HomeMy WebLinkAbout101108055 - PermitProject Address: 2209 N Linrntood St
Assessor's Parcel. 390-1 81-12 Lot: 20
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 4977 Historic: No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)547-5859
Permit #: {O11O8O55
Pin #: 13697
Building UBe: Slnglo Family Dwolling Occupancy: R3, U 1st FL Area Patio:
Job Type R.roof Constr Type V B 2nd FL Area T.l-Area:
Natue ot work Roroof code: cBc 20{9 other Areas yards Reqd
Existing Bldg. & use sFDwtattg.r.ge Flood zone: x{602320163J Garage Area v.lu.tion: g2s,oqr.oo
Proposed UBe: # of Stories:
Total
t eacrlptlon ot Work TrO .xilitng rcof and lnatall nsw comp ahingloE to SFO with .tt chod ger.ge. Rrpl.ce .hoathlngrplywood a. no.dod. Hand out
givan'
Planning Conditions:
Owner: MARK GODINEZ
Address: 27Og N LINWOOD ST
Santa Ana, CA 927056834
Phone' V14l 4744417
Tenant
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning !nsp. Req'd: No
Landscaping lnsp. Req'd. No
Contractor: SR2 Roofing Services, lnc.
Address: 320 North Park Vista Street
Anaheim, CA 92806
Phone: (7141 341-7411
State Lic #: 1040475
Lic Type: C-39
Engineer:
Address:
Phone:
License #.
Architect /
Eo':b t on Ioto I
Rooi i ng Serv i cES r
Bus. Lic#: 377A5 Desiqner: i.:,i.i , 'i,r, ir, .','. i :
Worters' Compensalion lnsurancq Addr€ss:
Policl #: 9230739 Phone: t. , , r,,, . ,Expires: o5roz2o22 License #:
Guevara, Jerry
07776002 57.507 Permit Fee $345.28
077L6002' s7770 Micrgfilm Records $4.05
07776002 s7672 Bldg. Stds. Revotving $1 00
0L776002 s7600 General Plan Update $23.79
077L6002 s7607 lssuance $59.30
Fire lnsp. Req'd:
Police lnsp. Req'd 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 afterits issuance,or if the work authorized
on the site by such permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced
Inspector MtD#' 2021-169007
Date: 0912412021 Misc. Receipt:
Date: Misc. Receipt:
Date: Ogl24l2121 Misc. Receipt.
Subject to Field:
No
No Account#
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
Zunrga, AllissaV
!
$23 79
$404.58
$1 .00
$4.05 Fee Total
Paid to Date:
Balance Due:
$433.42
$0.00
$433.42
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BUILDING. INSPECTOR RECORD
SITE.WORK DATE !D/SIG COMMENTS OWNER BUILDER DE1CARATION
I hocby affm undo pcnalty of po'juy that I m excmpt from thc ContractoB' Licw liw for thc following @n (Sc.7031.5
Bwincs and Profsion Codc): Any City or County which rcquire a po'mit to coEtruct, altq, imprcv_c &molish or rpat oy
sructue, prior to its iswcq also rcquic thc applimt for such pcnnit to frlc a sigtrcd staimqt thd t€G stE b licqucd prmilt
to thc prcvisioro of th€ Contrctor's Licms€d taw (Chapt6 9, Commcncing with Setion 7000 of Divirion 3 of thc Buincs ud
Prcfcsions Codc) or that hc or shc is qcmpt thscfrom ad rhc basis for thc allclcd cxmption. Any violBtion of SEtioo 7031.5 by ey
applicant for a pcrmit subjcts thc applic$t to a civil pmlty of rct morc tho fivc hundrcd dollm ($500).
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c omq of thc prcpc(y, or my cmployG with wagB I thcir rclc compcruation, will do thc wort dd thc $tuctrc is not
intqdcd or olfscd for salc (Se.7044, B6ins md Profeiom Codc: Thc Conraclor's LiccE Law do6 rct apply to u omcr of
thc Dropsty who hrilds or imptoc tllqot ad who doc sEh wrt himsclf or hwlf or thrcugh his or ho om mploycc,
providcd that such imFoEnals rc rct htqrdod or offqrd for sb, lf. hoM. thc hiHing or imtromt is sH vithin onc )qr
of complaion, thc otrnq Buildq will havc thc h[dor of troviry thd hc or shc dil mt build or irprovc Ihc propqty for tbc p[pos of
slc).
-1.
as owner of the prop€rty, am exclusivcly contracting with licenscd contractors to construct thc project (Sec. 7044, Brsincss
and holission Code: The Contractor's License Law does not apply to an owner of propcrty rvho builds or improves thereon,
and who contracts for such p,rojects with a Contracto(s) licersed pursuant to thc Contractor's License Law).
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am exempt undcr Section-, B. & P.C. for this reason.
flqlo'
WO RKER^S' COMPENSATION
DECLA,RATION
I hcrcby affrm undcr perialty of pcrjury onc of the following declarations:
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have and will maintain a Certificate of Consent to Self-lnsure for workcrs'compensation, as provided for by Secrion 3700 of the
Labor Codc, for the pcrformance of thc work for which thc pcrrnit is issucd.
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have and will maintain workers' compcruiation insurance. as requircd by Section 3700 of the l^abor Codc, for thc performance of
the work for which this permit is issued. My workers' compensation insurance carrier and policy numhr ine:
0 !^^ >
Poricyx,r^w, , 1,L9u1 9ol -at Expire*C)) - LL
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ceni& that in the performance of the work for which this permit is issued, I shall not employ any person in any manner
so as to become subjet to the workers' compensalion laws of California, and agrec that if I should become subject to the
workers' compcnsation provisions of Section 3700 of the l-abor Code I strall. forthwith comply with thosc provisions.
WARNING: Failure to securc workers' compensation covcrage is unlawful. and shall subject an onployer to criminal penalties and
compensation, damages as provided for thecivil fines up to one hundred thousand dollars ($100,000), in 'ru"'Section 3076 of the Labor Codc, intcrest and
i"1u. 4?-. L-l a Z t
I hcreby affrm under penalty of pcrjury that I am licensed 9 (cornmancing with Section 7000) of Division 3
of the Business and Professions Codc, and my license is in full force and effect.
License
) L'9 ?Y Y?
o*e: od[z?-4 ' U
W
I h*by affm undo pcoalty of pqjwy thal thsc is a @ostructbtr knditrg sg@cy for thc pqfomcc of thc wrk for which this pqmit b
isucd (Se. 3097, Civ. C.).
Lender's Name:
a
I-codcr's Ad&ess:
APPLICANT DECLARATION
I herdry aflirrn under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40. Part6)
-Rcquired
Lrtter of Notification
J
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certifi that the Heral regulations regarding asbestos rcmoval iue not applicable to this project.
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cctiry that I havc r€d this applicatiotr ed statc that thc abovc infomation is concl. I agrc to comply with all City and County
ordimncBlnd Statc trws rclaing to building comtruc{ion, ild hdeby authoriz repr6dtativc of this City od Counry to atq upon thc
above motioned prcpoty for ireparion purpos.
Applicant or Agent {.- \a;.
Pernrilee nRme
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f(t
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Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/Venul n su lation
Roof Sheathing 7-28-Lt a--{ t+2
Shear Wall
Framing
lnsulation/Energy
Drywal!
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL 6-f-A.t >--e, {r-
Gertificate of Occupancy
Notes, Remarks, Etc.
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