HomeMy WebLinkAbout101106279 - PermitProject Address: 1723 W St Anne PI
Assessor's Parcel: 408441-14 Lot: 14
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 4606 Historic: No
City of Santa Ana 20CivicCenterPlaza(M-19), Santa Ana,CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {0110,6279
Pin #: 60860
Description of Work: !nstall new roof mounted solar PV system. Per PV checklist
Plsnning Condltion.:
Engineer:
Owner: Veronica Coltoz Contractor: lnflnltly Energy lnc.
Adoress: i723 w SAINT ANNE PL Address: /X|234 Bu3he.3 P.rt Dr. tll Addressl
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Phone:
Tenant
1
Single Family Dwelling
Solar
Solar
SFD w/ garage
R.3, U
VB
cBc 2019
x-0602320257J
1st FL Area
2nd FL Area
Other Areas:
Garage Area
Totat
Patio:
T. !.Area:
Yards Req'd
Valuation: $20,000.00
Santa Ana, CA 927044760
(7141425-5610
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
Temecula, CA 92590
Phone: (951) 308-1738
State Lic #: 998627
Lic Type: B, C-10, C46
Bus. Lic #: 364951
Workers' Compensation I nsurance:
Carrier: State Comepensation Fund
Policy #: 914661 3
Expires. 111'1312021
I
Phone:
License #:
Architect /
Desiqner.
Address.
Phone:
License #.
H.tJ llo I n9
l-t1 I 16r,rr-12- 51 6 [r1 [r[lr:r
11 icrof ilm & Dscurile
1 1 16LrLl
\
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning !nsp. Req'd:
Landscaping lnsp. Req'd:
Fire lnsp. Req'd. No
Police lnsp. Req'd: No
Ffood Zone Cert. Req'd: No
AIrV
Date:
Date.
Date: 0313012021
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Totat
Paid to Date:
Balance Due:
$450.00
$24.30
$1 .00
$0.00Zuniga,
No
No
No
No
Account#Total
01 1 16002 51601
01 1 16002 51612
01 1 16092 57770
f
$4s0 00
$1 00
$24 30Every 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.
$47s 30
$0.00
$475.30
Inspector MID#: 2021-165 192
It I L I 5
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,
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsu Iation
Roof Sheathinq
Shear Wall
Framinq
lnsu !ation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif .
I
FINAL ?/qdz,J^,lle..
Certificate of Occu
Notes, Remarks, Etc.I
OWNER BUILDER DELCARATION
I lrcrcby nttrm uDdcr Fnalty of Frjury that I am cxcmpt from lhc c(rntrackfs' Liccnsc [iw l(rr thc tirlkrwing rca*rn (Se.70.]1.5
Ilusincss atul Prolbssiotr C(xlc): Any City or CouDty which rcquircs a lErmil k) conslruct. altcr. improvc. dcmlish or rcpair uny
stnrclurc, prior lo its issuancc, also rcquircs lhc apJrlicatrt for such IErmil h tilc a sig[cd slalcrcnt thal hc or shc is liccnsd pursuant
k) lhc pruvisi(rns of thc Contrackr.'s Liccnscd llw (Chaplcr 9, C(rmmcncing wilh Scction 7000 (rf Divisi(rn J of lhc Blsincss and
ProfcssiotrsC(xlc)orthathcorshciscxcmptthcrcliomandthchasislirrthcallcgedercmption. AnyviolationofScctiu?0.ll.5byany
applicant for d pcrmit suhjet$ rhc applicant b r civil pcnalty of not m(,rc than fivc hundrcd dollils ($5U)).
_1, as owncr of'lhc pmpcrty, or nry cmployccs with wagcs as thcir solc comgrcnsation, will do thc work and thc struclurc is nol
intcrxlcd or oll'crcd lirr salc (Sec'.7044, Business and Prof'cssiuns CrxJc: Thc Contracl()r's [.iccnsc Law does not apply lo an owncr of
lhc pn)pcrty who builds or improvcs thcreon, arxJ who docs such wrlrk himself or hcrsclf or lhrough his rlr hcr own empklyccs.
provitlcd that such impnrverncnts arc mrt intcndcd or oll'crcrl tbr sah. ll, lrowcvcr, the buikling or impnrvcnrcnt is solJ within ()nc yciu
ol'complction. thc Owncr Buildcr will lurvc the burden of proving that lrc or shc did not buikl or improvc thc pnrpcrty for thc purposc ol'
salc).
_1, as owncr ol'tltc property, anr cxclusivcly cr>ntracting with liccnscd conlracto$ t() construct thc projcct (Scc. 7U4, Busincss
arxl hrrlbssirn Ctxlc: Thc C<lntractor's Liccnsc Law drrcs not apply to an owncr of proJrcrty who builds or improvcs thcrcon,
and who c()ntracts trlr such pnrjccts with a Contractor(s) licenscd pursuant to thc Contractor's Liccnsc Law).
-Iamc.xcnrptundcrScctitln-'B.&P.C.lbrthisrcastrn.
f 1..'nar.
TVORKERS' CO[\I PENSATION
DECLARATTON
I hcrcby atTirm unrlcr Jrcnalty ol'Jrcrjury one of thc' tolklwing dcclarations:
_l have and will maintain a Certilicatc of Conscnt lo Scll'-lnsurc tirr wrlrkcrs' conrJrcnsati()n, as pnrvidcd lirr by Section 3700 of thc
l-atxlr Ctxlc. lilr thc Jrcrlbrmancc ol'thc work tor which thc Jrcrmit is issucd.
l nuu"and will maintain workcrs' compcnsation insurancc, as rcquircd by Sccrion J700 of the lahor Corlc. tbr rhc pcrlirrmarrce of
the work tilr which this prmit is issuctl. My workcrs' comlrcnsation insurancc carricr arxl Jxrlicy numbcr arc:
t\I!l"oe\Policy
_-l ccrtity that in thc pcrtrlrmancc ol'thc work lilr which this prmit is issucd, I shall not cmploy any lrcrson in anytnanncr
so as to bcconrc sub.jcct to thc workcrs' comgrcnsation laws of Calilirrnia, and agrcc that if I shoukl bccomc suhjcct to thc
workers' conrpcnsation provisions ol'Scction 3700 of thc Lahlr CrxJc. I shall, tbrthwith comply with thosc provisions.
IVARNING: Failurc to sccurc workcrs' comJrcnsation covcragc is unlawful, and shall subicct an cmpkrycr to siminal Jrcnaltics and
eivil lincs up lo onc hundrcd tlxrusand dollars ($lm,Uru). in adrlition to the cosl ol'comJrcnsation, damages as providcd lor rli
1Scction .1076 thc [-akrr CtxJc, intcrcst and
I
I hcrcby affirnr undcr Jrcnalty of pcrjury that I am liccnrcd Chaptcr 9 (conrnrcncing with
ol' thc Busittcss and Prof'cssions Corlc, arxl my liccnsc is in full filrcc anJ cft'crct.
z''
[.iccnsc Io Nunrhcr:
W
I hcrchy aflirm uodcr lEMlty of Frjury Ihat Ihcrc is s c(rnslruction lcndirg agency for thc Frformncc of lhc work for which this Jrcmit is
issucd (Scc. .1097, Civ. C.).
kndcr's Namc:
I.cndcr's Adtlrcss:
APPLICANT DECLARATION
I hcrcty allirm unrlcr Jrcnalty of pcrjury onc of thc lirlkrwing rleclarations:
Dcmolition Permits-Asbcstos Notification Federal Rcgulations (Titlc 40, Part6)
_Requ ircd Lcttcr of N<ltilication
_l ccrtily that thc l'cdcral rcgulutions rcgarding asbcslos rcmoval arc not applicablc to this projcct./W I ccrtify that I have read this application anl statc that thc abovc infirrmation is corrcct. I aprcc to comply with all City and County
rlrdinances and Statc Laws rclating to huilding constnrclion, and hcrchy autlxrrizc reprcscntalivcs of this City and County to cntcr
ahovc rncntkrnctl pnrpcrty lirr
.tplllicarrt or Agcnl
Pentrilee nanle
t"y 7ur) .l'Divisi,n 'l
I
7o
Flarr n9,-n7 -2n1q
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