HomeMy WebLinkAbout101107090 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CAS27O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O11O7O9O
Pin #: 20,495
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Proiect Address: 1076 N Cabrillo Park Dra
Assessor's Parcel: 931-776-80 Lot. 2-5 Block: NA
Unit: A-C Bldg
Tract 10580
Address Range: 1002-1098
Historic: No
Suite Range:
Zoning: R4
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Multi-Family (5 or more units)
Alteration
Windows
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
R-2
VB
cBc 2019
x-0602320164J
1st FL Area
2nd FL Area
Other Areas:
Garage Area.
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation: $+,633.00
Description of Work: Reptace (2) windows and (1) door, same location & size.
Planning Conditions:Batchi'.i772'l 6/2it 2it7
I I5,Engineer:t
t
Owner:
Address:
Phone:
Tenant
Julie Stonger
1076 A N Cabrillo Park Dr, Unit C
Santa Ana, CA 92701
(7141 721-1140
Contractor: Window World of OC
Address: 1534 N State College Blvd.
Anaheim, CA 92806
Phone: (7141 808-8322
State Lic #: 101 2249
Lic Type: B, C-17
Bus. Lic #: 365727
Workers' Compensation I nsurance:
Carrier: Property & Casualty lns Co of Hart
Policy #: 57WECZR4471
Expires: 0812212021
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icpf,f : trJISr_r+ 3g
Trnnsqct ion i-crtnAddress.
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
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iu I 16 tne
Lrl I 16rrLr2- 5i6r-rIrjLt0
ienercrl Flnn Upcicttr
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11 : 5g rrri
t521.56
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Guevara, Jerry
sden, Julie
Date: 0612912021
Date:
Date: 0612912021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07775002
07776002
07776002
07776002
07776002
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
Fee Total
Paid to Date:
Balance Due:
No
57607
57770
57672
57600
57507
$172 64
$4 05
$1 .00
$23 79
$5e 30
..No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd:
No
No Account#Total
Landscaping !nsp. Req'd:Flood Zone Cert. Req'd: No
Every permit issued 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 permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 s1600
01 1 16002 51601
01116002 51612
01116002 57770
$23 79
$231 .94
$1 .00
$4.05 $260 78
$0 00
$260.78
lnspector MID#: 2021-167153
a\
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Ve nVl n s u I atio n
Roof Sheathinq
Shear Wall
Framinq
Insulatio nlEnerqy
Drywall
Ext./lnt. Lath
Brown Coat
N/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
/
//./\
FINAL lnlzr LrJ'O1 I
Certificate of Occu
Notes, Remarks, Etc.
I}U I I,I)I'R DI.]I,CA RATION
I hcrchy dmrm undcr IEntrlIy of Frjury that I er cxcmpt frenr thc Contracton' Liccnsc hw for thc following rcasn (Sc.?031.5
Busincss and Profcssion Codc): Any City or County which rcquircs a pcrmit to construct. alter, impmvc, dcmlish or rcpair my
structurc. Jrior to its issulrcc. 8l$ rcquircs thc opplicant for such Frmit to nb a signcd statcmnt that hc or shc is liccnsd pusuant
to thc pmvisions of thc Controctor's Licenrcd taw (Chaptcr 9, Comncing silh Sslion 7000 of Division 3 of thc Busircss and
PmfcssionsCodc)orlhathcorshciscxcmpllhcrcftomsndthcbasisforthcallegcdcxcmplion. AnyviolalionofsectionT03l.5byrny
applicant for a pcmit subjccts the spplicant to a civil penalty of not mrc than fivc hundrcd dollus ($500).
_1. as owner of thc propcrty, or my cmployces with wagcs as thcir solc conrpensation. willdo thc work and thc structure is not
intcndcd or otfcred for sulc (.Sc.c.7044, Business and Professions Codc: Thc Contractor's Licensc Law docs not apply to an owner of
the proprty who builds or improvcs thcreon, and who docs such work hirnsclf or hcrsclf or through his or hcr own cmployccs,
providcd that such irnprovcrncnts arc not intcndcd or oflcrcd for salc. If. howcver. thc building or improverrnnl is sold within onc )aar
of conrphtion. thc Owncr Buildcr will have thc burdcn of proving that hc or shc did not build or improve the pmprty for the purynsc of
sah).
_1. as owncr of the propcrty, anr cxclusivcly contracting with liccnscd conlractors lo conslruct thc projcct (Sec. 7U4. Busincss
and hufbssion Code: 'l'he Colrtractor's Liccnse Law docs not apply to an owner of propcrty who builds or intprovcs thercon,
and who contracls frrr such projccts with a Conlraclor(s) Iiccnscd pursuant to lhc Conlraclor's Liccnsc Law).
_l arn cxcmpt undcr Scction_. B. & P.C. for this rcason.
f)ate:_
WORKIiRS' C( }M PENSA'IION
Dt'CI,A ITA"I'ION
I hcrcby afllrrl undcr pcnalty of'pcrjury onc ol'lhc ltrllowing dcclarations:
_l havc and will maintain a Ccrtifrcate of Conscnt to Sclf-lnsurc for workcrs' comJrcnsation. as providcd lbr by Section 3700 of thc
[:bor Codc, lbr the Jrcrfornrancc of the work for which thc pcrmit is issued.
work
and will ntaintain workcrs'cornpcnsation insurancc, as rcquircd by Scction 37fi) of thc Labor Codc, for thc pcrforrtuncc of
tbr which this pcrnrit is issucd. My workcrs' compcnsalion insurancc carricr iurd policy numbcr iu'c:
poricyNr,rt*r, 5? tN €CZE QQ-? I Expircs: gl2LtZt
_l ccrtity that in thc pcrltrrmance of thc work f<rr which this pcrmit is issucd. I shall not crnploy any pcrson in any manncr
so as to bccomc subject to lhe workcrs'compcnsation laws of California. and agrce that if I should bccomc subjcct to thc
workcrs' compensation provisions of Section 37fi) of thc [:bor Codc. I shall. forthwith comply with thosc provisions.
C
WARNING: Failure to sccurc workers'comJrcnsation coveragc is unlawful. and shall subjcct an
civil I'incs up to one hundrcd thousand dollars ($100.000),
Scclion 3076 of the Latxlr Code. intcrest and attorncy's fccs.
in addition to thc cost of damagcs as provided for thc
I hcrcby alfirm under pcnalty of prjury that I anr liccnscd 9 (comnrcncing with Scctkrn 7000) of Division 3
of thc Busincss and Profcssions Code, and nry liccnse is in full forcc
Liccnsccross' B Ct] LiccnscNumbcr:lotLLqa
0
W
I hcrcby rllirm undcr Jrcnulty ofJrcrjury that rherc is a construction lcnding rgcncy for thc lErformncc ofthc work tt r which this Jrcrmit Ls
issucd (Scc. 3097, Civ. C.).
Lcndcr's Narne:
[,cndcr's Address:
APPLICANT DT'CI ARATION
I hcrcby affinn undcr pcnalty of perjury onc of thc following dcclarations:
Dcrnolition Pcrmits-Asbestos Notification Fedcral Rcgulations (Titlc 40, Part6)
-Rcquircd
lrttcr of Notilication
_l ccrtify that the fcdcralrcgulations rcgarding asbcstos removalarc not applicable to this project.
with all City and County
and County to cnter upon thc
abovc rncntioncd property f<lr inspcction
Applicant or Agent
Permilcc name
0wner:_
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