HomeMy WebLinkAbout101102198 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1O11O2{98
Pin #: 98014
I. Proiect Address: 2104 S Parton St
Assessor's Parcel: 015-1 13-05 Lot: 1
Unit:Bldg: Address Range.Suite Range:
Zoning: RlBlock. G Tract: 597 Historic: No
Building Use: Single F.mily D elling Occupancy: Rn,U 1st FL Area Patio:
Job Type Reroof Conslr Type V B 2nd FL Area T.l.Area:
NatuE otwo*: Reroofln.ut. on code cBc 2016 other Areas yards Reqd
Existing Bldg. & use: sFo wratt ea.ag. Flood zone: x{602320276J carage Area vatu.tion: s12,ooo.oo
Proposed Uas * of slories:
Total
O.tc,iption ol work Rorcof wrlo.fiemovo and apply comp .hinglodshoathing to remain handout givedinst ll insul.tion in .tic,lconlEctor doiing (2)
un'Elated lltd6 da!ch|:li:J;,5+ - tl/i:., i(1..,, lDi Htiir..
Planning Conditions: Color to be Brown 0f I i ce: {.TYH Trnns#: 2r,r 1of?
owner: An. D.teon Ro6et63 contractor: pho.ntx D€vetopment tncorr Engino€r
";1;1,.:,:'..t
, ,.' -" " :
Address: 21oa S Panon St Address: 27702 crown Valley P.rkw., Addre$:
S.nrr Ana, CA 92?0?2823 Lad.r. R.nch, CA 92G9{
Phone: (?lit) 721-349{ Phone: (049) 254-2635 Phone:
Tsn.nt State Lic *t 9119?9 Licam€ *: :ir' .i {,r 1:. .,,Lilr.
Lic Type: C-36, B Archirect /
Bus. Lic i: 37a31a uesqner: ...rE -r.i: I ..;1,,i,,
Work6rs' Comp€Balion lnEurance: Address: '.: tr .'.. . , :.i.r ,Carrier: Stete Compan3atlon ln3ualenc€ C, 1,i:: J; , . j .t, ! i. ,;! i:::,Policy#r 92261E5 Phonel til ..,, :. , ' -
Expk€s: oz'lar2o2o Lic6n56 #: ilr,',::ii,, -l;: t, . - _ . . ,: ,,
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Kathy
Fire Insp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Date: 1111212019 Misc. Receipt:
Date: Misc. Receipt.
Date: 1111212019 Misc. Receipt:
Subject to Field:
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
07776002 57607 lssuance
Fee Totat
Paid to Date:
Balance Due:
Kelaher, Selena
$333.06
$3 e1
$1.00
$22.e5
$57.20
Y,t",nandez
No
No
No
No
Account#Total
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.
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$22 9s
$3e0.26
$1.00
$3.91 $418.12
$0 00
$41 8.12
lnspector MID#: 2019-155767
BU!LDING. INSPECTOR RECORD
SITE.WORK DATE ID/S!G.COMMENTS OWNER BUILDER DELCARATION
I hcefu a{finn und6 penahy of pqjury lhat I m exempt from lhc Contractom' Licrcc taw for thc following rcun (54.7031.5
BNin6s ild Profeion Codc): Any City or County which rcquirs a pcrnit to consiruct, altq. improvq danolish or rcpair my
3trucluq prior to its issumce. also rcquirc the applicat for such pennit lo file a signcd statmat lhar h€ or shc b licensed plmmt
to the pmvisiom of the Contractor's Liccnscd taw (Chapts 9. Commcncing with Sction 7000 of Division 3 of the Busine mr!
Prcf*sionsCode)orthathcorshciscxcmptthqcfromadthe bcisforthcallcgedcxmption. AoyviolationofSstionT0ll.5byany
applicanl for a pmit subjcts lhc applicant to a civil penalty of not morc thil fivc hundrcd dollss ($500).
i
l. as owner of the pro5rerly. or my etnployees with rvages as their sole compensation. rvill do the rvork and the stnrcture is not
intencled or offered for sale (Sec.7M4. l]usiness and Professions Cotle: 'fhe Contractor's License Larv does not apply to an owner of
the propoly rvho builds or improves thereon. ard who does such u'ork hinrself or herself or through his or her own employees.
providecl that such improvonents iu'e not intended or offerd for sale. lf. horvwer. the building or improvclnent is solcl rvithin one y'eiu
of cornplaion. the Orvner Builder will have the burden of proving that he or she did not build or irnprove the prcrpo'ty for the purpose of
sale).
I
_ _ l. as o\\,ner of the properly. iull exclusively contracting u'ith liccnsed contractors lo construct the project (Sec. 7044. Business
and Professkrn Code: 'l'he Contractor's l-icense Larv does not apply to an owner of property who builds or itnproves thereon.
and rvho contracts for such projects rvith a Contracto(s) licensed pursuant to the Contractor's License Larv).
I arn cxenrpt under Sectiort
-,
B. & P.C. for this reason.
l)nte:( )rr ncr'
WORKER,S' CONTPENSATION
DECLARATION
I hereby alTinn under penalty of po'jury one of the follorving declarations:
__ _t have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
Labor Code. for the performance of the work for which the perrnit is issued.
_l have and will maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. for the perfolmance of
the work for which this permit is issued. My workers' compensation insurance carrier and policy number are:
('irr t ict :
Policv Number:_Expires:
__l ceatiry that in the perfonnancc ofthe work for which this pcamit is issucd. I shall not mploy any pctson in any muna
rc stobecomesubjctlothcwo*6'compqvtionlasofcalifomia.andagrclhatiflshouldbccomcsubjsttothc
\rork6' cotnpostion prcvisions of Sation 3700 of the Labor Codc. I shall, fonhwith comPly with thos provisioru.
WARNING: Failure to suc sorkc'compeMtion covmge is unlasful. and shall subjct o anploycr to simhd pQahi6 ud
civil fina up to one hundrci thoMd dollm ($100,000). in addirion to lhe cost of compcmation, dmagcs c providcd for lhc '
Section 3076 of the Labor Code, interest and attorney's fees.
D"r., tUf2/l(1
l)li(' 1.,\ ll,\'l' !( )N
I here[y aflinn under penalty of perjury that I arn licensed under provision of Chapter 9 (cornmencing with Section 7000) of Division .1
of the Business and Professions Code. and rny license is in full force and effect.
I.icense Ctass, 6
u"t., ll ll2/ll
('oNS'l'lr[J("1'loN l. lrN l) I N(; A(; liN(']'
I hdEbyamnnunderpenaltycf perjurylhal thqcisacoNtruction lcndingag@cy forthepqfommce ofthework forwhichthispermit is
issued (Sec. 3097, Civ. C.).
Lender's Name:
I-ender's Address:
APPI,ICANT DECLAR/I'IION
I hereby allinn under penalty of perjury one of the follorving declarations:
Dcrnolition Permits-Asbestos Notification Federal Regulations ('l'itle 40. Pan6)
- -Required Letter of Notification
I certify that the federal regulations regarding ashtos removal are not applicable to this project.
I cdify that I have rad this applicatien md state that the abovc infomration is corecl. I agre to comply lvith 8ll Cily and Counly
ordinancG and State [arvs rclating to building costruclion. atrd h6cby aulhorize relrestalivs of this Cily md County to @tq upon lhc
above mentioned property for inspection
Applicrrnf or Agerrt SignntrrreI
Perrrrifee n$nre (print): -- #r'
I )irlc
4mt|t('
ilttz/0
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/Ve nul n s u !atio n
Roof Sheathing t( ltct ltq v*tY)6L fr(1
Shear Wall U
Framinq ,
lnsulation/Energy il/la/1 f V4--tfi/).rr-*trl
Drywall ,t
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
I
FINAL ttl04ta I2A nn 61 .#67
Certificate of Occupancy I ll
Notes, Remarks, Etc.
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