HomeMy WebLinkAbout101108067 - Permitrt
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 #: {01108067
Pin #: 84035
h/u
Proiect Address: 1521 E Twenty-First St-a- -
Assessor's Parcel: 396-062-08 Lol'. 27
Unit:Bldg: Address Range:Suite Range:
Zoning: AlBlock. NA Tract: 4167 Historic: No
Building Use: Single Femily Owolllng Occupancy: R3, U 1st FL Aree Patio:
JobTypa R.rcof ConstrType VB 2nd FLArea T.t.A.ea:
Nature otwork Reroof code: cBc 2019 olher Areas ya,ds Req.d
Existing Bldg. & Ueq SFowrattgarag. Flood Zone: x.O802320163J
proposed use # of stories: Ga*ge Area V'lu'tion: 118'000'00
Tolal
I).rcdption ot work TrO orlctlng .oof (comp ahlngls. and bullt up) and lnstall new comp shlnglo3 and bullt up roof to SFD wlth attachod gr.go.
Repl.ce .hoathlngrplywood aa nsoded. Hand out glven.
Planning Conditions:
Owner.
Address:
Phone:
Tenant
Patricia J Sornborger
1521 E 21st St
Santa Ana, CA 927057108
(7141 s04-9986
Contractor: Konrad Roof Co.
Address: 12036 Vose Street
North Hollywood, CA 91605
Phone: (818) 503-5250
State Lic #: 278652
Lic Type: C-39
Bus. Lic #: 379000
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9095788
Expires: 1012812021
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
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:
Arabe, Jill
Zuntga,nffirs$
07776002
07776002
07776002
07776002
07776002
57607
57770
57672
57600
57607
Date: 09/1 512021
Date:
Date. 0912712021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
$34s 28
$4 0s
$1.00
$23 79
$se 30No
No
No
No
Fire lnsp. Req'd.
Police lnsp. Req'd:
Flood Zone Cert. Req'd. No
No
No Account#Total
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterits 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
01116002 51612
01 1 16002 57770
$23 7s
$404.s8
$1.00
$4 05 Fee Totat
Paid to Date:
Balance Due:
$433.42
$0.00
$433.42
lnspector MID#: 2021-168824
iJ
BU!LDING- INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hrcby aflirm undu paalty of pcrjury thar I m exmpt from the ContractoE' Licffic Law for thc followitrg l@n (Se.7031.5
Busin6s atrd Profsion Codc): Any City or County which requirc a pomit to coretruct, alto, improvq ddnolish or rc?air ay
structuc, prior to its issumce. also rcquire thc applicot for such pcrmil to file a signcd statmot thal tE or shc is licoscd pmwt
to the provisiom of thc Contractor's Licenscd I:w (Chaptr 9. Comcncing with Setion 7000 of Division 3 of the Buins ud
ProfcsiomCode)orthathcorshcisqcmptthqcfromedthcbasisforthcallcgcdcxmption. AnyviolationofS6,tion?03l.5byey
spplicetforapennitsubjetsthc applicattoacivilpemltyofnotmorcthufivchundrcddollas($500).
_1, 6 om6 of thc pro6rty, or my mploye with waga c thcir slc compcnsarion, willdo thc wod< fld thc sructrc is rct
intodcd or olIqcd for slc (Sc.7044, Buins ud Profeioro Code: Thc Comncror's Lic@ ljw do6 not apply to u omc of
thcptopsry whobuil&orimprorctlu@tratdwhodesuchwd<himclforhmlforthrcughhisorhcommploye.
providcd that such impromts rc rct intodod or ofrscd for slc. If, howwa. thc buiHing or imprcvmt is sH within onc )ar
ofcomplrrior thc Owns Buildq will have the h!d6 ofproviu thd he or she did not build or imprcvc thc popcty for thc prrpos of
slo.
_1. as owner of the property. am exclusively contracting with licensed contractors lo construct thc project (Sec. 7U4, Business
and Profiession Code: The Contractor's License Law does not apply to an owner of propcay who builds or improves thereon.
and who contracts for such projects with a Contracto(s) licensed pursuant to the Contractor's License taw).
-l
arn exempt under Scction-, B. & P.C. for this reason.
\ryORKERS' COMPENSATION
DECLARATION
I hereby alfirm under penalty of perjury one of the following declarations:
_l have and will maintain a Certilicate of Consent to Self-lnsure for workers' compensation, as provided for by Section 3700 of the
Labor Code, for the pcrfonnance of the work for which the pennit is issued.
_l have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of
the work for which this pcnnit is issued. My workers' compensation insurance carier and policy numkr are:
Policy ,?2.9-zz
_l ccrrify that in the performance of the work for which this perrnit is issued. I shall not employ any person in any manner
so ils to bc.come subject to the workers'compensation laws of California. and agree that if I should bccome subjcct to the
workers' compensation provisions of Section 3700 of the labor Code. I shall. forthwilh cornply with thosc provisrons.
WARNTNC: Failurc to sccure workers'
civil frnes up to one hundred thousand
compensation coverage
dollars ($100,000), in r
is unlarvful. and shall subject an employer to criminal penahies and
addition to the cost damages as provided for the
Sertion 3076 of the Labor Code, interest and attorney's fecs.
I hereby aflirrn under penalty of perjury that I arn licensed 9 (cornmencing rvith Sectiorr 7000) of Division 3
of the Business and Professions Code, and my license is in full force and effect.
License c Nurnbcr:Z
W
I hercby affrm undo pcnslty of pcrjury thal thft is a coEtruction knding agmcy for the po fomcc of thc work for which this pqmit b
isucd (Sc. 3097, Civ. C.).
Lender's Nanre:
Lcndcr's Address:
APPLICANT DECLI\RATION
I hereby afiirm under penalty of pcrjury one of the following declarations:
Demolition Pennits-Asbestos Notification Federal Regulations (Title 40. Part6)
_Requircd Lettcr of Notification
_l certify that thc lbderal regulations regarding asbestos removal are not applicable to this project.
-l
cerri$ that I have read this application and state that the akrve infonnation
ordinances and State Laws relating to building construction, and the
above mentioncd propeny for inspection
Applicant or Agent
l'crnrilec nilnlc ,
o^ru,'7-27-Z)
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/Ve nUl n s u Iatio n I rl .D
Roof Sheathinq U\t.Yt^bnrry 5vl
Shear Wall
Framinq
Insu lation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonrv
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Fina! Report
Flood Zone Certif
Ir
FINAL eI t2la frfvldn
Certificate of Occupancy
Notes, Remarks, Etc.
Carrier:-
""", ?L7;z(
is corroct. I
D
Hifl; i$l= {f x : }.Ir,i5r o5
li gisa B:t: :E rg;E
fi,8PL3AoOx-Uo,-\
Fe
=3Spo
g8r\)o
(,
onc)
\
oo5r+-oo
F.;o-
'o
-lo!,of
o{
=(D
t:
To.a
3
II
F}z
c,
3
ETo
;'!
'o
-lobroo
F}
CL
CL-(Do
2
)-)
N
h
S
N
3\.tJt
a.ot-l-\
3a
=F)
3o-sobs
=a.
a
:'+
l=lr+Ir+
I9
IEl{
linlo)l=
l+'
lotl=
IPlo
l --rto
r()lcr
ls)
t\o
0,oo
at\
UIo
ou
-t0,o*
o\u_ :-\o
tr
=Fsq,:fr.IEo\.
=Fl
Eo
e.
-l
F
fo
(D
=oo
1[1g EB+ tys}F) E11Fri*ri I$F r[ 31i r Egid +
qdo,=;51i=r;1ili +1 *f * [ ]13 E=gli?r33 Ag= as B;I rs Eq*qi ilE ;a qHi g oro- d:^iirdAS;rA *1= 3 [E 265q3*irEHgSi ;E 7l!crJ =lslEgg sri*[ r ig IeB P
AAeasdi=E 65?Et Ei 3:, (l, -'!E-o, + -"-2 P 6 =E =
a r v o-
-:=rg ]=[ = 3+g " 33 P6E Eo, 1/'E E *;* ffi o,oq !3.
E i. gigEtEi etfq Bi ?-EqEEgg#IE1[i
8;e]fro :rD=:{-<:-a+ fig d "u;6 ;t i
==d Ee .' o-", H'5 ifu f or- o-;. = 5.; Lp fa33 rg + i; 11 r: E-; vt- o a + t+ 6 ^j I-.r:=F?e3i 3s i [a Ei
=
rD;6' o-- o 3 = wX ?2 ro 2 or rp q w -= ru G. g+=1^ *i g =A ag F-)1*P ilq a- 3il dE 3o' fr 1- ad q sq 7i-iT +r r E: Fe d3 qg -t rD rD vt =A' ur= i'tn o ., o, ,- ; i. L.rri fEEi E € i5.€ o-u ?:15 ; = ; $r t
a ga rD rD
(/l
5rta
Sa
F)tr\o
A|\-dot'lFoSo-
tr
=(.r
rD
=,Lfiao-
(-)o
-l,
oE
rDl
o{f(D
-t
EE 6Hfiil
$ ;.=
A'a t^-
iEg
$[$
F|)lo 6-'Eo
t'.=a
3i$\l.fDo't;
BBE$$gtD -Et
=.Fq3
!r GDu -gT
=aGTlta.=tont-
=^oS\ra=sIaTtt trofria)
iFBt
-ot
o
F}I-J
a'
r)o
3E'--o
F}oCt
-horrt
3
A'
=CL
a{rrP-o
b.o
ET
I()
o'.a
CL-.Dgt
CL
-a-
gt
!L-q,
CT
o
o
===gL
--aJo
'tE,o
c)
=.oz
+
\
r
!!
(^(i
-c)
04
p
Trf,
I
oaFi.o
..0\\)
.l-)>\
i-
->
--tF-
:P'12'-Jl
'-r2o
epr,-.F-t-
=.C,
6)I-t'-J2
-tri
t
lA\o