HomeMy WebLinkAbout10143589 - Permit^
City of Santa Ana
20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Building Permit #: {O143589
Permit Counter: (714) 647-5800 lnspection Requests: (714') 667-2738 /n
Project Address: 114 S Hickorv St
Assessor's Parcel: 398494-07 Lot: POR 11 Block: A
Suite. Bldg: Address Range:
Tract: PS&BLEEADD Historic: No
Suite Range:
Zoning: R2
Building Use: Single Family Dwelling - Detached
Type of Work: Alteration
Nature of Work: Window clo
Existing Bldg. & Use: SFD
Proposed Use: Residential
Constr Type:
Occupancy:
Code:
Flood Zone:
VN
R3
cBc 2001
x-0602320029F
1st FL Area: 0
2nd FL Area: 0
Other Areas: 0
Garage Area: 0
Total: 0
Patio: 0
T.l.Area: 0
Valuation: $6.500.00
Description of Work: Change out (13) windowslhandout given/auth on file
Planning Gonditions:
I
94acf ,'a-y'u 4rra-4 aP /r- / o -
Owner: -l9wid+lill#i 'v - ' Contractor: Owner-Builder
Address: 9f //-L Address:
E,rstinl 5lran2780
Phone: (ffi2
Engineer:
Address:
Phone:
License #:
Architect:
Address:
Phone:
License #:
I
a
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
renant: .7 l? -L/2o - F 7or
Planning Approval By:
Plan Checked By:
Permrt lssued By:
Subject to Field:
PWA lnsp. Req'd:
Plannir:g lnsp. Req'd:
Landscaping lnsp. Req'd
Ffr"rrtanciez,
Date: 03i1 612004
Date:
Date: 03/1 612004
Guiilen, Pedro lvlisc. Receipt:
lvlisc. Receipt:
Misc. Receipt:
077-07-s977 Permit Fee
077 - 07 - s977 Field Verification
077-07-5977 lssuance
Fee Tota!:
Paid to Date:
Balance Due:
$122.25
$62.50
$30.00
$2t 4.75
$0.00
$zt 4.75
Kathy
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
This permit shall expire by limitation and become null and void if the work authorized by this permit
is not commenced within 180 days from the date of this permit, or if the work authoized by this
permit is suspended or abandoned at any time after the work is commenced for a period of 1 80 days.
Before such work can be recommenced, a new permit shall be first obtained fo do so.
Account #: 01 1-01-591 1 lnspector
a
BUILDING. INSPECTOR RECORD A,I
SITE.WORK DATE ID/SIG.GOMMENTS Owner-Bui lder Decl aration
I hwby affim uda p68lty of pcrjuy lhrt I m ampt fm thc Coltrac1m' Limsc Law for thc following rcam (!.c.7031 5 Bsin6t
sd prcfBsim Codc): Any City tr CNty which rcquie a pcmit to cooltud, rltq, imprcvc, dmolish or rcprir ey 3tructuc, Fitr to it!
iss**, Aso *quiri Ojapptirut fc dctr pannlt io ntc a iigrrcd starmat thst hc q shc is timsed Punuat to thc FoYi3iw of thc
CmEaclc's Licmsrd Law'(-ChAta 9, Comin3 with Scaio ?000 of Divilim 3 of thc Buinq ad Profesim Codc) c that hc c
shc is cxqnpt thefrom md itc 6st fc Oc Atcgpd amptim .Any violction of Scstio 7031.5 by my appliwt for s prmil subjccts thc
sp,plicmt to 8 civil pqrdty of trot morc dre fivc hu&cd dollm ($500).
lr/u *n ot lp 6wrty, o rny orgloye with a.gs a thcir iol. cmpanruion, will do thc work ad thc smctuc is not irtcndcd
c+oftqcd fc salc ( S.'..ZOll, S*io;s da ircfsim Coac, Thc Cmtrrctu's Licmc L8w ds aor apply lo m ownc of thc propcry
who builds c imFovc thm, ud who de srch wo(t himclf q hcclf c thrcugh his u hc m mployc, prcvidcd that tuch
improvmot! e not intodcd or offmd fc aalc, If, howrycr, thc building or imprcvmot is sold within onc ycr of complction, thc
ownq-Buil<tcr will havc thc burdm of prcvin8 that hc or 3hc not build o improvc for thc purpcc ofsalc).
thc project ( Scc. 7044, Brsiness and_I, rlr owner of the propctty, am
Profession Code: The Contractor's
cxchuively contracting with licansed
of who builds or improves thereon , and whoLicense Law does not apply to an owner
contracts for such projects with a Contractor(s) licaued pumuant to the Law.).
_I am exempt under Section (,
Datc: Ovmer:/
I hereby affirm under penalty of pcrjury
_I have and will maintain a Certificatc of Consent to Self-Insure for workers'
Labor Code, for the performancc of the work for which the pcrmit is issucd.
compcnsation, as Provided for by Scction 3700 of the
t havc md will miatsin wqta' qnFraim iN|me, a rcquircd by Setio .370O
of thc Labor Codc, fd thc Pcrfmcc of thc
iqk for which thig pqmit is isucd My worko' cmPdrtid imrrue cmi6 ed policy nmbcr rc:
Cuiq:
Policy a(This section need not be complacd is for One hun&ed dollars less)
I certi$ that in the performancc of thc work for
became subject to the workem ' compensation laws
which this pcrnrit is any
of California,
comparation provisions of Scction 3700 of the Labor
t
L
a
e
and civilWARNING: Failure to secure workers'
fines up to one hun&ed thouand dollars
rs and shall subject an to
addition cost of composation, damage as provided for the Section 3076 of
thc Labor Code, interest and anornry's fees.
LICENSED CONTRACTORS DECI.ARATION
I h@by 8ffim ud6 paraty of pcrlury O*IE ii6ca uaa provisio of Chaptq 9 (comacing with Scction 7M0) of Divisi@ 3 of
thc Buins ud Ptofeims Codc, md my limsc ig in full fqe md cffet.
Licensc License Number
CONSTRUCTION LENDING AGENCY
t hftby sffm sdtr pcnslty of pcrjury rhal O* iwmmr"tion rcnaiag agocy fm thc pcfmcc of thc wck fq which this pcmit is
isucd (Sc. 3097, Civ. C.).
Lcnder's Name:
APPLICAIYT'S DECLARATION
Demolition Permits-Asbestos Notification Fedoal Rcgulations (Title 40, Part 6)
-
Required l-etter of Notification
_l certify that the federal regulations removal are not applicable to this project.
_ t certify that I have read this that the above I to comply with all City and County
ordinances and Statc Laws of this City and County to enter upon the
above mentioned
Applicant or agent
Permittee name (print) :
L
ls
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloorNe nUI ns u !ation
Roof Sheathing
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Requirements
Deputy Final Report
Engineer Final Report
Flood Zone Certificate
I t\
FINAL 10 u L1 rnxr
ICertificate of Occu pancy V
Notes, Remarks, Etc.I
as
those
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