HomeMy WebLinkAbout101107561 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: QM) 667-2738 lnspector Section: (714) 647-5853
Permit #: {O1107561
Pin #: 84035
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Project Address: 2405 S Salta St
Assessor's Parcel 412411-18 Lot: 15
Unit.Bldg: Address Range:Suite Range.
Zoning: R1Block: NA Tract: 3962 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Reroof
Reroof
SFD w/ att garage
R-3, U
VB
cBc 2019
x-0602320259J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T. !.Area:
Yards Req'd
Valuation: $12,300.00
Occupancy.
Constr Type:
Code:
Flood Zone'.
# of Stories:
D6cription of Worki TrO exiating root m.terial and lnstall new comp shinglo to SFD with etteched garage Rsplaco sheathingrplyarood e3 n€eded. H.nd
out givan.
Planning Condltions: Color lo be architocturally comp.tible with ra3idonce.
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Ownet':
Address:
Phone:
Tenant
JACKYE MAXWELL
2405 S SALTA ST
Santa Ana, CA 927045626
(7141 686-0668
Contractor: Mike Vogt Roofing
Address: 2658 Vista Ornada
Newport Beach, CA 92660
Phone: (7141 336-6422
State Lic #: 1064773
Lic Type. C-39
Bus. Lic #: 378672
Workers' Compensation I nsurance.
Carrier: State Fund
Poficy #: 9273545
Expires: 0312612022
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
lilrt
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
Martin, Eric
Zuniga, Allissa
Date: 08/1 712021
Date:
Date: 08/1712021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:v
07776002
07776002
07776002
07775002
07776002
57607
57770
57672
s7600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$34s.28
$4.05
$1 .00
$23.7e
$se.30
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
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.
01 1 16002 51600
01 1 16002 51601
01116002 51612
01 1 16002 57770
$23 7e
$404.58
$1.00
$4.0s Fee Totat
Paid to Date:
Balance Due:
$433.42
$0.00
$433.42
lnspector MID#: 2021-168214
BUILDING- INSPECTOR RECORD
SITE-WORK DATE ID/SIG COMMENTS OWNERDUILDERDELCARATION , .
I hcrcby affirm under IEMlty of pcrJury that I m cxcmpt frcm thc Contncton' Licens llw for thc following rearcn (54.7031.5
Busincss and Profcssion Codc): Any City or County which rcquircs a 1rcrmit lo construct, altcr. improvc, dcmlish or rcpir any
structurc. prior to its issuancc, trlw rcquircs thc applicut for such Frmit to filc a sigrcd statemnt lhat hc or slE is liccnscd puEuant
to thc pmvi$ions of thc Conlrrctor's Licensd [:w (Choptcr 9, Comrcncing wilh Sction 7fi)0 of Division 3 of thc Business and
Prefcssions Codc) or lhat hc or shc is cxcmpt thcrcfrom and thc besis for lhe lllcgcd cxcmption. Any violation of SNtion 703 1.5 by any
applicant for B 1rcmit subjccts thc applicant to a civil pcnalty of not mrc than fivc hundrcd dollus (S500).
_1. as owncr of the oropcrty. or my employecs with wagcs as their solc compcnsation, will do the work and thc structurc is not
intendcd or offcrcd for sale (Sec.7044, Business and hofcssions Code: The Contraclor's License [:w docs not apply to an owncr of
thc proJrcrty who builds or improvcs thencon, and who docs such work himsclf or hcrsclf or through his or her own employccs,
providcd that such improvenrcnts arc not intcndcd or offcrcd for salc. lf, howevcr, thc building or improvcrrcnt is sold within onc ycar
of comphtion. thc Owncr Builder will have the burdcn of proving that he or shc did not build or improvc the pmpeny for the purpsc of
salc).
-1.
as owncr of the propcrty. am cxclusively contracting with liccnscd contractors to construcl thc projcct (Scc. 7W. Busincss
and Profession Code: The Contraclor's License Law does not apply lo an owncr of property who builds or improves thereon.
and who contracls for such projects with a Contractor(s) liccnscd pursuant lo thc Contractor's Licensc L:w).
-Ialncxc!nptundcrSection-.B.&P.C.forthisrcason.I)nte:
}VORK F' RS' COI\I PENSA'I'ION
DECLARATION
I hcreby affirnr under pcnalty of pcrjury one of thc following declaralions:
_lhavcandwill maintainaCcrtificatcofConsenttoSclf-hrsurcforworkcrs'conrpensation,as providcdforbySection3T00ofthc
Labor Codc, l'or thc perfornuncc of thc work for which thc pcrrnit is issucd.
_l havc and will maintain workcrs'compensation 3700 of thc tabor Code, for thc ;rcrf<lrmancc of
thc work tirr which this pcrmit is issucd. My and plicy numbcr arc:
a
4,4t
Policy --Lo ,1-
_l ccrtify that in the pcrfornrancc of thc work for which this pcrmit is issucd. I shall not employ any lrcrson in any manncr
so as to bccomc subjcct to thc workcrs' compensation laws of California. and agrcc that if I should bccomc fuUpct to thc
workers' comlrcnsation provisions of Scction 3700 of thc [:tnr Code. I shall. fbrthwilh comply with thcrsc provisions.
WARNING: Failure to sccure workcrs'
civil lirrcs up lo one hundrcd thousand
Scction 3076 of the labor Codc. intcrcst
and
lhc
.L
I hcrcby affirm undcr pcnalty of pcrjury that I am liccnscd undcr provision of Chaptcr 9 (commencing with Scction 7000) of Division 3
of thc Busincss and Profcssions Code. and my liccnsc is in full force Bnd cffcct.
Liccnsc Nurnbcr:
I hcrcby alllrrn undcr pcnalty of pcrjury that therc
issucd (Scc. 3097, Civ. C.).
a construction lcnding agcncy for thc grcrfornrancc of thc work for which this permit is
lrnder's Namc:
[-cndcr's Addrcss:
APPLICANT DECLARATION
I hcrcby all-nnr undcr pcnalty of pcrjury one of thc following declarations:
Dcrnolition Pcrmits-Asbcstos Notification Federal Rcgulations (Titlc 40, Paa6)
_Rccluircd [rttcr of Notification
_l ccrtify lhat thc fedcral rcgulations rcgarding asbcstos removal arc not applicablc to this projcct.
_l ccrtily that I have read this application and state that thc atnvc infornution is corrcct. I agrcc to conrply with all City and County
ordinanccs and State Laws rclating to building construction, and hcrcby authorizc of this City and County to cnler upon thc
abovc nlcnlioncd propcrty lbr
Applicant or Agent
Permitee nanre
o,,",'*-17-Ll
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Vent/l nsu I atio n
Roof Sheathinq J uAz-
Shear Wall /l V \J
Framing
lnsu lation/Enerqy
Drywal!
Ext./lnt. Lath
Brown Coat
N/asonrv
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
I
FINAL 1 t lt t )-,N o\
Certificate of Occupancy ll t U
Notes, Remarks, Etc.
Owner:_
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Date:_b^ / 7-L/A
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