HomeMy WebLinkAbout102105456 - PermitCitV of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:1O2{05456
Pin #: {8{03
Proiect Address: 913 S Bamdal Sta
Assessor's Parcel: 407-062-30 Lot: 6
Unit:4/'f
Block: NA Tract: 9779
Bldg: Address Range:Suite Range:
Zoning: RlHistoric: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Miscellaneous
Nru - Demo
SFD w/att Garage
Occupancy:
Constr Type:
Code.
Flood Zone'.
# of Stories.
R-3, U
VB
cBc 2019
x-0602320257J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $1,000.00
Description of Work: Demo all unpermitted work and restore back to original permitted use.Bntchi:57515 12/14/Zlt?tt ID: oggroleslSOffice;':l'YH TrnnEi:74 2 cil 3Acct*: Rel*: l021llli456
Rcpt*:Lr3136884 12/I+/2$2A 1:34 Fn
Owner.
Address:
Plan Conditions:
J. Guadalupe Vasquez
9402 W. Brook Street
Santa Ana, CA 927042801
Phone.
Tenant:
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires.
J. Gundnlupe Vnsquer
Buildirrs
ttl I l6tt02- Sl6ttlt-ruu-
Genernl F Isn Updnt,e Fee
01 I 16t:trr2- 516r-rrirJ0u-
Blds St,dE Revolv ins
Ltl I 161102- 5161 Zrtt-rtr-
11 icrof i 1r & [tocurenl,E
01 1 16002- 1777r-uJLItr-
ViE0
C(:+ : ***rr*f r*rr*2102
_ $598. t6
$23 .7?
$1, u[
$4.1J5
f,86tr .q)7
Auth* :0834 t 6
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #.
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA Insp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Ceft. Req'd: No 01116002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
Chavez, Dave
Date:
Date:
Date: 1211412020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
077760 0 2
07776002
07776002
077760 02
07776002
07776002
07776002
Permit Fee
Microfilm Records
lnvestigation
Penalty
Bldg. Stds. Revolving
General Plan Update
lssuance
Y?.
57607
57770
57607
57607
57672
57600
57607
$172.64
$4 05
$104.26
$261.96
$1.00
$23.7e
$59.30Account#Total
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterits 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.
$23 7e
$598.1 6
$1 .00
$4.05 Fee Total:
Paid to Date:
Balance Due:
$627 00
$0 00
$627.00
lnspector MID#: 201 8-140912
T^^&OZr'r t)',1
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nVl ns u lation
Roof Sheathinq
Shear Wall
Framing
lnsulation lEnergy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
rA
FINAL 7-\3r9 ),.tfl-\A
Certificate of
Notes, Remarks, Etc.
OWNER BUILDER DELCARATION
I hcrchy allirm undcr Jrcnalty of pcrjury that I m cxcmpt ln)m thc G)ntrack)s' Liccns Llw tirr lhc tbllowing rcason (Scc,70-]1.5
Busincss ahl Protbssion Cqlc): Any City or Counly which rcquircs . JErmit to coNtrucl. altq. improvc. dcmolish or rcpair rny
structu.c, pri)r lo its issuancc, also rcquircs thc alplicanl for such [Ermil k) filc a si8rcd statcrcnt lhal hc or slE ir liccnsd pursuanl
lo thc prcvisiuls of thc C(rltrsctor's Licclsd kw (Chaptcr 9, Grmmcncing with Sstion 7fix) of Division .] of thc Busincss and
Prulcssions c()dc) or that hc or she is crcmpt lhcrcfrom and thc hasis t('r thc allcgcd cxcmplion. Any viohlion of Setirn 70.1 1.5 by any
applicant tbr a lEmit suhjccts lhc applicant to a civil pcnalty of not m)rc than livc humlred dollus (S5fi)).
--1,
as owncr of thc propcrty, or my cmployccs with wagcs as thcir solc comJrcnsation. will do lhc work arxl thc slructurc is nol
intcnrJcd rlr oll'crcd lilr sale (Scc.7044, [Jusincss and Pnrt'cssions Codc: The Contractor's Liccnsc Law drrcs not apply lo an owncr ol'
thc pn)pcrty who builtls or intprrves lhcrcon, and who tftrcs such work himsclf or hcrsclf or thruugh his rtr hcr own cmpkryccs,
providcd that such impnrvcm:nts arc lxrt intcndcd or oll'crcd lirr salc. Il. howevcr. thc buikling or impnrvcnrcnt is sokl within onc ycar
of complction, llrc Owncr Buildcr will havc thc hurdcn o[ pnrving that hc or shc ditl rrut build rlr impnlvc thc proJrcrty lilr thc purplsc ol'
salc).
_1, as owncr of thc propcrty, am cxclusivcly contracting with liccnscd contractrlrs to construct thc projcct (Scc. 7M4, Business
arxl lhltbssion Crxle: 'fhc Conlractor's Liccnsc Law drrcs not apply to an owncr of proJrcrty who builds or improves thcrcon.
and who contracts lirr such projccts with a Contractor(s) liccnscd pursuant to thc Contractrlr's Liccttsc Law).
_l am cxcmpt undcr Scction-, B. & P
I hcrchy all'irm undcr Jrcnalty ol'Jrcrjury one ol'thc tblkrwing tlcclarations:
_lhavcandwillmaintainaCcrtiticatcofConscnttoSclf'-lnsurctilrworkcrs'comJrcnsation.as providcdtbrbyScction3T00ofthc
l-ahlr Crx-lc. lirr thc Jrcrlilrmarrcc of thc work tilr which the pcrmit is issucd.
_l havc and will maintain workcrs' comJrcnsation insurancc, as rcquircd by Scction 1700 of thc Labor Codc. lirr thc lrcrlormancc of
thc work tirr which this permit is issuc'rl. My workcrs' compcnsation irisurancc carricr urd Jxllicy number arc:
Policy Numhcr: Expires:
_l ccrtily that in thc Jrcrlirrnuncc <l[ lhc work tilr which this Jrcrmit is issuctl, I shall rrot empkly any pcrson in any manner
so as to bcconrc subjcct to the workers' comJrcnsation laws of Calitirrnia, and agrcc that if I should hccomc suhjcct to thc
workcrs' comJrcnsation pnrvisions ol'Scction 3700 of thc Latxrr CrxJc. I shall, lilrthwith comply with thosc provisions.
WARNING: Failurc to sccurc workcrs' comJrcnsation coveragc is unlawlul, and shall suhjcct an cmpklyer to criminal Jrcnaltics and
civil lincs up to onc hundrcd thousand dollars (Sl00,U)()), in adrlition to lltc cost of com[rcnsation. damagcs as providcd lirr thc
Scction -1076 of thc Lahrr Ctxlc. intcrcst and attrlrncy's t'ccs.
oxn, s (7-lAl 2. o
DIi( ]I,AIL\'I'I0N
I hereby allrnr undcr pcnalty ol';rcrjury that I am liccnrad unrlcr provision of Chaptcr 9 (commcncing with Section 7U[) of Dit ision 3
of thc Busincss and Profcssions Codc, and my licensc is in tull tilrcc and ettcct.
Liccnsc Nunrhcr:
Il.rr^.
W
I hcrcby afftrm undcr Jrcnalty of Frjury that tlrcrc is a construction lctrdiDg agcncy for thc lrcrf(rmncc of lhc w(xk for which this;rcmit is
issucd (So. 309?, Civ. C.).
lxn,lcr's Namc:
[rndcr's Addrcss:
APPLICANT DECLARATTON
I lrcrcby all-rnn undcr Jrcnalty of pcrjury onc of thc folbwing dcclarations:
Dcmolition Permits-Asbestos Notification Fcdcral Rcgulations (Titlc 40, Part6)
-Rct1u
ired [-ct tcr of Notificat i<ln
_l ccrtity that thc tbdcral rcgulati<lns rcgeuding ashcstos rcnxrvalarc not applicablc t<t this projcct.
with all City and County
antl County to cntcr uJxrn thc
Applicant or Agent
Penrrilec nanle
a
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