HomeMy WebLinkAbout10197831 - PermitProject Address: 123 N Jackson St
Assessor's Parcel:198-25242 Lot: 147
Unit.Bldg: Address Range:Suite Range:
Zoning: R2Block: NA Tract: 540 Historic: No
.F
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O19783{
Pin #: ,"TrV
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use.
Single Family Dwelling Occupancy:
New Constr TyPe:
Single Family Dwelling/Open Patio Code:
vacant Flood Zone'.
Single Family Dwelling # of Stories:
R-3
SPK
cBc 2016
x-0602320256J
1
1st FL Area 1139
2nd FL Area
Other Areas.
Garage Area
Patio: 92
T.l.Area:
Yards Req'd
Valuation: $ 126,000.00
Total
Description of Work New pre-fabricated/manufactured sfd with (3) bedrooms, (2) bathrooms, laundry room,
front. GGUSD #5150
1 139
dining, kitchen, living room, & open patio in
Planning Conditions:.-. 't -
Owner:
Address:
Phone:
Tenant
Alexander Dantes LLC
17300 Redhill
lrvine, CA 92614
(949) 383-8309
Contractor: Cirus DeveloPment
Address: 17300 Red Hill Ave. #280
lruine, CA 92614
Phone: (916) 852-5575
State Lic #. 523605
Lic Type: B
Bus. Lic #. 346797
Workers' Compensation I nsurance:
Carrier: Hartford Undenrriters lns Co
Policy #: 72WE2O3188
Expires: 06/30/2019
Apollo Structural
Stephen Sam
4650 East Arrow Hlghw?y,
Montclair, CA 91763
Engineer:
Address:
Phone.
License #:
Architect /
Designer:
Address:
c-84945
YNG Architects
Yenny Ng
l- ee
Jt , tf 'J?.
gg
_ s??. [rg
S, u[r
+97 .7 tt
16.39
SI.i r 955 ,24
$Sr+Bil,61
ievcll, in...r
51612urJrJ-
l'l ic.of itm & Dn':uments.
Phone:
License #:
'JtJtitJ
? {tit
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
Guevara, Jerry
So, Anson
Hernan dez, Kathy
No
Date: 01l,3U2019
Date: 0112812019
Date: 0412512019
Subject to Field.
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Permit Fee
Plan Check Fee
Microfilm Records
Res. Dev. Fee - NA /
SMIP - Category 1
Bldg. Stds. Revolving
General Plan Update
lssuance/New Structu
Fee Totat
Paid to Date:
Balance Due:
$8s6 1 I
$1 ,305.12
$97.76
$5,955.24
$16.38
$6 00
$22 08
$146.80
$8,405.56
$1 ,305.12
$7,100.M
Account#
7 1587
Total
07776002
07776002
07776002
37773002
08907007
07776002
077760 02
07776002
57607
53600
57770
s3300
24000
57672
57600
57607
PWA lnsp. Req'd: No Fire lnsp. Req'd: No
Planning lnsp. Req'd: Yes Police Insp. Req'd: Yes
Landscaping Insp. Req'd: No Flood Zone Cert. Req'd: No
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.
lnspector MID#: 2017-136574
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
08901001 24000
31113002 53300
$22 08
$1 ,002.98
$6 00
$97 76
$16 38
$5,955.24
r_rrlfrfr-
-
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/S!G.COMMENTS OWNL,R BUI T,DER D},T,CA RA'I'ION
I herehy affirm under penalty of perjury that I am exempt from the Contractors' l-icense Law frrr the following reason (Sec.70.ll,5
Business and Profession Code): Any Clity or County which requires a Jrermit to construct. alter, improve. tlenrolish or repair any r
structure. prior to its issuance. also requires the applicant for such Jrrmit to file a signed statetrEnt that he or she is licensed pursuant
Io the pnrvisions of the Contractor's Licensed Law (Chapter 9. Commencing with ,section 7(XX) of Division 3 of the Business and
Pnrfessions Code) or that he or she is exempt therefrom anrl the basis for the alleged exemption. Any violation of Section 7031 .5 by any
applicant firr a permil subjects the applicant to a civil penalty of not nrrre than five hundred dollars ($5tXl1.
-1.
as owner of the property. or my empkryees with wages as their sole comJrensntion. will do the work and the struclurc is not
intentletl or offered for sale (Sec.7044. Business and hofessions Code: The Contractor's License Law does not apply to an owner of
the pnrJrerty whr huilds or impnrves ttrreon. anrJ whr drrcs such wrrrk himself or herself or through his or her own empkryees,
provitletl that such impnrvenrnts are not intended oroffered frlr sale. If, hrwever. the huikling or inpnrvenrnt is snkl within one y€:r
of completion, the Owner Buikler will have the burden of proving that he or she dkl not huikl or improve the property for the puryrse of
sale).
-1,
asownerof the property, amexclusivelycontracting with licensetl contracto$to c()nstruct the project (.Sec.7044. Business
antl Pnrfessirn Cotle: The Contractor's License Law tkres not apply to an owner of property who builds or improves thereon.
and who contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's Lic'ense Law).
-l
am exempt untler Section_. B. & P.C. for this reason.
l)ale:
-
Owner:_
WORKIIRS' COMPENSATION
DECLARA']'ION
I hereby affirm under penalty of perjury one of the firllowing declarations:
-l
have and will maintain a Certifrcate of Consent to .Self-lnsure for workers' compensation. as pnrvided for hy .Section 37(X) of the
Latnr Code. for the perfrlrmance of the work for which the permit is issued.
-lhaveandwill
maintainwrtrkers'comJrcnsationinsurance.as requiretlhy.Section.lT(X)ofthel-ahorCotle.fortheJrcrformanceof
the work firr which this permit is issued. My workers' compensntion insurance carrier and plicy number are:
Policy
-l
certify that in the ;rerformance of the work f<rr which this prmit is issued, I shall not emphy any frcrson in any manner
so asto hecrlrne suhject to the wrlrkers'comfrcnsation laws of Califrlrnia. and agree that if I shlukl become suhject tothe
wrtrkers' crtmpensation provisions of Section l7(X) of the l;rhrr Crile. I shrll. forthwith cornply with provisions.
WARNIN(i: Failure to secure workers' compensation c()verage is unlawful. and subject an to criminal penalties and
civil fines up to one hundred thousantt dollars ($l(X).(XX)), in atldition to the comfrcnsat as provided frrr the
Section .1O76 of the l.atxrr Code. interest antl attorney's fees.
Drn, L) '? s -2 L' )lAppricant:
I herehy affirm untler penalty of perjury that I am licensed un<ler provision of Chapter 9 (comrrncing with Section 7fiX)) of Division 3
of the Business and hofessions Code. and my license is in full firrce antl effect.
License
Date:_4* \s-z ot7 l-
CONS'T'RUC'TION LENIIING AGENCY
I hereby affirm under Jrenalty of per.iury that there is a construction hntling agency for the Jrerformance of the work for which this permit is
issued (Sec. 3097. Civ. C.).
Lrnder's Name:
Lender's Address:
APpLICAN'I' DECLAR {'l'tON
I hereby affirm under penalty of perjury one of the folkrwing declarations:
Demolition Permits-Astestos Notification Federal Regulations (Title 40, Part6)
-Required
Letter of Notifrcation
-l
certify that the federalregulations regarding asbestos rerxrvalare not applicahle to this pro.iect.
-l
certify that I have read this application antl state that the atxrve ts with all City and County
ordinances antl .State Laws relating to building construction. and hereby and County to en(er up()n the
ahrve mentioned property for inspection
Applicanl or Agent Signature:
l'erntilee nlnre
w
a orrr, -l 'L9-2 oll
Set Backs
Forms/Steel/Holdowns lo-ll-ri LOHta I
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nUI ns u I ation
Roof Sheathing
Shear Wall
fqming
lnsu Iation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry /o -ll? I o n*,d ^/at halcat€
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
F!NAL 7>Z.ZoU tL (-os ilsrlts -UI
Certificate of Occu pancy
Notes Remarks , Etc.
[:lev. 0B-0 f-201 5
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