HomeMy WebLinkAbout101105149 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests. (714)667-2738 lnspector Section: (714) 647-5853
Permit #: 1O1105149
Pin #: 88746
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Proiect Address: 2366 N Riverside Dra
Assessor's Parcel: 002-1 33-27 Lot: 111
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 425 Historic: Yes
Building Use: Single Family Dwelling Occupancy: R-3 1st FL Area
Job Type: Reroof Constr Type: V B 2nd FL Area
Nature of Work: Reroof Code: CBC 2019 Other Areas:
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.-Remove wood shake and apply Shakeliner to sfd only/sheating to remain/handout given
Planning Conditions:
Patio:
T.l.Area:
Yards Req'd
Valuation: $32,000.00
I
t
Owner:
Address:
Phone:
Tenant
Michael Mustafa
2366 N Riverside
Santa Ana, CA 927061613
(7141 3224742
Contractor. Robert A Warren
Address: 7417 Quil! Drive
Downey, CA 90242
Phone: (310) 890-1987
State Lic #: 377268
Lic Type: C-39
Bus. Lic #: 367730
Workers' Compensation I nsurance:
Carrier: State Fund
Policy #: 1869443
Expires: 0110112020
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner.
Address.
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping Insp. Req'd: No
Gomez, Pedro
Hernan dez, Kathy
Date: 1'110512020
Date.
Date: 1110512020
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002
07775002
07776002
0 7776002
07776002
57607
57770
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
$345 28
$4.05
$2.00
$23 7e
$5e.30
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
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 afterifs 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#'. 2020-162623
01 1 16002 51600
01 1 16002 51601
01 116002 51612
01116002 57770
$23 7e
$404.58
$2 00
$4 05 Fee Totat
Paid to Date:
Balance Due:
$434.42
$0 00
$434.42
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loo r/VenUl ns u latio n'Roof Sheathing I a-(5-21 U-,W @)
Shear Wall -v
Framinq
Insulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
[\4asonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
^/ ,/./l /-?_
F!NAL e,{d
Certificate of Occupancy I
NOtes, Rqmarks, FIc /\,lI,?I A
Yfubo,/tuY,(
OWNER BUILDER DELCARATION
I hcrcby affirm under pcnalty oi prjury that I &n excnrpt frnm thc Contraclors' Liccnrc law for thc following reason (Scc.7031.5
Buslncss and Profession Codc): Any City or County which requircs a Jrrmit lo construcl, alter, improvc, dcmolish or repair any
stnrcture. prior to its issuancc. also requircs thc applicant for such pcrmit to filc a signed statcmcnt that hc or shc ls liccnscd pursuanl
to thc provisions of thc Contractor's Licensed law (Chapter 9, Commencing with Section 7000 of Division 3 of the Busirrcss and
Profcssions Codc) or that te or shc is cxernpt thcrcfrom and thc basis for thc allcged cxemption. Any violation of Section 7031.5 by any
applicant for a pcrmit subjcrcts the applicant to a civil pcnalty of not morc than five hundred dollars ($5001.
_1. as owncr of the propcily, or my cmployees with wages as their sole compcnsation. will do thc work and thc structurc is not
intcndcd or offcrcd f<rr salc (Sec.7044. Busincss and hofcssions Codc: Thc Contractor's Licensc [:w docs not apply to an owncr o[
the propcrty who builds or inrprt'rves thcreon and who docs such work hirnsclf or hcrself or through his or her own cmployccs.
provided that such improverncnts arc not intendcd or offercd for salc. lf. howcvcr. thc building or intprovetnent is sold within onc ycar
of cornplction thc Owrrcr Buikler will have the burden of proving that trc or she did not build or improve thc propny for ttrc purposc of
sab).
_1. as owner of the property. am cxclusivcly contractrng with liccnscd contractors lo constmct thc projcct (Scc. 7W. Busittcss
and t\otbsskrn Code: '[hc Contractor's Liccnse Law docs not apply to an owner of propcrty who builds or inrproves thercon.
and who conlracls for such proicts with a Contracto(s) liccnsed pursuant to the Contraclor's Liccnsc Law).
-l
am excmpt undcr Scrction-. B. & P.C. for this rcason.
Date:_-__
WORKERS' COMPENSATTON
DECLARATION
I hereby affirrn under pcnalty of pcrjury one of thc following dcclaratiotts:
_l havc and will maintain a Certilicate of Conscnt to Sclf-lnsurc for workcrs'compcnsation. as gnovidcd for bySection 3700 of the
[:bor Code. for the pcrformance of the work for which the pernrit is issucd.
_lhavcandwill rnaintainworkers'compcnsationinsurancc,as rcquircdbySection3Tfi)ofthcLaborCodc.forthepcrforrnanceof
thc work for which this pcrmit is issucd. My workcrs' compensation insurancc carricr ruxl plicy numbcr arc:
Policy Numbcr: Expircs:
_l certify that in the pcrformancc of the work for which this prmit is issucd. I shall not employ any pcrson in any rnnncr
so as to bccomc subjcct to thc workcrs'comfrcnsation laws of California. and agrcc that if I should bcconr subjcct to the
workcrs' compcnsation provisions of Scction 37fi) of thc l":bor Codc. I shall. forthwith cornply with those provisions.
WARNING: Failure to sccurc workcrs' compcnsation covcragc is unlawful. and shall subjcct an cmploycr to crirninal Jrcnaltics and
,
civil fincs up to onc hundrcd thousand dollars ($100.000).in Aition lo thc cost o[IM danrages as provided for thc
Scction 3076 of thc l-abor Code, intcrcstf llo 7o
arrd attorrcy's
,"r., '
I I-t,
DT'CI ARATION
I hcrcby affirm under pcnalty of pcrjury that I am licensctl undcr provision of Chaptcr 9 (cornnnncing with Scrtion 7000) of Division 3
of the Busincss and Professions Code. and my liccnse is in full forcc and effcct.
Liccnsc
Date, I I ,roeo
W
I hcrcby uftirm udcr Fnalry of pcrjury Ihsl tlw is a snstruction lcnding agcrcy for thc tErfor|lrmc of thc work for $,hich lhis Imh is
issucd (Scc. 3097. Civ. C.).
[,cndcr's Namc:
frntlcr's Addrcss:
APPI ICANT DECLAITATION
I tueby aflirm under pcnalty of perjury one of thc following declarations:
Dcmolition Pcrmits-Asbcstos Notification Fcderal Regulations (Titlc 40, Part6)
-Requircd
lrtter of Notification
_-l ccrtify that thc fcdcralrcgulations rcgarding asbcslos renxrvalare nol applicablc to this projcct.
_l certify that I havc rcad this application and statc that thc abovc information
ordinanccs and Statc l,rrws rclating to building construction, and thc
ahlvc nrntioned propcrty for
Applicant or Agenl
l'ernrilee nnnre f(r rc{(1 5 2oLc)
Rev. 08-07-201 5
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