HomeMy WebLinkAbout10191670 - PermitCity of Santa Ana 2 0 Civic Center Plaza (M-1 9), Santa A na, CA 92702 Building Permit#: 10191670
Permit Counter: (7 14) 647-5800 Inspectio n Requests: (7 14) 667-2738 Inspector Section: (7 14) 647-5853 Pin#: 36416
Project Address: 1314 N Garnsey St Unit: Bld g: Address Range: Su ite Ra nge:
Assesso r's Parcel:
Building Use:
Job Type:
398-581-13 Lot: 24
Single Family Dwelling
Reroof
Block: A
Occupancy:
Constr Type:
Nature of Work: Reroof Code:
Existing Bldg. & Use: 4 UNIT APT W/DETACHED CARPOI Flood Zone:
Proposed Use: # of Stories:
Tract: 395
R-1
VB
CBC 2013
X-0602320144J
Historic: No
1st FL A rea:
2 nd FL Area:
Other A reas:
Garage Area:
T otal:
Zon ing: R3
Patio:
T.I.Area:
Yards Req'd: O@O
Valuation : $10 ,500.00
Description of Work: T/O existing comp shi ngle and install with new comp shingle to apartment building only. Replace sheathing. Total of 20 sqs. Hand
out given.
Planning Conditions: Repair any damaged fasci, eaves, rafters, wood members, etc.
Ow ner : ROBERT MITCHELL
Address: 1314 Garnsey St.
Santa Ana, CA 92706
Phone : (714) 953-9341
Tenant:
Con tra ctor:
Address:
Phone:
State Lie#:
Li e Type :
Bus. Lie #:
ALLEN-DE ROOFING/DRYW
5416 VALINDA AVENUE
Rancho Cucamonga, CA 91'
(909) 851-8363
599041
C-9, C-39
364157
Workers' Co mpensation In surance:
Ca rri er: State Fund
Policy #: 9048 043
Expires: 08/01/2017
Planning Approval By:
Plan Checked By:
Permit Issued By:
NPDES ln sp . Req'd:
Guerra , Pamela
Zuoiga , Amssa o/
No
Date: 12/20/2016
Date:
Date: 12/20/2016
Subj ect to Field:
Misc. Receipt:
Misc. Rece ipt:
Misc. Receipt:
PWA ln sp. Req'd: No
Pl an nin g ln sp. Req'd : No
Landscaping ln sp. Req'd: No
Fire ln sp. Req'd : No
Police ln sp. 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 oft 80 days after
the time the work is commenced.
Inspector MID#: 2016-133565
Accou nt#
01116002 51600
0111 6002 51601
01116002 5 16 12
Engineer:
Address:
Pho ne:
Li cense #:
Architect/
Des iqner :
Address:
Phone:
Li ce nse #:
T otal
$20.56
$349 .76
$1.00
Bat ch~:36702 -12/20/2016 ID: LROSALES
Office: CTYH Trans~: 6 2 of 2
Acct~: Ref~: 10191671
RcPt~:01692469 -12/20/2016 8:49 AM
Transaction Total 1742.64
ALLEN-DE ROOFING/DRYWALL CONTR
General Plan UPdate Fee
01116002-51600000-
Buildins ~349. 76
Blds Stds Revolving 11.uo
011160/H 1 f Mll~-P~1,;g!t.Rm!:1--$298 .50
01 1160ti2s 5 1612 Bldg. Stds . Revolving $~76& • .:'.,4
0111600FsiMB *&efiM!1*p 1~rupdate Aut h::=:0 \'%1~6
01116002 51601 Issuance $51.26
Fe e Total:
Paid to Date:
Balance Due:
$371.32
$0.00
$371.32
SITE-WORK DATE ID/SIG.
Set Backs
Forms/Steel /Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/V enUI nsulation
Roof Sheathinq IZ/.:zv//6
Shear Wall
Framinq
lnsulation/Enerav
Drvwall
Ext.lint. Lath
Brown Coat
Masonrv
Pool Fence
T-Bar
Handicao Rea.
Deoutv Final Report
Enqineer Final Reoort
Flood Zone Certif.
I I
FINAL fo/1,,Vo
Certificate of Occupancy '
Notes, Remarks , Etc.
BUILD I NG-INSPECTOR RECORD
COMMENTS
v I
OWNER BUILDER DELCARATION
I hereby affinn u nder pt.."tmlty of perj ury that I run exe mpt from the Contractors · License Law for the fo ll owing rc.;.s.on (SccJ.031.5
Business and Professio n Code); Any City or County which requires a permit to construct. a lter. improve. demolish or reif.~ ~t1y
structure. prior to its issuance. also requires the applicant for such pennit to file a s ign ed statement that he or she is licensed pursuant
to the provisio ns of the Contrnctor·s Licensed Law (Chapter 9 , Commencing with Section 7000 or Div ision 3 of the Business and
Professions Code) or that he or she is exempt therefrom and 1hc basis for the alleged exemptio n. Any v iola tion of Section 703 1.5 by a ny
applicant for a pennit subjects the a pplicant to a civil penalty of not more than five hundred dollars ($500).
_I. as owner of the property. or my employees w it h wages as their sole compensatio n. wiU do the work and the stmctlu·e is not
intended ororTered for sale (Sec.7044. Business and Professions Code: The Contractor's License Law does 1101 apply to an owner of
the property who buil& or improves thereon. and who does such work h imself or herself or 1hrough his o r her own em ployees.
provided that such improvements are not intended or offered for sale . I f. however. the building or improvement is sold within one }'ear
of completion. the Owner Builder will have the burden of proving that he or she did no1 build or improve the property for the purpose of
sale),
_I. as owne r of the property. run exclusively contractin g with licensed contractors 10 construct the project (Sec. 7044. Business
and Profession Code: T he Contractor's License Law d oes not apply to an own er of property who bu ilds or improves thereon.
and who contracts for such projects wit h a Co ntrac tor(s) licensed pursuant to the Contractor's License La w).
_1 run e:i:empt under Section, ________ . 8 . & P .C. for this reason.
Date.: ___________ Ow ner: _______________________ _
WORKERS' COMPENSATI ON
D EC L ARATION
I hereby affirm unde r penalty o f perjury o ne of the following declarations:
_l have and w ill maintain a Certificate of Consent to Self-Insure for workers· compensation. as provided for by Scclion 3700 of1hc
Labo r Code. for the perfonnance of the work for which the pcnnit is issued.
_I have and will m aintain wo rkers· com pensation insurance. as required by Section 3700 of the Labor Code, fo r the perfonnan ce of
the work for which t his pennit is issued. My workers· compensation insu rance can-ier :lnd polic y number are:
_1 certify that in the pcrfomiance of th e wo rk for which this permit is issued. I shall no t employ any person in any manner
so as to become su bject to t he workers' compensation laws of California. and agree that if 1 should become subjec1 to the
workers' compensatio n provisions o f Sect ion 3700 of the Libor Cod e. I shall. fonhwi1h comply with those provisions.
WARNING: Failure 10 secure workers' compensation coverage is unlawful. and shall s ubject an employer to crimin al penalties and
civil fines u p to o n e hundred tho usand do llars ($100.0~0). in addition to 1he cost of compensatio n. damages as p rovided for the
Secti~n 30~~ o f the Labor Code. inter~t and attonfy'Jes.
Dale: / 2., -2-u -( ~A1111 Ii cn,~:. ____________________ _
LICENSED CONTRACTOR
DEC LARATION
I hereby a flinn under penalty of perj ury tlrnl I run licensed u nder provision of Chapter 9 (commencing with Sectio n 7000) of Divis ion 3
of the Business and Professions Code. and m y license is in full force and effect.
LicenseClass L -"3"7 f;znber -R _ '5,n q /) C{-/
Dale /Z~-Zo -/le Conlra ~ ' -I) A a,,,,---
""7-...; T C/
~~N•TR' ,r·nnN LEN•'1w•f. ~ENry
I hereby affirm under penalty o f perjury that there is a con.s.1ructio n lendid'g agctlcy for th e pcrfonnanc e of the work for which this perm it is
issu ed (Sec. 3097. Civ. C,).
Lender's Name: _________________________ _
Lender's Address: _________________________ _
APPLICANT DEC L ARATION
I hereby affinn under penalty of perj ury one of the fol lowing d eclarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
_Required Letter o f Notification
_I c enify that the federal regu lations regarding asbestos removal are not applicable to this project.
_1 certify that I have read this appl ication and state that the vc infonnation is correct. I agree to comply with all C ity a nd County
ordinances and State Laws 1clai;7ng~ to m:_~~::rru cuon. A,er -~/2y authon ze reprcsentatwes ofthts City and County to e nter upon the
above m enlloned prope1t y for ms 1101/urpo.L. 1/ A ~ "--
Applican1orAgcnl Signnty cJ-.,, -, • &Y(__,,-Da le / 2. -Z.Q -/v::,
Pcrmilce name (p rinl): <.::::..--r,-:?/1 h / f ~ c..£. c;:./.,} '· '2t;:;,. . ., (