HomeMy WebLinkAbout102102186 - PermitLr,, of Sunta nra 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #:1O21O2{EG
Pin #: 37O9O
Proiect Address: 701 S Kilson Dra
Assessor's Parcel: 01 1-094-01 Lot: 6
Unit Bldg: Address Range:Suite Range.
Zoning: R1Block: NA Tract: 608 Historic: No
Building Use Singl. F.mily Dwolllng Occupancy: R-3, U 1st FL Area: Palio:
Job Type: Allomtlon Constr Type: V B 2nd FLArca: T.t.Area:
Nature of Work Romodet Code: cBc 2016 Other Areas: ya.ds Req.d:
Existing Bldg. & use: sfd wrdst gar.g€ Flood zone: x{602320278J carage Area: valuation: ts,ooo.oo
Prcposed User # of Stories:
Totat:
Ddcrlption otwork: Interio, romodol ot ontire house - replaco drywall in I badaoom, aolocata a wall in bathroom & close up one door. SIIOKE
OETECTOR HANOOUT GIVET{
Plannlng ConditioE: lntario, ti only. No oxtg.ior alt.tetion3 or modific.tiona.
Owner:
Address:
Phone:
Tenant:
Sashi Sureen
P O Box 62004
lrvine, CA 92602
(7141 s33-0s37
Contractor:
Address:
Owner-Builder
Phone.
State Lic #:
Lic l-ype:
iffiffJ;om pensation I nsu rance:
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner.
Address.
Phone:
License #:
Planning Approval By
Plan Checked By:
Permit lssued
NPDES lnsp.
PWA lnsp. Req'd
Planning Insp. Req'd:
Landscaping lnsp. Req'd:
ur, Ali
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Date: 1110812019
Date:
Date: 1110812019
Subject to Field:
Amsden, Julie
Misc. Receipt
Misc. Receipt
Misc. Receipt
Jason Kwak
0LLL5002
0 777 60'O 2
o 771- 600 2
0LLL6002
077L6002
07776002
0 77L60 0 2
0LL76002
5L601, Permit Fee
si60o SubJect to Field
57770 Microfilm Records
57607 lnvestigation
57601- Penalty
s7672 Bldg. Stds Revolving
57600 General Plan Update
5760L lssuance
Fee Total:
Paid to Date:
Balance Due:
$1 66 53
$166.53
$3 91
$1 00 57
$252 69
$1 00
$22 95
$57 20
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
01116002 51612
01 1 16002 53600
01 1 16002 57770
$22 95
$576.99
$1.00
$166 53
$3 e1
$771.38
$0.00
$7t 1 .38
lnspector MID#'. 2019-155753
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BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/S!G.COMMENTS OWNER BUILDER DELCARATION
I hereby aflirrn under pcnalty of psjury that I m cxcmpt from thc Contracto6' t-icre Law for the following reen (Ss.7031.5
Busines ud Profsion Code): Any City or County which requirG a pcrrnil to coNIruct. altq. improvc. donolish or npoir oy
structurq prior lo irs isuuse. also rcquirc lhc applicot for such pcmit to file a signcd $atm6t that hc or she b licoscd pumuanf
to thc provisioru of the Contractor's Licensed Larv (Chaptq 9, Commencing with Sction 7000 of Division 3 of thc Buincs md
Profcssions Codc) or that hc or sh€ is cxeinpt thqefrom ed the basis for the allcSed exmption. Any violation of S6tion 7031 .5 by any
applicantforapmitsubjatsthe applicanltoscivilpenaltyofnolmorethufivehundteddollrs($500).
Vj,. * oms of the prcpcrty. or my crnployrc with wag6 6 their sle composlion. rvill do thc wo* ild thc stnrluc b nol
intodsd oroffded for slc (Ss.7044, Busin6s ild hofGsiom Codq'fhc Codractor's Licmc Law dos not spply to m owns of
rhc prepety who builds or improvG th@n. ud who do6 such m* himself or hoself or through his or ha own cmployce.
provid.d that such impf,ovqrmts e not intaded or offaql for gle. If. howoa. the boilding or improvmt is reld rvithin one ya
ofcomplaion. the Owns Buildo sill have thc hrdn ofproving thd hc or shc did mt build or improvc lhc propqly for thc purlDs of
sh).
_ _1. as owner of the property. am exclusively contracting rvith licensed conlractors lo construct the project (Sec. 7M4. Business
and Prloftsskln Code: The Contractor's License Larv does not apply to an owner of property rvho builds or improves thereon.
and rvho conracts for such projects with a Contracto(s) licensed pursuant to the Contractor's License [:rv).
_l arn exernpt under Section-, B. & P.C. for this reason.,Jr &)6",.,-t1 l+4+\\'O RK ERS' ('(}I\I PENSA'I'IO N
DECLARA'I'ION
I hereby aflirm under penalty of perjury one of the following declarations:
___l have and will maintain a Certificate of Consent to Sclf-lnsure for u'orkers' compensation. as provided for by Section -i700 of the
Labor Code. for the performance of the rvork fior which the pennit is issued.
_l have and will rnaintain rvorkers' compensation insurance. as required by Section -i700 of the Labor Code. for the performance of
the work for which this permit is issued. My u'orkers' compexsation insurance carrier and policy number are:
Carrier:-
Policv Number:Expires:
)fIJ "."riry rr,"r in rhc pcrformance of the rvork for which this pmnit is issued. I shall not mploy any pcson in any mmno
\rc u to become subj(t to thc rvo(tffi'@mpqsdion laws of Califomia, md agrc that if I should bccome subj(t to the
work6' compenstion prcvisioro of Sation 3700 of the Labor Code. I shall. forthwilh comply with thoc prcvisiom.
WARNING: Failurc to suc workm' ompensalion covmge is unlawful. and shall subjst m mploys lo qimiml pemltis md
civil fins up to one hundrqt thosd dollm ($100.000). in addition to thc cost of compcmtion. darog* o prcr'idcd for the
Section -1076 of the Labor Code. interest and attorney's fees.
DECLARATION
I hereby affinn under penalty of perjury that I arn licensed under provision of Chapter 9 (cornmencing rvith Section 7000) of Division 3
of the Business and Professions Code. and rny license Ls in full force and effect.
License Class:_
Date:
_License Number:
('onlraclor:
CONSTRUCTION LENDING AGENCY
I hucby affirm undo penalty of perjury that thqe is a construction lending agmcy for the prfommce of the rvork for s'hich this permit is
issued (Sec. -i097, Civ. C.).
Lender's Name:
Lender's Address:
AISJ.ICANLDECI.AEAIION
I hothy affim unds penalty of pcrjury onc ofthc following deldations:
Dcmolition Psmib-Asb6tos Notificstion Fcdqal Rcgulations (Titlc 40, Pil16)
-Requircd
trltq of Notifi cation
-l
cqliry that the fcdqsl regulaliom rcgrding rbctos rmoval re not applicablc to this prcj6r.
{t cctiry tlat I have rmd rhis application od statethat the abovc infomation is corcct. I agr to comply with all Cityand County
o?inance md Statc kws rclating to building constructio[ ild hqcby authorize reprMtdiv6 of this City ad County lo @tq uPon thc
above mentioned property for inspection purposes. ,
Appticant or Agent rrrnr,J( #\g
Permitee name,rOtf; --?uu Dt--PL tt. crq ,
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/VenUl n s u latio n
Roof Sheathinq
Shear Wall I l
Framing ////S// t Fu/,/d
lnsulation/Enerqy I I
Drywall tl/)A [/q rkJ/,1 iY
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zgne Certif.
ll l>'ul fi flt,*fu lN,W I A FUJA ,ry,
I tbr I
FINAL / /blb L /OY
Certif icdtd of Occu pa ncy
Etc.
tI