HomeMy WebLinkAbout101107308 - PermitProiect Address: 2535 N Main Sta
Assessor's Parcel: 003-013-19 Lot. NA
Unit:Bldg: Address Range:
Pin #:
Suite Range:
Zoning: OBlock: NA Tract. NA Historic: No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA gllOZ Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O11O73OB
Building use: Clty Occupancy: l{rA 18t FL Area: Patio:
Job Type: BlocUR.t ining W.luFoncing Constr Typer t{rA 2nd FL Area: T.l.Area:
Naturo ofwork: Block w.ll code: cBc 2019 other AreaB: yards Reqd
Existing Bldg & use: city Flood zone: x{802320t63J G.l€ge Area: Vatu.flon:
'lo,Oqr.q)Propoaed Lrse: * of Stories: Totat O
D€qcrlptlon of Work: r-NO FEE CITY PROJECT PER ,IE e" owblockw.ll-.omov.l.ndconat]uctionofl03lin..rl€tofElthighblockw.ll(withl
It- high max. rct lnlngD on proporty lln. 6h...d wlth 2810 V.lencl. 3t.
Plannlng Condltlona:
Owner:
Address:
Phone:
Tenant:
a
City Of Santa Ana
20 CIVIC CENTER PLZ
Santa Ana, CA 927014058
Contractor: Tolly Landscape dba Tolly E
Address: 601 N Batavia St
Orange, CA 92868
Phone: 17141 969-2200
State Lic #: 791230
Lic Type: B, C-1 0, C-27
Bus. Lic #: 320882
Workers' Compensation I nsurance:
Carrier: Security National lnsurance Comp
Policy #: 738375290202
Expires: 0410112022
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
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 lnsp. Req'd: No
Arabe, Jill
So, Anson
Chavez, Dave ,2y
Date: 0710212021
Date. 01l,2012021
Date: 0112612021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
07776002
07775002
07776002
07776002
08907007
07776002
07776002
07775002
57607
53600
57770
57607
24000
57672
57600
57607
Permit Fee
Plan Check Fee
Microfilm Records
Fee Exempt
SMIP - Category 1
Bldg. Stds. Revolving
General Plan Update
lssuance
$229.00
$1s0.00
$4.05
$-468 44
$1 .30
$1.00
$23.79
$s9.30
Account#
Flood Zone Cert. Req'd: No N/A _ No Balance
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs issua nce,or if the work authorized
on the site by such permitis suspended or abandoned for a period of 360 daysafter
the time the work is commenced.
lnspector MID#: 2021-167242
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
N/A - No Balance
N/A - No Balance
N/A - No Balance
N/A - No Balance
Fee Total:
Paid to Date:
Balance Due:
$0.00
$0.00
$0.00
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG a CoMMENTS OWNER BUILDER DELCARATION
I hqcby aflim undo pcnalty of perjury that I m cxmpt from thc Contmclo6' Licse liw for thc followitrg r@n (Sc.7031.5
Busines md Prcfesion Code): Any City or County which requira a pennit to coEtrucl, altq, improve, demolish or r€pait ey
struduc. prior to its isuacc, also rcquirc thc applic@t for such Fmit to 6lc a sigtrod statm@t thd he or shc is licsE€d p6uat
to the provisioro of thc Contrrctor's Liccnsed taw (Chapl6 9, Commcncing with Sstion 7000 of Division 3 of thc Buins ud
ProfsionsCode)orthatlrcorshciscxmptthqefromadthe basisforthcallegedexmpion. AnyviolationofSerionT03l.5byany
applicant for a pmnit subjwts thc spplicut to s civil pemlty of not more the fivc hundred dollrs ($500).
_1, as owner ofthe property. or my employees with wages as their solc compensation. willdo the work and the structure is not
intended or offerd for sale (Se.7044. Business and Professions Code: The Contractor's License law does not apply to an owner of
the properry rvho builds or improvcs therqrn, and who does such work himself or herself or through his or her own employees.
provided that such improvonents are not intended or offerocl for sale. l[, horve\'€r. the building or improvement is sold within one year
of complaion. the Orvner Builder will have the hrden of proving that he or she did not build or improve the propoty for the purposc of
sale).
_1, as owner of the property, arn exclusively contracting with licensed contractors to construct the project (Sec. 7M4, Business
and Professbn Code: The Contractor's Licensc Law does not apply to an ownef, of property who builds or improves thereon,
and who contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's Liccnsc Law).
_l am exempt under B. & P.C. for this reason.
WO RKE R^S' COM PENSATION
DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
-l
have and will maintain a Certificate of Consent to Sclf-lnsure fior workers' compensation, as provided for by Section 3700 of the
I-abor Code, for the pcrformance of the work for which the perrnit is issued.
_l have and will maintain workers' compensation insurance. as required by Section 3700 of the tabor Code, for the performance of
the work for which this pennit is issued. My workers'carrier and policy number arc:
tt
a rav o a /-1 - AoAvPolicy
_l certify that in the performance of the work for which this permit is issued. I shall not
so as to become subject to the workers' compensation laws of California, and agree that if I
employ any pemon in any manner
should bocome subject to the
those provisioru.rvorkers' compensation provisions of Section 3700 of the Labor Code. I shall. forthwilh comply with
WARNING: Failure to sccure workers' compansation coverage is unlawful, and shall subjcct an to crirninal penalties and
civil frnes up to onc hundred thousand dollars ($100.000). in addition to the cost of as provided for the
Section 3076 of the kbor Code, interest and attorney's Ges.
.-?/
DECI.ARATION
I hereby affirm under penalty of perjury that I am licensod 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. t
' ?-L-.-7 (D 7 oLicenseNurnbcr:
l.-L1-Z
W
I hftby affm unds pcnalty of pqjury th8t thft is a @nstruc1bo lcrding sg6cy for thc pqfomcc of thc wrk 6r which this psrnil b
issucd (Se. 3097. Civ. C.).
lrndq's Nmc:
Lcnder's Address:
APPLICANT DECLARATTON
I hotby aflirm under penalty of perjury one of the following declarations:
Dcmolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
_Required Letter of Notification
_l ccrti& that the federal regulations regarding asbestos removal are not applicable to this project.
state that the above information is correct. I
above mentioned property for inspection
Applicant or
Pernritee name
and hereby authorize
?
"/-"/
Set Backs i/n/u I vI no
Forms/Steel/Holdowns '6/n/a eo
Erection Pads a t I \/'
UFER Ground
SLAB Floor
Su bfloor/Ve nUl n s u Iatio n
Roof Sheathing
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry 9,1*oh.t rAz"
Pool Fence l{/v,
T-Bar
Handicap Req
Deputv Final Report
Enqineer Final Report
Flood Zone Certif
^
FINAL qbhr \*?^
Certificate of Occu
Notes, Remarks, Etc./I
D
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