HomeMy WebLinkAbout101106765 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702
Permit Counter (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Building Permit #: lOllOGTGI
Pin #: 97'lCD9?Wt
Project Address: 2027 E Barclav Crt
Assessor's Parce!:400-132-01 Lot: 1 Block: NA Tract: 8704 Historic: No
Suite Range:
Zoning: R4
Unit:Bldg: Address Range:
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Description of Work
Planning Conditions:
Single Family Dwelling Occupancy: R-3, U 1st FL Area: Patio:
Reroof Constr Type: V B 2nd FL Area: T.l.Area:
Reroof code: cBc 2019
other Areas: yards Req'd:
Sfd datt garage Flood Zone: x-0602320164'
oarage Area: varuation:
# of Stories:
fotaf:
Reroof house & attached garage - install (l) layer 30# underlayment & class A GAF Timberline comp over existing (l) layer comp.
Handouts given.
$8,500.00
Owner:
Address:
Phone:
Tenant:
JEFFREY R CROZIER
2027 E BARCLAY CT
Santa Ana, CA 927013104
(7141 s47-3618
Contractor: Bronco Roofing lnc
Address: 811 E Lincoln Ave
Orange, CA 92865
Phone: 17141 282-7390
State Lic #. 344837
Lic Type' C-39
Bus. Lic #. 155962
Workers' Compensation lnsurance:
Canier: State Compensation lnsurance Fund
Policy #: 9012332
Expires: 0510112022
Engineer:
Address:
Phone:
License #:
Architect /
Desioner'
Address:
Phone:
Lrcense #:
Planning Approva! By:
Plan Checked By:
Permit lssued By.
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd:
Guevara, Jerry Date: 05l,2412021
Date:
Date: 0512412021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:web_issue
07776002
0 777 6002
0777 6002
0777 6002
0 777 6002
57607
5777 0
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving Fu
General Plan Update
lssuance
Fee Total:
Paid to Date:
Balance Due:
$345.28
$4.05
$1 .00
$23.79
$59.30
No
No
No
No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd:
Flood Zone Cert. Req'd
Account#Total
a
N/A - No
N/A - No
N/A - No
Balance
Balance
BalanceEvegt permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterifs issuance,or if the work
authoized on the slfe by such permit is suspen ded or abandoned for a period of
360 days after the time the work is commenced.
lnspector MID#: 2021-166325
$433.42
$433.42
$0.00
INSPECTOR RECORD
?SITE.WORK DATE ID/SIG.COMMENTS OWNER BTIII NER DELCARATION
I hereby affirm under penalty of periury that I am exempt form the Conffaclors' License Law for the following reason (Sec.70-31..5 Business
and Profession Code): Any City or County which requires a pennit to construct. alter. improve. demolish or repair any structure. prior to its
issuance. also requires the applicant for such permit to file a signed statement that he or she is licersed pursuant to the provisions of the
Contractor's Licensed [,aw (Chapter 9. Commencing with Se<tion 7000 of Division -1 of the Business and Professions Code) or that he or
she is exempt therefrom and the basis for the alleged exemption Any violation of Se<tion 70-31 .5 by any applicant for a pcrmit subiects the
applicant to a civil penalty of not more than five hundred dollars 1$-500).
Y131. rr owner of the property. or my employees with wages a-s their sole compensation. will do the work and the structure is not intended
or offered for sale (Sec.7044. Business and Professions Code: The Contractor's License Law does not apply to an own€r of the prop€Tg'
who huilds or improves thereon. and who does such wort himself or herself or through his or her own employees. provided that such
imprrrvernents il€ not intended or offerod for sale. lf. however. the building or improvement is sold within one yeirr of complaion. the
C)s'ner Builder will have the burden of proving that he or she did not build or irnprove tlre propertv for the purpose of sale),
Ilt. * owner of rhe proFrerty, am exctusively conrraoing with licensect contractors to constnrct the proiect (Sec. 7044. Business and
Profession Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and
who contracts for such pro.iects rvith a Contracto(s) licensed pursuant to the Contractor's License Law).
No I a,r, exempt under Section B. & P.C. for this reason.
WORKF'RS' COMPFNS ^ TION NT'CI ARATION
I hereby affirm under penalty of perjury one of the following declarations:
!o I n"r. and will rnaintain a Certificate of Consent to Self-lnsure for workers' comp€nsation. as provided for by Section -i700 of the
labor Code. for the performance of the work for which the permit is issued.
NO
_l have and will maintain workers' compensation insurance. as required by Section -1700 of the Labor Code, for the performance of the
rvork for rvhich this permit is issued. My workers' compensation insurance carrier and policy number are:
STATE FUND('an'ier:
9012332-22 o5.t01t2022
l: r pircs:Policy Nurnber:
YES
_ _l certify that in the performance of the rvork for rvhich this permit is issued. I shall not employ any person in any manner so
as to become subject to the workers' cornpensation laws of California. and agree that if I should bccome subject to the workers'
comp€nsation provisions of Section 3700 of the Labor Code. I shall, forthwith comply with those provisions..
WARNING: Failure to secure rvorkers'compensation coverage is unlawful. and shall subject an employer to criminal penalties and civil
fines up to one hundred thousand dollars ($100.000). in addition to the cost of compensation. damages as provided for the Section 3076
of the [,abor Code. interest and attomey's fees.
LICFNSTN CONTRACT()R NFCI ARATION
I hereby affrrm under penalty of perlury that I am licensed under provision of Chapter9 (commencing with Section 7000) of Division -3 of
the Business and Professions Code. and my license is in full force and effect.
c39
[-icense Class:
!14E37
l.icense Nunrber
CONSTRUCTION I F'NNING AGFNCV
I hereby afllnn under penalty of perjury that there is a construction lending agerrcy for the performance of the work for which this permit is
issued (Sec. 3097. Civ. C.).
Lender's Name: iloNE
NONE
l.ender's Address:
APPI ICANT NFCI ARATION
I herebv afl[mr undel penalty of per1ury one of the followrng declarations:
Denrolrtion Perntits-Asbestos Notrficatron Federal Regulatrons (Title 40, Part6)
!1 Required l-etterof Notification
YEg f certi$/ that rhe lederal regulations regarding asbestos removat are not applicable to this project.
a
t-I , cefli$/ that I have read this application and state that rhe above information is correct. I agree to comply with all City and Cotnty
ordinances and State l,aws relating to building construction. and hereby authorize representatives of this City and County to cnter upon thc
above mentioned property for inspection purposes.
Reroof
Roof (Diaphragm Sheathing/Frame)C - 2,7-J bYLryfr fi fii 6l+ b-+Ih cr*P t$^r?l
Structural Final G-7,-z.l
Plumbing (-/L\-
Under Floor I Under Slab
Rough
Shower Pan / Tub Test
Water Service
Sewer / Sewer Cap
Gas Air Pressure Test
Plumbing Final
Electrical
Service (Meter I Panel)
Grounding / Bonding
Rough
Electrical Final
Mechanical
Gas Air Pressure Test
Rough
Piping (HW, CW, etc.)
Exhaust Ducts
Mechanical Final
Notes, Remarks, Etc.
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