIA
Officei CTYH Trans~: 43 3
Planning Conditions:
vwner: Mauricio A & Gladys M a rt inez Contractor: Owner-Builde r
Address: 619 E VIRGINIA AVE
Ph one:
Tenant:
Santa Ana, CA 927061741
(714) 702-9529 ,,;.'-qrt c.~,
A ddress:
Ph one:
St ate Li e #:
Li e Type:
Bus. Lie #:
Work er s' Compensation Insura nce:
Ca rrier:
Po li cy #:
Ex pi res:
Plannin g App rova l By: Mar, Escarlet
Plan Checked Brcr· A hangian , Kath y
Pe rmit Iss ued B : A msde n , J ul ie
NPD ES ln sp.Re~d: No
Da te: 09/29/2016
Date: 11/02/2016
Date: 11/02/2016
Subject to Fi eld:
Misc. Rece ipt:
Misc. Rece ipt:
Misc. Receipt:
PWA lnsp. Re q'd: No Fire lnsp. Req'd: No
Plannin g lnsp . Re q'd : No Poli ce lnsp. Re q'd: No
La ndscapin g lnsp. Re q'd: No Fl ood Z on e Ce rt. 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 i s suspended or abandoned for a period o f1 80 days after
the time the work is commenced.
Inspector MID#: 2016-132046
Account#
0 1 116002 5 1600
0 1 116002 5 1601
0 1 116002 5 16 12
0 1 116002 57770
089010 01 24000
Engin ee r:
Address:
Phone:
Li cense #:
Architect /
Des iqner:
Ad dress:
Phone:
License #:
6864 0
T o t a l
$2 0 .56
$200.5 1
$1 .00
$14.0 0
$0.59
Acct.;;-· Ref=~: 1019:)?53
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Dary Eng i\ii¥frrtg:;; :c.,n !otctl ·H/6.~,:c
Diaa Yass1Jn ,, = • ~ ,, • ,--~•"c .1 t
2939 Camm~1del"T'oii1i ai irnJ.l,~\::,~ 1 ctr· 1 nez
HaciendatJ;!~J ghJ~. ~A:,!;l,1t4-~ate F,?E
(213) 725{8.0Jl.:1 60C':2 '5.:.600000-
C56295 i?.u i ~ci: n::
01116C,(i:2-::'.601(!:)0-
Blds Etd~-
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1'1 i crcf . l m
OJ.1160C2-
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0890:!.0C;:l
Cus.r
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0 1116002 51601
0111 6002 53600
0 1116002 57770
08901 001 24000
0 1116002 51612
0 1 116002 51600
011 16002 5 1 601
Revolvins
Si,:,:'.2000·-
,!. Documents
:'.;77(1::11)(1 -
:+000000-..
Permit Fee
Plan Check Fee
Microfi lm Reco rds
SM IP -Ca tegory 1
Bldg. St ds. Revo lvi ng
Gene ral Plan Upd at e
Iss uance
Fee Tota l:
Paid to Da te:
Bala nce Due:
$1.00
H I.00
to .. ~:~?
i500. 00
' .,1 .,:. '"' .. "'I·; I
$149 .25
$206.91
$14 .00
$0.59
$1.00
$20.56
$51.26
$443.57
$206 .9 1
$236.66
INSPECTOR RECORD n _ _ ._ BU.,.I LDING-,-------------------.-------,---;,;-;a..,....;.,..,...,------------------....---------------------------,----------------,-SITE WORK DATE ID/SIG.• COMMENTS OWNER BUILDERDELCARATION ~ • ' I hereby a ffirm under penalty ofperju1)' thnt I am e,'[empl fro m the Contractors· License Law for 1he fo llow ing reason (S,rc.703 1.5 •
Set Backs Business and Pro ressio n Code): Any Cit y or County which requires a pennit to construct. alter. improve. demo lish or repair any
structu re, prior to its issuance, also requ ires lhe applicant for such pennit to file a signed statement that he Or she is \i c;cnss-d pursuanl Forms/Steel /Holdowns to the provisions o f the Contractor·s Licensed Law (Chapter 9. Commenc ing with Section 7000 of D iv isio n 3 of 1he Business a nd ◄
Erect.IQ n Pads Professions Code) or that he or she is C."<C111pl therefrom and th e basis for the al leged exemptio n. Any ,1iol,nion of Section 703 1.5 by any
t-U:-:-F=E=R=--G=-r-o_u_n_d--,------------1-------+--------1--------------------,,J'•~~~ant for a pennit subjec1s the applicant to a civil penalty of not more than five hun dred dollars ($500).
l--------------------1--------1-------I------------------.J ~:,r(;t---:=e' f l. as own er o f the prope11y. or my employees with wages as their sole compensation. will do the work and the s1ructw·e i.c; not SLAB Floor / intended or offered for sale (Sec.7044. Business mid Professions Code: The Con tract or·s Li ce nse Law does 1\01 ripp ly lo an owner of
the propeity who builds or improves thereon. and who does such work him self or herse lf or through his or her own e mployees.
Subfloor/Vent/1 nsu lation provided that such im proYcmenlS are not intended or offered for s.,le. If. howe ver. the building or improvement is sold wit hin on1,year
of completion. the Owner Builder will have the burden of pro ving thrit he or she did not build or impro\'e th e pro pei1y for the purpose of
Roof Sheathinq sale). •
Shear Wall
FraminQ /-7 /;-z,J It. ll~ (,In
_I. as owner oft he property. am exclusively contracting wi th licensed comrnctors to conslrnct the project (Sec. 7044. Busi nc~
and ProfessKln Code: The Contrac1or's License Law does not nppl y lo an owner of propert y who builds or improves thereon.
and who comracts for such projects with a Contrnc101{s) licensed pursuant to the Contrnctor·s License Law).
lnsulation/Enerqy 1 1 ,, -I LJ
1--D_r.,,__vw_a_ll _________ -+_,. \.+\,;_,__\.,_1_7'---'~~:;,.=....,.r"-._..\....CC p(J,(.,___1-'v\P:.___'\ u _ _,,,Llll'1'------'-~.C,,\' ~"-------.I'.'( Dnl~ru; )~";';~er ;«;;'-6 -~;(~\\+-r:-~-·· ,B#~~n.
Ext.II nt. Lath \ l . ·~w°=o~R~K=cF,RccS~' cc,-,0~~~1r=ENSAn~NS~A~itr"'"N~---------
DEC L A RA TION Brown Coat I hereby affirm under penally of pt.."l'juryone oflhe fo llowing declarations:
Masonry
Pool Fence
T-Bar
_I ha ve and will main tain a Cc11 ificate of Consent to Self.Insure for \VO l'kers · co mpensation. as provided for by Section 3700 of the
La bor Code. for 1he pcrfomrnncc of the work for which the pcnni t is issued.
_I have and w ill ma inta in workers· compensation insurance. as requi red by Sect ion 3700 of the Labor Code. for the p,,·fonnancc of
the work for whic h this pt.."llnit is issued. My workc.i·s· compensation insurance cafficr and polic y num ber arc:
Handicap Req . Carrier: ___________________________ _
Deputy Final Report PolicyNumber: _________________ ,E,pires: _______ _
rE::-n_g.,__i_n_e_e_r_F_i n--,-a_l_R_e..Ji pL-,o_rt....:._ _____ +-------tf------l-------------------4<1~cr;;~:l..!.· f1..1cert ify that in the performance of the work for wh ich this pennil is issued. I shall not employ any person in any manner Flood Zone Ce rtif . / so as to become subject to the workers· compensation laws of Cali fornia. mid ngree that if I should become subject 10 t he
t----------------------<--------+-------1--------------------' workers' compensation provisions of Section 3700 of the Labor Code. I shal l. fo1thw ith comply with those prov isions.
WA RNING: Failure to secure workers' compcnsa1 ion coverage is unlawful. and sh all subject an employer 10 crimi nal pt"!ialtics and
I / civil fmcs up 10 o ne hundred th ousand dollars ($100,000), in addition to the cost of compensation . damages as pro \·ided for the
t-:F=I N:-:-A-:--:L----,o--/,f-,-:-,--.iqr--ff.'/,'Q7":"---,,././.,.,.,/,.---_,f-:1,(/,.,,...---, //,......,,/.r-: /--t-------+------------------>,t'" _section 3076 o[the Labor Code. interest and attorney"s recs.
1-------=v--+,__/-"-+/"-' j{,. ~,.___--'1':........i.,: L./'--'1.:1-, mL-.;;....._..:....I C/ .......... '1'_...i..,_ __ _._ ________ ~/,..;; Date: II-0 t&-:;Jo /i, ~ca nt:_&-=-::__ A---'~=a =~-=--, _:..__ _____ _
Cert·1t·1cate o·kOc·,r.·upanc•u 7 \ u rnNsED c o N~ II ,1.,1 , J DECLAIIATION Notes , Remarks, Etc. I hereby affirm un der penally of pe1j ury thnt I mn licensed under provision ofChnpl(.T 9 (commencing with Sectio n 7000) of Division 3
of 1hc Business and Pro fess ions Code. and rny license is in fu ll force .1nd efTcc t.
License Class: ______________ ,Liccnsc Number: _______________ _
D11te: ____________ Contrnctor: _____________________ _
C ONS TRUCTION LENDING AGENCY
l hereby affirm under pena lty o f pe1jury that there is a construction lending agency for lhc perfonmlnce of the work for which lhis permit is
issued (Sec. 3097. Civ. C.).
Lender 's Name: _________________________ _
Lender's Address: _________________________ _
A PPLICANT llECLAIIA T ION
I hereby affinn under penalty of perjury one of the fo llowin g declaratio ns:
Demolition Pcrmits•A sbcstos Notification f edera l Rcg ula1 io ns (Ti tle 40. Pm16)
_Required Letter of Notifi cation
_1 cei1 ify that the federa l regulations regard ing asbestos remo val are 1101 llpplicable to th is project.
) ..ii} certify that I ha ve read this applicalion and state that th e above infonnati on is cmTect. I agree to comply with all City and County
1---------------------------------------------------.:_J • ordmanccs and State Laws relat ing to building constrnction. and hereby authorize representatives of th is City nnd Co un ty to enter upon the
above men tio ned propeny for inspecc uJ'.:? ~I / / -0 7 -~/) / iJ,
,-----------------------------------------------------.,)::-lb Applicant or Age ut Siguature: -:J7 ./"'lj·
1
)(Dalc: ________ _
1------------------------------------------------L.../'..J\.'-Pe rmitee nnme(print): & lacft; 9 {!)~/.i?eZ.. I'