HomeMy WebLinkAbout101108105 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: 1O1108{05
Pin #: 3
Project Address: 606 S Shelton Sta
Assessor's Parcel: 010-28 4-15 Lot: 75
Unit Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 1470 Historic: No
)
\,
Building Use: Single Family Dwelling Occupancy: R-3, U 1st FL Area Patio:
Job Type: Reroof Constr Type: V B 2nd FL Area T.l.Area:
Nature of work: Reroof code: cBc 2019 other Areas; yards Req,d
Existing Bldg. & Use: Sfd w/att garage Flood Zone: X-0602320257J
Garage Area Valuation:
Proposed Use: # of Stories: Total
Description of Work: Reroof house & attached garage - install (1) tayer comp over (1) existing layer comp shingles. Handouts given.
Planning Conditions: Color & material to match existing condition
$7,000.00
Engineeri r,tti;i:j,r;t:r :,t.,,:t't]. i;,' i,j,..r
O{,ner: C.ndlce lllel ConlrEclor: Rrtlon.lRooflng Sewice! ... L.r . iiii
Addresr: 608ssh.ltonst Addre$i 2352 Fordham Or Address: t...ii r" -riiL
Sent An.,CA 92703 Cort iie!., CA t2626 ' "; '" r'":':r r "r' rr: i '
Phone: (323) 934-3U2 Phone; 17111932-2.{1 Phone: '"rrri1ii', 'L"ijrii':l
Ten.nt state Lic #: 01045329 Licens€ #:
Lic Typ6: C-39 Architecr /
Bus. Lic *: 37EG65
wo*6rs' compensation tnsumnc.: ff:fl: .], .,;lCalri€r: Slat Fund .ij ii.iir,,.. ...j.,!,r!,,r
Policy #: 92ao4E3 Phone: i:ri:.' ,."J,., ;.1:r*i.. i,jr
Expir6s: 1012612022 Licons6 *: '| l:';.' : ,'li ,:rr"'.
Planning Approval By:Martin, Eric
0777500'2 '57607 Permit Fee
07776002,5.77,70,MicrOfilrn RecordS,r
07776002 s7672 Bldg Stds Revolving
07776002 57600 General Plan Update
07775002 57607 lssuanceNPDES lnsp. Req'd: i
PWA lnsp. Req'd:
Account#TotalPlanning lnsp. Req'd:
Landscaping lnsp. Req'd:
Fire lnsp. Req'd. No
Police lnsp. 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 within 360 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.
Date: 0912912021 Misc. Receipt:
Date. Misc. Receipt:
Date: Ogt2gt2121 Misc. Receipt:
Subject to Field:
01 1 16002 51600
01 1 16002 51601
01116002 51612
01 1 16002 57770
Plan Checked By:
Permit lssued By.Julie
$345 28
$4.0s
$1 00
$23 7e
$5e 30
No
No
No $23.79
$404.58
$1 00
$4 0s Fee Totat
Paid to Date.
Balance Due:
$433 42
$0 00
$433.42
lnspector MID#: 2021-169 143
BUILDING. INSPECTOR RECORD
SITE-WORK DATE !D/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloo r/Ve nUI n s u Iatio n ,l ,
Roof Sheathinq Tlz,olzr
Shear Wall (l t I L-/
Framing
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence \
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif.
I
FINAL lolc b .tlCertificate of Occupancy \./
Notes, Remarks, Etc.
\/
OWNER BUIl,DER
I hoeby aflim unds pcoalty of perjury that I m exmpt from thc ContracloB' LiccE Law for thc followinS rcn (Se.7031.5
Busins ard Profcssion Codc): Any City or County which rcquirc a pcrnh to coBtruc{r altc, improvc, danolish or rrpair uy
structuc, prior to its issumcc, also rcquira thc applicilt for such pcmit to filc a signcd ststmdt thal hc or shc b liccNd pwant
to thc provisiom of thc Contrrctor's Liccnscd Law (Chaptq 9, Commcncing with Sctiotr 7000 of Division 3 of thc Buils md
Prcfsiom Codc) or that hc or shc is cxcmpt thscfrom ild thc bosis for thc allcTcd qmption. Any violation of Serbn ?031.5 by any
applicurforapornitsubjststhc applicuttoIcivilpaaltyofnotmorqthilfivehundrcddollffi(S500).t
_1. as owner of the property, or my employces with wages as their solc comporsation, rvill do thc work and the stnrcturc b not
intended or offered for sale (Sec.7044. Business and Professions Code: Thc Contractor's Licensc law does not apply to an owner of
the property who builds or irnproves thereon, and who does such work himself or herself or through his or hcr own cmployees,
provided that such improvoncnts are not intcndcd or offered for sale. If. howerrer, thc building or improvanent is sold within one year
of compleion. the Orvner Builder will have the hrden of proving tha hc or she did not build or improve the p,ropoty for the purpose of
sale).
-1,
as owner of the propcrty, am cxclusivcly contracting with liccnsed contractors to construct the project (Scc. 7044, Btsiness
and hofusion Code: The Contractor's License Law does not apply to an owner of property who builds or improvcs thereon,
and who contracts for such projects with a Contractor(s) licarscd pursuant to the Contractor's Liccnsc Law).
_l arn exempt undcr B. & P.C. for this reason.
Owner:
WORKERS' COM'ENSATION
DECLARATION
I hereby allirm under poralty of perju.y one of the following declarations:
-l
have and will maintain a Cenificate of Consent to Self-lnsure for workers' compensation, as provided for by Section 3700 of the
tabor Code,
*Afiau, unor Ihe work for
for the pcrformancc of the work for which the po'rnit is issued.
s'iII maintain workers'3700 of the l-abor Codc,for the of
which this p,ermit ls and policy number are:
&u.)
2t
-l
certi& that in the pcrformance of the work for which this pcrmil is issued, I shall not ernploy any pcrson in any manner
so as to bccome subject to the workers'compensation laws of California. and agree that if I should become subject to the
workers' compensation
I
WARNING: Failure to
provisions of Section 3700 of the l^abor Code I shall, forthwilh comply with thosc provisions.
scrure workers'compensation coverage is unlawful. and shall subjcct an anployer to criminal panaltics and
dollars ($100.000), in addition to the cost of compensation, damages as provided for thecivilfineslo one hundred thousand
Se<tion interest and attorney's
2 C-1 a ./.
I hercby affrrm under penalty of perjury that I arn licensed under Chapter 9 (commencing with Scction 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.t o4 6gz1
7
,clir^-A czf
W
I hocby alfm udc poralty of pqjury that th6c is a @Ntruclion loding agmcy for thc po fomcc of rhc work for which thb psnit is
issucd (Se. 3097, Civ. C.).
Lrnder's Name:
I-cnder's Address:
APPLICANT DECLAIIATION
I hereby afnrm under penalty of perjury one of the following declarations:
Demolition Pcrmits-Asbcstos Notifrcation Federal Regulations (Title 40, Pafl6)
_Required t ctter of Notification
certi$ that the federal regulations regarding asbestos removal arc not applicable to this project.\-
I have read this application and state that the above infonnation is correct. I all City and County
and State [.aws relating to
above mcntioned property
or Agent
Pernritee nBme 1r'5
7
upon the
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