HomeMy WebLinkAbout101108092 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: {O11O8O92
Pin #: 45612
./ tt./
Proiect Address: 2246 S Kilson Dra
Assessor's Parcel: 016-1 02-23 Lot: POR 23 & POR 2.Block: L
Unit:Bldg: Address Range:Suite Range:
Zoning: RlTract: 668 Historic: No
Building Use. Single Family Dwelling Occupancy: R-3, U 1st FL Area Patio:
Job Type: Demotition & GIear Lot Constr Type: V B 2nd FL Area T.l.Area:
Nature of Work: Demo & Clear Lot Code: cBc 2019 other Areas; yards Req,d
Existing Bldg. & Use: SFD w/ det garage Flood Zone: x-0602320278J
Garage Area: valuation:
Proposed Use: # of Stories: Total O
Description of Work: Demo SFD and detached garage and clear tot. AQMD on file. *r*NO FEE-CITY PROJECTTLETTER ON FILE***
Planning Conditions:
$10,000.00
Owner:
Address:
Phone:
Tenant
City of Santa Ana
20 Civic Center Plaza
Santa Ana, CA 92701
(7141 647 -5641
Contractor: J &G lndustrieslnc
Address: 18627 Brookhurst St #302
Fountain Valley, CA 92708
Phone: (7141 903-2002
State Lic #: 571859
Lic Type: ASBS, A, HAZ, C-21
Bus. Lic #: 160248
Workers' Compensation I nsurance:
Carrier: State lnsurance Fund
Policy #: 0802847
Expires'. 10/01 12022
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
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:
Police lnsp. Req'd
No
No Account#
Orozco,
Zuniga,
No
No
No
No
lvan
A[*v
Date: 0912712021
Date:
Date. 0912912021
Subject to Field:
Misc. Recerpt:
Misc. Receipt.
Misc. Receipt:
Permit Fee
Microfilm Records
Fee Exempt
Bldg. Stds. Revolving
General Plan Update
lssuance
Bond
$172.64
$4 0s
$-1,260.78
$1 00
$23 79
$59 30
$1 ,000.00Total
07776002
07776002
07776002
07776002
07776002
07776002
05i76002
57507
57770
57607
57672
s7600
57607
s3636
Flood Zone Cert. Req'd: No
fir1 permitissued shatl 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 permitis suspended or abandoned for a period of 360 days after
the time the work is commenced
N/A - No
N/A - No
N/A - No
N/A - No
Balance
Balance
Balance
Balance Fee Totat
Paid to Date:
Balance Due:
$0 00
$0 00
$0.00
lnspector MID#: 2021-169074
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DET,CARATION
t hacby affm unda pculty of pcjury that I m crcmpt tom thc Contre{oB' Lic@ [aw for thc following @n (5€.7031.5
BNins atrd Profsion Code): Any City or County which rcquirc a pomit to @struct, altq, imprcvg <krrclish or rrpair my
structuc. prior to its isumcc, also rcquirc thc applicut for such pqmit to filG a signcd stalmot th8t hc or drc b licGed plmad
to thc provisioE of thc Contraaor's Licmscd law (Chapt6 9, Comocing wirh Setior 7000 of Division 3 of thc Buins od
Prcfeions Codc) or thst hc or shc b qcmpt thqcfrom sd thc b6sis for thc allcged croplion, Any violation of Sdion 7031.5 by uy
applicut for a pfinit subjets thc applicut to a civil pcnalty of not morc thm five hundrcd dollm ($500).
_1. as owner of the propcrty, or my employes with wagcs as their sole compersation. will do the work and thc structure is not
intcndcd or offered for sale (Sec.7044, Business and Professions Code: The Contractor's Licerse Law docs not apply to an owner of
the propory who builds or improvcs thcreorL and who docs such work himself or herself or through his or hcr own employees,
providcd that such improvonents are not intcndod or offcrcd for sah. I[, howevcr. the building or imp,roverncnt is rcld within one ]rcar
of complaion, the Orvncr Builder will have the hrden of proving thd he or she did not build or improvc the propory for thc purposc of
sale).
_1, as owner of the propcrty, arn cxclusivcly contracting with liccnscd contraclors to construct thc project (Sec. 7044, Btsincss
and hofession Code: Thc Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a Contraclo(s) liccrsed pursuant to thc Contractor's Liccnse l-aw).
-l
am cxempt under Section-, B. & P.C. for this reason.
Owner:
WORKERS' COMPENSAT
DECLAITATION
I hereby affrm under pcnalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for workers' compensationt as provided for by Section 3700 of the
Labor Code, for the performance of the work for which the perrnit is issued.
_l have and will maintain workers'insurancc. as by Section 3700 of the Labor Codc, for thc pcrformance of
the work for which ffi issued.work€rs'and policy number are:
n
\--U 1 d \0 l)/rLPolicy
_l ccrti& that in the performance of the work for which this pcrrnit is issucd, I shall not employ any person in any manner
so as to become subject to the workcrs'compensation laws of California, and agree that if I should bccome subject to the
workers' compensation provisions of Section 3700 of the Labor Code. I shall. forthwith comply with thosc provisions.
WARNING: Failure to sccure workers'compensalion coverage is unlawful, and shall subject an onploya to criminal penalties and
civil fines to one hundred thousand dollars ($100.000), in addition to the cost of compensation, damages as provided for the
Section Code, interest Itr,l (^
I hercby affrm under penalty of perjury that I am licensod 9 (cornmencing with Scction 7000) of Division 3
of the Business and Profcssions Codc, md my licensc is in full forcc and effcct.
a
License A crl ogq.
W
I h@by affm unda pcnalty of pcrjury thd thw is a coDdruclbn boding rg6cy for thc pqfmcc of thc wo* for which this pqDit b
issucd (Se. 3097, Civ. C.).
Lcndcr's Namc:
Lcnder's Address:
APPLICANT DECLARATION
I hoeb,y affinn undcr penalty of perjury one of the following declarations:
Demolition Permits-Asbcstos Notification Federal Regulations (Title 40, Part6)
-Required
l-rtter o f Notification
_l certiff that the federal regulations regarding asbcstos rqnoval arc not applicable to this project.
_l ccrri$ that I have rcad this application and state that thc above information is correcl. I agrec to comply
ordinances and State Laws relating to building construction and hereby authorize represcntatives of this City
with all City and County
and County to u1xrn the
above mcntioned properry for
Applicant or Agent
?
rn
q lz
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/Venul nsu latio n
Roof Sheathing
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
,
FINAL t0 o u DA,*n /
Certificate of Occupancy
Notes, Remarks, Etc.
-Expires: