HomeMy WebLinkAbout10198260 - Permitcity of Santa Ana 20 Civic Center Plaza (N4-'19), Santa Ana, CA 92702 Building
Permit Counter: (714\ 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (7141647-5853
Permit #: {O198260
Pin #: 54584
E
Assessois Parcel: 007-101-01 Lot: 12
Unitl Bldg
Tract: PARKER
Address Range:Suite Range:
Zoning: RlBlock: NA Historic: No
Buildang Use: Commercial Occupancy: B 1st FL Area:
Job Type: Miscellaneous Constr Type: V B 2nd FL Area:
Nature of Work: Reroof Code: CBC 2016 Other Areas:
Existing Bldg. & Use: Commercial Flood Zone: X-0602320257 J Garage Area:
Proposed Use: # of Stories:
Totat;
Description of Work: Tear off existing roof material and install sheathing as needed. New Built up roof membrane
Patio:
T.l.Area:
Yards Req'd:
Valuation: $8,600.00
31 squares. Handout given.
Planning Conditions: ApProval for reroof only. No change of use or othor work permitted.
Owner:
Address:
Phone:
Tenant:
Linda Kuroski
1924 W. Fourth Street
Santa Ana, CA 92703
(714t.227-7s43
Contractor: South coast Roof, lnc
Address: 1132 W Barkley Avenue
Orange, CA 92858
Phone: (714) 744-5995
State Lic #: 365271
Lic Type: C-39, C43
Bus. Lic #r 12572'l
Workers' Compensation lnsurance:
Carrier: American Zurich
Policy #: WC4758341
Expires: 'l2l31l201A
Engineer
Address
Architect /
Desiqner:
Address:
Phone:
License #
Phone:
License #
Date: 11/05/2018
Date:
Date; 11/05/2018
Subject to Field:
Misc. Receipt
Misc Receipt
Misc. Receipt
07776002 57607 Petmil Fee
01776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
01776002 51601 lssuance
$320 50
$1 .00
$22.08
$55.04
Fire lnsp. Req'd:
Police lnsp. Req'd
Flood Zone Cert. Req'd: No
Evary permit issued shall become invalid unless tha work on the site authoized by
such pormil is commenced within 180 days after its issuance or if the wo* autllorized
on the sile by such permit is suspended or abandoned for a peiod of 180 days aftet
the time the wotk is commenced.
No
No Account#Total
$398.62
$0.00
$398.62
lnspector MID# 2018-147450
011 16002 51600
011 16002 51601
01116002 sl612
$22.08
$37s.54
$1.00
Proiect Address: 1924W Fourth St
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Planning 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
Gomez, Pedro
Chavez, Dave
*
Fee Total:
Paid to Date:
Balance Oue:
BUILDING- INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS OWNI'R BIJILDIiR DEI,(ARATION
I hdeb, aflifln und6 paah, of p€rjury lhd I m ei.mpr ftoo lh. Conlructo6 Licens. tiw lor the follouinB ll&n (s4 7011 5
Busin6s dd Proisioo Cod.): Ant Cny or (ounly whi.h r.\ton6 a p€ ii lo conslrucl. alt6. nnprolc. ddbolish r rePn ,
noc'd., Fior ro its irsroce. also r.qut6 llr applicmt lor such p.mn lo fiL a sisn d sldmat rh{ h. or sh€ b licm.d p6u&t
to rhc prcvisiod .r rhc Conlr.clore Li€.ns.d tnN (Ch.ptr 9. CoDncncins wilh S<rion 70\10 ol Division I oalhe Susin6s d
P@a.sions ( odc) or nlat h. or she is €rcrpl th6e6on sd lh€ bsG tor rh. allcscd .xonFion Ary rioltrlion ofScclnrn ?0ll.t fry a.y
aDlic.nl aor a p€mil subjcB the applic ttoacivilpcnaltyornolnDrclh&fivehundrcddoll&s(t500)
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intddcd or ofiscd lor el. (56 70.14. Busins ud Prcf6io6 Code T1. contraclols l-iccN. Lo* do6 nol a!rl, ro m osrr o f
tbcDbndty *ho hilds or imDro\6fi€@n. ard *lF d(E such srrt hi s.lf or h6daor rhmqh his or hd otr n.nploy6,
Fmvid.d lhal su.h intmlmnis m nor idaxk or ofided lor sl.. If. how*q, rh€ bqildins oi inprovmdt is vnd within o.. )qt
olcompl€lion. lhe o1m6 BuiU6 will havc lhc bd&n oatrorins $a b. or shc dil mt hrild or nnp.ort $e Fopdy lor rh. putPos ol
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p6po1r. m .rc lus iv.ly .o ntrct if,B wnh lictrd conlradoB lo co.srtud rh. r.jd lsa 7044. Rlms
and Boftssion Code: Thc Conr&roi. Licds€ L3* do6 nor apply to u ownd o f prop.ny wno builds or mpre!6 0(md.
aDd who conrmds for such Aojat wilh aCo.r6oro(s) lic@d pursmr to thcComracrois Lictue L.w).
Iancxcm underSerion-. a & P.C.lorrhis reason.
llaliEErra[uEls figx
DECLATAIIO!
I ncreby affim undcr p.nalry ol pdlury odc o f rh. followin! d(laralions:
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halc d will ma,nhin a Cctin.ar. ofconst ro sclf-lBur. aor srk.rs comp.nsarion, d rrovidol for by Serion l?00 ot lhc
l-abor Code. Ior thc pslomancc oilh€ rork lor whi.h rh. dmn is isu.d
,lhaveand{illmainrainwork.6comp.sarioninsorance,6r.qun.nbysdlioi:lT00ofrh.LabotCode,forlfi.tEfonndceol
$. \ork nrr sbich rhi pmir is is€d. My sorkfi comFcalion imurdc€ ceid dd Flic! nu,nbd r.
I c.niiy rhai inthcpdfo,nranceofthctro fo! {hich this pmnir t issu.n.l shall nor mploy flny pqvrn in anymdnd
$ as to h.coN. subjer ro rhc wo&6' comp€Mrion l.*s oacalilomia. lnd asrce llEl il I .kruld b..o'n subi4t to lhc
vort6' conpcGarb. povisioB oasBion i 700 of rhc L.bor cone I shall. fontvnh o Vly rirh rhos Provisions.
\n'aRN|NC: rialuc Io *u. $o&m' comp.Nali.n colm8. is onLNaul. ed shall subjdr d mplold ro aiminal poani6 d
.r1l fin.s up k, one hundred rhousmJ dollas ($100 ion lo rhe cosl olco,np.Mrion. d,naB6 6 provid.d tor rhe
cod.. im6nt Md atro!rey s 16
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I hcEby amm undo paally o apgjury thal I m licds€d trnds pmvision olChafls 9 (.ontmmcin* trnh S.dion 7000) ofDivisbn l
of lhc aBiner dd Pna6ioro Cod.. d my licft. is in full forc. od cfter.
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I h€rcby amrm unds pen.lly ol pqjury nl.l lhqc is a conslrullio. knding a8ocy lor th€ pdaomuc€ oflhc trorl for $hi.h rhis Fmil is
i.sudl(sa 1097. ci! a ).
AEI,TCANLDECIABAIIQ!
I hoah, ailnn undd pa.liy of pgjury onc ol the folloNins ddlEations
Denolirion Pmne^sb6rN Norifi.rrio. ltdsal R.sulalions {'I iil€ 40. Pan6)
Rcqutcd t4lle ol Notincdion
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cdiq nlal th. lcdsal resuhrn ds e!trdi.C ab6ros t molal e. flor.pplicablc lo th6 projEr
I cdilrlhd Iha!.readrhisflpplicationsdsrarelharrheat{\e iofomarn,n G.oadr IaEerocomply\rilhallCnyandcou.r,
ordi.ancs and srdc la$ rclarins to buildina cons1ructtun, od hscbyaurhoEeqnc$lariv6 oafiis Cny and Counly ro dld ltxin rh.
aborc nE(ioned prepedy l'or itupdr
rpDlir!tr1 o' ,\s.nr sisnrrur..rr\a)r/
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/Vent/l nsu lation l.
Roof Sheathing ,/'zt /ll -HA
Shear Wall
Framing
ln s u lation/Energ y
Drywall
Ext./lnt. Lath
Brown Coat
Ir,4asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL lz-7-6 4<1)itz'7
Certificate of Occupancy
Notes, Remarks, Etc.
6
LenJeir ^dd6
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