HomeMy WebLinkAbout101103032 - Permit}P Building,City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: {O11O3O32
Pin #: 669{8
Proiect Address: 2205 S Rousselle Sta
Assessor's Parcel: 01 6-1 01-14 Lot: POR 1
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: J Tract: 668 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
SFD w/att Garage
R-3, U
VB
cBc 2019
x-0602320278J
1st FL Area:
2nd FL Area.
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $12,000.00
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
Description of Work: lnstallation of roof mounted PV system. Worksheet attached to plans.
Planning Conditions:
)
Owner.
Address:
Phone:
Tenant:
Concepcion Bravo
2205 Rousselle Street
Santa Ana, CA 92707
(7141 3174715
Contractor: Vivint Solar - lrvine
Address: 1500 White Rd
lrvine, CA 92614
Phone: (562) 942-1270
State Lic #: 973756
Lic Type: B, C-10, C-39, C-46
Bus. Lic #: 345470
Workers' Compensation I nsurance:
Carrier: Arnerica n Zurich
Policy #: WC509601305
Expires'. 1110112020
Vivint.Solar
James Matthew Walsh
3301 N Thanksgiving Way, #500
LEHI, UT 84043
c73567
Vivint.Solar, :
.lamei Maittrew Walsh
3301 N Thanksgiving Way, #500
LEHI, UT 84043
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
i
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
Fire lnsp. Req'd: No
Police Insp. Req'd: No
Flood Zone Cert. Req'd: No
Chavez, Dave
Date:
Date:
Date: 0210412020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Total.
Paid to Date:
Balance Due:
$450.00
$54.74
$1 00
$0 00
,
No
No
No
No
Account#Total
01116002 51601
01116002 s1612
01 1 16002 57770
$450 00
$1 00
$54.74Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs issuance,or if the work authorized
on the site by such permitis suspended or abandoned for a period of 360 daysafter
the time the work is commenced.
$505 74
$0 00
$s0s.74
lnspector MID#: 2020-1 57550
t
I
BUILDING- INSPECTOR RECORD
SITE.WORK DATE !D/SIG.COMMENTS OWNER BUTLDER DELCARATION
I hocby affm unrlo pcralty of pcrjury that I m cr.mpt ftom thc ConiracloE' Licce law for the following rcen [ie.7031.5
Busines md Profcsion Codc): Any City or County which rcquirc a pcmh to coGtruct, altc, improvg dcrnolish or EpaL uy :
struciuc, lrior to its issuucc. also requirc thc appliclt for such pctrnit to filc a signcd $d@61 thd hc or shc b licqEcd ptmilt '
ro the prcvisioru of thc Contmctor's Liccnscd Law (Chapts 9, Comcncing with Sdtion 7000 of Division 3 of the Bsins md
Prcfsions Cod€) or thal hc or shc fu €x@pt thqcfrom ad the basis for the allcged amption. Any violation of Scction 7031.5 by any
applicmr for a mit subjets thc ap,plicant to a civil poalty of nol morc tha fivc hundrcd dollm ($500).
--1.
as owner of the propcrty, or my employc€s with wages as their sole compensation. will do the work and the structurc is not
intended or offered for sale (Sec.7044. Business and hofiessions Code: The Contractor's License law does not apply to an owner of
the property who builds or improves thereon. and who does such wo* himself or herself or through his or her own employees.
provided that such improvcrnants are not intended or offcred for sale. l[, howarer. the building or improvement is sold within one ]rcar
of completion. the O'rvner Buildcr will have the hrden of proving tha he or she did not build or improve the property for the purpose of
sale).
_1, as owner of the propcrty. arn exclusively contracting with licensed contractors to construct the projcct (Sec. 7M4, Business
and hof€ssion Code: The Contractor's l,icense Law does not apply to an owncr of property who builds or improves thereon,
and who contracts for such projects with a Contracto(s) licorsed pursuant to the Contractor's License taw).
-l
arn excmpt under Scction-. B. & P.C. tor this reason.
Dnte:__
yaBsEEs:caMPJNStUlO!
DECI.ASAIION
I h@by aItrm undq pcnalty of pojury one of thc following delaratiore:
_l have.nd will maintain a Cqtifrcatc ofcoMt to Selflmurc for rcrkc' rcmpcrudion, a povidcd for by Setion 3700 of thc
labor Codc, for the pqfomcc of thc wort for which the pqmit b isucd.
! -lr6avc and will msif,tain work6' compcroation ireurrec, c rcquired by setion 3700 of thc tabor Codc, for thc pcfomue of
thd work for which this pcrmit is issucd My workc' composation ireuficc cmi6 a[d policy nubc rc:
fi yr^e. ficcnvt ?L ,tal( L
Policy z
_i certi$ that in the pcrformance of the work for which this perrnit is issued. I shall not ernploy any person in any manner
so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the
workers' compensation provisions of Section 3700 of the labor Code. I shall. forthwith comply with those provisions. \
WARNING: Failure to secure workers' compensation coverage is unlawful. and shall subjo;t an onploycr to criminal penahics and
civil fines up to one hundred thousand dollars ($100.000).
Scction 3076 of the Labor Code. interest and attorney's fees.
in addition to the cost of compensation. damages as provided for the
)
orrc,'Z -4 - ? o'l c--
I hereby affinn under penalty of perjury that I arn licenscd (comrnencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
Licensecr"r* C( b
LicenseNumber:Ct7 7t
orr".'7-\-?u?o contracror, ViVlnlSolq,r.
CONSTRUCTION LEIIDING AGENCY
I hmby amm unds pcoalty of perjury that thqc is a coNtruclion loding agmcy for thc pafomce of the work for which this pqmit b
isucd (S(. 3097, Civ. C.).
knds's Nmc:
-
Lender's Ad&ess:l
APPLICANT DECLARATION
I haeby affirm under penalty of perjury one of the foilowing declarations:
Demolition Permits-Asbcstos Notification Federal Regulations (Title 40. Pat16)
--Required lrtter of Notification
t
-l
cstiry that thc fcdqal rcXulatiore regading obctos rmoval ue not applicablc to this prcjel.
IL:l cdiry thal I havc rod this application ild statc that thc abovc hfomtion is cor€1. I aBrc to comply with all City md County
ordhmcG ud State trws rclating to building construcliotr atd hqeby authorizc rcprGatativB of this City ud Couty to 6tG upon thc
above me'ntioned property for inspection purposes.
Pernritec nnme
L9 orrc,7- 4- ? oZ o
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/VenUl nsu Iation
Roof Sheathinq
Shear Wall
Framing
Insulation/Enerqy
Drwval!
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputv Final Report
Enqineer Final Report
Flood Zone Certif
\n^
FINAL t\n\ua /t\0061 ,TTYI
Certificate of Occupancy \\\[
Notes, Remarks, Etc.
Applicrnt or Agent Signature:_
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