HomeMy WebLinkAbout101107201 - Permita
Proiect Address: 1439 S Shelton Sta
Assessor's Parce!: 013-1 23-10 Lot. 27
Unit:Bldg: Address Range.Suite Range:
Zoning: RlBlock: NA Tract: 1373 Historrc: No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: 1O11O72O1
Pin #: 48975
11u
Building Use:
Job Type
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
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:
Totat
Patio:
T.l Area:
Yards Req'd
Valuation:$24,000.00
Description of Work: lnstall solar panels
Planning Conditions:Boichi:57881 7/I3i2L'21 D: ELIZABETH
Freedom Forever
Arashi Yoshioka
143 Saint Thomas Drive
Oak Park, CA 91377
:
s6285
(:(:i : *r***r*r ***16?(
tiei*: 101ir-r72r"rl
3i 2it2l lu: (r7 AH
tS36.05
I tt
Owner:
Address.
Phone:
Tenant
JavierB&ElisaHeredia
1439 S Shelton St
Santa Ana, CA 927071035
(7141 613-2479
Contractor: Freedom Forever
Address: 43445 Business Park Dr, #1'
Temecula, CA 92590
Phone. (951) 445-5645
State Lic #: 1029644
Lic Type: B, C-10, C-39, C46
Bus. Lic #: 370076
Workers' Compensation I nsurance:
Carrier: Redwood Fare and Casualty lnsura
Policy #: FRWC215868
Expires: 0110112022
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone.
License #:
$45tr, 00
$1 . LtU
$85. [r5
$536, L|5
Auth*:01 54 78
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES Insp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Fire lnsp. Req'd:
Police lnsp. Req'd:
Flood Zone Cert. Req'd: No
viore$
Date:
Date:
Date: 0711312021
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds Revolving
07776002 57600 General Plan Update
Fee Total
Paid to Date:
Balance Due:
$450 00
$85 05
$1 00
$0 00Verduzco,
No
No
No
No
No
No Account#Total
01 1 16002 51601
01 1 16002 51612
01116002 57770
$450 00
$1 00
$85 0sEvery 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
lnspector MID#: 2021-167392
$536 05
$0 00
$536.05
r'e s
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BIJILDER DELCARATION
I hcrcby affrm undcr Fnalty of Friury that I m cxcn$t frcm the Contrrctos' Liccn* lrw for thc following rorco(Sc.7031.! -
Busincss and Pmfession Codc): Any City or County which rcquires a lrcmit to construct. altcr. improvc, dcmlish or rctEir ur'
strcturc, prior lo its issumcc. also rcquircs thc applicant for such lrcrmit to filc I signcd stalcrcnt thrt he or slE is licenrcd pusuurt
to thc Fovisions of the ContBctor's Lienrcd kw (Chsptcr 9. Commrcing vith Setion 70q) of Division 3 of the Busircss ud
ProfesshnsCodc)orthathcorshciscxctr{,tthcrcftomandthcbasisfortheallcScdcrcmplion. Anyviolatkrnofssthn?03l.5by8ny
applicant for a [rcrmit subjsts thc lpplicant to a civil pcnalty of not mrc lhm five hundrcd dollus ($500). l
_1. as owner of thc pr)pcny. or my cnlpbyccs with wagcs as their solc cornpensation. willdo lhe work and the structure is rnt
intcndcd or offcrcd frrr salc (Scc.7044. Busincss and Profcssions Codc: The Contractor's Liccnsc l;rw docs not apply to an owncr of
thc proJrcrty who builds or irnprovcs thcrcon and who docs such wo* hinrelf or hcrsclf or through his or her own employccs.
providcd that such irngnovcnrcnts arc not inlcndcrl orofTcrcd lbr salc If. howcvcr. ttrc building or improvcnrcnt is sold within one ycar
of cornplction. thc Owner Buildcr will havc ttrc burdcn of proving that hc or shc did not buikl or improvc tlrc propcrty for thc purynsc of
salc).
-1.
as owner of thc property, am cxclusivcly contracting with licenscd contraclors to construct the projctt (Sec. 7044. Busiltcss
arxl Prrofession Codc: Thc Contractor's License Law does not apply lo Bn owncr of property who builds or improves thereon,
and who conracts for such projccts with a Contractor(s) liccnsed pursuant to the Contractor's Liccnse Law).
-IamexelnptundcrSc.ction-.B'&P.C.forthisrcason.Date:__Owner:_
WORKER^S' COM PENSATION
DECLARATION
I hcreby afllrm undcr pcnalty of pcrjury onc of thc following dcrlaratiorrs:
_l have and will maintain a Certificatc of Conscnt to Sclf-lnsurc for workers' comgrcnsation. as povided for by Section 3700 of thc
[:bor Codc, for thc performance of thc work for which thc pcrmit is issucd./v I have and will maintain workcrs' comlrcnsation insurancc, as rcquired by Section 3700 of the [:bor Codc, lbr thc performance of
Gi work for which this Jrcrmit is issucrl. My workcrs' compensation insurance carricr and plicy number are:
Ciuricr: lA!ry+ (,4. .^l Cora.^Uot
Policy \.rct\s ?ct t/,lr-
_l ccrtify that in thc ;rcrformance of the work for which this pennit is issued, I shall not ernploy any pcrson in any manner
so as to bccomc subjcct lo thc workers' compensation laws of California, and agrce that if I should trc.corrc subject to the
workers' compcnsation provisions of Scction 3700 of thc Latnr Code. I shall. f'orthwith comply with thosc provisions.
WARNING: Failure to sccure workers' compensation covcragc is unlawful, and shall subjcct an employcr to criminal Jrenalties and
civil fincs up to onc hundrcd thousand dollars ($100.000). in addition to thc cost of compcnsation. damages as providcd for thc
Scction 3076 of thc latnr Codc, intercst and attorncy's fecs.
Date:_AppllcanI
LICENSED CONTRACTOR
DT'CI.ARATION
I hercby alhrm undcr pcnalty of perjury that I anr licenscd under provision of Chapter 9 (comrrrncing with Scction 7000) of Division 3
of thc Busincss and Professions Code. and my licensc is in full forcc and cffect.
Liccnsc L-to Nunrbcr:roL?c#
r3 CT
W
I hercby affim urdcr lEmlty of Frjury that thm is a consruction hndirg agcrcy for thc trrformc of thc work for which this pcrmit is
issucd (Sc. 3097. Civ. C.).
Lcndcr's Narnc:
lrndcr's Addrcss:
APPLICANT NECI ARATION
I hcrctry affrrn undcr pcnalty of perjury onc of thc following dcclarations:
Demolition Permits-Asbestos Notification Fcdcral Regulations (Title 40. Part6)
_Required l*tter of Notification
_l ccrtify that thc fcdcralrcgglations rcgarding asbcstos rcnnvalarc not applicable to this proi"ct.
-4""rtitythar I havc rcad rhis application statc that the atnvc infornution is correct. I agrce to comply
reprcsentativcs of this City
with all City and Counly
ordinances and State [:ws relating to constructioru and hcreby authorizc and County to cnter uJnn thc
abovc rrrcntioncd propcrly for
1Applicant or Agent
I)ernrilc.e nanre 2n*
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loo r/VenUI nsu latio n
Roof Sheathinq
Shear Wall
Framing
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
JVasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
ll ^LL ilt
F!NAL ()'(lo )/rvT 3t
Certificate of Occupancv
Notes, Remarks, Etc.
Rev. 08-07-201 5
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