HomeMy WebLinkAbout10198834 - Permit (2)Proiect Address: 2229 112 W La Verne Ave-a Unit:
Assessor's Parcel: 109-1 21-15 Lot: 15 Block: NA Tract. 1346
Bldg: Address Range:Suite Range:
Zoning: RlHistoric: No
(l{6
city of Santa Ana 20 civic center Plaza (M-19), santa Ana, ci,92702
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Building Permit #: {O{98834
Pin #: 15487
Ft 6
Building Use: Acc.3so.y Dw.lling Unit-Convert Occupancy: R-3, U 1st FL Area 4E6 Patio:
Job Type Conversion Constr Type: V B 2nd FL Area T.l.Area:
Nature ofwork ADU Codei cBc 2ol5 Other Areas yards Req,d
Exisling Bldg. & Use: SFO wratt garage Flood Zone: X-0602320257J carage Area Valuation: 129,710.00
Proposed Use: # of Slories: 1 Total /186
D6crlptlon of Wo,k Conv.rt dotatched gerege to ADU (il87sf) with I bedroom,l b.throom, kitch.n, living room & l.undry end 3tor.g. .ro. ('l8Gf). Auth
on tile.
Planning Condition3: , ,,.
Engineer: SDeEtra MaGtEla & Enalnacdofflefi DA\4D & A]{GEL|CA I{EDRANO Contractoi owner€ulldcr Clir P. H.ttrr
Address: 2229W LAVERNE AVE AddnBss: Address:
Santa Ana, CA 927043509
(7141 501 -7269Phone.
Tenant
t
a
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation Insurance:
Carrier:
Policy #:
Expires:
Phone:
License #:
Architect /
Desiqner:
Address:
(e4s) e10-3607
5384
A.L. Drafting Service
Walfred Camargo, Designer
1345 Cabrillo Park Drive, #N-08
Santa Ana, CA 92701Phone: (7141 317 -V212
License #: :
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Fire Insp. Req'd. No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01116002 57770
3141 3002 53300
Guevara, Jerry /
Scott Fazeka. a nf,o..
Zuniga, O,,,r\
Date: 1210512018
Date: 0411112019
Date: 06/1712019
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Permit Fee
Plan Check Fee
Microfilm Records
Res. Dev. Fee - SAI/
Bldg. Stds. Revolving
General Plan Update
I ssuance
$320 50
$444 32
$48.88
$3,331 .28
$2 00
$22 08
$55 04
$3,779.78
Account#
72023
Total
07776002
07776002
07776002
37473002
07775002
07776002
07776002
s7607
s3600
57770
s3300
57672
57600
57607
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 authorrzed
on the site by such permitis suspended or abandoned for a period of 36(t days after
the time the work is commenced.
Inspector MID#: 2018-1481 30
$22 08
$37s 54
$2.00
$48 88
$3,331 .28
Fee Total
Paid to Date:
Balance Due:
@
$44432)
t-I ra
COMMENTSSITE.WORK DATE ID/SIG.
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVI ns u lation z/tlr',EW tbz
Roof Sheathinq zltoltq >Ail/o1
As-7td tlt'Shear Wall tlql t t
Framinq dz, lA B,r:r€ lo)
lnsu lation/Enerqy
Drywall $/utlrq offi/o)
Ext./lnt. Lath 8/e-t ltq BtA to.a,
Brown Coat Qln lr q oZ*{laa
[/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
nfsftUh,fuo* Sar <rt ilnl,s z/tln
'1oo^.*?ru 4t*glzolp.H les:2
der't)FINAL i"l tQ lttt \Z-/firyut,ti
Certificate of Occupancy ll ul
Notes, Remarks, Etc.
()lvNI.ll{
I hcrohy allirm undcr pcnalty of pcrjury that I am cxcmpt l(rm thc Cinrlrack)s' l-iccnsc law tbr thc lolk)wing rcr$n (Scc.}!hi
Busincss antl Prrrfcssiun C'rxlc): Any City or County which rcquircs a lmil kr cooslntcl. ahel improvc. rlcnxrlish or rcpaii any
struchrc, prirr k) ils issuancc, aly) rcquircs thc applicant t)r such Jrcr[ril k) l'ilc a signcd stalclEnl that hc or shc Ls'liccn*d ptrsuant
b thc provisions of tlrc Contrack)r's Liccnscd llw (Chaptcr 9, Comnrcncing wilh Scclion 7(X[ of Division -l of thc Busircss fnd
Pn)lcssionsCode)orthathcorshciscxcmptthcrcliomandthcbasisli)rthcallcScdcrcmptiotr. AnyviohlionofSetionTO-ll.5l'yany
applicrntli)ralErmilsuhjcctsthc applicantk)acivilpcntlty(rffrrlntlrcthanfiv('hundrc.ldollds(S5m).
_1. * owncr of the pr)lEny, or my cmpl()yccs with wagcs as tlrcir solc comFnsalirrr, willdo lhc work ukl lhc slrulurc is ft)l
intcnlcd or()lltrcdti)rsillc(Se.?(M4.BusircssandPr)lcssi()nsColc:ThcConlrack)r'sLiccnscliwdocsnotaPplyloanowncr(,1'
thcpn)IErty wh()builds([in{K)rcstlEG}n,axlwho&rcssilchM)rkhinrsclforhcrsll(trlhn)ughhisorhcrowncnlployecs.
pn)vidcd thtl such imp(rrcnrcnts rc [{ ir{cndcd or ollcrcd li}r slc. lll lr)wcvcr, lhc builling or irporcnrcnt is soll wilhin onc ycu
ol complction, thc Owncr Buildcr will harc thc hurdcn ol pnrvinS that hc or she did &)t huill rtr impruvc lhc pntlEfty ti)r tlrc puqr)$of
sab),
_1, as owncr ofthc p(rpctly. am exclusivcly coilracting wilh liccnscd contruclors k) conshuct thc projcct (Scc. 7044, Brsincss
.nd PRltilssi)nCodc:ThcG[tracior'sLiccnscl-awdocsftrlrpplyk)!nowncrofprolrcnywhobuildsorimprovcslhcrcon.
and who conlracts li)r such pmjccts with a Grnlracl(r(s) liccnsd pursuanl ft) lhc Conlrack)r's l-icensc lnw).
_l a:n excmpt undcr B. & P.C.tlris
o^tu,t 6- l?- I 4
DECLARATION
I hcrcby afl'irnr undcr Jrcnalty of ;rcrjury one ol'lhe lirllowing rlcclaral ions:
_l havc antl will maintain a Ccrtilicalc of Conscnt to Sctf-lrrsure lbr wrlrkers'crtnrpcnsalion, as providcd tirr by Scctirtn 37fi) rll'lhc
Lahlr Ctxlc. lilr the pcrtilrnrancc of thc work lbr which thc pcrmit is issucrl.
_l have and will maintain workcrs' compcnsatiotr insurancc. as rcquircd by Scction J700 ot'thc Labor Crldc, lbr thc pcrltlrmancc of
thc wrlrk lilr which this Jrcrnrit is issucrl. My workcrs' comlrcnsation insurancc carrtcr and grlicy numhcr arc:
Policy Numhcr: ExPires:
_l ccrtilythat in thc pcrklrnrance ol'thc work lirr which thrs;rcrnrit is issuctl. I shall not cntpkry any pcrs()n in any nlrlnllcr
so:tslohcconrcsulrjecttollrcworkcrs'comlrcnsatiorrlirwsol'Calilirrnia.attdagrcclhittit'lshoultlhcconrcsuhjcctttlllr'
wgrkcrs' conr;rcnsation provisions ol'scction l7(X) ol'the Lahrr Crxlc, I shall, lirrrhwith conrply witlt thrlsc llrovisions.
IVARNIN(i: ljailurc to sccurc worke.rs' conrpcnsation covcragc- is unlawlitl. antl shall strhjccl an cmpkryt-r to crintinal pcnaltics and
civil l'incs up lo onc hundrcd thousand dollars in addition to lhc cost ttf contJrcnsatitln. damagcs as provirlcd tirr lhc
Sccliott J076 ol'tltc Latxrr Crilc. inlcrcst and
tatez' 6- I V- / q
t
I Scrchy atf irnr undcr pcnaltyol'pcrjury that I arn liccnsctl untler prcvision of Chaplcr t) (ctlmnrcncing with Section 7fr) r'l'f)ivision J
ol' thc Busincss and Prcl'cssions Cotlc, and nry liccnse is in tirll tirrcc and etl'ect.
a
Liccnsc Class: l-iccnsc Numhcr:
CONSTRUCTION LENDING AGENCY
I herchy allirm undcr Fnalty of JLrjury that tlrcrc is a corstnrct i)n lcnding agcncy ltrr thc Jrcrlbrmancc (,f lhc work li)r which this Frmil tr
issrrcd (Scc. .1097, Civ. C.).
lrnrler's Namc:
lrnder's Addrcss:
APPLICANT DECLARATION
I lrrcby atl-rnn undcr penalty ol'perjury onc of thc lirlklwing tleclarations:
Dcnxrlition Pcrrnits-Ashcstos Notil'ication Fcdcral Rcgulations (Titlc 40. Pan6)
-Rcquircd
[-cttcr ot' Ntililicatittn
_l certilythal the l'cdcralrcgulalions regruding ashcslosrcntoval:trc tt()l applicahlc'lo lhis prrjcct.
_l ccrlify that t havc rcarl this application arxl statc lhtt lhe atxrvc intirntratirln is corrcct. I .lgrcc l() conrply
ivcs ol'this City
with allCity antl Counly
and County lo cnlcr ttprtn thcordinrnccs and Statc Laws rclaling to huilding
irhovc nrcnliottcd prrrpcrly lirr
Applicant or Agcnl
Penrrilcc nanrc (print
axl hcrcby authrtrzc rcprcscntat
*,- (- /V- /?
INSPECTOR RECORD aE .'.
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