HomeMy WebLinkAbout101102285 - PermitProiect Address: 1105 S Harmon St-a-
Assessor's Parcel: 108-343-07 Lot: 52
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 2535 Historic: No
l'
City of Santa Ana '20 Lrtr,r: Center Plaza (M-19), Santa Ana, CA927O2 pA Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 101102285
Pin #: 418OO
$1t,000.00
Description of Work: Tear-off & apply composition shingles. Handout given
Planning Conditions: Raplace 3he.thing, e.voa, and taacia boards a6 necded. L,:.lri:,i::rr' , .r. l
Engineer.
Owner: RICARDO R & MIREYA SANCHEZ Codractor: Nert LevelRoofing lnc. air,.iii,::,.:,,. .t;r i
Address: 1105 S HARiION ST Address: 37o1wMcF.ddon, LL Address: I !,1i.,.ir!. '1,,,1 ,
S.nta An., CA 9270420'19 Sant. Ana, CA 9270{
Phone: (714) 531-2592 Phone: (71a) 795'0805 Phone: ilt"i : r! 'l ;rjrli r:''r ; '
State Lic #: 1055315 Licensef:Ten'nt :-:--"- --::- - l"rrt'f'r' :1'r' i' 1LicTyps C-39 Architecl / ilj.tlai,;. .i.1 1..
Bus. Llc #: 373544 Desiqner: '.', ,- i,:
Workers' compensslion lnsurance: Address: ir lr:ill ,r4 " r'_
Carrier: Strte Fund
Policy#: 9256518 Phone: r, ,;'li . '.;,, . ,. ,.Expircs: 06t27m20 Lacense *: l:i:ir'- ;?;.,.,i:
Planning Approval By:
orrr6oe2';51d0I ''Pertnft'pgg:, ,' .', ; $333.06
07L76002 57770 MicrofilmRecords $3.91
077L6002 57672 Bldg. Stds. Revolving $1 00
07776002 57600 General Plan Update $ZZ.gs
0L776002 5L607 lssuance $57.20
ki, Teri
NPDES lnsp.
PWA lnsp.Fire lnsp. Req'd. No
Police lnsp. Req'd. No Account#Tota!Planning lnsp.
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use.
Plan Checked By:
Permit lssued By:
Single Family Dwelling
Reroof
Reroof
Sfd w/att garage
Occupancy.
Constr Type:
Code:
Flood Zone'.
# of Stories:
Date: 1112012019
Date:
Date 1112012019
Subject to Field:
R-3, U
VB
cBc 2016
x-0602320256J
1
Misc. Receipt:
Misc. Receipt.
Misc. Receipt:
1st FL Area
Znd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation:
Landscaping lnsp. Req'd. No Flood Zone Cert. Req'd: No
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 authorized
on the site by such permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
lnspector MID#: 2019-155994
01 1 16002 51600
01 1 16002 51601
011 16002 s1612
01 1 16002 57770
$22 95
$3e0.26
$1 00
$3.91 Fee Total
Paid to Date:
Balance Due
$418 12
$0 00
$41 8.12
t
BUILDING- INSPECTOR RECORD
SITE-WORK DATE ID/S!G.COMMENTS ffi
I hcrchy attirm undcr pcmtryT.,t !*;ury r# I ; "i"rp, t'L,n rhc CirntracklN' Liccnsc Law for lhc following rca$rn (Sec 70-11.5
llusincss and Prolession Cdlc): Any Cily or C(rutrly which rcquircs a Frmit k) coNtruct. altcr, impnrvc, dcmtlish or rcpair any
structurc. lrior to its rssuamc, also rcquircs the applicant lor such lErmit lo filc a siSncd slatcmnl that hc or she is liccn*d PuNatrt
lo thc pruvisions of thc Contractor's Liccn$d Law (Chaptcr 9, Conurcncing wilh Scction 7000 of Division J of thc Busincss and
P()lbssions Codc) or that hc or shc is cxcmpt thqcliom and the hasis lirr thc allcgcd cxcnlPlDo. Any violalion of Setion 703 1.5 by any
{pplicant lirr a pcmit suhjccts thc applicant ro a civil pcnally of not morc thm livc huntlrcd dollus (s5fi)).
_1. as owrcr of thc lr(rlrcrty, or my cmployccs eith watcs as lhcir solc com[rnsali{nl. will do thc work atrl tlrc stru1rc is n(}l
inlcnlcrl or ollcred l<r mlc (Se.7044. Busircss and Prufcssions Gxlc: 'fhc Contraclor's Liccns Law d(Es not apply b an owner of
thcp()IEdy wlxlhildsorifi{hrvc$tlEBrn.&lwh}d(Essuchwrrkhimscltorhcrsclforthruughhisorhcrowncmpktyccs,
providcd lhat such inpr)v(mnts rc ilil intcrnlcd or otlcrcd tilr s{h. ll, howcrcr, lhc huilding or im{m)vcmnl is soLl within onc yce
ofconrplction, thc Owrcr Builder will harc lhe hurdcn of pnrving thal hc or shc dil ftil huild or imFovc thc pn IEfly tirr thc puq[s of
salc).
_1, as owncr ol'thc pr()fE-rty, am cxclusively contracting with licenscd conlraclors to crtnstnlcl thc pnrjcct (Scc. 7(X4, Busincss
aml PnrL;ssion Corle: 'f hc Contractor's License Law docs not apply lo an owner of prolrcrty who huilds or improves thcrcon,
and whq contracts lirr such projccts with a Contractor(s) liccnscd pursuant to thc Conlractor's Liccttsc Law).
_l ant cxL'mpt ultrlcr B. & P.C. lirr this rcason.
WORKERS' COTITPENSATION
DECLARATION
I hcrcby at't'irm undcr pcnalty of pcrjury onc of thc lirlkrwing dcclarations:
_l havc an6 will nuintain a Ccrtificate of Conscnt to Sclt-lnsurc tor wrlrkers' comlrcnsation, as p()vidcd ftlr by Scction -]7ffi of thc
Latxrr Crxlc, frlr thc pcrformance ol'thc work for which the prmit ls issuetl.
_lhavcandwillmainlainworkcrs'conrpcnsationinsurancc,as rcquircdbyScction3T00ofthcLaborCodc,tbrthcpcfiirrmanccof
thc w6rk tbr which this permit is issucd. My workcrs' compcnsation insurance calricr and Jxllicy nunthcr arc:
Policy Number: [ixPircs:
_l ccrtity that in lhc Jrcrlitrmance of thc work lirr which this Jrcrnrit is issucd. I shall nol cmploy atly pcrson in any manncr
s6 as t6 hccome suhicct to the workers'compensation laws of Calitirrnia. and agrcc that if I should hccomc subjcct to thc
wgrkcrs' cgmJrcnsatign pnrvisions ol'scction -1700 of the Latxrr Ctxlc, I shall. filrthwith comply with thrsc pnlvisitlns.
WARNING: Failurc tg sccurc wrrkers' compcnsatioll coveragc is unlawl'ul. antl shall suhject an cnlplttyer to criminal pcnaltics and
civil t'incs up to 6nc huntlred thuusanrl dollars (.$100,m0), in addition to tltc cost of compcnsalion, damagcs as providctl ftrr thc
Scclion 1076 ol'tlrc l-atxrr Ctxlc,and I'ccs.
5cs uS t-,or\-Lo - \q
unrlcr provision ol'Chaptcr 9 (c<lrnntencing with Scction 7fin) rtl'Division .lI hcre'hy allirrn undr:r pcnalty of I itrn
ol' lltc Busincss antl uxl my liccnsc is in full tirrcc and cflect.
Liccnsc C Nuntbcr:rb 553 \5
S VqLa''r?-o- tq \eSU
I hcrchy allirm untlcr pcnalty of pcrjury that
issucd (Scc. 1097, Civ. C.).
isa agcncy titr lhc Jrcrformancc ttt'thc wtlrk firr which this Jrrrnit is
[-cndcr's Namc:
APPLICANT DECLARATION
I trcrrhy all-rnr undcr pcnalty of Jrcrjury onc of thc lillltlwing rlcclaratirlns:
Dcnxrlit iorr Permits-Asbcstos Notil'ication Fcdcral Rcgulat ions (Titlc 40. Part6)
-Rcquircd
lrttcr of Notilicalitu
_l ccrlity thal t'cdcral rcgulatirurs rcgarding ashcslos renroval arc n()t applicahlc to tltis pnrjcct.
-I
I hal with allCity and Ctturrly
onlittaltccs and County lo cnlcr ugrn llrc
alxrvt:
Pernritee
Agent
lirr insllcct ron purlx)scs,
,r",. I\-2O-\9
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loo r/Vent/l n s u latio n
Roof Sheathinq 112A4-19_*r4rdr
Shear Wall
Fr:aminq
lnsu lation/Energy
Drvwall
Ext./lnt. Lath
Brown Coat
Masonrv
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
I /^I
FINAL / / SlLc ,Y
Certificate of
Notes, Remarks, Etc
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