HomeMy WebLinkAbout101101309 - PermitPermit Counter: (714) 647-5800 lnspection Requests 17141667-2738 lnspector Section: (7141647-5853
Proiect Address: 1129 112 S Van Ness Ave-a-Bldg: Address Range:Urrrt
Assessor's Parcel: 01 3-094-08 l-ot 66 Block: NA Tract: 648 Historic: No
Suite Range:
Zoning: Rl
City of Santa Ana 20 Civic Center Plaza (tri 19) Santa Ana, CA92702 Building Permit #: {O11O13O9
Pin #: 32379
Building Use Accessory Dwelling Unit-Convert Occupancy: R-3, U 1st FL Area
Job Type: Reroof Constr Type: V B 2nd FL Area
Nature of Work: Reroof Code: CBC 2016 Other Areas:
Existing Bldg. & Use: SFD w/att garage & det porte coch, Flood Zone: X-0602320276J Garage Area:
Proposed Use: 2nd Dwelling Unit # of Storres:
Totat
Description of Work: Reroof det ADU-Remove and apply comp shingles/replace sheathing as req'd /handout '":* t : ,
i..-, . : .
/ 7 r_r:_t
lronsorrt ion Tobal
Patio:
T.l.Area:
Yards Req'd
Valuationr $t,41 5.00
Si 3'J/ ?r-tl,?- I D
Trnns+: 65Ref*: I
8/3it/? l:r1? 3
$i4
tJ I 1t:t1 Stly
: ? 3 F,l'1Planning Conditions:
E ngineer:
Address:
Phone:
License #.
Architect /
Desiqner:
Address:
Phone:
License #:
Robertn Roser"sOwner.
Address:
Phone:
Tenant
Roberta Rogers
1129 S Van Ness Ave
Santa Ana, CA 927071 135
(7141 41 5-e8s8
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Gerier.nl F lnn Updote Fee
Lll I 161:102- 51 5[tt-tt-tut-t-
Bur r ld ins
Ltl I 1,5rt02- 5l6LrltJltu-
P,lds Stds Revolvins
ttl I 1,5r:U2- 5161 2t-t[tt-t-
I'ln=[er i:nrd
C(:* : rr** *r*x ****r_r485
fi??.
$-19[t .
$1.
*c t ?rD.-lt 7 .
Aubh*:741.t4:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp Req'd
\r\h"rnandez, Kathy
Kelaher. Selena Date: 0813012019
Date:
Date: 0813012019
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt
01-776002 57607 Permit Fee
0LLL5002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
07776002 5L60L lssuance
Fee Totat
Paid to Date:
Balance Due:
$333 06
$1 00
$22.e5
$s7 20
No
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
$22 95
$3e0 26
$1 00Every permitissued shall become invalid unless the work on the site authortzed by
such permit is commenced within360 days afterifs issuance,or if the work authorized
on the site by such permit rs suspended or abandoned for a period of 360 days after
the time the work is commenced.
lnspector MID#' 2019-154094
$414 21
$0 00
$at 4.21
a
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS OWNNR BUILDI'R DELCARATION
I hcrcby aflirm undcr pcnillty of pcrjury lhal I am cxcnpl from lhc ContrachN' Liccn* lrw for thc fotlowing rcason (Scc.70.ll.5
Busincss aml Profcssion Cule): Any Cily or Counly which requircs l rrmil lo conslruct. allcr. improvc. dcmolish or rcFir any
slruclure. prior to ils issuancc. also rcquires the {pplicant for such Frtrlil to l'ilc { signcd stalerrctrl lhal hc or slrc is liccned pursu'anl
to lhc provisi(ms of thc Conlractor's Licenrcd Law (Chaplcr 9. Conmrcncing wilh Sslion ?Un of Division .3 of lhe Busincss rnd
P()l'cssionsCodc)orlhatlrcorshciscxcmpllhcrcfro[rilndlhchdsisforlhcsllcgcdexclrplion. AnyviolationofssthnT03l.5byony
{pplicatrl for a pcrmit suhjccts lhe applicant lo { civil pcn{lly of nol trk)rc thrn fivc hundred dollars (S5fi)).
_1. as owncr of lhc proprty. or nry cnrployccs with wagcs as thcir solc conlpcnsation. will do thc work and the struclurc is not
inlcntlctl or oll'ercd lirr sale (Scc.7044. Business and Profcssions Crxlc: 'l'hc Contractor's l.iccttsc l-aw docs nol apply lo alt owncr ot'
the prn;rcrty who builds or itnprovcs thcrcrrn. atd who drrcs such work hirnsclf or hcrsclf or through his or hcr own enlployccs.
provi(lc(l lhal such irnprovcrrrcnls arc t'lot intendcd orofl'crcd ftrr salc. lf. howcvcr. thc building or itnprovcnrnt is sold withinonc yenr
of cornplction. thc Owncr Buildcr will havc lhc burdcn of provirrg that hc or shc did not build or irnprovc thc propcrty ltrr lhc puqmscof
salc).
-1.
as owncr ol'lhc propcrly. anr cxclusivcly corrlructirrg with liccrrscd conlractors to conslrucl thc projcct (.Scc. 7044. Busincss
and hofcssionCodc: 'l'hcContrilclor'sLiccnscl-aw<locsnotapplyloanowncrofpropcrtyu'hohuildsorimprovcsthercon.
and who conlracls l'or such pro.iccts with a Conlractor(s) liccnscd pursuant lo lhc (-ontraclor's Licensc l;rw).
-IatncxclnptundcrScctirllt-.B.&P.C.lirrlhis5pason.^.tr|,I)are: -8:3!41- u*,u,,
DECLARATION
I hcrcby al'flrnr urrdcr pcnalty ol'pcrjury onc of thc following declaralions:
_l havcandwill rnaintainaCcrtificatcol'C<lrrscrtltoScll'-lrrsurcltlrworkcrs'cornpcnsalior'r.as providcdfirrbyScction3T(Dofthc
Labor Crxlc. ltrrthe pcrforrnancc of thc work f'or which thc pcrrnit is issucd.
-l
havc arrtl will rtrainlain u'orkcrs'corn;rcnsalion insurancc. :rs rcquircd by Scction 37(X) ol'lhc Lahor Codc. for lhc pcrlirrnrancc of
lhc work krr which this pcrmit is issucd. My workcrs' conlpcnsrtion insurancc cirrricr and prlicy nunrtrcr arc:
I
Policy
-l
ccrtify thal in lhc pcrlbrnurncc of thc work firr which this pcrnrit is issucd. I shall not employ any pcrson in any nlanncr j
so as lo bccornc subjcct lo lhc workcrs'compcnsatiolr lau,s of C-alit'orniir. arrtl agrcc thal il'l should bcconrc subjcct lo lhc
s'orkcrs' corrtpcnsation pnrvisions of Scction .1700 of the Lttxrr Crxlc. I shall. lorthwith cornply with thosc provisions.
lVARNIN(]: Failurc lo sccure wrlrkcrs' compcnsaliorl covcragc is urrlawl'ul. antl shall suhjccl an cnrpkrycr to crinrinal Jrcnaltic's and
civil lincs up lo onc hundrerl thousand dollars (SlOO.ffiO). irr additiorr lo thc cost of conrJrcnsalion. danugcs as providcd lbr the
Scction -1076 of lhc l-ahrr Codc. intcrest and atlorrcy's fccs.
Dare:- 3: ?:--la--- Appr,rrrr, -ffigfi& AJ44'4
r rcFr\sED ctx'rmctOn
DECLARATI(TN
I hcrcby afl'irru undcr pcnalty of pcrjury that I arn liccrrscd undcr ;rrovisiorr ol'Chaplcr 9 (corrrrncrrcing with Scction 7fiX)) of Division 3
of lhc Ilusittcss iuttl Prol'cssions Code. and nty liccrrsc is in lirll tirrcc arxlcllccl.
I.iccrtsc Class: Liccnsc Nurrrr^ur:
Date: ('ontrnclor:
C(INSTRUCTION LENDING AGENCY
I hcrcby amrm undcr lrnillty of ncrjury th0t lhsc is a conslructhn hndir8 aScncy for thc pcrformncc of thc work for which lhis trcrmit is
issued (Scc. 3(x)7. Civ. C.).
l*ndcr's Nanrc:
l.cnrlcr's Adtlrcss:
APPLICANT DECLARA'TION
I lrcrcby allirrn untlcr pcrtalty ol'pcrjury onc of'lhc firlkrwing <lcclarations:
Dcrnolition Perrnits-Ashcstos Nolification Fcderal Rcgulations ('l'itlc 40. Part6l
-Rctluircd
Lctlcr of Notitication
-l
ccrlitythat thc l'crleralrcgulaliorts rcgardirtg ashcslosrcrrtovalat'c nol ryplicahlc to this pro.icct.
_l ccnify that I havc rcad this application ard statc thrt thc ilbvc informstion is corcct. I trgrc to comply with all City and County
ordinances and Stalc hws rclating lo building construction. and hcrchy rulhorizc rcprcsntativcs ofthis Ciry md County to cnts ulnn tlE
atnvc mcnlioncd pmpcrty for insgrcqirfnjurpes.
Appric.trrorAsenrs t["rt"*, W Yt--YQ,+r*t o"n g' iO'(r
Pcmltee mme (pdna)r_ _
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor n
Su bf loor/VenVl nsu lation /\\
Roof Sheathinq lo-1 \) "w,i:,:\Shear Wall V \-/
Framinq
lnsulatio nlEnerqy
Drywall I
Ext./lnt. Lath "{XU/)
Brown Coat I L/
lt/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Fina! Report
Flood Zone Certif
t I \,l
FINAL -U -,D[\rpc lrwb7
Certificate of Occupancy 1 I V
Notes, Remarks, Etc.