HomeMy WebLinkAbout101102615 - Permitt. . J
Pin #:7
Proiect Address: 1242 W Pine Sta
Assessor's Parcel. 777 -777 -77 Lot:
Unit:BIdg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract. 1363 Historic: No
e
City 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
Permal#: {011026{5
Building Lrse: Slngls Family Owolling Occupancy: R-3, U 1st FL A.ea: 1596 Patio:
Job Type: ou Conatr Type: vB 2nd FLArea: 7E3 T.l.Area:
Nature of Work: t{ow SFo Code: cBc ml6 Oher Areas: yards Req.d:
Existing Bldg. & Use: Vacant Lot Flood Zone: X..0502320257J
proposed use: New sFo wr.tt 2nd 1. ADU # of stories: Garage Area: 4E7 valu'tlon: l2o0'000 00
Totah 23tg
D6crlptlon ot Worki ConEtruction ot. new lwo-story SFD wr.$ ADU (ADU on sopar.te pe.mit) .nd attached 2.car G.r.g., ""LOT ERGER TO BE
COMPLETEO PRIOR TO FINAL INSPECTION"*
Planning Conditions
Owner: Life Cycle Management, LLC
Address: 25 Brookline
Aliso Viejo, CA 92656
Phone: (g4g) 412-g?1g
Tenant:
Contractor
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation ! 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
(7141 ee7-91 20
c43205
Dream House Drafting & Design
Leticia Portocarrero
5096 Tolowa Avenue
Riverside, CA 92509
(7141 721-3412
,
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd: No
Planning lnsp. Req'd: Yes
Guevara, Jerry
Scott Fazekas & Assoc.
Chavez, Dave
No
Fire lnsp. Req'd: Yes
Police lnsp. Req'd: No
Date: AA2712020
Date: 0312612020
Date: O4l0gl2020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Permit Fee
Plan Check Fee
Microfilm Records
SMIP - Category 1
BIdg. Stds. Revolving
General Plan Update
lssuance/New Structu
Fee Total:
Paid to Date:
Balance Due:
l\t
$1 ,727.10
$6,052.01
$101 .66
$26.00
$8.00
$22.e5
$152.ss
$8,090.27
$6,052.01
$2,039.26
Account#
73926
Total
07776C 02
07776002
07776002
0 8907007
07776002
07776002
07776002
57607
s3600
s7770
24000
57572
s7600
57607
Landscaping 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 after ifs issua nce,or if the work authorized
on the site by such permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
lnsp*r MID#: 2019-156629
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
08901001 24000
$22.95
$1,879.65
$8.00
$1 01 66
$26 00
a
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BUILDING- INSPECTOR RECORD
SITE WORK DATE !D/SIG.COMMENTS ()WNE,R B I.]II,DER I)EI,CARA'I'ION
I hereby affirnr under penalty of pertury that I am exempt from the Cbntractors' I-icense [-aw for the following rean (Scc.7031.5
Busincss and Prolbssion Codc): Any City or County which requircs a pcrmit to construct, alter, irnprove, demolish or rcpair any
slructure, prior to its issuance. also requires the applicant for such permit to file a signed statemenl that he or she is licensed pursuanl
to lhc pnrvisions ol' thc Conlraclor's Licensed law (Chapter 9. Commencing with Section 7000 of Division 3 ol'the Bu.siness and
Professions Code) or that hc or she is exempt therefrom arxl tlre basis tbr thc alleged exenrption. Any violation of Sectircn 7031 .5 by any
applicant for a perrnit subjects thc applicant to a civilpenaltyof not nnre than five hundred dollars ($5001.
_1. a.s owner ol'thc property, or my cmployces with wagcs as lheir solc compcnsation, will do thc work and the stnrcture is ml
intemlcd or oflercd for salc (Scc'.7OC+, Business and Profcssions Code: The Contractor's Licensc l-aw tlocs not apply lo an owner of
the pnrperty who huilds or in{rorcs thcrmn, arxl who dcrcs such work himself or hcrself or through his or her own employees,
provided that such improvcrnents are rnt intendcd or ollerud for sale. ll, however, the building or improvennnt is soH within one )€ar
of conqrhtion, thc Owner Builder will have the burden of pnrving that he or she tlid not build or improve the propcrry for the purposc of
sale).
-1.
ns owner of the property, amcxclusively contracting with licensed L^onlracloni to construcl the project (Scc. 7(X4. Business
and Pnrlbssi<xr Code: The Conlractor's Licerrse Law does not apply to an owner of property who builds or inrproves thereon.
ancl who contracls for such projects with a Contractor(s) licensed pursuanl lo the Contraclor's Liccnse Law).
_l anrexempt under Section_, B. & P.C. lirr this reason.
I)ale:
WOR KI.I,RS' COM|'!:NSATION
DECLARATION
I hcrcby allirm undcr penahy of pcrjury onc of the tbllowing declarations:
_lhaveandwill nraintainaCertificateofConsenttoSelf-lnsureforworkers'conrpensation,as pr<lvidedforhySection3T00ofthe
Labor Codc, for thc pcrformancc of the work lbr which thc permit is issucd.
_l have and will nraintain workers' compensation insurance, as required by Sect ion 3700 of the Labor Code, for lhe performance of
thc work tbr which this ;rcrmit is issued. My workers' compcnsation insuruncc carricr arxl policy numhcr are:
Policy Number: Expires:
_l ccrtity lhat in the pcrformance of the work for which this permit is issucd, I shall not employ any lrcrson in any manner
so as to bccorne subject to the workcrs' comlrcnsation laws of California. and agree that if I stnuld bccomc subject to the
workers' comlrcnsation provisions of Section 3700 of the Labor Code, I shall, forthwith comply with thosc provisi<lns.
WARNING: Fuilurc to secure workers'comlrcnsation covcragc is unlawful, arul shall subject an cmployer to criminal Srenalties and
civil fines up to onc hundred thousand dollars ($l00,Un). in addition to the cost of compensation. damages as provided for the.
Section 3076 of the Labor Code, interest and attorrry's fees.
f t...,..
LICENSED CONTRA(:TOR
DECLARATION
I hcrcby allirm undc'r pcnalty of Srcrjury that I am licenscd under provision ol'Chaptcr 9 (cornrnencing with Section 7m0) of Division 3
of thc Busincss and Professions Code, and nry licensc is in full forcc and cffcct. I
License Class: License Number:
Date:I
CONSTRI,'CTION I,I.:NI)I NG AGT:NCY
I hercby atlirm under Jrenaltyof perjury that there is a construction hnding agerlcy frrr the perfornrar*-e of the work fbr which this permit is
issucd (.Scc. 3097, Civ. C.).
[,cndcr's Namc:
l-cndcr's Addrcss:
APPLICANT DECLARATION
I lrrcby affrm under penalty of perjury one of the following declarations:
Denyolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6)
_Requiretl lrtter of Notifrcation
_l certity that the federal regulations regarding asbeslos renroval are not applicable to this project.
_l certify that I havc read this application arxl state that lhc abovc information is correcl. I agree to comply with all City antl County
ordinances and State Laws relating to building constructiorL arxl hereby autlnrize representalives of this City and County to enter upon the
above mcntioncd propcrty for inspection purposes.
Applicunt or Agent Date:_
Permltee name (prlnt): -
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf I oor/Ve nUI n su Iatio n
Roof Sheathinq
Shear Wall
Framinq
Insulation/Enerov
Drvwall
Ext./lnt. Lath
Brown Coat
JVlasonrv
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Fina! Report
Flood Zone Certif.
FINAL
Certificate of Occupancy
Notes, Remarks, Etc.
tJ rC>
a
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BUILDING- INSPECTOR RECORD
DATE COMMENTS
Set Backs
Pads
UFER Ground
B
Shear
Ext./lnt,
Coat
Mason
Fence
rt
Fin
Zone
NAL
Etc.
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