HomeMy WebLinkAbout101102891 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 1O1102891
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Proiect Address: 1924 W Meadowbrook Dra Unit:
Assessor's Parcel: 412-53146 Lot: 133 Block: NA
Bldg:
Tract: 1631 1
Address Range:
Pin #: 1
Suite Range:
Zoning: SD4Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
Sfd w/att garage
R-3, U
VB
cBc 2019
x-0602320259J
2
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuationr $t 6,000.00
Occupancy.
Constr Type
Code:
Flood Zone'.
# of Stories:
Description of Work: lnstall roof mounted solar. Per Residential Photovoltaic Checklist.
Planning Conditions:
Owner: Kristy Dinh Contractor:
Address. 1924 W Meadowrook Address:
Santa Ana, CA 92704
Phone: ffieANCELLED Phone:
State Lic #:Tenant: b:\ C C,s\\ ra.c-'\o r- Lic Type:
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Yong
Yong
3055
Llr
Lr r
D : HGAR(:I I
ctn Rel*: 1Lrl1r128?s6976rr | / 2L /?it2lr 2z 47 F'H
n Totol $lrt-t1?,3t:t
Tesla Energy Operations
2102 Alton Parkway
lrvine, CA 92606
(7021 78s-2se8
8881 04
B, A, C-10, C-20, C-46
San Mateo, CA 94402
(650) 638-1028
c81774
$ 45[t , t-t
DATEi12\ 2r
Bus. Lic #: 324801
Workers' Compensation lnsurance:
Carrier'. Zurich
Policy #: EWS107458502
Expires: 10/31 l2O2O
$58.61
$1rl:119.3{
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp
Teri
Fire lnsp. Req'd:
Police lnsp. Req'd
Date:
Date:
Date. 0112112020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Phone:
License #:
Total
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds. Revolving
07776002 s7600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
$4s0 00
$58 6s
$1.00
$0 00
PWA lnsp. Req'd No
No Account#Planning lnsp. Req'd:
Landscaping lnsp. Req'd Flood Zone Cert. Req'd: No 01 1 16002 51601
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after ifs issua nce,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
No
No
No
01 1 16002 51612
01 1 16002 57770
$4s0 00
$1 00
$s8 65
$509 6s
$0 00
$509.65
lnspector MID#: 2020-157250
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG,COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsu I ation
Roof Sheathing
Shear Wall
Framing
Insu Iation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
lVlasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL
Certificate of Occupancy
Notes, Remarks, Etc
OWNER BU I LDER DELCARA'I'ION
I hereby affirm under penalty of Jrerjury that I am exempt from the Cuntractors' License Law for the following reason (Sec.70.11,5
Business and Profession Code): Any City or County which requires a permit to construct. alter, improve. dennlish or repair any
structure. prior to ils issuance. also requires the applicant frrr such permit to file a signed statement that he or she is licensed pursuant
to the prcviskrns of the Contraclor's Licensed Law (Chapter 9. Commencing with Section 7(XD of Division 3 of the Business and
PmfessionsCode)orthatheorsheisexempttherefromandthehasisfortheallegedexemption. AnyviolationofSectionTO.ll.5hyany
applicant for a yrcrmit suhjects the applicant to a civil penalty of not rnore than five hundred <Iollars ($5m).
-1.
as owner of the property. or my empkryees with wages as their vrle compensation. will do the work and the stru,cture ls not
interxled or offeretl for sale (Sec.7O44. Business and hofessions Code: The Contractor's License Law does not apply to an owner of
the property wlxl huiltls or inrpnrves thereon. an<l whl dtrs such work himself or herself or through his or her own emphyees.
provided that such improverrnts are not intended ur offeretl ftrr sah. If. hlwever, the huilding or inpnrvenrnt is sokl wihin one )rar
of completion. the Owner BuiUer will have the hurden of pnrving that he or she did rxrt build or improve tlrc fnof,erty forthc purprseof
sah).
-1.
asownerof theproperty. amexclusivelycontracting with licensed contractorstoconstruct the pmject (Sec.7044. Business
antl Pnrfessirn Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon.
and who contracts for such pnrjects with a Contracto(s) licensed pursuant to the Contractor's License Law).
-l
amexempt under Section_. B. & P.C. for this reason.
l)ate: ( )rvnrr:
WORKE,RS' COMPENSAI'ION
DE,CLARATION
I herehy affirm under penalty of perjury one of the following declarations:
-lhaveandwill
maintainaCertificateofConsentto.Self-lnsureftrrworkers'compensation,as providedforbySection3T(X)ofthe
Labor Code, for the perfrrrmance of the work for which the permit is issuetl.
1fi norrand will maintain workers' compensarion insurance. as required hy .Section 37fi) of the Lahor Code, for the performance of
- the work for which this permit is issgetl. My wrlrkers' compensation insurance carrier and plicy number are:
,*,*,,7,,1 bA (b(/:,Cfum ,
WWI ,4qF5.-a?- A(,'rt/zLoPolicy Number: l
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certify that in the performance <lf the work for which this Jrcrmit is issued. I shall not employ any Frcrson in any manner
so as to beconr suhject to the workers' compensalion laws of California. and agrce that if I should become subject to the
workers' compensation provisions of Section 37(X) of the lahor Code. I shall. forthwith comply with those provisions.
IVARNING: Failure to secure workers' colnpc'nsntion coverage is and shall subject an enrployer to criminal Jrenalties and
civil fines up to one hundred thousantl tftrllars ($1ffi.(XX)). in <lamages as provided for the
Section .1076 of the Lahrr Crxle. interest antl
Lt/'2222 I
I hereby affirm untler penalty of Jrerjury that I am 9 (comrrncing with Section 7(XX)) of l)ivision .l
of the Business and hofessions Co<le. and my license is in full frrrce and effect.
eetP'rLLT6
License
2 ?u Lo
I hereby affirm under penalty of per.iury that
issued (Sec. 3O97. Civ. C.).
tsa lending agency firr the perftrrmance of the work frrr which this prmit is
l-entler's Name:
Lender's Address:
APIDI ICAN'T DECLARA'I'ION
I hereby affnm under penalty of perjury rrne of the following tleclarations:
Denxrlition Permits-Ashestos Notification Federal Regulations (Title 40, Part6)
-Required
Letter of Notifrcation
regulations rcganling asbes(os removalare not applicahle trr this project.
application anrl the ahrve infirrrntion with all City antl County
and County t0 enter u;xrn the
ahlve rnentionetl
Applicant or Agent
Permitee name
ttl
CL l.?6 $kx
*,", I f ztf?PIA
Flev. 08-07-201
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