HomeMy WebLinkAbout101107772 - Permitf , !.
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 #: 1O1107772
Pin #: 53982
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Project Address: 1024 N Olive St
Assessor's Parcel:405-283-20 Lot: 34
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract 354 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Alteration
New Bathroom
SFD
Occupancy:
Constr Type:
Code:
Flood Zone.
# of Stories.
R-3
VB
cBc 2019
x-06023201 63J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio
T l Area:
Yards Req'd
Valuation:$7,000.00
Description of Work: Convert existing walk in closet into new bathroom. Owner form on file
Planning Conditions:
\Owner:
. Address:
r'l
Phone:
Tenant
b
Salvador Ramirez
1024 N OLIVE ST
Santa Ana, CA 927032334
(7141 884-2454
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone.
License #
Architect /
Desiqner:
Address.
Phone:
License #:
rPl-r I
Mustafa Bdaiwi Architect
Mustafa Bdaiwi
601 Parkcenter Dr, Suite 204
Santa Ana, CA 92705
(e49) 300-735s
c339s3
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
Machado, Miriam ,
Ahangian, KatW
Zunrga,rutissa\
Date: 0812512021
Date: 0812512021
Date: Ogl25l2021
Subject to Field:
Permit Fee
Plan Check Fee
Microfilm Records
Bldg Stds Revolving
General Plan Update
01 1 16002 51600
01116002 51601
01 1 16002 51612
01 1 16002 53600
01116002 57770
$23 79 \
$172 64
$1 00
$239 34
$12 15
Fee Total
Paid to Date:
Balance Due:
$172 64
$239 34
$12 15
$1 00
$23 7e
$448 92
$0 00
$448.92
Misc Receipt:
Misc Receipt.
Misc. Receipt:
0 7776002
07776002
077750 02
07775002
07776002
57607
s3600
57770
57672
57600
Fire Insp. Req'd. No
Pofice lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after lts issuance,or if the work authorized
on the site by such permtt rs suspended or abandoned for a period of 360 days after
the time the work is commenced
lnspector MrD#'. 2021-168434
t
. €UIIoING. INSPECToR REcoRD
S!TE.WORK DATE ID/S!G-COMMENTS OWNER BUILDER DELCARATION
I hcrcby afiirm undo penalty of pefury that I m qempt from thc Contractos' Licw taw for thc foltowiry @n (56.?0315
Buincs and Profeion Codc): Any City or County which rcquic 8 pqmh to construct, 8llq, imprcvg dsnolish or r.psir ily
struduq prior ro its isuilcc. also requirG thc applicmt for such pcnnit lo 6lc a signcd stdetMt thar hc or shc b licoscd pmuut
to thc prcvisiqns of tlrc Contractor's Liccnsed law (Chaptq 9, Commcncing wilh Setion 7000 of Division 3 of the Bwins md
Prcfessions Code) or that hc or she b qemp thq€from ud the b6is for the allcgcd cxmpion. Any violation of Srction 7031.5 by uy
appliciltforapcnnitsubjetsthc applicanttoacivilpcnsltyofnotmorcthofivchundrcddollm($500).
-1,
as owner of the propeny, or my employe$ with wages as their sole compensation. willdo the work and the structure is not
intended or oflered for sale (Scc.7044, Business and Professions Code: The Contractor's License Law docs not apply to an owner of
the property who builds or improves theron. and who docs such wort himself or hersclf or through his or her own employees,
provided that such improvancnts are not intended or offcrod for sale. If. howetrer. the building or improvernmt is sold within one )ear
of complaion, the Ourner Builder will have the burden of pncving tlrru he or she did not build or improve the property for the purposc of
sale).
-f
. as owner of the property. am exclusively contracting with licensed contraclors to construct thc project (Sec. 7U4, Business
and hofession ('ode: The Contractor's License Law does not apply to an owner of property rvho builds or improves thereon,
and who contracts for such projects with a Contractor(s) licensed pursuant to the Contractor's License l-aw).
_l am under B. & P.C.
Z 2_l
DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
-l
havc and will maintain a Certificate of Consent to Self-lnsure for workers' compcnsation. as provided for by Scction 3700 of the
Labor Code. for the performance of the work for which the perrnit is issued.
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have and will maintain workers' compensation insurance. as required by Section 3700 of the Labor Code, for the performance of
the work for rvhich this permit is issued My workers' compensation insurance carrier and policy number are:
Policy Number: Expires:,
_l ccrti& 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 subject to the work6s' compensation laws of California, and agree that if I should become subject to the 7- s
workers' cornpensation provisions of Section 3700 of the Labor Code, I shall, forthwilh comply with those provisions.
WARNING: Failurc to secure workers' compcnsation coverage is unlawful. and shall subject an anployer to criminal polaltics and
civil frnes up to one hundred thousand dollars in to of compensation. damages as provided for the
Section 3076 Labor Code. interest and IL;L/
DECI.ARATION
I hcteby affrnn under penalty of perjury that I am licensed under provision of Chapter 9
of the Business and Professions Code, and my licensc is in full forcc and effert.
with Section 7000) of Division 3
License Class: Licertse Number:
Date:
W
I hrcby affm unda pcmlty of perjury thal thtr is 8 coEtruclion Lnding agacy for thc psfomacc of thc rcrk br which this pannh is
issued (Se. 3097, Civ. C.).
lrndq's Nmc:
Lendcr's Addrcss:
APPLICANT DECLARATION
I hereby affimr under penalty of perjury one of the following declarations:
Demolition Perrnits-Asbestos Notification Federal Regulations (Title 40, Part6)
_Required Letter of Notification
-l
certi& that the federalregulations rcgarding asbestos removalare not applicable to this project.
___l cati$ that I have read this application and state that thc above inforrnation is correct. I agree to comply with all City and County
(.ordinances and State Laws relating to building hereby authorize rep,resentatives of this City and County to enter upon the
above mentioned property for (
Applicant or Agent
I)crnrilce nanre t,,/8 Z
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/VenUI n s u latio n
Roof Sheathinq
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Fina! Report
Engineer Final Report
Flood Zone Certif
I i
FINAL J^,{ilo lolu,a
Certificate of
Notes, Remarks, Etc.
Owner:_
Carrier:-
Contractor:_
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