HomeMy WebLinkAbout101107757 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Aha, CA92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {01107757
Pin #: 3{633
Project Address: 1237 S Rosewood Ave
Assessor's Parcel: 013-024-08 Lot: 123
Unit:Bldg. Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 557 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
Sfd w/att carport
Occupancy:
Constr Type:
Code
Flood Zone'.
# of Stories.
R-3
VB
cBc 2019
x-0602320257J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation:$15,000.00
Description of Work: lnstall solar panels.
Planning Conditions:
Owner:
Address:
Phone:
Tenant
SalvadorZ & Maria Lopez
1237 S Rosewood Ave
Santa Ana, CA 927071021
(7141 856-3138
Contractor: Freedom Forever
Address: 43445 Business Park Dr, #1 '
Temecula, CA 92590
Phone: (951) 445-5645
State Lic #: 1029644
Lic Type: B, C-10, C-39, C46
Bus. Lic #: 370076
Workers' Compensation I nsurance.
Carrier: Redwood Fire and Casualty lnsura
Policy #: FRWC215868
Expires: 0110112022
Engineer:
Address.
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Freedom Forever
Arashi Yoshioka
143 Saint Thomas Drive
Oak Park, CA 91 377
JOSe
Fn eetl olr
Hu I ld r ns
ul116t102-
tlldg Stds
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11 icrot'I lrn
Ltl I l6trrr?-
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s6285
t Al
Rel i
+ /Zit
riif , LtLt
$81
P -lr-ll r I'rrt l'2 LC
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd:
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Date:
Date:
Date: 0812412021
Subject to Field:
Mrsc. Receipt
Misc. Receipt
Misc. Receipt
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Total
Paid to Date:
Balance Due:
$450 00
$81 00
$1 00
$0 00Verduzco,
No
No
No
No
Account#Total
01 1 16002 51601
01116002 51612
01 1 16002 57770
$450 00
$1 00
$81 00Every 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 permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
$532 00
$0 00
$532.00
lnspector MID#: 2021-168351
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a,
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.coMMErvrs O1VNER BUILDER DELCARATION
I hocby aflim unda pqnlty of pcrjury that I m cxcmpt ftom thc Contraclon' Licw law for thc followillg rcmn (Ss.7031.5.
Buines ard Profsion Codc): Any City or County which rcquirc a po'mit to omtruct. ahq, imprcvc, dmolish or rpair ay
sruoue, prbr to its issuace. also rcquirs thc applicst for such pcf,nit to filc s signcd statmmt thar hc or slp b licmed pwart
to thc provisiom of thc Contretor's Liccnscd Law (Chapts 9, Commcing with Sction 7000 of Division 3 of thc Bwins aild
PrcfosionsCodc)orthatheorshcisdmptthscfromadthcbesisforthcallcgcdcxmption. AnyviolationofselionT03l.5bymy
applicmtforapemitsubjersthc applicmttoacivilpcmltyofnotmorcthelivchundrcddollus($500).
-1,
o omq of thc propcrty, or my mployc with wag6 I thcir mlc compcrsaion. will do thc wqk ad thc ltrudr b mt r ,
intqrdcd or offopd for slc (Se.7044, Buins md Prpfsioro Codc: Thc Conttactor's Licffi [rw do6 not eply to s omq of
thc Fopqty who hril& or improvs tlEo[ ed who do6 such w]* himsclf or hmclf or thrcugh his or ha om mploye.
prcvidcd that such imprcvffits rc rct intqrdcd or offsrd for sb. If. hoPBq, thc buildirg or imFovqn@t is rcld within one )an
ofcomplction, thc o\rno Buildq wil harc tlE hrdE ofproving thd lE or $c dil mt hrild or improvc thc popoty br thc prpos of
slc).
_1, I omq of thc propcty, m uclusivcly contrscting with lic@€d contractoB to @Ntruct thc prcjcl (Ss. 7044, Buine
and PDfusbn Code: Thc Cotrt6tor's Liccnsc Law doc not apply to a own6 of propcrty who builds or imprcvc thqorl
ud who contrads for such projGls with a ContEclo(s) licos€d pmwt to thc Contraclor's Licw kw).
-l
am exempt under Scction-. B. & P.C. for this reason.
WO RKER"S' COM PENSATIO N
DECLARATION
I hereby affrrm under penalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for workers' compensation. as provided for by Section 3700 of the
Labor Code. for the perforrnance of the work for which the pennit is issued.
_l have and will maintain workers'3700 of the Labor Code, for the performance of
the work for u*hich this ocnnit
/r,/.sh'e
is and policy number are:
Poricy Numbe,: FfZ bl LL '1nq Expires:
_l certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner
so as to become subje,ct to the work€rs'compcnsation laws of California, and agrec that if I should become subject to the
workers' compensation provisions of Seclion 3700 of the Labor Code. I shall. forthwith comply with those provisions.
WARNING: Failure to secure workers' compensation coveragc is unlawful, and shall subject an onployer to criminal pcnalties 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 labor Code, interest and attorncy's fees.
Applicant:
LTCW
DECI.ARATION
I hereby affrm under penalty of perjury that I am licenscd under provision of Chapter 9 (comrnencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
License t oz1 cLFl
W
I hmby affm undo pqBtty of pdury that thqr is a @Etruciioo lcding ag6cy for th. pqfolmcc of thc m* for which this pomil b
Civ. C.).
Lender's Address:
APPLTCANT DECLAITATION
I hereby allinn under penalty of perjury one of thc following declarations:
Demolition Pennits-Asbestos Notification Federal Regulations (Title 40. Par16)
-Required
lrtter of Notification
_l certi& that the federal regulations regarding asbestos removal are not applicable to this project.
J ..rri5, that I have read this application with all City and County
ordinances and State Laws relating to and County to enter upon the
above mentioned property for
Applicant or Agent
Permitee name G*
u
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloo r/Ve nul n su latio n
Roof Sheathing
Shear Wall
Framing
lnsu lation/Energy
Drnrvall
Ext./lnt. Lath
Brown Coat
Masonrv
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif.
\
FINAL rdan-lr,^r \xw
Certificate of
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