HomeMy WebLinkAbout101102222 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 101102222
Pin #: s3oe\-l
Proiect Address: 925 N Lowell Sta
Assessor's Parcel. 405-183-01 Lot: 43
Unit:Bldg: Address Range:Suite Range.
Zoning: R1Block: NA Tract. 455 Historic. No
Building User Single Femily Owelllng Occupancy: R-3, U 1st FL Area Palio:
Job Type: Re.oof Constr Type V B 2nd FL Area T.l.Area:
Nature ofwoft: Reroofrstucco code: cBc 2016 other Areas yards Reqd
Existing Bldg. & Use: SFD wrdet garage Flood Zone: X-050232 0l'l4J Gaage Area vatuationi gg,ooo.oo
PropGed Use: # of Stories:
Total
Oo6cription ol Wo.k Reroof wn.o.-Romovs (s) tile, replace sheathing and ro-installtilq on sfd and det garagerreiair'siucco on del gangdcontrectol
doing (2) unrelated trades/auth on file r-r:bt ! Kel
cpt*: ttZ8066t11 11/1.1r
ronsor:t i on Tobq IPlanning Conditions:
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
Graham, Jeffery Date: 1111312019
Date:
Date: 1111312019
Subject to Freld:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:$Hernan dez, Kathy
07775002
07776002
07776002
07776002
0 7L1,60 0 2
57607
57770
5L6L2
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
$333 06
$3 91
$1 00
$22 95
$57 20No
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd. No
Flood Zone Cert. Req'd: No 01 1 16002 51600
01 1 16002 51601
01116002 51612
01 1 16002 57770
Account#Total
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterits 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.
$22.e5
$390 26
$1 00
$3 e1 Fee Totat
Paid to Date:
Balance Due:
$+t 8 12
$0 00
$41 8.12
lnspector MrD#'. 2019-155845
Engineerl
Owner: B€th Thomas Contraclor: K L c conltructlon
Addres6: 925 N Lowellst Address: 5482 Oc..nu! DrlF AddrasE:
sanb Ana, cA 9z7o3z!23 Huntington Beach, cA 926a 't ., t " i
Phone: gt4) 305.1915 Phone: l711l7O217AO Lh-.,
State Lic *: il121? Lic€nse #:Tentnt
Lic Type B Architecl /
Bus. Licf: 37a329 Deeiqner.
WorkeB' Compensalion lnsurance: eOOr""",Canier: Sbte Compenaauon lnaurance .,.,i ..r!,i,",,.".,.,.
Policy tr: 92343a3 Phone:
Epiresi otlosl2o2o License #:
BUILDING- !NSPECTOR RECORD
SITE-WORK DATE ID/SIG COMMENTS OWNER BUlLDER DEL('ARATION
I hoeby aflirm undfr pflalty of perjury that I m cxcmpt from lhe Conlracton' Licqs taw for thc following rcen (Se.70-11.5
Businss and Profcssion Cod.): Any City or County rvhich requiro a Jn'rnit to conslrucl. alto. improve demolish or repair uy
structure. prior to its isuocc. also requirB thc applical for such peflnit to file a signcd statmol that he or shc is licmed pwant
to the frovisions of the Contrctor's Licenscd [:w (Chapt6 9, Commencing wilh Selion 700O of Division 3 of the Busins atrd
Profc$ionsCode)orthatlEorsheisexemptthqefromildthe b€sisforlhe allegedexmrption. AnyviolaliooofSetionTOsl.5byan!
applicantforapermitsubjctsthe applicanltoacivilpcnallyofnolmorelhilfivchundreddollus($500).
__1. as o\r,ner of the prop€Tty. or my employets $'ith \r'ages as their sole compensation. w'illdo the w'ork and the structure is not
interrdcrl or offered for sale (Sec.7M4. Business and hofessions Code: T'he Contractor's License Larv does not apply to an owner o[
the property rvho builds or irnproves thereon. and rvho does such rvod< hirnself or herself or through his or hcr orvn employees.
provided that such inrprovonents are not intended or offcrd for sale. If. horvever. the building or improvemenl is sold within one year
of cornplaion. the (hvner Builder uill have the burden of proving tha he or she did not build or improve the propa'ty for the purpose of
sale).
_ l. as o\t,ner of the properly. am exclusively contracting with licensed conlractors lo construct the project (Sec. 7044,llusiness
and ttofession Code: 'l'he Contractor's License l-arv does nol apply to an o$'ner of property rvho builds or improves lhereon.
and rvho contracts for such gnojects u'ith a Contracto(s) licensed pursuant to the Contractor's License Larv).
-larnexemptunderSection.--.B.&P.C.forthisreason.Drte:_Orlrter:
n'oix t.:ns' ('(lnl pl.nis,t I toirt
DECLARA'I'ION
I hereby alTirrn under penalty of pajury one of the follorving declarations:
_ ,l have and rvill rnaintain a Certificate of Consent to Self-lnsure for rvorkers' cornpersation. as provided for by Section -1700 of the
labor Code. for the performance of the rvork for s'hich the pennit is issued.
_l have and rvill maintain workers' compensation insurance, as required by Section -i700 of the labor Code. for the poformance of
the work for which this permit is issued. My workers' conrpensation insurance carrier and gnlicy number are:
cmo, 5/ a./e Feu r/
poricyNu,na",, ?2 313q 3 --Expires: -eZ/y!?o'4
'
I cerrify that in the perforrnance of the rvork for u'hich this permit is issued. I shall not ernploy any person in any manner
so as to become subject to the rvorkers' compensation larvs of California. and agree that if I should bectlnre subject to the
workers' cornpensation provisions of Section 3700 of the l-ahrr Code. I shall. fonhrvith ctxrply rvith those provisions. '
WARNING: Failure to secure rvorkers' cornpensation coverag,e is unlau'ful. and shall subject an onployc'r to crinrinal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of cornpensation. darnages as provided for the
Section -1076 of the Labor Code. interest and attorney's fees.I
)--2 /
Dtr('l.ARA'l'loN
t hereby affrnn under penalty of perjury that I arn licensed under provision of Chapter 9 (comrnencing with Section 7000) of Division -1
of the Business and Professions Code, and my license is in full force and cffect.
Lotzt7License Ctass: B [.icense
Date:. / 1:-/)-:Dt2- Conrractor(
W
I hrcby affnn undr pcnalty of pcrjury that thqc is a consruclion lending agocy for thc pqfomilcc of thc wort for whhh thb psmh b
issucd (Sc. -1097. Civ. C.).
kndq's Nme:
-
Lender's Address:
APPLICA N't DEC LARA'I'ION
I ho$y affurn under penalty of perjury one of the follorving declarations:
Dernolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
-Required
Letter of Notification
-l
cerri$r that the lHeralregulations regarding asbestos rernoval are not applicable to this project.
_l certi$ that I have read this application and state that the above infonnation is correct. I agree to comply with all City and County
theordinances and Statc Laws relating to and hereby authorize representatives of this City and County to enter upon
above rncntioned propoty for
Applicunt or Agent
Pernrifee nnme (print):- - E d
,1*
-
Dare,L t /t s /r-tZ
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/VenUI ns u lation //A tl
Roof Sheathinq Eflr+r-L // t /Et/7 I .TZ.lC / fULSc-'l'{ lfll t 1 r-Ztual
Shear Wall I
Framing
lnsulation/Enerqy
Drynrvall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
//,FINAL / L/ZOU'//oc(
Certificate of Occupancy
Notes, Rgrnarks, Etc.. -^t 1 //L/t6r9 k/1.u4 ,#Tffi
L'o/L