HomeMy WebLinkAbout102102640 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #:1O2{0264tc
Pin #: 72E97
Unit:Bldg: Address Range:4MProject Address: 510 S Glenarbor St
Assessor's Parcel: 109-781 -50 Lot: 21 Block: NA Tract: 3921 Historic: No
Suite Range:
Zoning: R2
Building Use: Single Family Dwelling Occupancy
Job Type: Miscellaneous Constr Type:
Nature of Work: N/V - Demo Patio Cover/Legalize Wi Code:
Existing Bldg & Use: SFD w/att Garage Flood Zone'
Proposed Use: # of Stories:
R-3, U
VB
cBC 2019
x-0602320257 J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Owner-Builder form on file.
Patio:
T.l.Area:
Yards Req'd:
Valuation: $S,000.00
Description of Work: Legalize window change outs and remove unpermitted patio cover
Bntch*:5.i6;'iltllf ice: t:'l'YH
L/'"!/?tl?rl ID: (:(:tJl
TrnnE*: 167 1 rPlanning Conditions:
'[rcnsflcL iorr
llnr' icr llerj i rrn
G*:nernl Plnn Urrdnte Fee
r_r I I 1,5r[j2- ::i I 6tjulJ0tJ-.
tluildirrg
t-tl I l 6tJu?-" ::i I 6r-r I r-rr-rr_r-
tllds SLds Hevolviris
'Jl I 16tJU2- :1161 2r.rr:n_r-
li icr'of ilm & ltocurnentg
tJl I 16r-rr-r2 - 177-t 7r_rr-rr_rr_r-.
Uisq
C(:+ : * * *f )r* r * * x **r-r5r-r2
593 | /? /2irIlr ,l ; Irr F,Hftrt 0l $6?r-i . tJt:r
tF
Owner:
Address:
Phone:
Tenant:
Maria Medina
510 S. Glenarbor Street
Santa Ana, CA 92704
(7141 909-3735
Contractor
Address:
Owner-Builder
Phone.
State Lic #:
Lic Type.
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
,
$6?t-t . t:t[l
Au[hi: lS.i.6t-t.T
Planning Approval By:
Plan Checked By.
Permit lssued By:
NPDES Insp. Req'd. No
PWA lnsp. Req'd: No
Planning !nsp. Req'd: No
Landscaping lnsp. Req'd: No
Graham, Jeffery
Chavez, ,T"
9-t'
Date: 0110212020
Date:
Date: 0110212020
Subject to Field:
Account#Total
07776002
07776002
07776002
07776002
07776002
07776002
07776002
57607
57770
57607
57607
57672
57600
57607
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
Permit Fee
Microfilm Records
lnvestigation
Penalty
Bldg. Stds. Revolving
General Plan Update
lssuance
$166.53
$3 e1
$100.57
$252.6e
$1 .00
$22.9s
$57.20
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Every permitissued 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
01116002 51612
01 1 16002 s7770
$22 e5
$576 ee
$1.00
$3 91 Fee Total:
Paid to Date:
Balance Due:
$604.85
$0 00
$604.85
lnspector MID#: 2020-156846
t
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BUILDER DELCARATTON
I hcrchy afftrm undcr Fnalty of Frjury that I m cxcmpt thrm thc ConlractoN' Liccnrc hw for thc li)ltrwin8 rca$n (Scc.70.l1.5
Busincss anl Protbssion Code): Atry City or County which rcquircs a lrcrmit k) qrnstruct. altcr. improvc, dcmolish or rcpat any
struclurc, prior to ils issuancc, also rcquircs thc applicant li)r such lEmit lo l'ilc a siSncd stalcmcnt that hc or she is lienscd pusuant
to thc [n visions of tlE Contractor's Liccnscd ltw (Chaltcr 9, Commcncing with Scction 7fi)0 of Division 3 of thc Busincss ud
PrulbssionsCodc)orthathcorshciiexcmptthcrcfromatulthchasisforthcalleScdcrcmption. AnyviolalionofSetionTOJl.5byany
applicant for a trcrmil suhjsls the applicant b a civil pcnally ()f n(il m)rc lhm tivc hundrcd doll&s (Ssfi)).
/l-4$" ,r*n .rf thc prclrny, or my empl)yes wilh wagcs as thcir solc com[Ensation, will rlo thc wtrk axl thc strctm is nol
intcnlql or otcrcd tbr slc (Se.7O44, Busincss and PR fcssi(rns c(i.lc: Thc Contrrckrr's Liccnsc kw docs not apply to u owncr of
thcpnlJE.ty whohuildsorimFovcslhcG)n,anlwhod(rcssuchurrkhimsclforhcrrclforthftrughhisorhcrowncmployecs,
prcvidcd that such impnrrcmnts m mt intcndcd orollbql tir slc. Ii horcvcr, thc huilding or improvcmnt is srll withitr onc ycu
of comphtiln, thc Owrcr Buil,ler will hare thc huniur of prcving that hc or she dil nil hui&l or in{row the Imfdy for thc turlns of
sb).
_1, as owner ot'the pn)Frty. am exclusively contracting with liccnscd contractors lo constluct thc pnljcct (Sec. 7044, Busincss
an.J [tutbssionCrxlc: I'hcContractor'sl-iccnscLawdocsnotapplyloanownerofprolrcrtywhohuildsorimprovesthcrcon,
and who conlracts firr such projects with a Conlractor(s) liccnscd pursuant to thc Conlractor's Liccnsc Law).
_l am exempt undcr B. & P.C. tirr this rcason.
a 4
I hcrcby alfirrn undcr lL-nalty ol'Frjury onc ol thc lilllowing
_l have and will mainlain a Certilicatc of Conscnt to Self-lnsurc ti)r workcrs' comlrcnsation, as providcd tbr by Scction 37fi) of the
Labor Cule, lbr the grcrlbrmance of thc work tirr which the grcrnrit Ls issucd.
_l have and will maintain workers' comJrcnsation insurance. as rcquired by Scction 37fi) of thc Labor CrxJe, tirr the ;rrftrrmance of
thc work tbr which this Jrcrmit is issued. My workcrs' comlrcnsation insurancc c.urier an-l Sxllicy number are:
Carricr:
Policy Number: Expircs:
.A
l/..f.Lnif y,m, in thc lrcrlirrmrec ()f thc work tir whi.h this fErmit is issucd. I shall nol cmploy any lrcson in any Mncr
' so as k, beom subFct t, thc wod(crs' con[rns.tion laws of Calitirmia, and agrce thal if I slxruld tsorc suhjcu b lhc
workcrs' @mlEnsati(rn pruvisions of Selion 37m of lhc tlhor Gxlc. I shall. forthwith comply with tlf,rs provisions.
WARNING: Failurc l(, surc workcrs'q)mlEnsation covcragc is unlawful, and shall suhjcrt m cmplrrycr to sininal ltmltics ild
civil lincs up lo orc hundrcd thousand dollus ($100,0m). in additkrn lo lhc cost of compcnsation, damges as providcd for thc
Scction .1076 of thc Latxrr Cdc, intcrcst and allomy's fecs.
ta
I hcrchy allrm undcr penalty of pcrjury l
ol' thc Busincss and Prol'cssions Codc, iud nry liccnse is irr lirll lirrcc- iutd ctfbct.
l,iccnsc Class: Liccnsc Nuntbcr:
Il.. a n.f r^al ra^rnr.
W
I hcrchy aflirm undcr trcnalty of pcrjury that thcrc is a onslruclk)n bnling agcncy lirr thc lErlol:lrwce of thc wor* for which this lmit is
issucd (S@. 1097. Civ. C.).
k'ndcr's Name:
krrdc-r's Addrcss:
APPLICANT DECLARATION
I lrcr.-hy attirm undcr Fnalty of perjury onc ol'thc lbllowing dcclarations:
f)cmolit iorr Permit s-Asbcslos Notificat ion Fcdcral Rcgulat krns ('l-it lc 40, Part6)
_Rcquircd l*ttcr of Notifrcalion
-l
certily that the lcdcral rcSulations rcgruding asbcsk)s rcmlvol rrc no( applicahlc lo this pmjcct.
Ll.cttify that I havc rcad lhis application anl state that the atnvc infomlion is corcct. I a!re to @mply with all City and Counly
oRlinanccs ed Stalc llws rclating to buikling conslruction, aril hcrcby authorirc rcfcscntalivcs oflhis Cily ed County to cntcr uF)n tlE
atxrvc mntiorcd p$[rc]ty lbr inspeclion puFrss.
AppricsnrorAsenrsrrn rrnYrrl d I t .r r(4, ); ^ ", **, - O l' 7' 2- O
Permiteename(orint):K -.14 O{'r A .tt4 {- 11 ira C
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenUl nsu Iation
Roof Sheathinq
Shear Wall
Framing
Insulation/Energy
Drywall
Ext./!nt. Lath
Brown Coat
JVlasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
t//A
FINAL alaflo TU6, nh)
Certificate of Occupancv t I
Notes, Remarks, Etc.
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