HomeMy WebLinkAbout10110469 - PermitBUILDING PERMIT 'SzADDRESS: F.27 N- PPTsror, sr
PROJECTCity of Santa Ana
SUITE #:J.BTYPE: REs /RP
ADORESS
RANGE:611-663 *BUILDING #:ReroofNATURE
OF WORK:
Bl@k: NA
LEGAL
OESCRIPTION: Lot 1
NO. OF EXISTING
BUtLDtNGs& usE:cOndO cOmpleX
TYPE OF
CONSTRUCTION: V-N R-1OCCUPANCY
GROUP:108 61Tract:
I hGr.by attirm undcr p.natty of pcriury that I am cxcmpt from thc contEctoE
liconslraw ,or the ,ollilinq rea$n:
_lU1 Scaion 7044A, l, as Mcr of th6 property, or my employ6s with mges as
their $16 compGnstion, will do th6 mrk. and the structuro is nol intrndGd or
offcrcd for slc.
amSection
iiaA;-sed
70448, l, as mcr of thc
4 05 -08 L-23ASSESSOR'S
PARCEL #:
TENANT IMPROVEMENT
AND
'
OR REMOOEL AREA:
FLOOOzoNE X- 0
owNER: Shadow Wood owners Assoc NEW / AOOL,
1st FLR. SQ. FT
NEW/ADDL.
OTHER SO, FI
NEW / ADDL.
GARAGE SO, FTADDRESS; 635 N Bristol St NEW / ADDL-
2nd FLR. SO FT.:
zoNlNG: c-5/sP-l/R 895.00JALUAT1ON:Unit 4l
Santa Ana, CA 9270ifPHoNE:f t4 / 542-3525 l!lXU.)^'.,", vcr'DArE: Qg /24/96
CONTRACTOR:BLOG. SAFETY
PLAN CHECK BY:DATE:
cw 0,u)PERMIT
ISSUED BY:05/24/96DATE:ADDRESS
NIMPROVEMENTS
REOUIRED:NLANOSCAPING
REOUIRED:
PHONE:
* OWNER *STATE
LICENSE #:TYPE:
SANTA ANA
BUSINESS LICENSE ':
I hcraby atlirm undcr plnalty of p.iury one of tho lollwing Dsclarations:
v I haw and ull maintarn a Ccrtificate Of Consant to Selt-lnsurc for Work6B'
C-ompcnstion, as prflided for by Section 37OO of the Labor Cods, for the
pcrtomancc of thc rcrk lor which this Pemit is issusd.
_l hare and will maintain WorksE Compensation lnsuranca, as roquired by
Seciion 3700 of the Labor Code, for the performance of thc mrk tor which this
pemit is issued. My Workec' Compensation lnsurance carrier and policy number
WARNING: Failure to sscure Workers' Cgmpensatron c@era9e rs unlawlul, and
shall sub.iect an employer to criminal penahlE and crvrl ines up to one hundred
thousand dollaE ($10O,oQO), in addition to the cost o, compensation. damages as
prdided tor in Sction 3706 ol the Labor Code, interest, and attorney's fees.
nC-9-
I
is issued, I
to the WorkeE'
to the
are
Policy
Labor3700provisions
those
(this section
or less).
Workers'
forthwith
ENGINEERYARCHITECT:
ADDRESS
PHONE:
LICENSE #:
Licen$ Class:_ Licanse No.:_
prryisions ot
Business andof Oivision 3 ot thc
is in and oflecl
Oat6:_Contractor:
replace 4.5comp, handoutf
JOB DESCRIPTION:
Partial
( approx )Eiven
T /O,sqo
City of Santa Ana
Building Safety Div. M-19
P.O. Box 1988
Santa Ana, Ca.92701
206 W. 4th. Street
2nd Floor
(714) 647-5800
AMOUNT QTY32.00 151.00 1
17 .00 1
FEES:
FE
E
FEE
ISSUANCE
E32.0051.0017.00
FEE TOTALPAID TO DATE
BALANCE DUE
100.000.00100.00
PERMIPRE-I TFE
NSP
I hersby aftirm undsr pcnafty of po4iury that there is a construction lending agency
tor the performanco of the rcrk ior which this permit is issued S€c. 3097, Civ. C.)
DGmolition Parmits-Asb.stos Notitication Foderal Regulations Fi0c 40, Part 6)
_Rcquircd Lclt r of Notfretion.
thc fcdcral rcgulations rcgarding asbGstos rcmffil are not_l certity that
applipobb to this
{tccntvuat
pro.iect.
to
I haw rcad this and statc that the abde information is
@tracl. I andwith all ordinanccs and Statc la$
and ot this Cityrclating !o
and County to cntcr
Applicant or agent sig.
Pcrmitt@ namc (print):
Lcndc/s
Lond./s
OWNERSUILDER DECLARATION
WORKERS COMPENSATION DECLARATION
LICENSED CONTRACTORS DECLARATION
CONSTRUCTION LENDING AGENCY
APPLICANT'S DECLARATION
Mailing Address Public Counter
This petmil shall expir€ by limilalion and bocome null and void if lhe work aulhorized
by this petmil is nol commenced within 1E0 days from lhe dale of lhis permil, or if the
wotk aulhorized by this permit is suspended or abandoned for 180 dafa, al any lime
affer work was commenced, ln such case a new permil shall ,irsl be obtained before
such work can be recommenced.
PERMIT NO. 10110469
Account No.011-01-5911 - Pemrt Vawation cs-6os
ztwlt ,N{{?tloa cEW_o47 4 2472_
I surre
I neruce,
Notes, Remarks, etc.:
UniUSu ila'
BUILDING --. INSPECTI@N RECORD
OWNER.BUILDER
I hereby afiirm under penalty of perjury that I am exempl from the Conlractors' Lic€nso Law following reason
(Sec. 7031.5 Business and Professions Code): Any City or County which requires a p€rmit lo conslruct, alt€r,
improve, demolish, or repair any slruclur€, prior to its issuance, also requires lhe applicanl for such permil to lile a
signed slatement that he or she is licensed pursuanl to lhe provisions of the Contraclors' Licenso Law (Chapler 9,
commencing with Section 7000 of Division 3 of lhe Business and Professions Code) or that he or she is exempl
therefrom and the basis for lhe alleged exemption. Any violation of Seclion 7031.5 by any applicant for a permit
,.,, spbjectstheapplicantloacivilpenaltyofnotmorethanfivehundreddollars($5fi)).
1.",:) .t,.i.i
: - _1, as owne;Vthe propqtf,'olrqy employees wilh wages as their sole compensalion, will do th€ urork, and the
.. .'slructure is not lntbnrlcrtor offered for iale (Sec. 7(X4, Business and Professions Code: Tho Conlraclors' License
' j Law does nol apply toln'cfvner bl the property who builds or improves lhereon, and who does such rrvork himself or
herself or lhrough his or her ourn employees, provided that such improvemonts are not intended or ofiored for sale. lf,
however, lhe building or improvemenl is sold within one year of complelion, lhe Oruner-Builder will hav€ lhe burdon
of proving lhat he or she did nol build or improve for th6 purpose of sal6).
t\Lq
i
Ir
_1, as ownsr of lhe property, am exclusively conlracling wilh licensod conlractors lo construcl lhe projecl (Sec.
7(X4, Business and Professions Code: The Conlracrlors' Licensa Law does nol apply lo an ourner of property who
builds or improves theneon, bhd wbo contracts for such projects wilh a Conlraclor(s) licensed pursuant to lhe
Conlraclors'Lioonso Lawi: : I- ,,1 , ,.:;:.:t
_l am oxempl under B. & P.C. for lhis reason
Orvner:
Site Work Remarks Date Signature t.D.
Setbacks
Forms/Steel /Holdowns
UFER Ground
Slab Floor
I
Steel:(r -'., .
Pool Fence r L I
Masonry
I
! , qfitr t
Building Remarks Date Signature t.D.
Under Pinninq (floor ioistl
Foundation Ventilation
s23Jl d teRoof Sheath
lnsulatidn / Enerqy I
Exterior Lattr
Dry.hlall ': r' '' 'r
Brown Coat
T-Bar
Handicap Requirements
FRAMING -L A
IFINAL (Shell onlyl n,lVl'I /\,*./
)FINAL (Tenant lmprovementl tnjll i U'
I I
I I
I
I
.l
I I
-l
l
l)t ;
I
I
I
I
I
I I
I I
I
I I
I
I