HomeMy WebLinkAbout101107580 - PermitCity 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 #: {O11O758O
Pin #: 1
t
Project Address: 2021 S Lowell St Unit:Bldg: Address Range:Suite Range:
Zoning: Rl
e
t Assessor's Parcel: 01 5-149-07 Lot: 9 Block: NA Tract: 1339 Hrstoric: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
Sfd w/att garage
Occupancy.
Constr Type:
Code:
Flood Zone'.
# of Stories:
R.3, U
VB
cBc 2019
x-0602320257J
1st FL Area
2nd FL Area
Other Areas:
Garage Area.
Totat
Patio:
T. !.Area:
Yards Req'd
Valuation: $38,268.00
Description of Work: lnstal! roof mounted solar panels per checklist.Botch+ : 6Lt38l S/ I 8/ 2{t?l I0 : oriloro lesl 5
0f I ice: (:TYH Trans* s 23 I of IAcct*: Ref*: ltt11tt75,9u
Rcp t*: tt338 16+2 8i l9i 2tr2l 1CI: u3 AH
Tnsnsoct I on Totol t189.45Planning Conditions:
Engineer:Danie! Vl6qutfrhm 5o.t i:r r.
Daniel W Dunzik
370 Buril[HilERoad
SKILLMAT\$. NSrt CdSg:i 1 6[r I r.tttr-i-
(eo8) 8?{L,IqhEt,[,[ !, l]] liltftL"b-s6a?T,:if - sr d s H€vu 1 ,, ri e
r-rl I l6LrLrf - 5t o1 ltrt-r[r-
J (:t (:h ecil 1_1 1 !t-ii 7
Owner:
Address:
Dawn Mills
2021 S Lowell St
Santa Ana, CA 927072515
(7141454-6938
Contractor: Momentum Solar
Address: 539 W Walnut Ave, Suite A
Orange, CA 92868
Phone: (510) 692-4261
State Lic #: 1026366
Lic Type: C-10, C-39, C46
Bus. Lic #: 368879
Workers' Compensation lnsurance:
Carrier. American Zurich
Policy #: 447993700
Expires: 0212612022
Address:$+50, Ltu
$36.4:;
$2. [l[|
t488.41
Phone:
Tenant
Phone:
License #:
Architect /
Desiqner.
Address.
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES Insp. Req'd.
PWA !nsp. Req'd:
Planning lnsp. Req'd.
Amsden, Julie
Date:
Date:
Date: 08/1 812021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
$450 00
$36.45
$2 00
$0 00
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
Landscaping lnsp. Req'd:01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$4s0 00
$2 00
$36 45Every permit issued 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.
Fee Totat
Paid to Date:
Balance Due:
$488.45
$0.00
$488.45
lnspector MID#: 2021-168242
SITE-WORK DATE ID/SIG COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Ve nUl n s u latio n
Roof Sheathing
Shear Wall
Framing
lnsulatio nlEnerqy
Drywall
Ext./lnt. Lath
Brown Coat
Jvlasonry /
Pool Fence
T-Bar \
Handicap Req.\
Deputy Final Report
Engineer Final Report /
Flood Zone Certif .
FINAL ro\5\,ra _\N.n'o \
Certificate of
Notes, Remarks, Etc.
\
--J
\
/
I hercby affrm undcr Fnalty of Frjury that I m cxcmpt ftom thc Contraclor' Liccns lrw for thc following rcasn (5€.7031.5
Busincss und Profcssion Codc): Any City or County which rcquircs a pcrmit lo @nstruct. sltq, improve, dcmlish or rcpair any
structure, prior lo its issuancc. ds rcquircs thc applicml for such lrcmit to lih a signcd statcmnl lhat hc or she is licensd pusuol
lo thc provisions of the Conlractor's Liensd tiw (Chapter 9, Comcrcing with Scctiotr 7000 of Division 3 of ttE Busircss eg
PmfcssionsCodc)orthatheorshciscxcmptthercfromsndthcb&sisfo.thcollcgcdcxcmption. AnyviolationofscctionTO3l.5byany
applicant for a pcmil subjetts the applicant to a civil pcnahy of not mrc than fivc hundrcd dolles ($5m).
_1. as owncr of thc proprty. or nry employccs with wagcs as their solc conrpcnsation. willdo thc work and thc structurc is not
intendcd or offcrcd for salc (Scc.7044. Business and Profcssions Codc: The Contractor's License [:w docs not apply to an owncr of
thc propcrty who builds or improvcs thcrcon. and who docs such wo* hirnsclf or hcrself or through his or hcr own employces.
provrdcd that such improvenrcnts are not intcndcd or oflcrcd for salc. lf, howevcr, thc building or improvcnrcnt is soH within one )rcar
of comphtion. thc Owner Buildcr will have thc burdcn of proving that hc or she did not build or improve thc prcpo'ty for thc purprsc of
salc).
-1.
as owncr of thc proprty, am cxclusively contracting with liccnsed contractors lo construct thc projcct (Sec. 7W. Busincss
and hofcssion Codc: Thc Contractor's Liccnse Law docs not apply to an owncr of propcrty who builds or improves thcrcon,
and who contracts for such projccts with a Contractor(s) liccnsed pursuant to thc Contractor's Liccnsc kw).
-IamcxemptundcrScction-.B.&P.C.forthisrcason.
}VORK I.'RS' CONI PUNSA'tION
DECLAITATI(IN
I hercby affirm under pcnaltyofpcrjury om ofthe followhg delffations:
-lhavcardwillmintainaCcrtiticalcofConsnttoSclf-lnsureforworkem'com;rcnution,as
povidedforbySetion3?00ofthc
Labor Codc, for thc prformrcc of thc mrk for which thc pmit is issucd.
.Lt havc ona will maintain workcs' compcnsation insurarcc. as rcquircd by S$tion 3?00 of thc bbor Codc, for thc pcrformrcc of
thc work for which this pcmit is issucd. My workc6' @mJrcnstion insurarcc cmicr axl policy number ac:
Av.-or, rr^,^ ?:n rh
Poricy*r^*r,44-)Qcl?1OO Expires:
-l
ccrtily that in thc pcrfornuncc of thc work for which this pcrmit is issucd, I shall not cmploy any pcrson in any manncr
so as lo beconrc subjcct to lhe workcrs' compcnsalion laws of California. and agree that if I should bccomc subicl to thc
workcrs' compcnsation provisions of Scction 3700 of the latnr Codc. I shall, forthwith comply with thosc provisions.
WARNING: Failure to sccurc workcrs'conrpcnsation covcrage is unlawful, and shall subjcct an cnrploycr to crirninal pcnaltics and
civil fines up to onc hundrcd thousand dollars (S100.000). in addition to thc cost of compcnsation, danragcs as provided for the
Scction 3076 of thc Lahrr Code. interest and attorncy's fccs.
r<L
I hereby allirrrr undcr pcnalty of pcrjury that I anr liccnscd
of thc Busincss and Profcssions Code. and rny liccnsc is
provision of Chaptcr 9 (comrrrcncing with Scction 7000) of Division 3
forcc and cffcct.
ctorr, CIO LicenscNumbcr:l0)Jo" a 0
I)ate:tslt*lzt contracto r, NOwrrr-rllrrn'r, SOl cul1l
W
I hcrcby affirm undcr Fnalty of pcrjury that thcrc is a @nstruction bnding agcrcy for thc pcrfomncc of thc work for which this lEmit is
issucd (Scc. 3097. Civ. C.).
[rndcr's Narc:
[.cndcr's Addrcss:
APPLICANT DECLARATION
I hcreby affinn undcr pcnalty of pcrjury one of thc following declarations:
Dcmolition Permits-Asbcstos Notification Federal Rcgulations (Titlc 40. Part6)
_Requircd lrttcr of Notification
-l
ccrtily that thc fedcral rcgulations rcgarding asbcstos renxrvaliuc rx)t applicablc lo this projcct.
ccrtify lhat I havc rcad this application and statc that
and State Laws rclating to building
above mcntioned propcrty for
or Agent
Pentritee nanle
lk 1-J
BUILDING- INSPECTOR RECORD
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Date:_Owner:
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