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HomeMy WebLinkAbout101107463 - Permit--1 City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853 Permit #: {01107463 Pin#: 58W Proiect Address: 1246 S Clara Sta Assessor's Parcel: 109-091-27 Lot: POR 12 Unit:Bldg:Address Range: 1246-1248 Historic: No Suite Range: Zoning: R2Block: B Tract: 604 Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area: Job Type: Alteration Constr Type: V B 2nd FL Area: Nature of Work: Window change out Code: CBC 2019 Other Areas: Existing Bldg. & Use: SFD w/det Garage Flood Zone: X-O6O2320257J Garage Area: Proposed Use: # of Stories. Total: Description of Work: Legalize (6) Window change outs and interior remodel. Owner-Builder form on file. Planning Conditions: Patio: T.l.Area: Yards Req'd. Valuation: $2,000.00 Owner. Address: Phone: Tenant: Juvenal & Maria Jaracuaro 1248 S CLARA ST Santa Ana, CA 927043202 Contractor: Address. Owner-Builder Phone: State Lic #: Lic Type: Bus. Lic #: Workers' Compensation !nsurance: Carrier: Policy #: Expires: Engineer: Address: Phone: License #: Architect / Designer. Address: Phone: License #: Planning Approval By: Plan Checked By: a Permit lssued By: . NPDES lnsp. Req'd: No 'r PWA lnsp. Req'd. No Planning Insp. Req'd: No Landscaping lnsp. Req'd: No Gomez, Pedro Chavez, Dave Date: 0810912021 Date. Date: 08l,0$2021 Subject to Field: Misc. Receipt: Misc. Receipt: Misc. Receipt: 2?'. 0 77760 02 07776002 0 77750 0 2 077760 02 07776002 57607 57770 57672 57600 57607 Permit Fee Microfilm Records BIdg. Stds. Revolving General Plan Update lssuance $172 64 $4 0s $1 .00 $23.79 $s9 30 Fire lnsp. Req'd: No Police lnsp. Req'd: No Flood Zone Cert. Req'd: No 01 1 16002 51600 01 1 16002 51601 01116002 51612 01 1 16002 57770 Account#Total Every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 360 days after ifs issua nce,or if the work authorized on the site by such permitis suspe nded or abandoned for a period of 360 days after the time the work is commenced. $23.79 $231 .94 $1 .00 $4.05 Fee Total: Paid to Date: Balance Due: $260 78 $0 00 $260.78 lnspector MID#: 2021-167908 t BUILDING- INSPECTOR RECORD SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION I hcrcby ilffirm undcr pcnalty of pcrjury that I m cxcmpt frcm thc Contractom' Liccns kw for thc followinS rcaen (5(.7031.5 Busincss and Profcssion Codc): Any Cily or County which rcquircs a Frmit lo onstrucl. allcr. improve, &mlish or rcpdir any structurc. prior lo its issuancc. also rcquircs the applicet for such Jrcmil to filc a sigrcd stalcmnt thal hc or slrc is liccnscd pu6uant to lhc prcvi$iors of thc Coilractor's Liccnscd [:w (Chaptcr 9, Commcrcing with Scclion 7000 of Division 3 of thc Busittcss and Prefcssi<nsCodc)orthathcorsheiscxcmptthercfiomandthcbasisforthcdllcgcdcxcnution. AnyviolalionofseliotrT03l.5byany applicanl for a permil subjets thc applicant to a civil pcnalty of not Norc than fivc hundrcd dollils ($500). d,. o* owrcr of Ihc prcpny, or my cmplolrccs with wagcs as thcir sh conrJrcnsation, willdo thc work srd the stnEtw is ml intcndcd or offcrcd for sle (Sd.7O44, Busincss ud Profcssions Codc: Thc ContEctor's Liccns ljw d@s not .pply to il owncr of lhc pm]Eny who builds or imlrrcrcs thcmn. ard who des sEh mrk himsclf or hcrelf or thrcugh his or hcr own employccs. providcd lhat such impmrcmnls N mt intcnfu oroffcrcd for slc. lf. howcw. lhe boibing or imprcvcnrnt is sH within orc )ae ofcornphtion. thc Owncr BuilCs will harc thc budcn ofpmving that hc or shc dkl rct buiu or in{,orc Ihc prcIsly for thc puqns of sh). -1. tr$ owncr of the pmpcny, om cxclusivcly contmcting with liccn*d conlrsctoF to construct thc pmjelt (Ss. 7O44, Busincss arxl Proli:sskrn Codc: Thc Contractor's Liccnse Law docs not apply to an owncr of prcpcrty who builds or imprcvcs lhcrcon. snd who @ntEcts for such prcjccts with a Contmcto(s) lhcnsd pursuant to thc Contractor's Liccnrc [aw). -lantcxclnplundcrSection-'B.&P.C.forthisreason.o,r",qo8/o? /2o2 DECLAITATION I hcrcby affirnr under penalty of pcrjury onc of the following declarations: _l havc and will maintain a Certificatc of Conscnt to Sclf-lnsurc for workers' compensation. os provided for by Scction 3700 of thc Labor Codc. lbr the pcrfornrance of thc work tbr which thc pcrmit is issucd. _l havc and will milintain workcrs' comlrcnsation insurancc, as requircd by Scction 3700 of thc [:bor Codc. for thc lrcrfornuncc of thc work for which this permit is issued. My workers' conryrcnsation insurance calTier and plicy numhr iue: ccrtily that in thc pcrtbrnrancc of thc work tbr which lhis pcrrnit is issucd, I shall not crttploy any pcrson in any manncr so as to bcconrc subjcct to thc workcrs'comperrsation laws of California. and agrce that if I should bccomc subject to the workcrs' compcnsation provisions of Scction 3700 of the latnr Codc. I shall, lbrthwith comply with thosc provisions. WARNING: Failure to secure workcrs'compcnsation covcrdgc is unlawful. and shall subjcct an cmployer to criminal pcnaltics and civil tincs up to one hundred thousand dollars ($l0o.00tl). in addition to the cost of compensation. damages as provided for the Scction 3076 of the [:bor Code. interest and attorney's fccs.a D,t", . 06 / o? /202/ I hcrcby allirrn under penalty of pc{ury lhat I artt liccnscd 9 (cornrncrrcing with Scction 7000) of Divisionl of thc Busincss and Prot'cssions Codc. and my liccnse is in t'ull forcc and clfcct. License Class: Liccnsc Numbcr: Date: W I hcrcby sfiirm undcr penalty of Frjury lhat thrc is a @nstruction hnding agcrcy for thc pcrfomurce of thc work for which this pcrmit is issucd (Se. 3097, Civ. C.). , lrndcr's Addrcss: D APPLICANT DF'CLARATION I hcrcby afTinn under penalty of perjury onc of thc following dcclarations: Dcnrolition Pcrmits-Asbcstos Notification Fedcral Rcgulations (Titlc 40. Part6) -Rcquircd Lctter of Notification a, -l ccrtily that thc fcdcrol rcgulntions rcgarding asbestos rcmvalarc nol 8pplicablc to this projccl. J-l ccnify rnar I havc rcad this applicalion ald shtc that thc abovc inforrotion is coEel. I agrc to comply wiih 8ll Cily and Counly r6rdinanccs and Starc tjws rchring to building construction, ard hcreby authorize rcpresntalivcs oflhis City and Coutrly to cnls uIDn thc abovc rncnliortcd propcrty for inspcction Applicant or Agent Permitee name tp.intl, K 5t/ L o,r"t r8 /c? /202 I Set Backs Forms/Steel/Holdowns Erection Pads UFER Ground SLAB Floor Su bf loor/VenVI nsu Iation Roof Sheathinq Shear Wall Framinq lnsu Iation/Enerqy Drywall Ext./lnt. Lath Brown Coat [Vlasonry Pool Fence T-Bar Handicap Req. 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