HomeMy WebLinkAbout50101196 - Permit!-City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Grading
Permit Counter: (714) 647-5800 lnspection Requests: (7141667-2738 lnspector Section: (7'l4l647-5853
Permit #: 50{01196
Pin #: 435{E
Unit:wProiect Address: 1242 W Pine St-a -
Assessor's Parcel: 777-777-77 Lot:Block: NA Tract: 1363
Bldg: Address Range:Suite Range:
Zoning: RlHistoric: No
Building Use: Single Family Dwelling
Job Type: New
Nature of Work: Grading
Existing Bldg. & Use: Vacant Lot
Proposed Use: New SFD w/att 2nd fl. ADU
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
R-3, U
VB
cBc 2019
x-0602320257J
1st FL Area:
Znd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation:
Description of Work: Grading for new SFD and aftached ADU. Auth on file.
Planning Conditions:
t\
Owner:
Address:
Phone:
Tenant:
IAS Management LLC. c/o Steve Al Contractor:
25 Brookline Address:
Aliso Viejo, CA 92656
(949) 412-8219
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Shucri "Chuck" l. Yaghi
Shucri l. Yaghi
112 E Chapman Avenue, D
Orange, CA 92866
(7141997-9120
c43205
Dream House Drafting & Design
Leticia Portocamero
5096 Tolowa Avenue
Riverside, CA 92509
(7141 721-3412
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES !nsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping Insp. Req'd
Guevara, Jerry
Sarlak, Behrooz
Zuniga, Allissa
Date: 0211312020
Date: 02113l,2020
Date: 02113l,2020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
07776002
07776002
57606
s7606
57600
5760 6
57770
Permit Fee
lmprovements
General Plan Update
lssuance
Microfilm Records
$333.06
$s00.00
$22.e5
$s7.20
$0.00No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd Account#
No
No Total
Flood Zone Cert. Req'd: No 01 1 16002 51600 $22.e5
$8e0.26Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterifs issuance,or if the work authorized
on the site by such permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
Fee Total:
Paid to Date:
Balance Due:
$913.21
$0.00
$gt 3.21
lnspector MID#: 201 9-156629
01 1 16002 s1606
V
G RADI NG.I NSPECTOR RECORD 1,
I
APPROVALS DATE ID/SIG.COMMENTS Ow-Buildq Delsmtion
I hcrcby affrrm undo pcmlty of pcrjury that I m qcmpt fom thc Contrscton' Liccns Law for lhc followitrg tlmn (s.7031.5 Businds
ard Prcfcssion Codc): Any City or Couty which rcquim a 6mit to orutrucr, sk6, imprcrc, &mlish or rcpot my structw. prior to ts
isrumc, alm rcquim thc spplicail for $ch pcmir to filc a sigmd stalmnt fiat hc or shc ii liccffid pumut to thc prcvisions of thc
CootEctor'r LiccNrd Lsw (Chlptcr 9, Commcrcing with Sction 7000 ofDiviik n 3 ofthc Bwincas atd Prcftslioro Codc) or lhal hc or
shc ii ilcmpt tlrefom and thc borir for thc allcgcd cxcmption .Aoy vhlstion of Sction 7031.5 by my rppli@rt for r pcmit $bjltB thc
applicsnt to I civil pcmltyof ma mrc than live hundrcd dollan (t5fl)).
_1, &i owEr of thc pmpdly, or my cmployc with w.86 a. thcL $lc @mpcnlatiott vill do rhc work atd fic atrucluE h ml htcnded
or offaed for olc ( Se.7044, Bu.iBr .nd Pmfcaeioni Codq Thc Contrelor'r Licc[r Law doe mt apply to m owr of thc pmpcny
who builds or imprcrcr therclt and who do6 srch work himrlf or hre|f or thrcugh his or hcr om cmplorrcs, pmvidcd thst swh
impmrcmcnts re mt intcndcd or olfcrcd for slc. tf. howcq. thc building or imprcrcmcnt is sld within orc ya of omplaion, thc
Owrcr-Buildr will harc thc burdcn of pmving lhlt lrc or lhc mr build or impmrc for thc purporc of ulc).
_1, &i owrcr of thc ,rrcpcrly, sm qclurivcly coilreling with lice[sd @ntmctoE lo @N]rucr thc projct ( Se. 70,14, Busines ard
Prcfcsri<rn Codc: Thc Contmctor'r Liccre lre doa mt apply to u orc of prcpcry wtn builds or imprcB thcrcn , and wtn
contracts for such projects with a licensed pursuant to the Contractor's License Law.).
_l am exempt & P.C. for this
Date:
I hereby affirm under penalty perjury one the
_l hsvc ard will mhtrin a Ccrtificatc of Coffint to Sclf-Itrflrc for mrtcrr' mmpenstion, as prcvidcd for by S6tion 3700 of thc
Labor Codc, for thc pcrfomre of thc wort for which thc Fmit is issed.
_l hrvc and will maintEin work6' mmpcnstion in$Bre, ar rcquircd by Scction 3700 of thc Lsbor Co&, for thc pcrfomancc of thc
work for which thi! pmil is iscd. My workm' compcnsalion insnre c.rier ard policy numbcr rc:
Policy
('[his section need not tc completd if the permit is for One hundred dollars t$1001 or less),
in any mann? so as to
the workers'
5
performance work for u'hich this is issued, I shall not employ
laws and agree if I should
compensation of the
\
WARNING:to workers' compensation is and an employer to criminal
fines up to one hundred thousand dollars ($100,000),in
the Labor Code, interest and attomey's fees.
the cost of compensation, damages as provided for the Section 3076 of
@
I hcrcby allirm unda pcElty of pcrjury thrt I m lienrcd undcr pmvision of Chaptq 9 (@lmncirg with Sction 7000) of Divirion 3 of
thc Buircs lnd Prcftlriou Codc, Erd my liccw is in frll forcc and cfIct.
License License Numher
Date: Contractor:
W
I h€rcby affirm urdq pcmlty of [Erjury lhot thcrc is a mnstrucrion lcnding EEcrcy for thc Frfomncc of th. uork for which this ,rcrmit is
isscd (56. 3097, Civ. C.).
l:ndcr's Namc:
Lender's Address:
APPLICAIIT'S DECLARATION
Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part 6)
_ Required lrtter of Notification
asbestos removal are not applicable to this project.
state that the above information is correct. I agree to comply City and County
above mentioned
Applicant or agent
Permittee name
and hereby authorize re?resentatives of this City uJr'on the
Preliminary Soil Report
Excavation
Fills
Sub Drains
Buttresses
Soils/Geology Report
Statement of Compaction
Compaction Report
Flood Elevation Cert
Paving
Sub Grade
Aggregate Base
Water Test & Seal Coat
Asphalt Concrete
Soils Eng. Cert.
Rough Grading Release
Final Civil Cert.
tl
FINAL ro /r LD TDhF6)
Notes, Remarks, Etc.,
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