HomeMy WebLinkAbout101102211 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (7'14)667-2738 lnspectorSection: (714)647-5853
Permit #: {01'1o.2211
Pin #: 6641{
I
Project Address: 2126 N Spinnaker St
Assessor's Parcel: 101-572-10 Lot: 51
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock. NA Tract: 3833 Historic. No
Building uss Slngle F.mlly Dryelllng Occupancl: R-3, U lst FL Area: Patio:
Job Type: Ro@of Conetr Typo: V B 2nd FL Area T.l.Area:
Natuae of Work Rerool Code: cBc 201 5 Oher Areas: yards Req.d:
Exisling Bldg & use: sFo wratt c..ago Flood zone: x{6o23201/a4J Garage Area: valuaflon: ls,ooo.q,
Proposed Use: #ofstories:
Totat:
D€lcription ot Work: Toar ofi s{rllng roof m.torial and in.tall n.w compshlngls roof matsrlal Rspalr sheathlng .nd t scia.s roqui.rd, H.ndoutoiyon
Ownoa-Buildor folm on lila.
Planning Conditions:
Engineer:
Owner: JOSEFIMZARCO Conlmcto.: Own.r-Buildlr
Addre$: 2128 SPII{iIAXER ST Addressr Addre3s:
s.nta An., cA e2708r362 il' 1i. 1 il il; liil': .
Phone: Phon6: Phone: Ji, i ,:tr i :: -)
T.n.nt Stale Lic l: License *: rr,:,ra ri:ll;4:/ | ,:'. .
Lic Type: Archit6ci / 1r(rn';rtr:i'r' ri'i'
t Bus. Lic #: Deshner: .iL:;:fllA .r.rtt(il
Wo*erc' Componsation lnsulanca: Address:Carrier: .;i i,r. . ,t :r I ii 1.:. L . I .
Policl *: Phone: ii:lJ;i1r ? : h'/'!Lrr'":rr:
Epires: License *: ,:'i::,rri , r,.1 ., ;l
,' rrii. :! dl, .i \.,. ' :
prannins ApprovsrBy: Graham, Jerbry oat,, 11t1z2o1s Misc. Receipr f;i::f ELffi iffi*lfi*" ttf$
Pran checked By: Date: Misc. Receipt outads):fthiz rittiti: itisi aevoving ir.*
Pemit l$ued By: Chsvez, Dave Datei. 11112t2o19 Misc. Receipt o[15oir{i-rf046?s.}Fhn'Updsts 122.s5
NPDES lnsp. Req'd. No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Subject to Field:
No
No Account#
07776002 57607 lssuance
Fire lnsp. Req'd:
Police lnsp. Req'd:Total
Fee Total:
Paid to Date:
Balance Due:
$s7.20
$418.12
$0 00
$41 8.12
Flood Zone Cert. Req'd: No 01 1 16002 51600
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 permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$22.es
$390.26
$1.00
$3.e1
lnspector MID#: 201 9-155795
BUILD!NG. INSPECTOR RECORD
SITE.WORK DATE !D/SIG.COMMENTS OWNER BUILDER DELCARATION
I h6eby amrm undq pcnalty of pcrjury that I m exempt from thc Contracton' Licw Law for thc following rcmn (5(.7031.1
Busins roxt Profsion Codc): Any City or County which requirc a pc[mh to construc{. alta. improvc &rnolish or repair my
structure. Jrior to its iswce. abo requir6 thc applicmt for such pfimit to filc a signcd statmot that h€ or shc b licq&d p$uet
to thc previsioN of thc Cotrtractor's Licmsql Law (Chaptq 9. Commcncing s'ith Sstion 7000 of Division 3 of thc Busins md
Prefe$ions Code) or that hc or shc is cxcmpt thqcfrom ild thc basis for the allcged cxmption. Any violation of Sdion 7031.5 by uf
applicantforapmnitsubjetsthc applicanttoacivilpenaltyofnotmorethilfivchun&cddollils($500).
[y'gs o*no of f hc property. or my emplo]c with wag6 I their sle mmpflsation. will do the work ild the structrc b not
-mr*f,ql or offcrcd for ele (Se.7044. Rusine ud Prcf*ioG Codc:'Ihc Contractor's f.icffic lrw do6 not apply to d owns of
thc properiy who builds or imlrcvc th6@tr md who do6 such rrcrk himself or hffielf or thrcugh his or he own cmployc.
providcd rhat such imfrov@sts e mt iiladcd or offacd for sle. lf. howos. lhc building or improvmdt is eld wilhin onc yw
ofcomphion. the Owna Buildq will have thc burdar ofproving thd he or she did rct build or impovt the prupory for thc purPos of
sle).
___ l, r ounr ofthe propqty. m exclusivcly contractirS with licfiscd contraclo6 lo coGtrucl th€ proj€:t (Ss. 7M4. Buins
and ProfasionCodc:TheContractor'sLiccnscLawdo6notapplyloroorvnoofpropcnywhobuildsorimprovcsth6@n.
and rvho conlmcls for such projsls whh 8 Contmclo(s) licffed puNuot lo lhc Contractor's Licme Lsw).
_l arn exempt under Section-,lbr this
o^r",' ///t?/l?()rnlrcr: X
I hereby affirm under penalty of po'jury one of the
_l have and rvilt maintain a Cerrifrcate of Consent to Self-lnsure for \r'orkers' compensation. as providd for by Section -3700 of the
Labor Code. for the performance of the work for rvhich the perrnit is issued.
_l have and rvill maintain workem' compensation insurance. as required by Section 3700 of the Labor Code. for the perfonnance of
the work for rvhich this permit is issued. My workers' compensation insurance carier and policy number are:
Can'ier:-
-Policy Number:-Iixpires:
-):l,cnify that in the pqforrmncc of the $,ork for which this Imit is isstrcd. I shall not mploy any pcrmn in any mmno
-s 6 to becomc subjet to thc wortffi' compcnmtion la*s of Califomia. and 8grc that if I should bcomc subjct to thc
sorts' cornpcnstion provisioro ofSccrion 3700 ofthe labor Code I shall. fonhrvith comply with thorc prcvisioro.
WARNING: Failurc to wue rvork6' comJEnsation mvmge is unlarvful. md shall subjccl o mployu to siminal fmlties od
civil fines up to one hundred thousand dollars ($100.000). in lhe cost of compensation. damages as provided for the
attorney's fees.
r<
9 (commencing rvith Section 7000) of frivision 3I hereby alTirrn under penalty of perjury that I zun pro\,ision of
of the Business and Professions Code. and my license is in full force and effect.
License Class:-License Nurnber:
Contrnctor:l)atc:
CONSTRUCTION LENDING AGDNCY
I hercby aflirm unde penalty ofpmjury that thce is a coNtruction lf,ding aSency for the pqfonnmce ofthe rvork for which this ponit is
issued (Ss. 3097. Civ. C.).
[.entlcr's Naltte:
l.ender's Address:
APPLICANT DEC LARATION
I herelry allirm under penalty of perjury one of the following declarations:
Denrolition Pennits-Asbestos Notification Fedcral Regulations (Title 40. Parl6)
---Required Letter of Notification
__l corify that the federalregulations regarding asbestos rerno!'alate nol applicable to this project.
state that the above
the
above rnentioned property for inspection
f,AbD,*,-/{'t;// rApplicnnt or Agenl Signature' *
I'errrrilcc nanrc (llrinl): '
and
bo-^ Q '
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/Ve nUl n s u lation ,I 'A rt.z=
Roof Sheathinq tItvltet Lhrld,'t168
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonrv
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
I ,l /)/)M)
FINAL llll't ll7 /lt/,01411 au/r\%/
Certificate of Occupancy I t
Notes, Remarks, Etc.
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