HomeMy WebLinkAbout101107421 - PermitProject Address: 412 W Halesworth St
Assessor's Parce!: 398-551-02 Lot: POR 1, POR 2 Block: NA
Unit Bldg: Address Range:
Tract: TURNER'S ADD Historic: No
Suite Range:
Zoning: P
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {01107421
Pin #: 45O9O
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Building Use: Single Family Dwelling Occupancy. R-3 1st FL Area
Job Type: Reroof Constr Type: V B 2nd FL Area
Natureof Work: Reroof Code: CBC 2019 OtherAreas:
Existing Bldg. & Use: SFD w/det garage Flood Zone: X-0602320163J Garage Area
Proposed Use: # of Stories:
Total
Description of Work: Reroof w/t.o. sfd only-Remove and apply comp shingles/replace sheathing/handout given/auth on file
Patio:
T.l.Area:
Yards Req'd
Valuation: $9,000.00
Planning Conditions:
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Owner:
Address:
Phone:
Tenant
Aaron Cornejo
412 W Halesworth St
Santa Ana, CA 927061327
(7141 6404933
Contractor. Arana Roofing
Address: 15243 McDonnell Avenue
Fontana, CA 92336
Phone (323) 376-0624
State Lic #: 953146
Lic Type: C-39
Bus. Lic #: 342897
Workers' Compensation I nsurance:
Carrier: State Comp lns Fund
Policy #: 9161505
Expires: 0612512022
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
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Planning Approval By:
Plan Checked By:
Permit lssued By: (.
NPDES lnsp. Req'd:
PWA lnsp. Req'd.
Planning lnsp. Req'd:
Landscaping lnsp. Req'd:
Soto, Ricardo
Hernan dez, Kathy
Date: 0810212021
Date:
Date: 0910212021
Subject to Field:
I
No
No
No
No
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002
07776002
07776002
07776002
07776002
57607
57770
57672
s750 0
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$345 28
$4 05
$1 00
$23 79
$59.30
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 1 16002 51600
01 1 16002 51601
01116002 51612
01 1 16002 57770
Account#Total
Every 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.
lnspector MID#: 2021-167792
$23 79
$404 58
$1 00
$4 0s Fee Total
Paid to Date.
Balance Due:
$433 42
$0 00
$433.42
O LILI J
BUILDING- INSPECTOR RECORD
SITE-WORK DATE ID/SIG COMMENTS OWNER BUTLDER DELCARATION
I hcrcby aflirm undcr rcnalty of lErjury that I m cxcmpt frcm lhc CoNractoN' Licen* [:w tbr thc following rc&sn (Scc.7031.5
Busincss and Prcfcssion Codc): Any City or Couily which requircs a pmit to construcl. altcl irrprove. dcmlish or rcJnir my
slruclurc. prior to its issuancc. alm rcquircs thc applicant for such Jrcrmit to lih a signcd statcmnt that hc or she is licensd puEuant
to lhc pmvisions of thc Contractor's Licenscd I:w (Chapter 9. Commercing with Section 7000 of Division 3 of the Busiress ond
Pmfcssions Codc) or thut hc or shc is cxcmpt thscfrom and thc basis for thc allcgcd cxcmption. Any violation of Sstion 703 1.5 by any
applicant for a Ennit subjets thc applicant lo ! civil pcnalty of not mrc than five hundrcd dollus ($500).
-1.
as owncr of thc propcrly, or my cmployces with wagcs as thcir solc conrlrcnsation. will tlo thc work ard the structurc is not
intendcd or offcrcd lbr salc (Scc.7044. Business and hofcssions Codc: Thc Contractor's Liccnsc Lrw docs not apply to an owncr of
thc proJrcrty who builds or improvcs thercrrrr. and who docs such work himsclf or hcrsclf or through his or her own crnpklyccs.
providcd that such improvcnrcnts arc rrrt intcndcd or ollbrcd ltlr salc. lf, howcvcr. thc building or impr)vcnrcnt is sold within onc )car
of contplction. thc Owncr lluildcr will have thc burdcn of proving lhal hc or shc did not build or improvc thc propcrty ftrr thc purposcof
sale).
-1.
as owncr of thc propcrty, anr cxclusivcly contracting with liccnscd conlractors lo conslruct thc projcct (Scc. 7044. Busincss
and ftof'cssion Code: The Contraclor's Liccnse Law docs nol apply to an owncr of property who builds or improves thereon.
and who conlracts for such projects with a Contractor(s) licenscd pursuant to the Contractor's Licensc t aw).
-IamcxcmptunderScction-.B.&P.C.forthisrcason.Dale: Owner:_
WORKF.RS' COMPF.NSATION
DECLARATION
I hcrcby alfirm undcr penalty of pcrjury one of thc following dcclarations:
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have and will maintain a Ccrtificatc of Conscnt to Sclf-lnsurc fbr workcrs' compcnsation. as provided for by Section 3700 of thc
I-abor Codc. ltlr lhc pcrformancc of thc work filr which thc pcrmit i.s issucd.
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havc and will maintain workers' compensalion insurancc. as rcquircd by Scct ion 37fi) of thc Labor Codc, for thc pcrformancc of
lhc work lor which is contJrcnsation insurancc carricr and Jxrlicy nuntbcr arc:
e
/zs /r,I
Policy o 6
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ccrtify lhill in thc pcrformncc of thc work for which this fErmit is issucd, I shall not cmploy any pcrson in any rmnncr
s as Io tEorc subjccl to thc workcrs' compcnsation laws of Califomia, and agrc Ihat if I should becom subFct to thc -workcrs'comJrcnsrtionprcvisionsofScction3T00ofthetiborCode,lstull.forthwilhcomplywilhthosprovisions.
WARNING: Failurc lo scurc workcN'@mlEnsation covcragc is unlawirl. and shall subjcrt an employcr to simiml Fmltics and
civil fincs up to onc hundrcd thousand dollm (SI00.000). in addition to thc co$ of comlrcnslion. darogcs as provided for the
Scction 3076 l;tbor Codc. intcrcst and altorney'sozo z/
DECI ARATION
I hcrcby affirrn undcr pcnalty of pcrjury that I arn liccnsed undcr provision of Chaptcr 9 (commcncing with Scction 7000) of Division 3
of thc Busincss and Profcssions Codc, and my liccnsc is in full forcc iurd cffcct.
Liccnscrr^r.' eeq LiccnseNumbcr:? 5e/ /6
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I hcrcby affum under [Enslly of pcrjury that thcrc is a construction lcnding agcrcy for thc prformrcc of lhc work for which thk lrcrmii is
issued (Se. 3097, Civ. C.).
kndcr's Nam:
Lcndcr's Addrcss:
APPI ICANT DECLARATION
I hcrcby affrnn undcr pcnalty of perjury one of thc following dcclarations:
Dcnrolition Pcrmits-Asbcstos Notification Fcderal Rcgulations (Titlc 40, Part6)
-Rcquired
[-ettcr of Notification
-l
ccrtity that thc fedcralrcgulations rcgarding asbcstos rcmovalarc not applicablc to this projcct.
statc that thc uhrvc infonnation is corrccl. I agrcc to cornply with all City and County
to entcr upon thc
ahovc rncntiorrcd propcrty for
Applicant or Agerrt
hercby authorizc rcprcsentatives of this City and
z z/
Set Backs
Forms/Stee!/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nt/l n su latio n
Roof Sheathing gl -?-t4 lZJ-Z a
Shear Wall
Framing
lnsulatio nlEnergy
Drywall
Ext./lnt. Lath
Brown Coat
lt/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL u-15-Z{/A_(s Nc /4rg,tT zr7
Certificate of Occupancy
Notes, Remarks, Etc.>_
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Exnircs:
Applicant:
Permitee nanle (print):_