HomeMy WebLinkAbout101102202 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: {O11O22O2
Pin #: 24531 ,. I
{\
I
Proiect Address: 1509 W Santa Clara Avea
Unit:
Assessor's Parcel: 001 -271-05 Lot: 95 Block: NA Tract: 2061
Bldg: Address Range:Suite Range:
Zoning: RlHistoric. No
Building Use: Singlo F.mlly Dwelllng Occupancy: R-3, U lst FL Area: Palio:
Job Type: Rsroof Constr Type: V B 2nd FL Areaj T.l.Area:
Nature ofwork Reroo, Code: cBc 2016 OlherAreas: yards Req.d:
Exisling Bldg. & u3e: SFO wratt carago Flood zone: X..0802320,t44J
p,posed uae: # of stories: Garage Area: vtlu'tion: t8'0d''q'
Tolal:
Desc.iption ot Work: Toar ofi orlGtlng rcof and lnstall new comp shlngle root matorlel. 50 yoar alphelt shlnglea. Ropalr Bheathlng e6 noodod. Handout
oivear
Planning Conditions:
Engineer:0ffice:(:TYH Tr.nns*:?7 1ol?.Acct*: Ref*: 1r_r1lrJ?2rJ:lRcpt*r0?g1156?5 IL/12/7LtLq 12:35 F,H
lransoct ion Totcrl t521.li:X Con t, r nct or.
Beoch (: i ty Roof i ns
Address:
Phone:
Tenant:I Architect /
Designer:
Address:
Phone:
License #:
Owner:
Address:
David Chant
1509 W SANTA CLARA AVE
Santa Ana, CA 927061803
(7141 414-s460
Contractor: Beach City Roofing
Address: 25775 Avenida Pedregal
San Juan Capistrano, CA 9i
Phone: (949) 697-6561
State Lic #: 697489
Lic Type: C-39
Bus. Lic #: 374324
Workers' Compensation lnsurance:
Carrier: State Compensation Insurance Fur
Policy #: 9044265
Expires: 0210112020
Phone:
License #:
Genernl Flnn Updnbe Fee
u1 1 16lru?- 516ur:niu[r-
Buildins
Ll1 t I 5t-ttl2- 5 1,5rJ1 r:llrlr-
Bl,Js Sbds Revo1v ins
Lll 1 16t:tt-t?- 5 1 o1 ?t-tutt-
ll i cr of i lm & Oocumen t sftl t t At'ir]?- \77 7t-tirr-tir-
$3?[t .
$3
o77rcoi/,[ib#grlxFr*ry$fifigi
1 0+ Hut h + :, fr,*lftPlanning Approval By:
Plan Checked By:
Permit lssued By:
NPDES Insp. Req'd:
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping Insp. Req'd: No
Graham, Jeffery
Chavez, Dave
No -PQ c
Date: 1111212019
Date:
Date: 1111212019
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07775002 57770 Microfilm Records
07776002 s7672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
07776002 57607 lssuance
Fee Total.
Paid to Date:
Balance Due:
$3.91
$1.00
$22.95
$57.20
$+t 8.12
$0 00
$41 8.12
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
Every 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.
01 1 16002 s1600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$22.e5
$3e0.26
$1.00
$3 el
lnspector MID#: 2019-155780
t
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS 0\\'NF,R Ilt rIl,l)1..R l)F.1,(',tRA'l l()N
I hseby affirm unds p€nalty of pqjury that I m exmpt frem the ContracloE' Licarc lrw for thc following rcen (56.70-11.5-
Buinss and Profsion Code): Any City or County which rcquira a pannit to construct. altc. improvc dcmolish or rcpair my
structuq prior to its issumcq also requir6 the applicmt for such lmit to file a signed stdmot that he or she b licqscd pmuilt
to thc prcvisions of the Contractor's Licenred Larv (Chapter 9. Commencing with Setion 7000 of Division 3 of the Busines md
Prefe$ionsCodelorthathcorsheiscxcmptthGefromedthebasisfortheallegedexemption. AoyviolationofSdionT03l.5byany
applicantforapmitsubjctsthe applicsnttoacivilpenaltyofnotmorethmfivehundrcddollm($500). '
_1. as owner of the Fnoperty. or my employers with rvages as their sole compensation. rvilldo the rvork and the structure is not
intended or offered for sale (Sec.7044. Business and hofessions Code: 'I'he Contraclor's [-icense [.aw does not apply to an o\lner of
the property rvho builds or irnproves therqrn. and who does such wort himself or herself or through his or her own employees.
provided that such irnprovonents are not intended or offerd for sale. tf, however. the building or itnprovement is sold within one year
of completion. the Orvner Builder rvill have the burden of proving that he or she did not build or irnprove the propoty for the purpose o[
sale).
-1.
as owner of the property. am exclusively contracting rvith licensed contractors to constnrct the project (Sec. 7044. Buiness
and [tofession Code: I'he Contractor's License Lau'does not apply to an owner of property rvho builds or improves thereon.
and rvho contracts for such projects rvith a Contracto(s) licensed pursuant to the Contractor's License Larv).
-l
am exempt under Section-. B. & P.C. for this reason.
Date: Owner:
WORKF'RS' CONI PENSATION
DECLARATION
I hereby affrnn under penalty of perjury one of the follow'ing declarations:
_l have and rvill maintain a Certificate of Consent to Self-lnsure for rvorkers' compensation. as provided for by Section 3700 of the
Labor Code. for the perfionnance of the rvork for rvhich the petmit is issued.
-l
have and rvill rnaintain workers' cotnpensation insurance. as by Section 3700 of the Labor Code. for the performance of
the rvork for is workers'carrier and plicy number are:
.D
Policy *rrb"r, - ClO Lf t t_.a
Exoires:z/z r,
_l ceflify that in the performance of the rvork fiur rvhich this perrnit is issued. I shall not employ any person in any manner
so asto bec1rme subject to the workers'cornpensation larvs of California. and agree that if I should becorne subject to the
rvorkef,s' compensation provisions of Se'ction .1700 of the Labor Code. I shall. forrhrvith cornply rvith those provisions.
WARNTNG: [;ailure to s€cure ttorkers'
civil fines up lo one hundred thousand
compensation coverage is unlas'ful. and shall subject an onployer to criminal penalties and
compensation. damages as provided for thedollarsincost of
Section -1076 of the Code. interest and attorney's
/
DECT.ARATION
I hereby affirm un<ler penalty of perjury that t arn licensed under provision of Chapter 9 (cornmencing with Section 7000) of Qivision 3
of the Business and Professions Code. and my license is in full force and effect. o
License Class: I
,rnu)l[ffi
a
Number:
W
I hrcby affim unda pcnalty of pcrjury that th@ is 8 construc(ion lcnding agocy for thc pcfomcc of thc work for which this pqmit b
issued (Se. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
APPLTCANT DECLARATION
I h6dry allinn under penalty of perjury onc of the following declarations:
Dernolition Perrnits-Asbestos Notification Federal Regulations (Title 40. Part6)
-Required
Letter of Notification
colify that thc federalregulations regzu'ding asbestos rcrnovalare not applicable to this project.
certi$/ that I have read and state that the ahrve inflormation is correct. I agree to cornply rvith all City and County
ordinances and Slate l-au's building and hereby authorize represextatives of this City and County to enter upon the
above mentioned property for
Ap;llicarrt or Agcrtt
l'ernritee nunre (grrirrt): F AAf h-( O ,Ly-- orr"rl'ftn(q
Set Backs
Forms/Steel/Holdowns
Ereqtion Pdds
UFER Ground
SLAB FIoor
Su bfloor/VenUI nsu lation I ^/l ^A
Roof Sheathing ////1/q /(Wtecz vaw
Shear Wall I
Framing
Insulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputv Final Report
Engineer Final Report
Flood Zone Certif
A
f.^,,(.r. nA
FINAL ///lv/{4 /-rutz /cv_q
Certificate of Occupancy
Notes, Remarks, Etc.
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