HomeMy WebLinkAbout101104822 - Permitf City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1011o,48.22
Pin #: 44793t
rl
Proiect Address: 27 17 S Genter Sta
Assessor's Parcel: 412-255-08 Lot: 3
Unit:BIdg. Address Range:Suite Range:
Zoning: R1Block: NA Tract: 8343 Historic: No
Building Use: Single Family Dwelling
Job Type: Solar
Nature of Work: Solar
Existing Bldg. & Use SFD w/att Garage
Proposed Use.
Occupancy.
Constr Type:
Code.
Flood Zone.
# of Stories:
R-3, U
VB
cBc 2019
x-06023202s9J
1st FL Area:
2nd FL Area.
Other Areas:
Garage Area
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $28,000.00
Description of Work: lnstallation of roof mounted PV system.
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
Ken Nguyen
2717 S. Center Drive
Santa Ana, CA 92704
Contractor: Solartime Electrical Service:
Address: 14371 Euclid Street, #2F
Garden Grove, CA 92843
Phone: (626) 757 -6677
State Lic #: 1051 487
Lic Type: B, C-10
Bus. Lic #: 374129
Workers' Compensation I nsurance:
Carrier. State Fund
Policy #: 9257733
Expires: 0711912021
Engineer.
Address:
Phone:
License #.
Architect /
Desiqner:
Address:
Phone:
License #:
BDP Engineering, lnc
Bau D Pham
13302 Century Blvd, #A
Garden Grove, CA 92843
(7141 e0e-6060
c60087
Solartime Electrical Services
14371 Euclid Street, #2F
Garden Grove, CA 92843
(626) 7s7 -6677
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES Insp. Req'd: No
PWA lnsp. Req'd: No
Planning !nsp. Req'd: No
Landscaping lnsp. Req'd: No
Arabe, Jill
Ahangian, Kathy I
Verduzco, Viof"t$
Date: 0912312020
Date: 1111012020
Date: 1111612020
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
$4s0.00
$40.50
$2.00
$0.00
Fire lnsp. Req'd:
Police Insp. Req'd:
No
No Account#Total
Flood Zone Cert. Req'd: No 01 1 16002 51601
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterifs issuance,or if the work authorized
on the site by such permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
lnspector MID#:2020-1 61706
01 1 16002 51612
01 1 16002 57770
$450.00
$2.00
$40.s0
$492 50
$0.00
$492.50
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BT'ILDER DELCARATION
t hcrcby affirm under ,rcnalty of pcrjury thal I u crctrpt ftom thc Contraclom' Licensc hw for Ihe following mmn tSec.zBt.l
Busincss ard Profcssion Code): Any City or County which rcquircs a ;rcmrit to conslml. allcl improvc, dcmolish or rcJuir ut!
strclurc, lrirr to its issurec. alm rcquircs the applicant for such lEmit to Iilc I signcd stalcmnt lhat he or shc is liccnrcd pusuilt
to thc Fovisions of thc Contractor's Licen*d trw (Chaptcr 9. Comrcrcing with Sction 70fl) of Division 3 of thc Busiress md
PrcfcssionsCodc)orthathcorsheiscxcnptthdefromardthcbssisfortlEallcgcdcxcmption. AnyviolationofstrtionT03l,5byanl
applicsnt for o pcrmit sbjsts thc applicet to s civil pcnalty of nol mrc thu fivc hundrcd dollus ($500).
__1. as owrrcr of thc prof,crty. or my employccs with wagcs as thcir solc conlpcnsation, willdo thc work and the stnrclure ls mt
intcndcC or offcrcd for sale (Sec.70l4. Business and Profcssions Codc: The Contraclor's Liccnsc l-aw docs not apply lo an owncr of
thc pmpcrty who builds or inrproves thcrcon. and who dcrcs such work himself or hcrsclf or through his or hcr own employces.
providc-d that such imp,r<lvcnrcnts arc not interxlod oroffcrcd for salc. If. howcver. thc building or irprovcnrnt is sold within onc )rcar
of cornpbtion. thc Owrrcr Builder will havc thc burdcn of proving that hc or she did not build or improve thc propcrty for the purpsc of
salc).
_1, as owncr of the proFrcrty. arn exclusively contracting with liccnscd contractors to construct the prolcrt (Scc. 7W, Busincss
and hofcssion Cotle: Thc Contractor's Liccnsc Law does not epply to an owncr of propcrty who builds or improves thereon.
and who contracts for such projccts with a Contractor(s) liccnsed pursuant to the Contraclor's Licensc [aw).
---l am excmpt undcr Scction--, B. & P.C. for lhis reason.
I)ale:Owner:__
WORKER.S' COM PEtr{SATION
DECLARATION
I hereby aft'irnr undcr pcnalty of pcrjury one of thc following dcclarations:
__l havc urd will maintain a Certificatc of Conscnt to Self-lnsure fbr workers' comgrcnsation, as provided tbr by Scction 3700 of thc
l-abor Codc, for thc pcrfornrance of thc work for which the pcrmit is issued.
y'l nur" and will maintain workers' compensation insurance, as required by Section 3700 of the t-abor C-ode, for the performarrce of
thc work for which this permit is i.ssuod. My workers' qompensation insurarrce carrier and gnlicy numbcr arc:
,*,*,, ?J,.i € f-r r-,t l
Policy
_l certify that in thc Jrcrformancc of the work for which this pcrrnit is issued. I shall not employ any pcrson in any tnanncr
so as to bccomc subjcct to thc workers' compcnsation laws of California. and agrec that if I should bcconrc subject to tlre
workcrs' compcnsation provisions of Section 3700 of thc l-:bor Codc, I shall. forthwith cnmply with thosc provisions.
WARNING: Failurc to sccurc workers' comgrcnsation covcragc is unlawful. and shall subjcct an cntployer to criminal pcnaltics and
civil tincs up to onc hundred thousard dollars ($100.0m), in addition to thc cost of compcnsation, danrages as providcd for thc
Section 3076 of thc labor Codc, interest and attorncy's fces.
D,t", ttf tb/Lo
I,ICENSI'D C(TN'I'RACTOR
DI.'CLARA'I'ION
I hercby affirm undcr penalty of pcr.yury that I am liccnsed undcr provision of Chaptcr 9 (comnrncing with Scrction 7Un) of Division 3
of the Business and hofcssions Codc, and my license is in full force atrd effect.
Licensc Nunrbcr:to{tq&1
I)ate:tt/tL., /, t)fic4w
W
I ltrcby affm urdcr Jrnalty of lrrjury thar th@ is a construction hnding agcrcy for thc psformnce of the uork for which this Jsmit is
issued (Scc. 3097, Civ. C.).
Lcrtdcr's Naltrc:
Lrndcr's Addrcss:
APPLICANT DECI ARATION
I hoeby aftirm undcr ;rcnalty of prjury one of thc following dcclarations:
Demolition Pcrmits-Asbcstos Notification Fedcral Rcgulations (Title 40. Part6)
_Rcquircd lrttcr of Notilication
t
--l ccrtily that thc fcdcral regulations rcgarding asbcstos rcmovalarc not applicablc to this projcrct.
l)ermilce nanle
Set Backs
Fo rrn s/Stee l/Ho ldowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenUl nsu latio n
Roof Sheathing
Shear Wall
Framing
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Jtlasonry
Pool Fence
T-Bar
Handicap Req
Deputv Final Report
Enqineer Final Report
Flood Zone Certif .
FINAL lLl'll7r/>k*81
Certificate of Occupancv l
Notes, Remarks, Etc.
Rev. 08-07 -201 5
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and state lhat
alxrvc mcntioned properly frrr ittspcction purposes.
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