HomeMy WebLinkAbout10191514 - PermitCity of Santa Ana 20 Civi c Center Plaza (M-19), Santa Ana, CA 92702 Building Permit#: 10191514
Pe rmit Counter: (7 14) 647-5800 Inspection Requests: (7 14) 66 7-2738 In spector Secti o n: (7 14) 647-5853 Pin#: 33800
Project Address: 1506 W First St Unit: Bld g: Addres s Rang e: Suit e Rang e:
As sessor's Parce l:
Building Use:
Job Ty pe:
Nature of Work:
007-320-04
Other
Revis ion
Revision
Ex isting Bldg . & Use: Vacant Lot
Proposed Use:
Lot: NA Bl oc k: NA
Occ upancy:
Constr Type :
Code:
Fl ood Zon e:
# of Stories:
Tract: NA
N/A
N/A
CBC 2013
X-0602320257 J
Description of Work: Revision to 10189848. Change in wall material for line of sight for neighbor.
Planning Conditions:
Owner:
A ddress:
Phone :
Tenant:
Olson Company
3010 Old Ranch Pky #100
SealBeach,CA 90740
(562) 596-4770
Co ntractor:
Addre ss:
Phone:
State Lie #:
Lie Type:
Bus. Lie #:
Olson Urban Housing L P
3020 Old Ranch Pkwy #400
: Seal Beach, CA 90740
(562) 596-4770
939166
B
363131
Worke rs ' Compensation In suranc e:
Carrier: CYPRESS INSURANCE COMPANY
Policy#: INWC701771
Expires: 01/01/2017
Planning Approva l By :
Plan Chec ked By:
Pe rmit Iss ued By:
Fregoso, V in ce ~
So, An so n
Zunig a, Alliss a
Dat e: 11/30/2016
Date: 12/01/2016
Date: 12/01/2016
Subj ect t o Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
NPDE S lnsp. Re q'd : No
PWA ln sp. Re q'd : No Fire lnsp. Req 'd : No
Pla nnin g lnsp. Re q'd : Yes Police lnsp. Req'd: N o
Land sca ping ln sp. Req'd : No Floo d Zone Cert. Req'd : N o
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#: 2016-129804
A ccount#
N/A -No Bala nce
Engin ee r :
A ddress:
Phone :
Li cense#:
A rchitect /
Des i!'.l ne r:
Address:
Ph one:
Lice n se #:
6891 0
To tal
Hi st ori c: No
1st FL Area:
2 nd FL Are a:
Other A re as:
Garage A rea :
Total:
Rimrock Engineering
Todd Majeroni
9030 W Cheyenne Ave
Las Vegas, NV 89129
(702) 838-5311
C069616
Zoning: C2
Pa t io:
Tl.A rea:
Y ard s Re q 'd:
Valuation : $0.01
0 111 6002 53600 Revision
0111 6-002 5 1 61 2 Bldg . St ds. Revolving
01116002 5 1600 General Plan Upd at e
Fee Tot al:
Paid to Date:
Balance Due:
$206.9 1
$0.00
$0.00
$206 .9 1
$206.9 1
$0.00
BUILDING-INSPECTOR RECORD
SITE-WORK DATE ID/SIG. COMMENTS O WNER llUI L DE R D E LCARAT ION
I hereby affirm under penalty of perjury th at I run exempt from the Contractors· License Law for the following r.:aso n (Scc.7031.5
Set Backs Business and Profession Code): Any City or County whi ch requires a penn it to construct. alter. improve. demolish or repair any
structure. prior to its issuance, also requires the ap plicant for s uc h pennit to fi le a signed statement t hat he or she is licensed pursuant
Forms/Steel/Holdowns to the provisio ns of the Contractor's Licensed Law (Chap1er 9. Commencing with Sect ion 7000 o f Divisio n 3 of the Bus ittt:ss and
Erection Pads Professions Cod e) or that he or she is exempt th erefrom and the basis for the al leged exempt ion. A11y violation of Section 703 1.5 by any
applicant for a pc11nit s u bjects the app lic<mt to a c ivil penalty o f no t more than fi ve hundred dollars ($500).
UFER Ground _1, as owner of the propeny. or my employees with wages as their sole compensation, will do the work and the stmctLu·e lS not
SLAB Floo r intended or o ffered for sale (Sec. 7044. Business and Professions Code: T h e Contractor's License La w does not apply to an owner o f
1he property who builds or improves thereon. and who does such work himself or herself o r through his or her own employees.
Su bfloor/V enUI nsu lation provided th at such improvements are not intended or offered for sale. If. however. the building or improvemem is sold within o ne year
Roof Sheathinq
o f completion, the Owner Builder wit\ have th e burden of proving that he or she d id not build or impl'ovc the propeny for the p urpose o f
sale}.
Shear Wall _I. as owner of the property, am exclus ively contract ing wit h licensed contractors to constnict the prnjcct (Sec. 7044 . Business
Framinq and Profess ion Code: T he Contractor·s License Law does nol apply to an owner of property who builds or improves th ereon.
and who con trncts for such proj ects with a Contractor(s) licensed p ursuant to 1he Contractor's License La w).
lnsulation /Ene rav _I run exempt ur1der Sect ion . B. & P.C. for this reason.
Dryw a ll Date: O w ner :
Ext.lint. Lath WOR KERS' CO MPE NSATIO N
DEC L A RA TION
Brown Coat I hereby affirm under penalty of perjury one of the follow ing declarations:
Masonry _1 have and will ma intain a Certificate of Consent to Self.I nsure for workers' compensat ion, as provided fo r by Section 3700 o f the
Pool Fence Labor Code, for the pcrfonnance of the work for which the permit lS issued.
T -Bar _1 have and will maintain workers· compensat ion insurance. as required by Sect ion 3700 oflhe Labor Code. for the perfonnance of
the work for which this pen n it is issued. My workers· compensation ins urance canier and policy number ru-e:
Ha ndi cap Req. Canier:
Deputy Final Report Policy Number: Ex pires:
Enqinee r Final Repo rt _I certify that in t he performance of the work for which this permit is iss ued, I s hall not employ any person in any manner
Flood Zone Certif. so as to become subject to the workers' compensation laws of Cali fornia. and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of1h e Labor Code. I shall . forthwith comply with those provisions.
WAR NING: Failure to secure workers' compensation coverage is unlawful. and shall subject an employer to criminal penalt ies and
ci\•il fines up to one hundred thousand doll ars ($100,000}. in addition to the cost of compensat ion. damages as provided for the
Section 3076 of the Labor Code, interest and attorney's fees.
FINAL /7.-3-/H 10c'Z...."") Date: Applican t:
Certificate of Occupancy LICENSED C ONTRACTOR
D ECLARATION
Notes, Remarks, Etc. I hereby affirm under penalty of perjury that I am licensed under provision of Chapter 9 (commencing with Sectio n 7000) of Division 3
of the Business and Professions Code . and my license is in full force and efTecl.
License Class: License Number:
D n t c: C ontrnct or :
C O NST RUCT ION LENDIN G A GENCY
I hereby affinn under penalty of perjury that there is a construction lending agency for the performanc e o f the work for which this pennit is
issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender· s Address:
A PPLIC A NT D ECL ARA T ION
I hereby affin n under penalty of perjury on e of the following declarations:
Demolition Pennits-Asbestos Notificat ion Federal Regulalions (Title 40, Part6)
_Requ ired Lette r o r Notificat io n
_I certify that the federal regulat ions regarding asbestos removal arc not applicable to this project.
_, _;,,,"• ',_,_, ,_, •w""'" ~-~•"'''""'''"'"'""~""' ordinances and State Laws rela_ti~t~uilding cons ct ion. d hereb ·, uthorize pr entativ of this City and Count y to entcT upon the
above mentioned property for ms on purpos .
A p pl.ica nt o r Agent Sig nature: ..--· . ~ L7 O:tte: -/ 1 -f -/'
P ermitee n:ime (prinl): c'?ir .\ l5l ,{ -;_/
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