HomeMy WebLinkAbout101105687 - Permit{City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: 101105687
Pin #: 58620
Project Address: 2226 S Halladay St
Assessor's Parcel: 016-104-18 Lot: 17
Unit:Bldg: Address Range.Suite Range:
Zoning: R1Block: P Tract: 668 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
SFD w/det Garage
R-3, U
VB
cBc 2019
x-0602320278J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l Area:
Yards Req'd
Valuation: $19,000.00
Occupancy.
Constr Type:
Code:
Flood Zone'.
# of Stories:
0
Description of Work: lnstallation of 19 roof mounted PV system
Planning Conditions:
Botch*:61 I 14
0l f ice: i:TYH
Acct * :
l rri 14/2it2l
l'r nrr e# : 6
Ref*
ID: LROSic
I tU I r-t5,5
Owner:
Address:
Phone:
Tenant
JUAN M HERNANDEZ
2226 HALLADAY ST
Santa Ana, CA 927072908
(7141 545-3548
Contractor: Freedom Forever
Address: 7200 Fenwick Lane
Westminster, CA 92683
Phone: (7141 404-0194
State Lic #. 1029644
Lic Type: B, C-10, C-39, C46
Bus. Lic #: 370076
Workers' Compensation I nsurance.
Carrier: Berkshire Hathaway
Policy #: FRWC2'17374
Expires: 06/01 12022
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Phong Truo.lg ' :
i l-.t!r, r?rtrl3000 E Blrch'st #201
Brea, CAifl?p31
(7141 269,$q95.,1,1 ,:, i:iiir
C70784 ,1';': . ' ', :, i,.
I
.i:
Freedom &,Beach Signmakgrs lnc
PNB Conlnactor,,
1555 B McGaw Ave
lrvine, CA 92614 : , ,:
(949) 7s2-8200
$556 ..ir
Aut, h'i : t-r
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA !nsp. 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
Ahangian,
Verd uzco,
No
No
No
No
Kathv I
viorenrf{
Misc. Receipt:
Misc. Receipt:
Misc. Receipt.
Date:
Date: 1011412021
Date: 1011412021
Subject to Field:
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Totat
Paid to Date:
Balance Due:
$450 00
$1 05 30
$1 00
$0 00
Account#Total
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$450.00
$1 .00
$10s.30
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 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
$s56 30
$0 00
$ss6.30
lnspector MtD# 2021-163822
/7
BUILDING. INSPEGTOR RECORD
SITE.WORK DATE !D/SIG COMMENTS OWNER BUTLDER DELCARATION
I hreby a{Iim unda pcnalty of pojury that I m qmpt from thc CoilractoE' Licre lrw for the following @n (Se.7Dl.5
Buinas ud Profsion Codc): Any City or County which rcquirc a pcmh to @Ntruct, altq. improvg danolish or rcpoir uy
structuq Fior to its issmcg aho rcquirc thc eplimt for such pqmit to filc a signcd statmmt rhd hc or slE b licsrscd pmuet
ro thc Fovisioru of the Coilractor's Liccnsc{ trw (Chapts 9. Comacing with Sction 7000 of Division 3 of thc Buitw ud
Profsioro Codc) or that hc or shc is ampt thrcfrom md thc bosis for thc allcgcd cmption. Any violatiotr of S6rbn 703 I .5 br sny
applicmtforapamhsubjetsthe applicettoscivilpcEltyofnotmorcthafivchundrcddollus($500).
_1, as owner of the property, or my employees with wages as their sole compensation. witldo the work and the structure is not
intended or ofFered for sale (Sec.7044, Business and hofessions Code: The Contractor's License Law does not apply to an owner of
the prrrpcrly who builds or improves theron. and who does such work himself or herself or through his or hcr own employees.
provided that such ilnprovanents are not intended or ofFerod for sale. If, howwer. the building or improvement is sold within one year
of cornplaion, the Orvner Builder will have the hrdcn of proving that he or she did not build or improve the propoty for the purpose of
sale).
_1, as owner of thc property. arn exclusively contracting with licersed contractors to construct the project (Sec. 7044, Business
ard Pmfcssion Code: The Contractor's License law does not apply to an owner of property who builds or improves thereon,
and who contracts for such fojects with a Contracto(s) licensed pursuant to the Contrac'tor's Licerse l-aw).
-l
am exempt under Section-. B. & P.C. for this reason.
WORKERS' COIVIPENSATION
DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
-l
have and will maintain a Certificate of Conseirt to Self-lnsure for work€rs' compensation, as provided for by Section 3700 of the
l-abor Code, for the performance of the work for which the pennit is issued.
' I have and will maintain workers' compcnsation insurance. asi required by Section 3700 of the Labor Code, for the pcrformancc of
the work for which this p€ilnit is issuod My workers' compqudion iruurance carrier ard policy numbcr are:
c (o-
Policy oq '/zo >Z
AI certifu that in the performance of the work for which this permit is issucd, I shall not cmploy any person in any manner
so as to become subject to the work€rs'compemsation laws of California, and agree that if I should becorne subject to the
workcrs' compensation provisions of Section 3700 of the Labor Code, I shall. forthwith comply with those provisions.
WARNING: Failure to secure workers' comperuation coverage is unlawful, and shall subject an onployer to cdminal 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 tabor Code, interest and attorney's fees.
,,,". t7/tc(/? nZ I aovn...^. kek ChA
IherebyafIirmunderpcrraltyofpcrjurythatIamlicerrscrt,ffiChapter9(commencingwithSection7o00)ofDivision3
of the Business and Professions Code, ard my liccnsc is in full force and effect.
License ,r*, B/ d0/c 4 6/cs7 LicenseNumber: \ r L1 6e/ c/
,,,", lv l4t/u2 I (rcr.Gr-,tH?/L
W
t hocby alfm undo poalty of p6juy thal thsc is 8 @nstrucrbr kndiry agacy for thc psfomacc of thc work for which this [mil b
isucd (Se. 3097. Civ. C.).
l*ndq's Nmc:
I-cnder's Ad&ess:
AIII.ICANLDECI.ASAIIA!
I hothy aftru unds pcnalty of pajury orc of thc following dclanriore:
Dcmolition Pmits-Asb6tos NotiIicstiotr Fcd@l Rc?ulatioB (Titlc 40, P{t6)
lRcquircd latq of Notificalion
-l
cdiry thrt thc fcdeml rcgulntioro rcgarding sbctos moval uc not applicablc to this prcjct.
z_l cctiry thot I havc ud this application and 3tatc that th€ abovc infomrliotr is o161. I agc to @mply with all City ad Couty
odimc ,rd Statc LM rEhiDg to building @nsnrcriou ad hacby uttoriz rctrMtdiv6 of thb city ed Coutrty to atq upotr thc
abovc mtioncd prcpory for inspoctior pupos
Applicant or Agent
Permitee name
o,t",t0/&/2o7)
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloo r/Ve nUI n s u I atio n
Roof Sheathing
Shear Wall
Framing
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif I
lolnle,,JAb
I V f.
FINAL lol nla lln
Gertificate of Occu
Notes, Remarks, Etc.
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