HomeMy WebLinkAbout101107876 - PermitProject Address: 910 E Buffalo Ave
Assessor's Parcel: 003-21 2-13 Lot: 53
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 1529 Historic. No
City 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 #: {O1107876
Pin #: 42177Ptv
Building Use: Singl. F.mlly Dvrolling Occupancy: R€, U lst FL Area Patio:
Job Type Rorcof Constr Type V B 2nd FL Area T.lIrea
Nature of work R.roof code: cBc 2019 oherAreasi yards Req.d
Existing Bldg. & use: Sf.t wr.tt g...g. Flood Zone: x{m2320153J GaEge A|ea v.tu.$on: I9,ooo.oo
Poposed Use # ofstories:
Tolal
tlolcrlpgon ot Work R.root house & att chod g.rago - rcmovs (l) layor comp & (1) l.yor wood, inrtall sho.thing & i.lt & Cert lnl.od L.ndma.k
chlnglos, ICC *'13E9. H.ndoutr glvon
Plsnnlng Conditiona: RaPlaco aheathino, eavaa and faacla boaada aa naadad.
Owner:
Address:
Phone:
Tenant
Stacie Daniel
910 E Buffalo Ave
Santa Ana, CA 92706
(949) 637-0417
Contractor: Hoyt Roofs lnc
Address. 1809 N Orangethorpe Park
Anaheim, CA 92807
Phone: (7141 227-6099
State Lic #: 6061 11
Lic Type: C-61 , C-2, C-39, D-24
Bus. Lic #: 161673
Workers' Compensation I nsurance:
Carrier: American Zurich
Policy #: WC112580502
Expires'. 1213112021
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:ir:ilJ7
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Guevara, Jerry
Amsden, Julie
Date: 0910712021
Date:
Date: 0910712021
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002
01776002
07776002
077760 02
07776002
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance?
s7607
57770
57672
s7600
57607
$345.28
$4 0s
$1.00
$23 79
$59 30
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd:
No
No Account#Total
Landscaping lnsp. Req'd:Flood Zone Cert. Req'd: No
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 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.
lnspector MID#: 2021-168620
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$23.79
$404.s8
$1.00
$4.05 Fee Total
Paid to Date:
Balance Due:
$433.42
$0.00
$433.42
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATTON
I hrcby aflirm undcr poralty of perjury thar f m cxcmp ftom thc Contracton' Licffi tiw for thc foltowing rwn 1Se.f0il.5
Bsinss md Profsion Codc): Any City or Coutrty which requirs a po'mit to construct, altc. improvq dmolish or repair uy
struclrc, prior to its issuucc, also rcquiG the spplicilt for such pemil to filc I signcd statmot that hc or strc is lic$cd puuut
to thc prcvisiom of thc Contractor's Liccnscd Law (Chapts 9. Commocing with Sstion 7000 of Division 3 of the BEine$ ed
Prcfesions Code) or that he or shc is cxcmpt th@fiom ed thc basis for the alleged cxmption. Any violation of Sdion 7031.5 by any
applicantforapcmitsubjctsthc applicattoacivilpcmltyofnotmorcthmfivehundrcddollm($500).
_1. as owner of thc property. or my employees with wages as their sole compensation. will do thc work and the structure is not
intended or offered for sale (Sec.7M4, Business and Professions Code: The Contractor's License Law does not apply to an owner of
thc property who builds or improves theroon. and who does such work himself or herself or through his or her own employees.
provided that such improvanents are not intended orofferod for sale. If, howet/er, the building or improvement is sold wilhin one year
of complaion, the Owner Builder will have the burden of proving ttrrat he or she did not build or imp,rove the propo'ty for the purpose of
sale).
-1,
as owner of the property, arn exclusively contracting with licerued contractors to construct the project (Sec. 7U4, Business
and Pnoftssion Code: The Contractor's Licensc Law does not apply to an owner of property who builds or improves thereon.
and who contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's Licensc [,aw).
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am exempt under Section-, B. & P.C. for this reason.
WORKER,S' COMPENSATION
DECLARATION
I hereby affrrm under penalty of pojury one of the following declarations:
/
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havc md will Mintab a Cqtilicate of CotMt to SclfJrouc for workq' compcNdior\ I providcd for by Setion 3700 of thc
labor Code. for thc pcfonmcc of thc work for which thc pqmit b issued.
ff have and will maintain workcrs' comperuation insurance. as required by Section 3700 of the labor Code. for the petformancc of
work this permit is issuod. My workers' compensation insurance cilrier and policy number are:
z-/tr/rrI7----7
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cqtiry that in thc pcrfomancc of thc work for which this pcmit is isued. I shall not cmploy my pmon in my mmna
e Gtob@mesubjettothewor*6'composationlawsofcalifomia.mdagcthatiflshouldbeomcsubjcttothc
workc'compemtionprcvisiomofSetion3?00ofthet borCodc.ldEll.fonhwith@mplywiththo*prcvisiom.
WARNING: Failurc to suc work6' ompcnsaiion ovmge is untawfut, ed shall subjct m qployE to siminal pqEltics sd
civil lincs up to ooc hmdrcd thoMd dollm ($100.000). in addition to thc cosi of compcution. &maga u prcvidcd for thc
Section 3076 Labor Code. interest and attorncy's fees.
DECI.ARATION
I hereby affrnn under penalty of pcrjury that I arn licensod under provision of Chapter 9 (cornmencing with Scction 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
Number:
W
I hercby affm unda penalty of perjury that th6e is a @nstruciioo lcnding agocy for thc pqfomucc of the work for which this [mit is
issucd (Sa. 3097, Civ. C.).
Lmdd's Namc:
Lcndcr's Address:
APPLICANT DECLARATION
I hereb)raffirmunder penalty of perjury one of the following declarations:
Demolition Per:rnits-Asbestos Notification Fedcral Regulations (Titlc 40. Part6)
_Required Letter of Notification
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coti$r that the federal regulations regarding asbestos removal are not applicable to this projed.
F*ifu that I have read this applicarion and state that rhe above infonnation is correct. I agree to comply
ordinances and State Laws relating to building construction. and hereby authorize representatives of this City
with all City and County
and County to e'nter upon the
for inspcction
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/Ve nUI ns u latio n
Roof Sheathing q lll 4,t 'LrA,ap
Shear Wall t \\.,/
Framinq
lnsulation/Energy
Drwvall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
,/t
FINAL 9/,7bh ,J-fr 1o
Certificate of Occupancy (t lv
Notes, Remarks, Etc.f
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