HomeMy WebLinkAbout101106980 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2
Permit Counter (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Building Permit #: l0llOCeSO
Pin #: IO52l
Unit:Bldg: Address Range.1il'rProject Address: 1518 W Dahl Ln
Assessor's Parcel:109413-05 Lot: 47 Block: NA Tract: 3070 Historic: No
Suite Range:
Zoning: Rl
Building Use.
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use.
Single Family Dwelling
Reroof
Reroof
Occupancy:
Constr Type:
Code:
Ffood Zone'.
# of Stories:
R-3
VB
cBc 2019
x-06023202s7 J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation:$6,509.00
Description of Work: Tear off existing, install 23 squares of comp roofing
Planning Conditions:
Owner:
Address
Phone:
Te na nt:
Primitivo Villasenor
1518 W Dahl
Santa Ana, CA 92704
(7141696-2940
Contractor: Smart Home Solutions
Address'. 7212 Paseo Del Rio
Los Angeles, CA 90040
Phone. 17141 321-7790
State Lic #: 242949
Lic Type' B, C-2, C-39
Bus. Lic #: 349287
Workers' Compensation lnsurance:
Carrier: State ComP lns Fund
Policy #: 9278377
Expires: 0612012021
Engineer:
Address:
Phone:
License #:
Architect /
l-)esioner'
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA !nsp. Req'd:
Planning Insp. Req'd:
Landscaping lnsp. Req'd:
web_user
Date:
Date:
Date: 0611612021
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
0 777 5002
0777 6002
0777 6002
07776002
0 777 6002
57607
5777 0
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving Fu
General Plan Update
I ssua nce
$345.28
$4.05
$1.00
$23.79
$59 30No
No
No
No
Subject to Field
Fire lnsp. Req'd. No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
N/A - No
N/A - No
N/A - No
Balance
Balance
BalanceEvery permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs issuance,or if the work
authorized on ftre site by such permit is suspen ded or abandoned for a period of
360 days after the time the work is commenced.
Fee Total.
Paid to Date:
Balance Due:
$433.42
$433 42
$0.00
lnspector MID#: 2021 -166825
!NSPECTOR RECORD
SITE-WORK DATE !D/SIG.COMMENTS OWNER BI.II LDER DELCARATION
I herebl alTinn under penaltl' of periury that I anr exempt ftrrm the Contractors' l-icense l-aw for the follorving reason (Sec.70.11..5 Business
and Profession ('ode): Any City or County which requires a perrnit to construct. alter. improve. dernolish or repair any structure. prior to its
issuance. also requires the applicant for such pennit to file a signed statement that he or she is licensed pursuant to the provisions of the
('ontmctor's l.icensed l.arv (Chapter 9. Comrnencing rvith Section 7000 of Division .1 of the Business and Professions Code) or that he or
she is exenrpt therefi'orn and the basis for the alleged exemption. Any violation of Section 7031 .5 by any applicant for a permit sub.iects the
applicant lo a civil penalty of not more than five hundred dollars t$,-500).
N! t. .r o\!'ner of rhe property. or my enrployecs rvith rvages as rheir sole cornpensation. will do the rvork and the structure is nor intended
or offbred for sale (Sec.7044. Business and Professions ('ode: The Contractor's [.icense l-arv does not apply to an olvner of the propety
rvho builrts or improves thereon. and rvho does such rvork himself or herself or through his or her ou,n employees. provided that such
improvonents are nol intended or offered for sale. lf. hos,o'er. the building or improvonent is sold within one y€r of complaion. the
Os'ner Builder s'ill have the burden of proving that he or she drd not build or im;nove the properw for the purpose of sale).
ro l. a. owner of the property.am exclusively contracting u'ith licensed conmctors to construct rhe project (Sec. 7044. Business and
Profession ('ode: The Contractor's License l.arv does not apply to an owner of property rvho builds or improves thereon. and
rvho contracts for such projects with a Contractor(s) licensed pursuant to the Contractor's l,icense Law).
No I a,, exempt uncler Section - _ _. B. & P.C. for this reason.
\I'OR.KF'RS' COMPFNS TTION NFCT ^ RATION
I hereby affirm under penalry of perjury one of the following declarations:
!! f n.u. and w'ill maintain a Certificate of ('onsent to Self-tnsure for rvorkers' compensation. as provided for by Seoion -1700 of the
Labor Code. for the performance of the work for rvhich the permit is issued.
YES
__-l have and rvill rnaintain workem' compensation insurance. as required by Section 3700 of the [,abor Code. for the pcrformance of the
work for which this pennit is issued. My workers' compensation insurance carrier and policy number are:
STATE FUNDCarrier:_ _
9278377 0c120t2021
NO
_l cenifu that in the performance of the u,ork for rvhich this permit is issued. I shall not employ any person in any manncr so
as to become subject to the rvorkers' comrrcnsation laws of California. and agree that if I should become subject to the workcrs'
comFrcnsation provisions of Section 3700 of the Labor Code. I shall. forthwith comply with those provisions..
W'ARNIN(i: I;ailure to secure worters' conrpensalion coverag,e is unlawful. and shall suh.iect an ernployer to crirninal penalties and civil
fines up lo one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for thc Section 3076
of the l-abor ('txle. interest and attomey's fees.
LI('T'NST'D ('ON'TRACTOR NTCI ARATION
I hereby alTirm under penalty of perjury that I am licensed under provision of Chapter Q (commencing u,ith Section 7000) of Division 3 of
lhe Business and Professions Code. and rnv license is in full force and effect.
B.C-30.C-2
l-icense ('lass:2129/;9
License Number
C()NS'[RI.I('TTON I .FNNING .t(:I.'N('Y
I hereby af inn undcr penalty of periury that there is a construction lending agency for the perfonnance of the work forrvhich this grerrnit is
issued 1!isq. .1097. ('ir,. ('.).
l-encler's Narne:
l-endcr's Atlclress:
APPI I('I.NT NFCI {,R,ATION
I herebv allinn under penalt_y of perlury one of the followrng declarations
I)entolrtton Pernuts-Asbestos Nottlicalton Federal Regulalrons (Trtle 40. Part6)
!9 Required l.etterof Notification
tlt , ceflify thar the federal regulations regarcling asbestm removal are not applicable to this pro.iect.
YES
I cefli$ that I have read this application and state that the above information is correct. I agree to comply with all City and County
ordinances and State [as's relating lo building construction. and hereby authorizc representatives of this City and County to enter upon the
above menlioned property for inspection purposes.
Reroof t r4l
Roof (Diaphragm Sheathing/Frame)(LTIU Dkwi (
Structural Final '7 l9t1-\l-rtP91j g
Plumbing I
Under Floor I Under Slab
Rough
Shower Pan / Tub Test
Water Service
Sewer / Sewer Cap
Gas Air Pressure Test
Plumbing Final
Electrical
Service (Meter I Panel)
Grounding / Bonding
Rough
Electrical Final
Mechanical
Gas Air Pressure Test
Rough
Piping (HW, CW, etc.)
Exhaust Ducts
N/echanical Final
Notes, Remarks, Etc.
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