HomeMy WebLinkAbout10181826 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O{818,2G
Pin #: 85753
Proiect Address: 2221 S Rene Dra
Assessor's Parcel: 408465-09 Lot: 10
Unit:Bldg: Address Range:Suite Range:
Zoning: R1Block: NA Tract: 2207 Historic: No
Building Use.
Job Type.
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Reroof
Reroof
SFD
Occupancy.
Constr Type:
Code:
Flood Zone'.
# of Stories:
R-3
VB
cBc 2013
x-0602320259J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $e,792.00
Oe3cription of Woft: Reroof SFD, not dotach.d Garrga. Removo old comp rhinglo and inst ll n.w cla!3 A asphalt ahinglgs. 2400 sq. ft. Contractor will
alao p€do.m two unrolatod trad6 (now siding and p.int), H.ndout givon
Planning Condition3:RaPtir tny dtmaggd oave6, fascla, lafters, ctc. and repalnt as nocdcd. '
Engineer:
Owner: Golden LoafFlnanclel Conlraclor: Marka3 De3lgn and Con3tru
Address: l0a0l VEI{lcE BLVD 24 Address: 5022 V.nt ge Ave. Address:
Culverclty, CA 902320000 ilorth Hollywood, CAgl608
Phone: Phone: (310) 77a4843 Phone:
Tonant state Licf: a328!2 License#:
Lic Type: B, C-10 Archilect /
eus Lic*: 347514 ij.;i;;;;, .
Wo*erE Comp€nsalion lnsurEnce: Address:Carier: EXEMPT
Policy*: Phone:
Expirss: License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES Insp. Req'd: No
PWA lnsp. Req'd: No
Planning !nsp. Req'd: No
Landscaping !nsp. Req'd. No
Pezeshkpour, Ali
Chavez, Davb4
Date: 0710112014
Date:
Date.07101l,2014
t>
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002 57607 Permit Fee
07776002 57672 Bldg. Stds. Revolving
01776002 57600 General Plan Update
07776002 57607 lssuance
Fee Total:
Paid to Date:
Balance Due:
$282.52
$1 .00
$19.46
$48.52
Fire Insp. Req'd: No
Police lnsp. Req'd. No Account#
Flood Zone Cert. Req'd: No 01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
Total
$19.46
$331 .04
$1.00Every permitissued shall become invalid unless fhe work on the sife
authoized by such permit is com menced within 1 80 days after its
issuan ce, or if the work authorized on the site by such permif is
suspen ded or abandoned for a peiod of 1 80 days after the time the
work is commenced.
lnspector MID#:2014-115280
$351.50
$0.00
$351 .50
BUI!-DING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG,COMMENTS Owns-Builds Dcclaration
I hereby affirm undcr p€mhy of plrjury that I rm exempt form the ContractoB' Liccnsc Law for thc folkrwrng rason (src.?03 I .5 Busintss
and ProGssion Codc): Any City or County which rcquira r pcmit to comtrucl. alt6. impreve. dcmolish or rcpair rny structuc. prior,kr its
issurncc. also rcquirc thc applicsnt for such pcmit lo filc a signcd stalmnt lhst hc or shc is liccDscd purcuant to thc prcvisiom of thc
Cont.actor's Licensed Llw (Chaptq 9, Commcncing with Sction 7flD of Drvision I ofthe Busin63 rnd Prof6sions Codc) or that he or
shc is cxcmpt lhefrom and lhc bsb for thc allcgcd cxonption .Any violation ofseclion 70-l 1.5 by any applicant for i ponit subjccts thc
rpplicant to a civil pcnalty ofnot morc than tivc hudrcd dollaE ($500).
_ l.s owncroflhcpropcrty.ormycmployccswithwag6asthcirsolccompcnsalion,willdolhcwo*endthcstructurcisnotintcndcd
or offered for sle ( Se 7044, Busincss and Professions Code: Thc Contraclor's Liccnsc Law do6 ool apply to an owner ofthe prcpcrly
who builds o. imprcvG thcron. and who do6 such work himsclfor hc$clfor through his or hcr own cmploys. providcd th.t such
improvcments arc not intcndcd or offcrcd for salc. lf. howcvcr. thc building or improvcmcnt is sold within onc ycar ofcomplction. thc
Owner-Builder will hsve thc burd.n ofproving that hc or shc not build or improvc for thc purpos. ofsale).
_1, as owner of the propefly. arn e.xclusively contracting with licensed conlractors to construct the project ( Sec. 7044. Business and
Profession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon , and who
contracts for such projects with a Contractor(s) licensed pursuant to the Contractor's License l-aw )
_-l am exempt under Section
Date:
.8. & P.C. for this reason.
_Owncr:
WORKERS COMPENSATION DECLARATION
I hcrcby affim undcr pcnalty ofpsjury onc ofthc following dslsrations:
_l havc ard will maintain a Ccnificrtc ofConscnl to SclfJf,sure for workers' compensrtion, as provided for by Section 3700 ofthe
t bor Codc. for thc pcrfomncc of thc work for which thc p€mit is issucd.
_l haveandwill nraintainworkers'@mpensationirsurance,as requiredbySectionlT0oofthet,aborCodqfortheperformnccofthc
work for which this pernrit is issued. My workcrs' compenstion insurancc canicr and policy numbcr arc:
Carrier:_
Policy Number:_ _E.xpires:
(This section need not be completed if the permit is for One hundred dollars {$100} or less)
#hrffiat in the performance of the work for which this permit is issued. t shall not employ any person in any manner so as to
' became subject to the workers' compensation laws of California, and agree that if I should become subject to the workers'
compensation provisions of Section .1700 of the Labor Code. I shall. forthwith comply with those provisions..
_Applicant:
WARNING: Failure to seure workcrs' compensation coverage is unhwful. snd shrll subjst an employer to siminal pcnaltics ard civil
fines up lo onc hundrcd thousand dollaE ($100.000).in addtion to thc cost ofcompcnsation. darnagcs as provided for thc Strtion 1076 of
the Labo. Codc, interet and attorney's fc.
LICENSED CONTRACTORS DECLARATTON
I hcrcby atfim undcr pcnnlty of pcrjury that I am liccnscd undcr prevision ofchrptcr 9 (ommcncing with Scction 7000) of Division 3 of
thc Busin6s and Prof6sions Codc. and my liccNc is in full forcc and cffcct.
[,icense Class:23263L B,c{.f.*u,no*Y32632
"",,7/// ?_Contractor:
CONSTRUCTION LENDING AGENCY
I h(cby aflim undcr pcnaly of pcrjury lhat th.rc is a coEtruction lcnding rgcncy for thc pcrfomncc of thc work for which this pcrmit is
issucd (Sc. 3097. Civ. C.).
Lender's Name:
Lender's Address: -
Dcmolition Pcmits-Asbestos Notitication Fcd.o, *ffititffiffi
_ Rcquircd lrttcr of Notification
_l ccnify that thc fcdcralregulstions rcgarding 6b6tos rcmovalarc not npplicablc to this prqiet.
,€i;i$,-an", , *vc rcad this application and sratc rhar rhc abovc infomarion is conccl. I rgrcc to comply wirh 8ll City and county
ordimncG and Statc kws rclsting to building comtruction. ed hcrcby authoriz rcprBcntrtivB ofthis City and County to otcr upon thc
abovc mcntioncd propcny for inspation purposc.
Applicant or agenl _Date:
Pcrrnittee narrre (print ):-.s--_r,*C
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/VenUInsul
Roof Sheathing ^t//ff-T ll-Qc ^l,q KlZt)
Shear Wall (
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL
Certificate of Occupancy
Notes, Remarks, Etc.
Forms\Building-lnspection Record.doc 03.31.06
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