HomeMy WebLinkAbout101107601 - Permit'.!
D Unit.Proiect Address: 854 E Harwood Pl-a-
Assessor's Parcel: 01 1 -224-01 Lot: 39 Block: NA Tract: 2025
Bldg. Address Range:Suite Range:
Zonrng: RlHistoric: 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 #: {0110760{
Pin #: 74245w
Building Use: Slngle Family Ow.lling Occupancy: R-3, u lst FL Area Patio:
Job Type Roioof Constr Type V B 2nd FL Area T.t.Area:
Nature ofwor*: R.root Code: cBc 2019 OtherAreas yards Req.d
Existing Bldg. & Use: Sfd wrdet g.rage Flood Zonei X{802320278J
proposed use: # of storiea: Garage Area velu'tion: $15'000 00
Tolat
Da6crlptlon of Vyork Ro.oof houa. & detrtched garage - 6move cohp 3hlngles, leplace any darragad 3heathlng, indrll ngr conp ahlnglea Hando{t!
givon.
Plannlno Condlllona: Propo.ed coloa la a darkar tlnlah that tho axl lng and ia conPallbl..
Owner:
Address:
Phone:
Tenant
ALICIA TOVAR
854 E HARWOOD PL
Santa Ana, CA 927016220
(7141499-2559
Contractor: Pro Vision Col Roofing
Address: 774 Shalimar Dr, Unit C
Costa Mesa, CA 92627
Phone: (949) 8914687
State Lic #: 1061 155
Lic Type. C-39
Bus. Lic #: 378687
Workers' Compensation I nsurance.
Carrier: State Fund lns
Policy #: 9264497
Expires: 0911712021
Engineer:
Address:
Phone:
Licerrse #:
Architect /
Desiqner:
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp.
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd:
Fire Insp. 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
Martin, Eric
Amsden, Julie
Date: 08/1 912021
Date:
Date: 08/1 912021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07775002
07776002
07776002
07776002
07776002
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57607
57770
57672
57600
57607
$34s.28
$4 0s
$1 00
$23 79
$s9.30No
No
No
No
Account#Total
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterits issuance,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#: 2021-168283
$23.7e
$404.s8
$1 00
$4 0s Fee Totat
Paid to Date:
Balance Due:
$433.42
$0.00
$433.42
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DEI,CARATION
I hocby affm unda pcnalty of pejury that I m cxcmpt from the ContmcloB' Licro Law for thc following |wn (Se.7031.5
Busincs and Profsion Codc): Any City or County which requirG a pqrnit to costruct, alto, improvq danolish or rcpair uy
structuq prior to its issuacc, also requirs thc applicmt for such pcrmit to filc a signcd statmot that hc or shc b licqEcd pulswt
to thc Fovisioc of thc Contrrctor's Licenscd Law (Chaptc 9, Commcnchg with Setion 7000 of Division 3 of thc Buins ud
ProfmionsCode)orthathcorshe isexilptthtrfromildthebsisfortheallcgcdcxmption. AnyviolationofsclionT03l.5bya{iD
applicat for a pennit subjcts the applicant to a civil pcnalty ofnot more tha fivc hundred dollus ($500).
_1. as owner of the property, or my employees with wages as their sole compensation. will do the work and the structure is not
intendod or offered for sale (Sec.7044, Business and hofessions Code: Thc Contractor's License Law does not apply to an owner of
the properry who builds or itnproves thereon. and who does such work himsclf or herself or through his or her own employees,
provided that such improvonents are not intended or offered for sale. II. however. the building or improvement is sold within one year
of complction, the Ourner Builder will have the hrden of proving tha he or she did not build or improve the property for the purposc of
sale).
a
-1.
as owner of the propeny, am exclusively contracling with liccrued contractors to construct the project (Sec. 7044, Business
and Profisssion Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projeds with a Contracto(s) licensed pursuant to the Contractor's Licerue taw).
-l
am exempt under Section-, B. & P.C. for this reason.
Date:
!&BtsEESSAMEENIAIIAN
DECT.ARATION
I hseby aIfim undo poulty ofpojury onc ofthc following detaratiom:
/ {-l Uvc aa witl maintain 8 Ccf,ificstc of Coltgt to Sclf-lmuc for mrkc' omp€rEation. I Fovidcd for by Setion 37OO of thc
L8bor Codc. for thc pqfoIrucc ofthc work for which the pantrit b issucd.
(t havc md will maintain workm' compcrcation ircurecq 6 rcquircd by Setion 37OO of thc kbor Code. for thc pqfomecc of
- the work for which this pqmit is isuod. My workc' compcrualion iruumcc tri6 and policy numba rc:
'=[rr\t- F.]^c\q-n-7\
_l certi& that in thc performance of the work for which this pcrmit is issucd, I shall not employ any person in any manner
so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the
workers' cornpensation provisions of Section 3700 of the Labor Code. I shall. forthwilh comply wilh those provisions.
WARNING: Failure to secure workers' compensation coverage is unlawful. and shall subject an onployer to criminal penalties and
civil fines up to one hundred thousand dollars ($100.000). in addition to the cost of cornpensation, darnages ts provided for the
Section 3076 of the Labor Code, interest and attorney's fbes.
LICENSED CONTRAC'I'OR
DECLARATION
I hcreby affirm under penalty of perjury that I am licensed under provision of Chaptcr 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
License
_{_\
Nunrber:
I
W
I hcby affm unda penalty of pcrjury that thqc is a comtruction lcnding agmcy for thc pqfollmcc of thc work for which this psmh b
issucd (Se. 3097, Civ. C.).
lsrds's Nmc:
Lender's Address:
APIIJCANI.DECI.ABAIION
I hadry atrrm unds poalty of psjury one of the foUowing deluatiom:
Dmolition PmiteAsb6tos Notification Fcdfial Rcgulations (Titlc 40, P{r6)
-Rcquired
Lctr6 of Notificalion
-l
cdiry thst thc fedGal rcgulatiore rcguding rbctos rooval uc not .pplicablc to this prcjet.
-$J cotifo rha I havc @d this application and ststc thd thc abovc information is coEE1 I agr to @mply with 8ll City ud Courty
-ririlimcc od Statc L:ws rchting to buitditrg colgructioD, ed haeby uthorire rcpmtativB of this City sd CoEty to 6t6 upotr tlrc
above mentioned property for inspection
\,Applicant or Agent
Permitee nflnle
o,,", 0[ lcl / ll
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloorNenul nsu latio n I ,
Roof Sheathing Y DA.W
Shear Wall /
Framing
lnsulation/Enerqy
Drynruall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence 1
T-Bar \
Handicap Req
Deputv Final Report
Enqineer Final Report
Flood Zone Certif
t\I t-?//
F!NAL U L\Vtl}Wc /
Certificate of Occupancy t
Notes, Remarks, Etc
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