HomeMy WebLinkAbout101108211 - PermitCity 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 #: {01108211
Pin #: 33053//..,
\Project Address: 3306 S Garnsey St
t Assessor's Parcel. 410-192-01 Lot'.72
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 7058 Historic: No
Building Use: Single F..rlly Dwelllng Occupency: Rn, U 1st FL AreE Patio
Job Type Roioot Constr Type V B 2nd FL Area T.t.Area:
Nature ofwork Roioot code: cBc 2019 oher Areas yards Reqd
Exbting Bldg. & use: sFowr.ttg.r.go Flood zone x{€02320259J
Garage A.ea v.tu.$or: szr,ooo.oo
Propos€d Use: #ofstories:
Total
De.crlptlon of lYo.k TrO oxi.ting rcof a.ph.lt lhinglo m.tori.l .nd in.t ll n.w lightwoight tilo(<6 1b.). R.plac. .h..thingrplywood .. ne.d.d. H.nd out
given.
Owner:
Address:
Planning Conditions:
Phone:
Tenant
Lisa Clemente
3306 S GARNSEY ST
Santa Ana, CA 927073922
(7141 707-0757
Contractor: Premium Roofing Systems
Address: 2054 Continental Ave.
Costa Mesa, CA 92627
Phone: (7141 884-5108
State Lic #: 1042214
Lic Type: C-39
Bus. Lic #: 370747
Workers' Compensation I nsurance:
Carrier: State Compensation lnsurance Fur
Policy #: 9233137
Expires: 0611312022
u
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
LIt'l i Ce; t: I I
rr--!lrHLLUr
Rcp ti: Lt34 32
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Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES Insp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Fire lnsp. Req'd:
Police lnsp. Req'd:
No
No Account#
Martin, Eric
Zuniga, Allissa
Date: 1010812021
Date:
Date: 1010812021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07176002
07776002
07775002
07776002
07776002
s7507
57770
57572
s7600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Totat
Paid to Date:
Balance Due:
'l
$345.28
$4 0s
$1 00
$23 7e
$5e 30
Total
Flood Zone Cert. Req'd. No
Every permit rssued 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 rs suspended or abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 577-t0
$23.79
$404.58
$1.00
$4.05 $433.42
$0.00
$433.42
lnspector MID#: 2021-169331
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BUILDER DT:LCARATION
I hoeby aflim undc panalty of perjury that I m acmpt ftom thc ContractoB' Licce Law for thc followiog lwn (56.7031.5'
Bwin6s ild Profeion Codc): Any City or County which rcquiu a po:nit to coNtruct, alts, imprcvq donolish or repair uy
structue, prior to ils issumce, also rcquira thc applicmt for such pcrmit Io filc a signcd statmat lhal he or slrc is licdEcd pGmt
to Ihe povisioB of the Contractor's Licemcd law (Chaptq 9, Commmcing wilh Scction 7000 of Division 3 of the Buins ud
Pofwions Code) or that hc or shc is qcmpt thscFotn od thc bssis for thc allcgod cxop(ion. Ary violation of Sclion 7031.5 by uy
applicantforapamitsubjctsthe applicuttoacivilpcnaltyofnotmorcthafivchundrcddollm($500). a
-1,
r omo of thc propcrty, or my mplo)6 with wag6 I thcir $lc comp@sation. will do thc work ad the stndrc b not
intqrded or offsed for slc (Se.7M4. Buine md Profeioro Codq Thc Contractor's Liccr t w do6 not apply to m oms of
thc pIopqiy who builds or imprcG thcotr ad who do6 such mr* himsclf or hc$lf or thrcugh his or ho om @ploy6, a
providcd that such improvqrcnts rc rct intodrd or ofTqcd for slc. lf, how. thc hilding or improvcmt is mld within onc )an
ofcompldon, thc Orvno Buiktq will havc thc hrda ofpoving rha he or dre did rct tuild or irnFovc ihc propsry for the puposc of
sdc).
_1. c omq of thc Fopqty. m cxclBively contracting with licGcd contractoB to coGlruc{ thc projcl (S€. 7044, Bwin6
od Profssbn Code: The Contrclor's Licensc Law do6 trot apply lo m owtrs of propeny who builds or improvG th6@n,
md who contncts for such p{oj€ts with a ContEcro(s) licGcd puEuant to thc Conlractor's Licre [rw).
-IalncxemptunderSection-.B.&P.C.forthisreason.
lloto'
WORKERS' COMPENSATION
DECLARATION
I hercby affirm under penalty of perjury one of the following declarations:
_l have and will maintain a Certificate of Consent to Self-lnsure for workers'cornpensation, as provided for by Section 3700 of the
Labor Code, for the p€rfonnance of the work for which the pennit is issued.
_l have and will maintain worksrs' compensation insurance, as required by Section
the work for which this pennit is issued. My workersiompensation insurance carier
ca;ier. ' 9fa?e
-3700 of thc Labor Code, for the performance of
and pplicy nunrber are:
t /r /zz-Policy
-l
cerrify that in the perfcrrrnance of the work for which this perrnit is issued. I shall not
so as to become subject to the workers' compensation laws of California. and agre€ that if I
employ any person in any manner
should become subject to thc
and
the
Section 3076 of the Labor Code, interest and
l)t,.('t.,\ tt. \'l'l( )N
I hereby affirm under penalty of pcrjury that I am licensed under provision of Chapter 9 (cornmencing 7000) of Division 3
of the Business and Professions Code, and my licensc is in full force and effect./,ot4z?-lLiccnscNumber:
""", z lo/tr/zl Ior'rvt
CONSTRUCTION LENDING AGENCY
I h@by affm und6 penalty of psjury that th@ is 8 consruclion lading agocy for the pqfomcc of thc work for which this pqmit b
issucd (Sa. 3097. Civ. C.).
Lcnder's Name:
Lcnder's Address:
APPLICANT DECLARATION
I hqtbyaftinn under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Pan6)
_Required Letter of Notification
( certi& that the federalregulations regarding asbestos rernovalare not applicable to this project.
_l cerri8 that I have read this application and state that is corrcct. I agree to with all City and County
and County to enter upon theordinances and State Laws relating to building construction,of this
abovc mentioned property for
Applicant or Agent
I'errrrilcc nirnrc
o,,", CO ig { tl
I
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/VenUl ns u lation I I
Roof Sheathinq la/te/zr
Shear Wall tt tv
Framing I
lnsulation/Energy
Drnruall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputv Final Report
Enqineer Final Report
Flood Zone Certif
FINAL tJn/*t
Certificate of Occupancy ,l \-/
Notes, Remarks, Etc.
Owner:
provisions.
dollzu's in addition to thc cost
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