HomeMy WebLinkAbout101102121 - PermitCity of Santa Ana 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 #: {0110.2121
Pin #: 9905!
Project Address: 3809 S Timber St
Assessor's Parcel: 410-062-19 Lot: 31
Unit:Bldg: Address Range:Suite Range:
Zoning: R1Block: NA Tract: 6433 Historic: No
Building Use: Single Family Dwelling
Job Type: Alteration
Nature of Work: Wall Demo
Existing Bldg. & Use: SFD w/att Garage
Proposed Use:
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area.
Total:
Description of Work: Remove partial wall between kitchen and dining area. Wall to be verified to be non load-bearing & not a shear wall.
Planning Conditions: No additional square footage proposed.
Occupancy:
Constr Type.
Code:
Flood Zone'.
# of Stories:
R.3, U
VB
cBc 2016
x-0602320278J
Patio.
T.l.Area:
Yards Req'd:
Valuation: $9,000.00
J
Owner:
Address:
Phone:
Tenant:
DAVIDV&JOMINTZER
3809 S TIMBER ST
Santa Ana, CA 927074950
(7141 812-8012
Contractor: California First Remodeling
Address: 4157 W sth St Ste 228
Los Angeles, CA 90020
Phone: (2131 277 -1738
State Lic #: 1027042
Lic Type: B
Bus. Lic #: 368840
Workers' Compensation lnsurance:
Carrier: Hartford Casualty lns Go
Policy #: 22WECAA4XK1
Expires: 0711212020
Danny Chaaya PE
Danny Chaaya
P.O. Box 46341
Los Angeles, CA 90046
(310) 210-2t10
c45555
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA Insp. Req'd: No
Planning lnsp. Req'd: No
Gomez, Pedro
Chavez, Dave
No Pa;'
Date: 1110412019
Date:
Date: 1110412019
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
F. Heidari
07776002
07776002
07776002
07776002
07776002
07776002
Permit Fee
Subject to Field
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57607
53600
57770
57672
57600
s7607
$166.s3
$166.s3
$1 1.73
$1.00
$22.9s
$57.20Fire lnsp. Req'd:
Police lnsp. Req'd:
No
No Account#Total
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every permit rssued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs issua nce,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.
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 53600
01 1 16002 57770
$22.95
$223.73
$1.00
$166.s3
$1 1.73
Fee Total:
Paid to Date:
Balance Due:
$42s.94
$0.00
$425.94
lnspector MID#: 201 9-154944
t
lcco
BU!LDING. INSPECTOR RECORD t
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DET,CARATION
I hocby aflirm undr pamlty of pcrjury that I m cxempt from the Contracto6' LiccN Law for the following r@n (Sa.7031.5
Businss ud Profession Codc): Any City q County which rcquirs a pmit to co$trucl. alt6. improva dernolish or repair my
structuc. prior to its issuacc. also rcquirs thc applicilt for such pemit to filc a signed statmcnt that h€ or shc b licffed pmumt
to lhc provisions of thc Contractor's Licmscd law (Chapts 9. Commocing wilh SEtion 7000 of Division 3 of thc BNins ild
Profsiorc Codc) or thar hc or shc is crmpt thcefrom od thc basis for lhc allcged cxmplion. Any violation of Sfirion 70.11.5 by anv
applicantforapennilsubj6tsthe applicanttoacivilpenahyofnotmorethantivchundrcddollrs($500).
_ _1. as o\!'ner of the propreny. or my employees \r'ith \!'ages as their sole compensation. s'ill do the rvork and the structu€ is not
intcnded or offered for sale (Sec.7044. Business and Professions Code: The Contraclor's l-icense [.au' does not apply to an orvner of
the property rvho builds or improves thereon. and rvho does such wo* himself or herself or through his or her orvn employees.
providd that such improvonents ate not intended or offered for sale. lf. horvever. the huilding or improvernent is sold u,ilhin one year
of cornpletion, the Owner Builder will have the burden of proving th.t he or she did not lmild or improve the propoly for the purpose of
salc).
__-1. as owner of the properly. am exclusively contracting rvith licensed conlractorc to conslruct the pro.iect (Sec. 7044. Business
and hofession Code: The Contraclor's l,icense l-arv cloes not apply to an o$,ner of propcrty rvho builds or irnproves thereon.
and rvho contracts for such projects rvith a Contractor(s) licensed pursuant to the (-onlractor's l.icense l.as').
-l
am exempt under Section-- . B. & P.C. for this reason.
Owner:___
\},ORKERS' CONI PENSA'tION
DE(:LARA'tION
I hcrcby affrrm under penalty of pojury one of the follorving declarations:
--l have and rvill maintain a Certificate of Consent to Self-lnsure for workets' compensation. as provided for by Section 3700 of the
Labor Code. for the perfonnance of the rvork for rvhich the permit is issued.
_-l have and rvill maintain rvorkers' compensation insurance. as required by Section -1700 of the Labor Code. for the perfonnance of
___l cerril-v that in the perforrnance of the rvork for rvhich this permit is issued. I shall not ernploy any person in any manner
so astobecomesubjecttothervorkers'cornpensationlarvsofCalifornia.andagreethatiflshouldbecomesubjecttolhe
n'orkers' compensation provisions of Section -1700 o[the Labor Code. I shall. forthrvith cornply rvith thosc provisions.
WARNING: Failure to secure workers' compensation coverage is unlas'ful. and shall subject an crnployer to criminal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for the
#;T'4"1";"lf' :-;"", n== ===,,
I hereby affirm under penalry of perjury that I am licensal *,,t* p"*'ttt"" "f Clrapter 9 (commencing rvith Section 7000) of Division l
of the Business and Professions Code. and rny license is in full florce and effect.
!D
License Number: t lL I o?.rn d2.I -icc:rtse
oarc,l YO\l 4| (lontrnctor'-L
CONS'I'RUCTION LENDING AGENC}'
I hmby affim unds penalty ofpctjury thu thae is a construaion lending agcncy for thc pofomnncc ofthc $ork for ufiich this pennit is
issued (Se'c. 3097. Civ. C.).
Lender's Name:
Lender's Ad&ess:
APPLICAN'T DECLARA'I'ION
I hercby aftirm under penalty of per.iury one of the follou,ing declarations:
I)enrolition Perrnits-Asbestos Notification Federal Regulations (Title 40, Par16)
-_--Required Letter of Notification
^ --l cqriry that the fedoal regulations rcguding mbetos removal re not applicable to this prcjct.
Wn* r^^rl have red this applicarion ed srarc that the abore infomation is corcct. I agrc to @mply with all cityand County
ordinancc md State lanvs rclating to building construction. ud hqebyauthorize rqrffitativc of this City and Countyto mtd uponthc
abovc motioned prcpeny for impction purpos.
Applicant or Agent Signature: L-I)nte: -ll-U)A I I
l'erntiteename(printl: K ftr N)9y CInAY+
t
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/VenUl nsu lation
Roof Sheathinq
Shear Wall
Framing
lnsu lation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
I
FINAL rc
Certificate of
Notes, Remarks, Etc
+
Dnte:__
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