HomeMy WebLinkAbout101107281 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cA927o2
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Building Permit #: l0l 1lO72S1
Pin #: GOIIIw
Project Address: 2503 N Valencia St Unit:Bldg: Address Range:Suite Range:
Zoning: RlAssessor's Parcel.396-022-08 Block: NA Tract: 733Lot: 12 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Single Family Dwelling
Reroof
Reroof
Occupancy:
Constr Type
Code.
Flood Zone'.
# of Stories:
R-3
VB
cBc 2019
x-0602320163J
1st FL Area:
Znd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation:$4,396.00
Description of Work: Tear off existing, install l2 squares of comp and 4 squares of built-up roofing
Planning Conditions:
Owner:
Address
Phone:
Tenant:
Formin Leal
2503 Valencia St
Santa Ana, CA 92706
17141932-924e
Contractor: All Service Roofing
Address . 16371 Hemlock St
Fountain Valley, CA 92708
Phone: V14l457-0906
State Lic #: 1070058
Lic Type' C-39
Bus. Lic #: 377457
Workers' Compensation lnsurance:
Carrier: Stste Fund
Policy #: 9284028
Expires: 09/1 412021
Engineer:
Address:
Phone:
License #:
Architect /
l)esioner'
Address:
Phone:
License #:
Planning Approval By.
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscapang lnsp. Req'd:
web_user
(
Date.
Date:
Date: 0711912021
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
0777 6002
0 7776002
0777 6002
0777 6002
0777 6002
5760 7
57770
57572
s7600
5760 7
Permit Fee
Microfilm Records
Bldg. Stds. Revolving Fu
General Plan Update
lssuance
Fee Total:
Paid to Date:
Balance Due
$345.28
$4.05
$1 .00
$23.79
$59.30No
No
No
No
Subject to Field
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
N/A - No
N/A - No
N/A - No
Balance
Balance
BalanceEvery permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs rssuance,or if the work
authorized on the srte by such permit rs suspended or abandoned for a period of
360 days after the time the work is commenced.
$433.42
$433.42
$0.00
Inspector MID#: 2021 -167501
t
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILNER DELCARATION
I hereby affirm under penalty of perjury that I am exempt form the Contractors' Liccnse Law for the following reason (Scc.70-11.5 Business
and Profession Code): Any City or County which requires a pcrmit to construct. altcr. improve. demolish or repair any structure, prior to its
issuance. also rcquires the applicant frlr such permit to file a signed statanent that he or she is licensed pursuant to the provisions of the
('ontractor's Licensed Law (Chapter 9. Commencing with Section 7000 of Division -i of the Business and Professions Code) or that he or
she is exarpt thercfrom and the basis for the alleged excmption. Any violation of Section 7031 .5 by any applicant for a perrnit subjecs the
applicant to a civil penalty of not more lhan fir'e hundred dollars (3500).
!o- t, .r owner of the property. or my employees with wages as their sole compensation. will do the wort and the s[uctur€ is nor intended
or offered for sale (Sec.7044, Business and Professions Code: The Contr-actor's Liccnse law does not apply to an owner of thc fopcrty
rvho builds or improves thereon. and who docs srch wort himself or herself or through his or her own cmployees, providcd that such
improvements are not intended or offcred for sale. lf, howwer. the building or imp,rovanent is sold within one year of ccrmplaion. the
Owner Builder rvill have the burden of proving that he or she did nd build or improve dre properw for the purpose of sale).
!o t. .. owner of the property. am exclusively contracting wirh licensed contractors to construct the project (Sec. 7M4. Business and
Profession Code: The Contractor's l,icense Law does not apply to an owner of property who builds or improves thereon, and
rvho contracts for such proiects rvith a Contracto(s) licensed pursuant to the Contractor's Liccnse Law),
Io I urn exempt under Section
- - B. & P.C. for this reason.
woR.KFRS' COMPFNSATTON nrcl ^ rtATtON
I hereby alTinn under penalty of perlury one of the following declarations:
Nlt n.". and rvill maintain a Cerrificate of Consent to Self-tmure for workers' comp€nsation. as providod for by Section 3700 of the
l.abor Code. for the performance of the work for which the permit is issued.
YE8
_ I have and will maintain rvorkers' compensation insurance. as required by Section 3700 of the labor Code. for the pcrformance of the
work for which this perrnit is issued. My workers' compensation insurancc carrier and policy number are:
can-ier:
Stato comP Inr Fund
92Ea02t
Policy Numtrer:_
NO
Expires:
09t1112021
-_ I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manncr so
as to become sub.iect to the workers' comp€nsation larvs of California. and agree that if I should become subiect to the workers'
compensation provisions of Section -1700 of the l-abor Code. I shall. forthrvith comply with those provisions..
WARNIN(i: Failrne to secure n,orters' compcnsation coverage is unlarvful. and shall subiect an employer to criminal penalties and civil
fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for the Section 3076
of the Labor ('ode. intetest and attomey's fecs.
t ICENSFN ('ONTRA(TOR NF'CI ARATION
I hereby affinn under penalty of periury that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of
the Business and Professions Code. and my license is in full force and effect.
c-30
l.icense Class:
1070058
l.icense Nurnber
CONSTRTICTION I FNNING AGFNCY
I hereby afTirm under penalty of per.iury that there is a construction lending agercy for the perfornunce of the work forwhich thispermit is
issued (Sec. -1097. Civ. C.).
l.ender's Name: _
l.ender's Address: _
APPI I('ANT NFCI AR.ATION
I hereb,v aftimr undel penalty of per.|ury one of the followrng declarations
Denmlrtion Pernrrts-Asbestos Notrfrcatron Federal Regulatrons (Trtle 40, Part6)
No_ Requirecl [rtter of Notifi cation
YEs I cefliry that the federal regulations regarding asbesros removal are not applicable to this proJect.
tI f cefliS/ thar I have read this application and state that the above information is correct. I agree to comply wirh all City and County
ordinances and State l-aws relating to building construction. and hereby authorize representatives of this City and County to cxter upon the
atrove mentiord property for inspection purposes.
Reroof
Roof (Diaphragm Sheathing/Frame)8-t(-zt Ea,"af t41
Structural Final 8-\j-2^Dzi<rt' {t
Plumbing
Under Floor I Under Slab
Rough
Shower Pan / Tub Test
Water Service
Sewer / Sewer Cap
Gas Air Pressure Test
Plumbing Final
Electrica!
Service (Meter I Panel)
Grounding / Bonding
Rough
Electrical Final
Mechanica!
Gas Air Pressure Test
Rough
Piping (HW, CW, etc.)
Exhaust Ducts
Mechanical Final
Notes, Remarks, Etc.
INSPECTOR RECORD
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