HomeMy WebLinkAbout10597120 - Permitcity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA,27O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-273A lnspector Section: (714) 647-5853
Permit #: 1059712IJ
Pin #: 19154
q
Proiect Address: 941 W Camile St
Assessor's Parcel:008-24243 Lot: 37
Unit Suite Range:
Zoningr R2Block: A Tract: 253 Historic No
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Miscellaneous
Water Damage Repair
SFD datt garage
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Storiesl
R.3, U
VB
cBc 2016
x-0602320257J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Total
Patio:
T.l.Area:
Yards Req'd
Valuation: $2,500.00
Description of Work: Repair drywall, replace insulation due to water damage
Planning Conditions:
Engineer: tlt"1"i.or (i\ll rr(lns+: l/? it,Owner: Jose & Martha Lopez Contractor: Fire Repair Specialists lnc d A,,-{;j; iipf+i lrlir;,/l::,
Address: g4lwcamilest Address: 3430w. Maywood Avenue Address: ftirt+:ir')'irl L,,'i / /?4.")ltlll |1:"t'''t i
SantaAna,CA 927033901 Santa Ana, CA 92706 Trr1r1id,:r.ilrl] totfll .ii?|.,i:,l,
Phone: Phone: (7f4) 308-0694 l.hone: .. I r-r, Firr,(rr. rpp. i,,.li:,ts In,; dl,
State Lic #: 939434 Lrcense r:
Tenant
Lic Type: B Archirect / 6en'+r,tl f:'lqn tjpdqte F,re r.il
i -., ; - r ,:-.' p-ar Bus Lic #: 333250 -''"':''""" r-ll 1lirrl?- ' t6Lrur-rrltr-
!t .r workers' compensation rnsurance: ffi[::l iil ;]:1I-,,;- . r6u1l,rr"r- - 6f '"i
Carrier: Everest National p.lrjr iii,rl:: lii:vr,l !,, ine" .'.';.:zss EiXill Il:,T13i3'," illli;- rjiiil::,:::,,;ill::::;,._
.,,, ,,;,..,i .
0 777600 2
o 17750 02
0 77760 0 2
07776002
0 77760 0 2
57607
57607
5760 7
57672
5760 0
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'
McCann, Melanie
Hernandez, Kathy
Dale:0712412018
Date:
Dalet 0712412018
Subject to Field:
Misc. Receipt:
Misc. Receipl:
Misc. Receipt:
Permit Fee
lnvestigalion
Penalty
Bldg. Stds. Revolving
General Plan Update
$160.25
$86.78
$243.16
$1.00
$22.08
$55.04
\q"
No
No
d: No
07776002 51501 lssuanceFire lnsp. Req'd:
Police lnsp. Req'd U Account#
Flood Zone Cert. Req'd: No O1 1j6002 51600
Every pormit issued shall become invalid unless the work on the site autho zed by
such pefinit is commenced within180 days aftet its issuance.ot il lhe wotu authorized
on the site by such pemit is suspended or abandoned for a pedod of180 days after
the time lhe work is cofifienced.
$22.08
$545.23
$1.00
$568.31
$0.00
$568.31
lnspector MID#: 2018-144865
01 1 '16002 51601
0'1 1 16002 5'1612
Fee Total
Paid to Date:
Balance Due
Bldg: Address Range:
Total
BUILDING. INSPECTOR RECOHD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVlnsulation
Rool Sheathinq
Shear Wall
Framin s
lnsulation/Energy
Drywall Y/rz/rt'\>W L-1,1 4.
Ext./lnt. Lath
Brown Coat
rYIvlason
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif .
n
FINAL Q//o//l ,4H.L/,
Certilicate o, Occu pancy 1 7 =r -v/
Notes, Remarks , Etc
OWNER BUILDER I}ELCAR TION
I heEby nfltn undcr lcntrlly ol pcrjury th l trflr crcnrtr ironr lnc Cotrtr.dor' Li(ne L!* r'or thc iollosinr tcasn (Scc 70lllr5
Bu\incs lrn Profc$i.tr Codcr Any Cit, or Courty which rcquircs n Fnnil lo sr{rud- alrcr inrpDvc. &nxrth 'r rcn5t rn,
nru.rurc, tiF roik i\suatre. sho r.qxiftsrhc lPdi.anr tor \!chFrnir ro lil.a\t'rd iarcnf,nr rhnr hcorrh. is hccnscd NrsuMr
r) rht nmvkn,ns ofltr CoorEcnr s l-icen\cd ljr lChiprcr 9. Commcncins rjrh Secrn,n ?o0O or Divi\ion.l or rhc Busind$ rtrd
Pofcsrions Codc) or thrr hcorshc kcxc rflthcr.lio dndrh.b{sisforrhcrllcecdcxcnpridr AtryvnnllionoiScclinrT03l.5hyrny
+rlica tua pcrmir suhjccrslhc applicanl roncivilrcnakyolnol nDrclhrn rivc hundrcd dollar(ts(xl)
I.isoqtrcrofrhcroFny.ornryenrDlorr.(wnharscs,srh.irslc.onp.trs.rion.willdorhcwo itrdrh.srMrchml
i cftlol orofieredlors0lclSc.7O44.Busim$afldPmfc$ionsCodc:lhcConlEcloisl-iccn*Ir*doc(n.r!pnl,brnowncror
ihc pmlEnl, wtk) builds or iqrovcs rh.M[ nnd wh) drrs sxch kd( himr.lfor hcrslfor rhrough hi\.r h.r o+'n cmployc$.
,iovidcd rhrr ru.h ihpohtunrs e *n incid.rl or oflcftrl lir ek ll ho$c\tr. rh. t{ildinB oi nrymvcnEnr h $ld wirhin otrc ,ur
oicotrplcrion. rne Owmr Buildc! will haE rhc hudcn oi rmviry rhlr hc or +c dil nol l,uih or nllprcn rh. pmlleny ror tr. purtby or
Lato* crofrhclln)n.ny. rcrclurivclrc.ntkringtrirhli.cn\cdcotrrxctmn,conntudrh.pn)jd(S..7(}]-1.8uinct\
aRl Pnli\\i.n G)dc: Thc C.nrd.rtr \ t-i.ctr\c I-r* doc\ nor rrply b rtr otr tur nl rn,l]tn y sh. tuild \ or impnEs r lkrcon.
id who 6itaci\f(tr\uchpmjcrr\qirhrCotrtrckn(rlic.tr\cdnur\urrk,ihcCont&ttr1Li.ci{.lrta)
I r crcnrpt und$ Skr o I ,{ l't' lnrr[n .r!ri
Drre orner:
woxxr rc' col*r rli,r'irol
D[!:!IAArI0!
I hEb, arimhdcr pcnrlryofFrjuryone olrhc lollowin8 dcclorrrions:
thrrcanJwill'nsi'nrinrCcnifiurcolConsrnri'Scltlnsurcnn*orkcK.ompttr\rri'nr,r\pnrnhdturbySc.rion.lrrx)olrhc
Lhtr('{xlc.i(trrhcp.rronru ccolrtuwor\lar*hichrhcpcnni isi$ued
_lh.icnod willmoi.lain workcB .on[.n. i.n insurdncc..s rcquircd hySNlio.]7(x)oflhe tjhnr Codc- for rhc pcrtortuncc.f
the sork lor wnich rhis t'cmir is i$ucd. Mysorkd( snp.nsdion insuntrmqdicr 0fl1B'licy nunrbcr lrc
Icrnlyrhrrinrhctcrfonmmfolrhc*orkf(tr*hichrhi\|xrnirisi\\kd.I\hllnor.n[k)tanvr^--*o i']nfynr nE
$ r\lo hcconr \rhlc.lro lhc uorkcrs compcn{trnr h$sof('rlifi nr. rtrd rtr.c rhdr ill slDuld 6(con. {,njcd hrlr
workcr ..nDcnsiriontmrisiotrsolSccrionlT(x)olrhcLfitr(-onc,lshtrll I conDly wirh rhE pornioDs
WARNINC failurc n' trurc s(trkcs comr.nsrinD covcrasc is utrl,r rnd shxll n'hllcr rtr cn+k)kr r. cnnn il l{mlrir\ nid
(illl linrs ur b o ! htrnd'cd {housrn{l dolli.\ rll(x).lXx)). i', x,ltlir rd ol conrpcn\drnn,, da rrgcs .( l)n)ridcd hr rhc
scc!on ro?a orhc 1xhtr(ndr. i, .rf{ rnlxiinn.y \ rccr
I hcrcbylnnNundcrlcmlrroipcrjuryrhat I rD liccn$!u crpmvhionoiChmrcr9(conlcncin8sirhse.ii,n7(xr0)olDivi\b..1
ol ihc Bnqnc$and PmfcsiorsCodc. aM nylicctr{ is in fullf .c d cliccr
IjA!$BIICUANIEIDINIiAGEM;I
I hcrcby 0flirf,und.r Fh,hyorp.rjury lhal th.rc i\ r.onsrfl.lirn hndine qcncy for $c pcrlrirNncc olth. work fin *hichrhh pcrmir n
issu.d (Sc. 1097, Civ C )
AITIIIAITLDECIAXAUA!
I hc.ct y uninn undcr lrnrhy olpcrjury o"c oirhc Lllowins dcchnlions
D.mlirion Pcrmils.Ashc(os Norificrrion ljcderalltc8ulariotrs llirlc40- PlrrO
-Rcquncd
Lellcr of Norifi c.rhn
I (.,rilyrlrrrlrc lrnchlrcguhri{,tr! rcguiir! r\l).i.:run$rldc ! nt,t)lniUc t) rhlr l).tc.r
I..nilrrtu( I hrvc rcadrhi\ rpplic!i
o nrncc\ r Srrrc lr'(sr.ldi',9 k, $tr'
rbok nrnri,nEl piopcnl lnr in\rh-(ion
inin'ruri(r i\.omcr I JgG b.rmply *irh all
hcrcby arrhtrizc rcrcscrr,rivc( olrhii Citt !nd
Anpli(nnl or AEut SiInnl(rc
I
I
t-+-