HomeMy WebLinkAbout101105164 - PermitProiect Address: 1030 N Lincoln Avea
Assessor's Parcel: 398-194-19 Lot: 9
Unit:Bldg: Address Range:
Tract: HAWKIN'S ADD
Suite Range:
Zoning: SD84Block: A Historic: No
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 #: {01105164
Pin #: 8{ 122
Building Use. Single Family Dwelling Occupancy. R-3, U 1st FL Area:
Job Type: Reroof Constr Type: V B 2nd FL Area:
Nature of Work: Reroof Code: CBC 2019 Other Areas:
Existing Bldg. & Use: 2 SFD w/det Garage Flood Zone: X-0602320163J Garage Area:
Proposed Use: # of Stories:
Total:
Description of Work: Tear off existing roof material and install new comp shingle roof materiat. New sheathing as required
fgapr qte> 46rt{- HtNDa(,'r GrrlE$'
Planning Conditions:
Patio:
T.l.Area:
Yards Req'd.
Valuation: $9,900.00
Owner.
Address.
Phone:
Tenant:
Jerome Verdugo
1030 N. Lincoln Ave.
Santa Ana, CA 92701
(7141 574-0357
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Engineer
Address.
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Plannrng Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Orozco, lvan
Chavez, Dave2a
Date: 1110912020
Date:
Date: 1110912020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
077760 02
07776002
07776002
07776002
57607
57770
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Total:
Paid to Date.
Balance Due:
$34s.28
$4 05
$1.00
$23 79
$se 30
Fire lnsp. Req'd: No
Police lnsp. Req'd: No Account#Total
Flood Zone Cert. Req'd: No 01 1 16002 51600
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after ifs issua nce,or if the work authorized
on the site by such permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
lnspector MID#: 2020-1 62653
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$23 7e
$404 58
$1 .00
$4.05 $433.42
$0 00
$433.42
t
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELOINATION
I hcrcby offrm under pcnelty of pcrjury thal I m cxempt from Ihc Contracto6' Licens llw for thc followinS Msn (Scc.7031.5
Busilcss and Pmfcssion Code): Any City or County which rcnuircs a lrcmit lo @nstrucl, altcr, imprcrc. ddmlish or rqrir my
srwturc, prbr to ils issuec. also rcquircs thc alrplicant for such lrcmit to filc a signed slatemnt lhal he or shc is liccnsd punumt
to thc Eovisions of the Conrractor's Licenrcd law (Chaptcr 9. Comrcing wilh S€lion 7000 of Division 3 of the Busiress od
PrcfcssionsCodc)orthathcorshciscxctrlptthcrcfrcmordthcbasisforthcallcgcdcxctrrption. Anyviol.tionofSetionT03l.5bymy
applicanl for I permit subjets thc applicmt lo I civil pcmlty of not mrc thil fivc hurdrcd dollrs ($50O).
--1. as owncr of the propcny. or m), employecs with wagcs &s thcir solc compcnsalion. willdo lhc work and thc stnrcturc Ls rnt
intenclcd or offercd for sale (Sec.7044, Busincss and Profcssions Coclc: Thc Contractor's Liccnse law docs nol apply to an owncr of
thc propcrty who builds or improves thcrcon, arxl who docs such work himself or hersclf or through his or her own employecs,
providcd that such imJrovcrnents are not intcndod or offcrcd for sah. lf. howcrcr. thc buihing or inprovcmcnt is sold within onc )rar
of cornplction. the Owncr Buiklcr will have thc burden of proving that lrc or shc dkl not buih or improve thc property for thc puryxrsc of
salc).
_1. as owncr of thc proprty. am cxclusively contracting with licenscd conlractors to construct thc projrrt (Sec. 7(W, Busincss
and Prrolbssion Codc: Thc Contractor's License Law does not apply to an owncr of progrcrty who builds or improves thcrc'on.
and who contracts for such proicts with a Contraclor(s) liccnscd pursuant to the Contractor's Liccnsc taw).
-lamexcmptunderSc.ction-.B'&P.C.forthisrcason.Dalc:( )rr lrt'r
WORKERS' COMPM{SATION
DECLARATION
I hcrcby affirrn undcr pcnalty of grerjury one of the following dcrclarations:
_l havc alxl will maintain a Ccrlificatc of Consent to Sclf-lnsurc for workers' compcnsalion, as povided for by Section 3700 of thc
Latxrr Gdc. for thc perfonruncc of thc work for which thc pcrmit is issucd.
_l havc and will maintain workcrs' compcnsation insurarrce. as rcquired by Scction 3700 of the [:bor Code. fbr thc performarrce of
thc work for which ls conrpcnsation insurancc carricr arxl plicy number are:
Carrier:-
Policy -U .a L42ZL
_l ccrtify that in thc pcrformancc of thc work for which this pcrmit is issued. I shall not enrploy any pcrson in any manner
so as to bccomc subject to thc workers' compensation laws of California, and agrcc that if I should bcconrc subjcct to thc
workers' conrpcnsation provisions of Scction 3700 of thc labor Code. I stull, forthwith comply with those provisions.
WARNING: Failure to sccurc workcrs' compcnsation covcrage is unlawful, and shall subjcct an cmploycr to criminal pcnalties and
civil fincs up lo one hundred thousand dollars ($100.0ffi), in to the cost of compcnsalion.as providcd for thc
Scction of I-abor and attorncy's fccs.
o
LICENSED CON'TRACTOR
DI'CLARAI'I()N
I hcrcby aflinn undcr pcnalty of pcrjury that I arn licenscd undcr provision of Chaptcr 9 (comnrcncing with Scrction 7000) of Division 3
aof thc Busirrcss and hofessions Codc. and my liccnsc is in full force and effc.ct.
orsLiccnsc
a Nurnhcr:
W
I hcrcby nffim urdcr ]rcnalty of pcrjury tha thcrc is a onslruction hnding agcrcy for lhc pcrformcc of lhc work for which this lrcmil is
issucd (SE. 3097. Civ. C.).
[.cnder's Address:
APPLICANT DECLARATION
I horby affirm undcr pcnalty of prjury onc of thc following dcclarations:
Dcmolition Pcrmits-Asbcstos Notification Fedcral Rcgulations (Titlc 40, Part6)
-Rcqu
ircd lettcr of Notification
__l ccrtify that thc fedcralregulations rcgarding asbcstos rcnxlval ilre nol applicablc to this projcct.
state that the atnvc infornution is corrcct. I agrce to conrply with all City and County
arri hercby authorizc rcprcscntalives of this City and County to entcr thc
abovc rrrcntioned property for inspcction
Applicnnl or .\genl
Permitee name (print):\-(-
l.lcu zc
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl ns u latio n I
Roof Sheathinq ll'la"N t)fJa/&ffi6J
Shear Wall
Framinq
lnsu latio n/En ergy
Drywall
Ext./lnt. Lath
Brown Coat
ltlasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
rI ,,
FINAL tt u 1^)Dt(lf,
Gertificate of Occupancy
Notes, Remarks, Etc.
Ltl lo D/t+y /
tl /
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Rev. 08-07-201 5
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