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Home My WebLink About101105096 - PermitCity 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 #: {01105096 Pin #: 9420.2 Project Address: 521 W Memory Ln Assessor's Parce!: 002-035-08 Lot: 8 Unit:Bldg Tract: 3374 Address Range:Suite Range: Zoning: R1Block: NA Historic: No Building Use: Job Type: Nature of Work: Existing Bldg & Use: Proposed Use: Single Family Dwelling Alteration Door replacement Sfd w/att garage Occupancy: Constr Type: Code: Flood Zone'. # of Stories: R-3, U VB cBc 2019 x-0602320163J 1st FL Area: 2nd FL Area: Other Areas: Garage Area: Total Patio. T.l.Area. Yards Req'd: Valuation: $2,500.00 Description of Work: Replace (1) sliding glass door - like-for-like. Planning Conditions: Owner: Address: Phone: Tenant: MICHAEL BUCKMASTER 521 W MEMORY LN Santa Ana, CA 927061125 (7141 667-6161 Contractor: Renewal by Andersen Oranl Address: 22982 Alcalde Drive, Unit 10 Laguna Hills, CA 92653 Phone: (7141 259-5120 State Lic #: 990416 Lic Type. B, D-24, C-l7, D-21 Bus. Lic #. 349936 Workers' Compensation I nsurance: Carrier: Old Republic lns Policy #: MWC31415820 Expires: 10/01 12021 Engineer: Address: Phone: License #: Architect / Designer: Address: Phone: License #: Planning Approval By Enriquez, Gissel Plan Checked By: Permit lssued By:Amsden, Julie NPDES !nsp. Req'd: PWA !nsp. Req'd: Date: 1012912020 Date: Date: 1012912020 Subject to Field: Misc. Receipt: Misc. Receipt: Misc. Receipt: 07776002 07776002 07776002 07776002 07776002 57607 57770 57672 57600 57607 Permit Fee Microfilm Records Bldg. Stds. Revolving General Plan Update ! ssuance Fee Total: Paid to Date: Balance Due: $172.64 $4.0s $1 .00 $23.79 $59.30 No No No Fire lnsp. Req'd: Police lnsp. Req'd: No No Account#TotalPlanning lnsp. Req'd: Landscaping lnsp. Req'd:Flood Zone Cert. Req'd: No 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 permit is suspe nded or abandoned for a period of 360 days after the time the work is commenced. 01 1 16002 51600 01 1 16002 51601 01 1 16002 51612 01 1 16002 57770 $23.7e $231 .94 $1 .00 $4.05 $260 78 $0.00 $260.78 lnspector MID#: 2020-162488 BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWIIER BUILDER DELCARATION I hcrcby affirrn undcr pnalty of perjury that I am cxcmpt from thc Contractors' Liccnse Law for the following reason (Scc.7031.5 Busincss and Profcssion Codc): Any City or County which rcquircs a pcrmit to conslruct. altcr. improvc. dcmolish or rcpir any struclurc, prior to its issuarrce. also rcquircs thc applicant for such permit to file a signcd slatcmcnt that hc or shc Ls liccnsed pursuant to the provisions of ttrc Contractor's Licenscd [:w (Chapter 9, Comrnencing with Scrtion 7000 of Division 3 of the Business and Profcssions Codc) or that he or shc is exempt thcrefrorn and thc basis for the allcgcd exemption. Any violation of Scction 7031.5 by any applicant for a permit zubjcrcts the applicant to a civil penalty of not more than five hundred dollars ($500). _1. as owner of the propcrty, or my employees with wagcs as their solc compcnsation, willdo thc work and thc struclurc is not intcnded or offcrcd for salc (Scc.7G[4, Busincss and hofcssions Code: The Contractor's Liccnsc l,aw docs not apply to an owner of the proprty who builds or improvcs thercon. and who does such work himself or herself or thrcugh his or her own cmployees. providcd that such improvcmcnts arc not intcndcd or oficrcd for sale. I[, howcrrcr. thc building or inqlrovenrcnt is sold within one ]car of cornplction. thc Owncr Buildcr will havc thc burdcn of proving that hc or she did not build or improvc thc propcrty for the pur;nsc of salc). _1. as owncr of thc property. am cxclusivcly contracting with liccnsed contractors lo conslruct thc project (Scc. 7U4, Business and Profcssion Code: Thc Contraclor's Licensc Law docs not apply to an owncr of propcrly who builds or improves thercon. and who contracts for such projccts with a Glntractor(s) liccnsed pursuant to thc Contractor's Licensc [,trw). _ _l anr cxcnrpt under Scction_. B. & P.C. for this reason. Date:()u'ner: WORKERS' COMPENSATI()N DECL^ RATION I hcrchy affirm under penalty of pcrjury onc of thc following dcrclarations: '-l have and will maintain a Certificatc of C<lnscnt to Sclf-lnsure for workcrs' compensation. as providcd for by Section 3700 of the Labor Codc. for the pcrforrnance of thc work for which the frcrmit Ls issued. {,r 1 thc havcandwill maintainworkcrs'conrpcnsatiorrinsurancc.as rcquircdbyScction3Tfi)oflhcLaborCode,fortheperformanceof work for which this permit is issucxl. My workcrs' cornpensation insurance carricr arxl policy numbcr arc: /0 / t /"-c,t-t _l ccilify that in lhc pcrformrcc of thc work for which this Frmit is issucd" I shall uol cmploy any prson in oy mner s as Io be@m subjcrt to the uqkc6 comlrcnstion laws of C{lifomi., ild agrc that if I should bccorc suhj$t to ilE workcN cotr{rcLerionpmvisiomofScction3T0Oofthct2borCo&.lslBll.fonhwirh@mplywithlhosprcvisions. WARNING: Failurc to *curc udkcrs' @r{rcnstion covssgc is unlaeful. and shsll subjsl dn cmploycr to cimiml penaltls and . civil fircs up to orc hundrcd tlbusmd dolles ($100.(m). in addition 10 the cost of cotr{Enstion. damges as provilcd for thc 3076 of l,atnr Codc. intercst and allorncy's fecs. NECLARATION I hcrcby affirm under penalty of pcrjury that I am licenscd undcr provision of Chaptcr 9 (contnpncing with Sccti<ln 7000) of Division 3 of thc Business and Professions Code. and my license is in full force and effcct. Nulnbcr: Conlraclor:krcu-* I bl Qtt ale c_J CONSTRUCTION LFTYDING AG EN CY I hcrcby alfirm uMcr IEnBlty of Frjury that lhcrc is a construction hnding agcmy for lhc Frformcc of thc work for which this permit is issued (Sec. 3097. Civ. C.). lrndcr's Namc: Lcnder's Addrcss: APPI ICAXT neCtlRlrrn I hocby aftinn undcr penalty of pcrjury onc of thc following declarations: Dcrnolition Permits-Asbcstos Notification Fcdcral Rcgulations (Titlc 40, Part6) -Rcquircd l,ctter of Notification -l ccrlify that thc fcdcnl rcgulslions rcgading asbcslos rcmval arc nol applicoblc lo this pmj@1. f$ccnify rnut I Mvc ]ead this spptication srd statc that thc ahovc infomlion is offi. I agre to corryly with all City and County Afilnares and Statc Laws rclating to building constructiotr dd hcrcby authorirc reprc*ntativcs of this Cily rnd County to oter ulEn the abovc mntioncd prcperty for inqrction purJns. f,ppn"urt or Agent o*", /o/>q{Lo \Pcmlc,*rerirl ffar,ztsr) C),I,xa\ Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Su bf loor/VenUl ns u latio n Roof Sheathinq Shear Wall Framinq lnsulatio nlEnergy Drywal! Ext./lnt. Lath Brown Coat Jtlasonrv Pool Fence ( T-Bar Handicap Req. Deputy Final Report Enqineer Fina! Report Flood Zone Certif FINAL t)l/o lp DfrVtr Gertificate of Occupancv Notes, Remarks, Etc. 1 / Rev. 08-07-201 5 ?7nqt L.