HomeMy WebLinkAbout101104114 - PermitAssessor's Parcel:399-15r-07 Lol: 57
Unit Bldg: Address Range
Block: NA Tract 2419 Hisloric: No
City of Santa Ana 20 civic Center Plaza (M-19), Santa Ana, c492702 Building Permit #: 101104114
Pin #: 332748/
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Reroof
Reroof
SFD w/att garage
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
R-3, U
VB
cBc 2019
x-0602320144J
1 st FL Area
2nd FL Area
Other Areas
Garage Area
Total
Oescription of Work: Reroof Wt.o.-Remove comp shinglBs and apply Boral tile ESR-1647
Edgar Benitez
2301 Lori Ln
Santa Ana, CA 92706
(714) 696-4090
Owner-Builder
Address:
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Conrpensation lnsurance
Carrier:
Policy #:
Expires:
Phone:
License #
Architect /
Desiqner;
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp Req'd:
Planning Insp. Req'd:
Landscaping lnsp. Req'd
Soto, Ricardo
Hernandez, Kathy
Dale:0712212020
Date:
Dale0712212020
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
077760 0 2
0 77760 0 2
077760 0 2
077760 0 2
0 777600 2
57607
57770
57672
5760 0
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
\U*
$345.28
$4.05
$1.00
$23.79
$59.30No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Flood Zone Cert. Req'd No
Every petmit issued shall become invalid unless fre work on lhe site auth,)rized by
such permit is commenced wlhin360 ctays afte'its issuance,or if the wo* authotizecl
on the site by such pemtt is suspended or abandoned fot a period of360 days aftet
the lirne lhe wo* is commonced.
lnspector MID#: 2020-160286
01'1 16002 51600
01'116002 51601
01116002 51612
0't 116002 57770
$23.79
$404.58
$1.00
$4.05 Fee Total
Paid to Date:
Balance Due
$433.42
$0.00
$433.42
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address: 2301 W Lori Ln Suite Range:
Zoning: Rl
Planning Conditions: Charcoal colol
Engineer:
Contractor;
Address:
Patio:
T.l.Area:
Yards Req'd
Valuation: $8,000.00
Owner:
Address:
Phone:
Tenant
BUILDING- INSPECTOR RECORD
SITE-WOHK DATE tD/stG.COMMENTS OWN["N BUILDER DELCARATI(}N
I h.icby afl1rm undcr p.n,lty oi n rilry lhar I mcxcn{ romrhc CoftrdoN Liccns L3, lor rlt finhsins r.r$. (5(70115
Ausinc$ art Prolcssnn Codc): Any Cny or County which rcqoncs { Fmir ro conndc'. alld. inpro!.. d.mlth or EF.n my
srMtuE. I,ri, b ns nsuacc. also rcquircs th. dpplicant for slch lcmil lo filc a sisncd \l!r.mnr rh, lt or sh. ir li.cn$d pu^nmr
t' thc ptuvisions of th. Contmbls Liccnsd trw (Chrlcr 9, G'rlmmi.3 wilh Scrion 7(x)0 .r Divirion ll orrh. BDsims dd
Pmfcsrhns Gxle) or thrl h. or shc is cxcrrrr rtrrcfiom nd rh. b.sir ror rhc .lLg.d cxcmption. Any violllbn ofSsrion 7031.5 6y rny
aptlicant for 6 Frmil subj(c ttE aptlicant lo o civil !,.mlty ol nol m)a lhu five hldred douas ($500).
-1.
as owrcr ollhc ImIEriy, or m, emplorcs wirh wulei as rhcir blc omFnsdridl. eill d. lh. eork dd ltE stru.lw is ml
inrcndcd or oficrcn ior slc (Se.7044. Busims ond Profcsions Cdc TIE C,ntac'ols Lic.nr Lrw do.s mr ,ffly b d owmr or
rhc nn,frny wh)t il& or inproEs rlx$n. turl who dcs suh mrk hiNellor hcrclf or rhmugh ht or her own.mploltcs,
lroviddl rh ru.h imFoRmnl\ m mr inl.nd.d or olTcEn for $h. IL tsscEr, lhc tuildin8 or iqmwrnr t sou wtnh 6nc Fr
olconqlhrbtr rhc Oetur Builld willtEw llE hed.n oftmving rh tE or shc dil ml build or Lrpmt drc pn,Fnr lor rlt pnqretrf
_l,,sosmrofrhc pn,!cnt, amcxclusiv.lrcdnkr.rir! wirh lrcn{d .onr0.ton to .onsocr rlr FNrd (s.c 7olil, Bunmrs
$n h,iR\ion Codc:'rhc Conkrrff\ Liccns Lau d,Es nor applyb an owncr .l proFdy *ho builds o. imrmvcs thcron,
rtrd who conlrach for such Fojccrs qirh a C.nrrro(, lic.nsd Durunr lo rhc Corrracrols Lt.n* riw).
I antcxemrl undcr Sern,n
1:2L:14!4 "**
ITECLA&IIIoN
I lrEby ritn'n undcr FnrlrrolFljury oncolrlr rolbwins d*.'larari,,n\:
. _r hlrc ald will roinrain c Ccn iltare dl Con*m ro S.lf l6ur. tor n-o*c6 conpcns.lt,n, rs providcd for bySccrion 1700ofrnc
kbor Gnq Ior rtr pc orflmc of lh€ wod( fo! rhkh lhc pemil is isrued
_l hiK Nnd *ill mima,n workc(' comp.nsalion iNur.Ec, d rcquiEd bySalion 17Ul of lhc Lakrr Code, for rhe Frf(l@t. of
rhc sork lor whkh rhis pcnnir is nwcd My*Gkcrs onw.stion insuoncccarier ad fnlty nxmh.r &.
_l.cnrryrhar h rhc tE rorntrmcorrh.w.r*rorvhichihis JErmi n Gslcd.l shnllnot crq,loyanyrE6.n in rn, tunn.r
so r to b.mm subj..r lo ttE wdlcs comlrcnetion lars of Califomi!. Md agrcc rhar i, I sibuld lr.otu subj.d ro rlr
wo crl conlEnslionlmvishnsofSedionl?00otrhcLahrrCode,I\h:ll,ronhwith.omplyqlhrhoEpmvisions
WAnNING: Failu.c t' $curc w.rt.r( LrnlEosin'. svmgc is unl,wtul. ind shall subFt m qrplorr k' alninal Fallrts and
civil lincs trn b on. hlndrd rnoutrd dollm ($lm.om), in addirion io rhc cos of coryrcnsliotr. drmscs as Eovidcd aor th€
Sc\r,on t076olrtE tjbor C''dc, mr.rcn a ouorrcysfc...
,",". ?.2u t aD noro-n,
oEc!4BAIIg!
I hcEby uann udcr pctuty oa perjnry rhd I d lie.s.d undo l,Dvthn oachaprd I (co,rmncing *ilh Sclion 70(x)) 6f Division l
or ihc Dusinc$ atrd Profcsions Codc, {d my li€ene is in tull Io@ r'd .ffer
CQNIiISI]SUONIEIDNGACEN.CI
I hcr.by rfirmurtcr rEmlry oI,Erjury lhar rhcrc n a con(tucrion hndins sscmy ror rh. tdr..lM.c olrhc work for shthlht Frmil i!
nsucd (Scc. :1097, Civ. C.)
ATELICANTDECIJAAIg!
I ho$y arirn undcr pcnlhy ot rqrlry one ofrh. folloeiis dtlrarions:
Dcnmlilioh PcrnillAshcslos Notiicaliotr Fidcrrl RcBuhlnrns (Titlc 40. Pan6)
Rcquird ldt.r ol Ndificrtion
l.cnifyrhd rhc fcltuBl rcgulaliotrr 68$dirS rsbcslos rcnrva, arc nor arlltrblc b rhh P8*rr
_l.cnittrhar I hrwrcdrhh ippli. mtrand{alcrh lhc ltorr informlion h mnecl I aE e io cDftOIy wnh all Ciry and C.unr,
odln,kcs ond Statc tiss rchtins ro buildins construcrion. id h.rcby aurh.riz r.prcsbrariks ofthnCiiy.nd Colntylo ols uron rlE
lboR nE iomd pmFny ror insFlA
Apt i.xnr or A[cnl Sisnnluru
e$u- $eie-7-22402D
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Roof Sheathing
Shear Wall
Framing
lnsulation/Energy
Drywall
Brown Coat
It/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
I I I
FINAL 9lbe.lk 1 DFq'2 ,,7
Certilicate ol Occupancy I
Notes, Remarks, Etc
Rev.0B 07 2015
Subf loor/VenVlnsulation
Ext./lnt. Lath
Flood Zone Certif .
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