HomeMy WebLinkAbout101103029 - Permit (2)Proiect Address: 1127 W Fifth Sta
Assessor's Parcel:008-083-1 3 Lot: 3
Unit:Bldg: Address Range:
Tract. MCFADDEN & WTLSON ADD Historic: No
Suite Range:
Zoning: RlBlock: NA
City 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 +{e
Permit #: {O11O3O29
Pin #: 88EiE
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
SFD
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
R-3
VB
cBc 2019
x-0602320257 J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $e,000.00
Description of Work: lnstallation of roof mounted PV system. Worksheet attached.
Planning Conditions:
Owner.
'Address:
Phone:
Tenant:
Shakan Keith
1127 W. Fifth Street
Santa Ana, CA 92703
714785798
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: America n Zurich
Policy #: WC509601305
Expires'. 1110112020
Engineer
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Vivint.Solar
James Matthew Walsh
3301 N Thanksgiving Way, #500
LEHI, UT 84043
c73567
Vivint.Solar
James Matthew Walsh
3301 N Thanksgiving Way, #500
LEHI, UT 84043
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
Date:
Date:
Date: 0210412020
Subject to Field:
Misc. Recerpt:
Misc. Receipt:
Misc. Receipt:
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Total.
Paid to Date.
Balance Due:
$450 00
$54.74
$1.00
$0 00Chavez,O^u/r?
Fire Insp. Req'd:
Police 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 within 360 days after ifs issua nce,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.
Inspector MrD#' 2020-157547
No
No Accou nt#Total
01 1 16002 51601
01116002 51612
01 1 16002 57770
$450 00
$1 00
$54 74
$505 74
$0 00
$505.74
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS oWNERBUILDERDELCARATTON r
I hqcby affm unde pcmlty of perjury thst I m cxcmpt from thc Contractom' Licere Law for the following rwn (5&.7031.5
Bsin6s and hofsion Codc): Any City or County which rcquirc a pcmit to sEIrucl. alte, improvc, dcmolish or rtpair my
structw, prior to its i$umce, also rcquic the applicot for such pcrmit to 6le a sign€d statmat thd hc or she b licscd pwmt
to thc pmvisioru of the Contretor's Licensed Law (Chapt6 9, Comnencing with Setion 7000 of Division J of the Busin$ od
Prcfsions Code) or that hc or she is cxmpt thftfrom ild the basis for the alleged ermpion. Any violation of Sction 7031.5 by my
applicantforaptrnitsubjatsthc applicanttoacivilpenaltyofnotmorcthsfivehundrcddollm($500).
__1. as o\lner of the propert),. or my employees with wages as their sole compensation. will do the work and the structure is not
interrded or offered for sale (Sec.7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of
the property who builds or improves thereon. and who does such work himself or herself or through his or hcr own employees.
provided that such improvoncnts are not intcnded or offered for sale. l[, howwer, the building or improvement is sold within one ]Ear
of complaion, the Ourner Builder will have the burdcn of proving that he or she did not build or improve the propoty for the purpose of
sale).
_1. as owner of the propcrty. am exclusively contracting with licensed contractors to construct the projett (Sec. 7044, Business
and Pnofession 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 Contracto(s) licensed pursuant to the Contractor's Liccnse Law).
_l am exempt under B. & P.C. for this reason.
WORKER,S' COM PENSATIO N
DECLARATION
I hereby affirm under pcnalty of perjury onc of the following declarations:
__lhavcurdwillmintahaCcrtificate ofcoMttoSelf-lNucforworkss'compwtion.c providedforbySction3T00ofthc
tabor Codc, for thc pqfoIrmcc of thc wort for which thc pcrmit is isucd.
VrZI have snd will maintain workm' cornpcmation imuruce, r rcquired by ss{ion 3?00 of thc Labor Codc, for thc pqfomoce of
the work for which this Fnnit is issued My workm' ompcrrarion ireurucc wio and policy numba rc:
a n'CG.-t ZtJf t( k
3 3
I6?oPolicy
_l certify that in the performance of the work for which this perrnit is issued. I shall not employ any person in any manntr
so as to become subject to the workers'compensation laws of California, and agree that if I should become subject to the _
rvorkers' compensation provisions of Section 3700 of the Labor Codc. I shall. forthwith comply with those provisions.
WARNING: Failure to sccure workcrs' compensation coverage is unlawful. and shall subject an etnployer to criminal petralties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. darnages as provided for the
Section 3076 of the Labor Code. interest and attorney's fees.
a-k rf oir.t4i( ( Va
DECI.ARATION
I hereby affirm under penalty of pcrjury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Profcssions Code, and my license is in full force and effect.
Licenseclr"r' ' C (O LicenseNumbcr:
3 cr"5 7 {a
af)olp'2 -t/1^7 o2 c,('ontractor:* Vr v*t4 5
W
I hrcby alfim undo pcnalty of pcjury that th6c is I @retrucliof, lcnding agmcy for thc pqfommcc of thc mrk for which this pqrnrt b
isucd (Se. 3097, Civ. C.).
Lender's Narne:
Lcnder's Address:
APPLICANT DECLARATION
I hoeby aff:nn under pcnalty of perjury one of the followrng declarations:
Dernolition Permits-Asbcstos Notification Federal Regulations (Title 40, Pan6)
_Required l.€lter of Notification
_l ccrti& that the federal regulations regarding asbestos rcmoval are not applicablc to this project.
llv I ceflify that I have read this application and state that the above infonnation with all City and County
and County to ent€r upon theordina-nces and State Laws relating to building construction. and
-/al c
Pcrmitee nlrnre
t
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/VenUl ns u lation
Roof Sheathing
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Jlqqd Zqne Certif I t\
k*lto V['.r I q Nco VVtrlv,(u6
I trt t Cr/
FINAL A/U/{-Ig7YI W )avu
Certificate of Occupancy
Notes, Remarks, Etc.
Section
Dete:_Owner:_
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