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Home My WebLink About101101882 - 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 #: {O11O{ E8,2 Pin #: 142e($ Proiect Address: 2922 W La Verne Ave-a- Assessor's Parcel: 109-576-09 Lot: 98 Unit:Bldg: Address Range:Suite Range: Zoning: RlBlock: NA Tract: 3627 Historic. No Building Use: Job Type: Nature of Work: Existing Bldg & Use: Proposed Use: Single Family Dwelling Solar Solar SFD w/att garage R.3, U VB cBc 2016 x-0602320256J 1 1st FL Area: 2nd FL Area: Other Areas: Garage Area: Total: Patio: T. !.Area: Yards Req'd: Valuation: $7,150.00 Elsa Dominguez 2922 W La Verne Ave Santa Ana, CA 927043021 (7141 338-e610 Occupancy. Constr Type Code: Flood Zone'. # of Stories: Contractor: Vivint Solar Developer Address: 9847 Pioneer Blvd. Santa Fe Springs, CA 90670 Phone: (562) 942-1270 State Lic #: 973756 Lic Type: B, C-10, C-39, C46 Bus. Lic #: 345470 Workers' Compensation I nsurance. Carrier: American Zurich lns Co Policy #: WC5096013 Expires: 1 110112020 0 Dascription ofWolki lnstall roof mounted solar panels. Per R6idential Photovoltaic Checklist. Planning Conditions: Owner: Address: Phone: Tenant: Engineer Address: Phone: License #. Architect / Designer: Address: Phone: License #: Vivint.So]iric i:ur'l, i :. James MItihint lllhl$hr Dr:,;,,1I oti i:ir' 3301 N Th.anksgiving Way, #500 LEHI' ur;#pfpr:"i; i I6rr r i.rr.rr.r-- [i 1d s lit ci s [ii:.''ri j. v i rr g C73567 irl l, I 6.r:n:r?-- lr 1 61 :r:u:l:r- !'i i,:l-'r;i i J. m .! lii':.:urnerr i; i,. t-t1 I I 6t-tt-tll' i..i'i'7 ',;t-tt.tt-tt-t' L i:1. i li r,i,: k j t-til 1 F45tt. [n:l $1 . [t[t $3.?1 ,I Planning Approval By: Plan Checked By: Permit lssued By: NPDES lnsp. Req'd: No PWA lnsp. Req'd: No Planning lnsp. Req'd: No Landscaping lnsp. Req'd: No chavez, Dave ! c Date: Date: Date: 1112112019 Subject to Field: Misc. Receipt: Misc. Receipt: Misc. Receipt: 07776002 57607 Permit Fee 07776002 57770 Microfilm Records 07776002 s7672 Bldg. Stds. Revolving 07776002 57600 General Plan Update Fee Total: Paid to Date: Balance Due: $450 00 $3.91 $1 00 $0.00 Fire lnsp. Req'd: Police lnsp. Req'd: Flood Zone Cert. Req'd: No Every permitissued shall become invalid unless the work on the site authorized by such permit is commenced within 360 days afterits issuance,or if the work authorized on the site by such permitis suspe nded or abandoned for a period of 360 days after the time the work is commenced. No No Account#Total 01 1 16002 51601 01 1 16002 51612 01 1 16002 57770 $450 00 $1 .00 $3.e1 $4s4.91 $0.00 $454.91 Inspector MID#: 201 9-155219 ta BUILDING. INSPECTOR RECORD SITE.WORK DATE ID/SIG-COMMENTS OWNER BUILDER DELCARAI'ION I hocby affim undo penalty of pajury that I m cxempt from lhc Contraclon' License Law for thc following rffin (58.7031, llusinBs ed Prof*ion Code): Any City or County which requirc a pwnit to corolruct. ahe, improve. donolish or repair any struc1[e, prior to its issuuce. also rcquirc the applicmt for such pcnnit to lilc a signed statmal that hc or shc b licmsed pmuilt to the Eovisions of thc Contractor's Licmscd law (Chaptd 9. Commencing with Setion 70O0 of Division 3 of the Busines md I Prefe$ions Code) or that he or shc is exonpt thocfiom od the b6is for the allegcd cxmpion. Any violation of S6lion 70-l1.5 by any applicantforapennitsubjetsthe applicanttoacivilpcnaltyofnotmorcthulivehun&cddollus($500). t --1. as o\\,ner of the property. or my employees with rvages as their sole compensation. rvilldo the rvork and the structure is not intendoJ or oflered for sale (Sec.7044. Business and Professions Code: I'he Contraclor's License Larv does not apply to an orvner of the proper-ty rvho builds or improves theron. and rvho does such u'ork hirnself or herself or through his or her orvn employees. provided that such irnprovanerts are not intended or offered for sale. If. hos'el'er. the building or improvemcnl is sold rvithin one year of complaion. the Orvner Builder rvill have the hrden of proving tha he or she did not build or impnove the propory for the purpose of sale). --1. as o\r'ner of the property. am exclusively contracting rvith licensed contractors to construct the project (Sec. 7G14. Btsiness and Profession Code: The Contractor's License Law does not apply to an o\r'ner of property rvho builds or improves thereon. and rvho contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's License [-arv). --l arn exempt under Section-, B. & P.C. for this reason. Date: Owner:_ WORKERS' COIIT PENSATION DECLARATION I hereby alTirm under penalty of perjury one of the following declarations: -_l have and will rnaintain a Certifrcate of Consent to Self-lnsure for rvorkers' cornpensation. as provided for by Section 3700 of the Labor Code. for the performance of the work for rvhich the pennit is issued. _l have and will maintain workers' compensation insurance. as required by Set'tion 3700 of the l,abor Code. for the performance of the work for which this permit is issued. My rvorkers' compensation insurance carrier and policy nuntber are: . *tmL(tdn ?,){ (c l^ tkrlicy Nr,,,b.r, J lYv{,-- fM - .a l:x prrcs:ttf t/zo _-__ I cerlify that in the perforrnance of the rvork for which this permit is issucd. I shall not ernploy any person in any tnanner so as to become subject to the rvorkers' cornpensation laws of California. and agree that if I should become subject to the rvorkers' compensation provisions of Section 3700 of the l-abor Code. I shall. forthrvith comply with those provisions. WARNING: Failure to secure rvorkers' compensation coverag,e is unlau,ful. and shall subject an onployer to criminal penalties and civil fines up to one hundred thousand dollars ($100.000). in acldition to the cost of contpensation. dzunages as provided for the Section 3076 of the Labor Code. interest and attorney's fees. ,D( DECLAITA'I'ION I hereby alTirnr under penalty of perjury that I am licensed under provision of Chapter 9 (commencing rvith Section 7000) of I)ivision 3 of the Business and Professions Code. and nry license is in full force and effect. LLicenset License Number:a t' a (.onrrrcrn., il )q,,ict w1q) ('ONS'l lr[ ('l ION l.l:Nl)lN(; ,\(;l':N('\ I hreby affirm undo pmalty of perjury that thre is a construction hnding agocy for thc pofomace of lhe rvork for shich this glnit is issued (Sec. 3097. Civ. C.). lrnder's Name: Lerrder's Address: APPLICANT DEC LARA'I'ION I hffiby affrnn under penalty of pe{ury one of the follorving declarations: I)ernoIition Permits-Asbestos Notification Federal Regulations ('l'itle 40. Pat6) - Required Letter of Notification I cotify (hat lhc federal regulalions rcgoding mltsftrs rcntrval arc n()l flil)licahlc lo lhis lnr)jcct. h/ I corify that I have ru<J this applicalion ard statc thal lhe alxrvc inftrrnratior is conrl. I alrc lo coilrply wilh 0ll ('ity and (iNoty :il1T:ffilfiTfJff;X1lli*,:,"'iif.::lsn'criut' ild hcrcr)v 'utrx)rirc rcptscnratilcs orthis ('i(v atrd (bu*]: 1'"j':' u' ;,,,,;";;;;.;;;,;*-,-,-,r )2 ,),,e: ' lllZl/"1 I'er,ir(rtrane(priru,*- DqqLcl vqrgqs Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Su bfloor/VenUl nsu lation Roof Sheathinq Shear Wall Framinq lnsulation/Enerqy Drywall Ext./lnt. 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