HomeMy WebLinkAbout101107287 - 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 #: {01107287
Pin #: 48{56
Project Address: 1001 S Standard Ave
Assessor's Parcel. 01 1-251-06 Lot: 31
Unit:Bldg. Address Range:Suite Range:
Zoning: R3Block: NA Tract: 3293 Historic. No
Building Use: lrlulti-F.mily (5 or morc unlta) Occupancy: R-l 1st FL Area Patio:
Job Type: Ro.oot Conslr Type V B 2nd FL Area T.l.Area:
Neturc ofwo*r Ro.oot code: cBc 2019 ctther Areas yards Req.d
Existing Bldg & Use: Ap.rtmsnt Bldg Flood zon€: x{602320276J GaEge Area vetu.flon: 149,958.00
Proposed Use: # oI Stories: Totat O
Oe.cription ol Worki TrO exi.ting roof end lnstall now complhingl€c to.p.itment bulldlng. Repl.c. .ho.thingy'plywood .. n.eded, Hand out glv.n,
Planning Conditions:
Engineer.
q
Owner: Jamboree Management Co
Address: 22982 Mill Creek Dr
Laguna Hills, CA 92653
Phone. V14l 231-721G
1'enant
Contractor: Royal Roofing Construction
Address. 172 E Orangethorpe Avenue
Placentia, CA 92870
Phone: (7141 680-0015
State Lic #: 988169
Lic Type: B, C-39
Bus. Lic #: 348947
Workers' Compensation Insurance:
Carrier: Employee Service Group
Policy #: WC018978003
Expires. 1213112021
Address.
Phone:
License #.
Architect /
Designer:
Address:
Phone:
License #:
I
1[il.
l,fr i
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES Insp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
;:;::.M
Date: 0711912021
Date:
Date: 0711912021
Subject to Field:
Permit Fee
Microfilm Records
Bldg. Stds. Revolvrng
General Plan Update
I ssuance
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
077760 0 2
077750 02
07776002
07776002
57607
57770
57672
57600
57607
Fee Totat
Paid to Date.
Balance Due:
$345.28
$4.0s
$2.00
$23.79
$59.30
$434.42
$0.00
$434.42
Fire Insp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Flood Zone Cert. Req'd: No
Every 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.
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$23.79
$404.58
$2.00
$4.0s
Inspector MtD#'. 2021-167505
rEfl El- O
1 1 16Lr{
t
SITE-WORK DATE ID/SIG COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf !oor/VenUl ns u I atio n
Roof Sheathing 1hzh,,
Shear Wall t/I
Framing
Insulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
lt/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
,t
FINAL a h,14,n\,-
Gertificate of Occu
Notes, Remarks, Etc.I
OWNER BUILDER DELCARA'IION
I hcreby affirm urtdcr pcnalty of pcrjury that I am exenq)t from the Contractors' Liccnsc law for the following reason (Sec.7031.5
Busincss and Profcssion Codc): Any City or Counly which rcquires a pcrmit to construct, altcr, improve, dcmolish or repair any
slructure. prior to its issuancc. also rcquircs thc applicant for such Jrermit to filc a signed statemcnt that he or she is licensed pursuant
to the provisions of the Contractor's Liccnscd taw (Chaptcr 9, Commencing with Sc'ction 7000 of Division 3 of thc Business and
Professions Code) or that hc or she is excmpt thcrcfrom and thc basis for thc allcged cxcmption. Any violation of Section 7031.5 by any
applicant for a permit subjcrts the applicant to a civil pcnalty of not rnorc than fivc hundrcd dollars ($500).
-1.
as owncr of thc propcrty, or my cmployccs with wagcs as thcir sole compcnsation, will do thc work and ttrc stnrcture Ls not
intendcd or offcrcd for salc (Sc'c.7044. Busincss and hofessions Code: The Contractor's License law docs not apply to an owncr of
lhe proprty who builds or improvcs thcrcon. and who docs such work hirnself or herself or through his or her own employees.
providcd that such im;lrovcnrcnts arc not intcmlcd orofferod for salc. lf. howevcr. thc building or inprovenrcnt is sold wilhin one )rear
of comphtioo thc Owner Buildcr will havc ttrc burdcn of proving that hc or she did nnt buiH or inqrrovc thc propcrty for tlrc purposc of
sale).
-1.
as owncr of thc proprty. am exclusivcly contracting with liccnscd conlraclors to construct thc projcct (Sec. l$dd. Susirrcss
and Profcssion Codc: The Contractor's Liccnse Law docs not apply lo an owncr of property who builds or improves thcreon,
and who contracls for such pojccts with a C-ontractor(s) liccnscd pursuant to thc Contractor's Liccnse l-aw).
_l anrcxcmpt undcr Sccti<ln_. B. & P.C. for lhis reason.
l)ntr. ()rr ner.
WORKEITS' COMPENSATTON
DECI ARATION
I hcrcby affirnr undcr pcnalty of pcrjury onc of thc following dcrlarations:
_l havc and will maintain a Ccrli[-rcate of Conscnt to Sclf-lnsurc for workers' comgrcnsation, as providcd for by Sc.ction 3700 of the
[:bor Crdc. for thc grcrfornunce of thc work for which the pcrnrit is issued.
_l have and will maintain workcrs' compcnsation insurancc. as rcquircd by Scction 3700 of thc labor Code. for the performarrce of
the work for which this prmit is issuod. My workcrs' compcnsation insurancc carricr ad plicy numbcr arc:
I'/z-3 /-Z/Policy
_l ccrtify that in the Jrcrforrnarrcc of thc work for which this pcrrnit is issucd. I shall not crnploy any pcrson in any rnanner
so as lo bccomc subjcct lo thc workcrs' conpcnsation laws of California. and agrce that if I should becornc subject to tlrc
workcrs' compensation provisions of Scction 37fi) of thc l-abor Codc, I shall, forthwith cnmply with thosc provisions. r
WARNING: Failurc to sccurc workers' compcnsation covcragic is unlawful. and shall subject an crnployer to criminal pcnaltics and
civil fincs up lo onc hundrcd thousand dollars ($100.0m), in addition to thc cost of compcnsation, damages as providcd for the
.o,J*i:,?Ti*:i
LICET{SED CONTRACTOR
TTF'CI ARA'I'ION
I hcreby af firm undcr Jrcnulty ol'pcrjury that I arn liccrrsccl under provision of Chaptcr 9 (comnrcncing with Section 70m) of Division 3
of the Business and Profcssions Codc. and my liccnsc is in full t'orcc arxl etl'ect.
l-iccnse c3 )
Numbcr:?C
"-. /
CONSTRUCTIoN LENDING AGENCY
I hcrcby affirm undcr lEnalty of Frjury that thcrc is a mnstructbn hndinS agcrcy for thc JErformcc of thc work for which this Frmit is
issued (Scc. 3097. Civ. C.).
[rndcr's Narrc:
lrnder's Address:
APPLICANT DECLARATION
I hcrcby affrmundcr pcnalty of pcrjury one of thc following dcclarations:
Dcmolition Pcrmits-Asbestos Notilication Federal Rcgulations (Titlc 40. Part6)
-Rcqu
ircd [rttcr of Notification
-l
certify that thc fcderulregulations rcgarding asbcslos rennvalarc not applicablc to this projcct.
with all City and County
and County lo enter upon tlre
Applicant or Agent
Pernritcc nanre ( print ): _
BUILDING. INSPECTOR RECORD
f
Rev. 08-07-201 5
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