HomeMy WebLinkAbout10264571 - Permit �l
,rt 20 Civic Center Plaza M-19 , Santa Ana, CA 92702 Building Permit#: '1026457' _
City of Santa Ana ( )
Permit Counter. (714) 647 5800 Inspection Requests. (714) 667 2738 Inspectors Section. (714) 647 5853
Project Address: 910 E Catalina Ave Unit: Bldg: Address Range: Suite Range:
Assessor's Parcel: 003-222-13 Lot: 133 Block: NA Tract: 1529 Historic: No Zoning: R1
Building Use: Single Family Dwelling Occupancy: R-3 1st FL Area: Patio:
Job Type: Alteration Constr Type: V B 2nd FL Area: T.I.Area:
Nature of Work: Alteration Code: CBC 2007
Other Areas: Yards Req'd:
Existing Bldg. & Use: Sfd w/det garage Flood Zone: X-0602320163H
Garage Area: Valuation: $1,000.00
Proposed Use: #of Stories: 1
Total:
Description of Work: Remove unpermitted addn (2) bedrooms and patio cover.
Planning Conditions:
Engineer:
Owner: Marco Brito Contractor: Owner-Builder
Address: 910 E Catalina Ave Address: Address:
Santa Ana, CA 92706
Phone: (714) 542-3171 Phone: Phone:
State Lic#: License#:
Tenant:
Lic Type: Architect/
Bus. Lic#: Designer:
Workers'Compensation Insurance: Address:
Carrier:
Policy#: Phone:
Expires: License#:
011-01-5911 Permit Fee $37.25
Planning Approval By: Duarte, Rebecca Date: 10/31/2008 Misc. Receipt: oll-01-5911 Investigation $77.00
Plan Checked By: Date: Misc. Receipt: 011-01-5911 Penalty $193.00
Permit Issued By: Verduzco,Violets Date: 11/07/2008 Misc. Receipt: 011-01-5911 Issuance $36.75
Subject to Field:
PWA Insp. Req'd. No Fire Insp. Req'd. No
Planning Insp. Req'd: No Police Insp. Req'd: No
Landscaping Insp. 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 Fee Total: $344.00
within 180 days after its issuance, or if the work authorized on the site by such permit is suspended or abandoned Paid to Date: $0.00
for a period of 180 days after the time the work is commenced. Balance Due: $344.00
Account#: 011-01-5911 1 nspector MID#: 2008-84120
BUILDING- INSPECTOR RECORD
SITE-WORK DATE ID/SIG COMMENTS Owner-Builder Declaration
• I hereby affirm under penalty of perjury that I am exempt form the Contractors License Law for the followings reason(sec.703 I.;Business
FForm
acks and Profession Code):Any City or County which requires a permit to construct,alter,improve,demolish or repair any structure,prior to its
issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the
s/Steel/Holdowns Contractor's Licensed Law(Chapter 9,Commencing with Section 7000 of Division 3 of the Business and Professions Code)or that he or
she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the
Erection Pads applicant to a civil penalty of not more than five hundred dollars(S500).
U F E R Ground _I,as owner of the property,or my employees with wages as their sole compensation,will do the work and the structure is not intended
or offered for sale(Sec.7044,Business and Professions Code:The Contractor's License Law does not apply to an owner of the property
SLAB Floor who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such
who
are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the
Su bf l o o rNe n t/I n s u I. Owner-Builder will have the burden of proving that he or she not build or improve for the purpose of sale).
Roof S heath i n _I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business and
gProfession Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who
Shear Wall contracts for such projects with a Contractor(s)licensed pursuant to the Contractor's License Law.).
xempt under Section ,B.&P.C. or this reason.
Framing — L
,-
Insulation/Energy Date. d owne
D rywa I I WORKERS COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
Ext./I nt. Lath _I have and will maintain a Certificate of Consent to Self-Insure for workers'compensation,as provided for by Section 3700 of the
Brown Coat Labor Code,for the performance of the work for which the permit is issued.
Mason _I have and will maintain workers' compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the
Masonry work for which this permit is issued.My workers'compensation insurance carrier and policy number are:
Pool Fence Carrier:
T-Bar
Policy;'umber: Expires:
Handicap Req. (This section need not be completed if the permit is for One hundred dollars(S100)or less)
Deputy Final Report _I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to
py became subject to the workers'compensation laws of California,and agree that if I should become subject to the workers'
Engineer Final Report compensatgpn provisions o Section 3700 of the Labor Code,I shall,forthwith comply with those provisions..
t%Flood Zone Certif. Da Applicant:
WA �1LING:Failure to secure workers'compensation coverage is unlawful,and shall subject an employer to crir;inal penalties and civil
fines up to one hundred thousand dollars(S100,0W),in addition to the cost of compensation,damages as provided for the Section 3076 of
the Labor Code,interest and anorney's fees.
FINAL U LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provision of Chapter 9(commencing with Section 7000)of Division 3 of
Certificate of Occupancy the Business and Professions Code,and my license is in full force and effect.
Notes, Remarks, Etc. License Class: License Number
Date, Contractor:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
issued(Sec.3097,Civ.C.).
Lender's Name:
Lender's Address:
APPLICANT'S DECLARATION
Demolition Permits-Asbestos Notification Federal Regulations(Title 40,Part 6)
_Required Letter of Notification
_I certify that the federal regulations regarding asbestos removal are not applicable to this project.
I certify that I have read this application and state that the above information is correct.I agree to comply with all City and County
ordinances and State Laws relating to building construction,and hereby authorize representatives of this City and County to enter upon the
above mentioned property for inspection purposes.
O
Applicant or agent sig.\ '� ` � Date:
Permittee name(prin�T
�Jk th,V,C-0 e�B'R -V�
M:\WP51\Permit-Inspection Forms\Building-Inspection Record.doc 03,31.06
MAYOR F CITY MANAGER
Miguel A. Pulido 14" David N. Ream
MAYOR PRO TEM ° `�`. ;: CITY ATTORNEY
Claudia C.Alvarez °°•�• �� -` Joseph W. Fletcher
COUNCILMEMBERS CLERK OF THE COUNCIL
P. David Benavides _ Patricia E. Healy
Carlos Bustamante
Michele Martinez
Vincent F.Sarmiento
Sal Tinajero CITY OF SANTA ANA
PLANNING do BUILDING AGENCY
20 Civic Center Plaza • P.O. Box 1988
Santa Ana,California 92702
www.santa-ana.org
OWNER-BUILDER VERIFICATION (HSC 19831)
Attention Property Owner:
An "owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information at your earliest opportunity to avoid unnecessary delay in
processing and issuing your building permit. No building permit will be issued until this verification is received.
(Read information on Page 2 prior to completion of this form.)
1. I personally plan to provide th major labor and materials for construction of the proposed property
improvement (yes or no) +�
2. 1 (have/have not) -����r,-' =-; signed an application for a building permit for the
proposed work.
3. 1 have contracted with the following person (firm) to provide the proposed construction:
Name
Address City
Phone Contractor's License No.
4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise
and provide the major work:
Name
Address City
Phone Contractor's License No.
5. 1 will provide some of the work, but I have contracted (hired) the following persons to provide the work
indicated:
NAME ADDRESS PHONE TYPE OF WORK
Signed: - �------ .._- —�--
Property Owner (print): .��� �-✓ - �1 ��
Property Address: <73
Date: L� -' '
DRAW A PLOT' PLAN III CLUDING THE FOLLOWING INFORMATION
OI cf E; USE INIQ
5. NATION,SIZE,AND USE OF ALL
1• 'PROPE`RfIY� � EMSTING&PROPOSED BLDGS
I
2. ADJACENT tSTREE'rN 6. LOCATION AND SIZE OF PARKING SPACES
3. NORTH.kRROW - AND DRIVEWAYS
t3,. LOCATION,SIZE,AND USE OF PROPOSED WORD
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