HomeMy WebLinkAbout101107975 - Permitr'l
City of Santa Ana 20 Civic Center F'laza (tur119), Santa Ana, CA927O2
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Buitding
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714) 647-5853
Permit #: {01107975
Pin #: 2632U^
{
Project Address: 940 N Fair Wilt
Assessor's Parcel: 405-211-28 Lot. 19
Unit Bldg Address Range: 940-942
Historic: No
Suite Range:
Zoning: R2Block: NA Tract: 2980
Building Use:
Job Type:
Nature of Work.
Existing Bldg. & Use:
Proposed Use:
Duplex
Reroof
Reroof
Duplex w/att garage
Occupancy:
Constr Type.
Code:
Flood Zone'.
# of Stories:
R-3, U
VB
cBc 2019
x-0602320144J
1st FL Area
Znd FL Area
Other Areas:
Garage Area
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation: $4,000.00
D€€criPtion of Wolk Roroot duplex & attached garage - remove (1) layeE asphalt shingles, rapl.ce eny damaged stl.alhing, lnstsll3lr* lelt & 30re.r
Plannlng Conditions:Roplacorjepalr any damaggd wood mambgra, fascla, Eayea, l.ft6r8, otc prior lo tinal approval.
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Dn vet/iEion Roo
E i err etlr
Owner:
Address:
Phone:
Tenant
Elijah Gorea
940 N Fair Way
Santa Ana, CA 92703
(949) 683-7663
Contractor: Vision Roof Service
Address: 2385 Via Mariposa
Laguna Hills, CA 92637
Phone: (760) 625-7796
State Lic #: 651509
Lic Type: C-39
Bus. Lic #: 368067
Workers' Compensation I nsurance:
Carrier: American Zurich lns Co
Policy #: WC009578004
Expires. 1213112021
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l'lcr i,t er (:flr'd
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Fee
e
Planning Approval By.
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd.
Landscaping Insp. Req'd
Orozco, lvan
sden, Julie
Date: 09/1 612021
Date:
Date: 09/1 612021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
07776002
07776002
s7607
57770
57672
s7600
s7607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
$345.28
$4 0s
$1 .00
$23.79
$5e.30
No
No
No
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.
$23.79
$404 58
$1 .00
$4.05 Fee Total
Paid to Date:
Balance Due:
$433.42
$0.00
$433.42
lnspector MID#: 2021-168836
I\
{BUILDING. INSPECTOR RECORD,.
SITE.WORK DATE !D/SIG.COMMENTS .T OWNER BUTLDER DELCARATION
I hocw affm unda pcnalty of pajury thar I m q€mpt Gom thc ContrrctoE' Liccffi tsw for thc following tlen (Ss.7_031.5
Bwine and Prcfesion Codc): Any City or County which require a pamit to construct, altq, improvc, danolish or rcpai uy
structuc. prior to its iswcq also requirB thc applicet for such pcnnit to filc I signcd stalmmt tha hc or slrc b limcd pwst
to thc fovisioB of th€ Cotrtmctor's Licmscd Law (Chapt6 9, Comcncing with Setion 7000 of Division 3 of thc BNinN ed
Prcfsios Codc) or that hc or shc is ampt th6c&om ad thc b6sis for thc allcgcd cxmption. Any violation of Sctbn 7031.5 by uy '
applicmtforapcrmitsubjctsthc applimttoacivilpcnaltyofnotmorcthafive hundrcddollus(t500). !
_1, as owner ofthe property, or my employees with wages as their sole compensation. will do the work and the stnrture b not
intendod or off€red for sale (Sec.7M4, Business and Professions Code: The Contractor's Liccnsc l-aw does not apply to an owncr of
the propo'ty who hrilds or improves thereon. and who does such work himself or hcrsclf or through his or hcr own employees.
providd that such improvernents are not intendcd or offcred for salc. I(, howerrcr. the building or improveme,nt is sold within one ]€ar
of cornplaiorL the Orvncr Builder will havc the hrden of pnoving tlra he or she did not build or irnprove the property for thc purposc of
sale).
L
_1. as owner of thc prop€tty, am exclusively contracting with licensed contractors to construct the project (Sec. 7O44, Buincss
ard Proftssion Code: The Contractor's License Law does not apply to an owner of propcrty who builds or improves thereon.
and who contracts for such projects with a Contraclo(s) licenscd pursuant to the Contractor's Licensc law).
-l
am excmpt under Section-, B. & P.C. for this reason.
Jlo lo.
WORJ(ER,S' CONT PEN SATIO N
DECLARATION
I hercby affirm under penalty of perjury one ofthe following declarations:
by Section 3700 of the
for the pcrfonnancc of
t/
Policy 0
_l certi& that in the performance of the work for which this pcnnit is issued, I shall not employ any person in any manner
so as to bccorne subject to the workers' compensation laws of California, and agree that if I should bccome subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall, forthwith comply with those provisions.
WARNING: Failure to secure workers' compansation coverage is unlawful, and shall subject an onployer to criminal ponlties and
civil fines up to one hundred thousand dollars ($100,000). in addition to the cost of cornpensation, darnagcs as providcd for the<'"i ii::,:
LICENSED CONTRACTOR
DECI-ARATION
I hcreby affirm under penalty of perjury that I am licenscd under provision of Chapter 9 (commorcing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
Num\:r:
t
W
I hwby aI[m uda pcnalty of pojury that thG is a coEtruclbn knding agocy for thc pofo|]mcc of thc work fu which rhis pqmn b
issucd (S*. 3097, Civ. C.).
Lctrder's Name:
a
[-ender's Address:
APPLICANT DECLARATTON
I hodry affinn under penalty of perjury one of the following dcclarations:
Dernolition Permits-Asbcstos Notification Fderal Regulations (Title 40, Pafl6)
-Required
l-ctter of Notification
asbestos removal are not applicable to this project.
the above infonnation is correct. I agree to cornply with all City and County
represefltalives of this City and County to entcr
above mentioned property for inspection
zApplicant or Agent
\rmitee
4-t-?/6-2 r"n"
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloorNe nUl ns u lation
Roof Sheathing )-Z{-Zl.Erfrl )
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./!nt. Lath
Brown Coat
Masonry
Pool Fence V
T-Bar
Handicap Req.
Deputv Final Report
Enqineer Final Report
Flood Zone Certif.
FINAL 7--?-b?l har.<rq2
Gertificate of Occu pancy
Notes, Remarks, Etc.
\
/
\
/
Code, for the performance of the work for which the po'mit is issued.
have and will maintain workers'
work this permit is issued.and policy number arc:
/,r/zr/2
c
cati$ that I have read this application
State [-aws relating
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