HomeMy WebLinkAbout101107791 - 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 #: {01107791
Pin #: 22741
1^A
Project Address: 3640 S Main St
Assessor's Parcel. 932-910-1 5 Lot: NA Block: NA
Unit: D Bldg
Tract: NA
Address Range: 3620-3640
Historic: No
Suite Range:
Zoning'. C4
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Condominium
Miscellaneous
Windows/Door
Condo
Occupancy:
Constr Type:
Code:
Flood Zone'
# of Stories:
R-1
VB
cBc 2019
x-0602320278J
1st FL Area
Znd FL Area
Other Areas:
Garage Area:
Totat
Patio.
T.l Area:
Yards Req'd
Valuation:$3,000.00
Description of Work: Change out (4) windows and (1) sliding door. Owner form on file.
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Jennifer Wang
3640 S Main St Unit #D
Santa Ana, CA 92707
(626) 238-7824
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Engineer
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #
rt7
YH
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
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 1 16002 s1600
01 1 16002 51601
01116002 51612
01116002 57770
Jacinto, Heidi
Zuniga
Date: 08/1 212021
Date:
Date: 081261202'l
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
01116002
07L1,6002
0 771"6002
0L775002
071,L6002
57601
57770
51572
57600
s7607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Totat
Paid to Date:
Balance Due:
$172.64
$4 0s
$1 00
$23.7e
'$sg. go
Account#Total
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.
$23 79
$231 94
$1 00
$4 05 $260 78
$0 00
$260.78
'!nspector MtD# 2021-168024
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1111luil
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby affrm undcr penalty of pcrjury thal I m cxmpt from thc ContractoE' Licqc kw for thc following l@n (Se.7031.5
Buinss and Profsion Codc): Any City or Couty which rcqui!6 a pqmit to coNtruct, alt6, itnprovq danolish or repair oy
stnctue. prior to its is@cq also requic thc applicat for such pcmit to filc a signcd stal@ot that he or shc is licG€d plNet
to the provisiom of th€ Contrrctor's Licmscd taw (Chapts 9, Commcncing with Sation 7000 of Division 3 of thc Buins md
PrcfesionsCode)orthathcorshe isexmptthtrfrommdthcbasisforthcallegedexmption. AnyviolationofSetionT03l.5bymy
applicant for a pcrmit subj€ts thc applicut to a civil pcmlty ofnot morc the fivc hundrcd dollus (t500).
_1. as owner of the property. or my employees with wages as 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 owner of
the property who b,uilds or improves thereon. and who does such work himself or herself or through his or her own cmployees.
provided that such irnprovernents are not intcnded or offercd for sale. I(, howet/er. the tuilding or improvement is sold within one )rcar
of cornpletion. the Orvner Buildcr will have the hrden of proving tha he or she did not build or improve the property for the purpose of
sale).
-1,
as owner of the propefiy. am exclusively contracting with licersed contraclors to construct the project (Sec. 7U4, Business
and hofission Code: The Contractor's Liccnse Law does not apply to an owner of propcrty who builds or improves thereon,
and who contracts for such projects with a Contracto(s) licersed pumuant to thc Contractor's Licersc taw).
_l arn t]. &reason.
DECLARATION
I hereby affirm under poralty of perjury one of the following declarations:
-l
have and will maintain a Certificate of Consent to Sclf-lnsure for workcrs' comp€nsationt as provided for by Scction 3700 of the
Labor Code, for the performance of the work for which thc pcrrnit is issucd.
-l
have and will rnaintain workers' compcnsation insurance. as required by Section 3700 of the l,abor Code, for the performance of
the work for which this permit is issued. My workers' compssalion insurance carrier and policy numb€f, are:
Policy Number: Expires:
_l certiff that in the performance of the work for which this permit is issucd. I shall not
so ,ts to become subject to the workers' compensation laws of California. and agrec that if I
employ any person in any manner
should bccome subject to the
workers' compensation provisions of Section 3700 of the Labor Code, I shall, forthwith cornply with thosc provisions.
WARNING: Failure to secure workers' compensation coverage is unlawful. and shall subject an einployer to criminal penaltics and
civil fines to one hundred thousand dollan ($100.000), in addition to the cost of compensation, damages as provided for the
Section l-abor Code, interest and attorney's
I)I.:('LARA'I'ION
I hereby affrrn under penalty of perjury that I arn licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
Liccnsc Class: License Numbcr:
llolo.f'nrrlronlnr.
W
I hcrcby affm undo penalty of psjury thal thqc is a construction lcnding agocy for the pofomcc of the work for which this pqmit b
issucd (Se. 3097. Civ. C.).
Lender's Name:
Lcndcr's Address:
APPLICANT DECLARATION
I hercb}, affinn under penalty of perjury one of thc following declarations:
Dernolition Pennits-Asbestos Notification Fedcral Regulations (Title 40. Part6)
-Required
Letter of Notifrcation
-l
cqtiry that thc fctoal rcgulatiom rcarding cbctos rmoval uc not applicablc lo this prcjet.
2[r{ cqtify that t tuve rcad this application md statc that thc abovc infomation is coret. I agG to @mply with all City md County
drtrinmce md Statc taws retaing to buildi4 coretructioc and haeby authoria rcprffitativG of this City ed Coutrly to 6t6 upon the
above mentioned property for
Applicrnt or Agent
Pcrnritec nAnlc ,
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/VenUI nsu Iation
Roof Sheathinq
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif.
ft
FINAL to/n/2,rl>tTu
Certificate of
Notes, Remarks, Etc.I
Carrier:-
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