HomeMy WebLinkAbout101106983 - PermitCif) cf Santa Ana 20 '*' ^^r-16r?C,r,. -19), SanEfAnri;n g:Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: {01106983
Pin #: 96072
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Project Address: 1224 W Cubbon St
Assessor's Parcel. 010-272-06 Lot: POR 10
Unit:Bldg:
Tract: NININGER
Address Range:Suite Range:
Zoning: RlBlock: NA Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Miscellaneous
Window Change out
SFD w/det Garage
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
R-3, U
VB
cBc 2019
x-0602320257J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation: $e,000.00
Description of Work Window change out. 10 windows. Owner-Builder form on file.
Planning Conditions:
6t24121. AZ (11window modified to reflect change in window size(smatler) in living room and to infill window in kitchen. No header
changes. OK per Planning.-site/floor plan revised and approved.
Owner-Builder
t
Ovrner:
Addiess.
Phone:
Tenant
Naui Huitzilopochtli
1224 W CUBBON ST
Santa Ana, CA 927034924
(7141 248-3821
Contractor:
Address:
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Date: 06/1712021
Date:
Date: 06/1712021
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
Engineer:
Address:
Phone.
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Total
0 77760 0 2
07776002
07776002
077760 02
07776002
Go F
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
Orozco, lvan
Chavez, Dave
57770
57672
5760 0
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$172.64
$4 05
$1 00
$23 79
$s9 30
(
Fire lnsp. Req'd: No
Police lnsp. Req'd. No
Flood Zone Cert. Req'd: No 01 1 16002 51600
01 1 16002 51601
01116002 51612
01116002 57770
Account#
Every permitissued 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 permitis suspended or abandoned for a period of 360 days after
the time the work is commenced
$23.79
$231 .94
$1 00
$4.05 Fee Totat
Paid to Date:
Balance Due:
$260.78
$0 00
$260.78
lnspector MID#: 2021-166836
1
BU ING.. INSPECTOR RECORD
coMr\,[E.:ol'prjury that I atn cxcmpt liom thc rrs' t-icense [.aw for thc following reason (Scc.7031.5
-". -.*.,.. and Profcssion Codc): Any City or County which rcquircs a [Ermit to construct, altcr, improvc, dcmlish or rcpair any
struclurc, prbr to its issuance, alm rcquircs the applicant for such Frmil to lile a signed staterenl thal he or $c is liccnscd pumuanl
to lhc prcvisions of thc Contractor's Liccnsd ljw (Chaptcr 9, Commcncing wilh Setion 7000 of Division 3 of thc Busincss and -
Pmfcssk ns Codc) or that hc or shc is cxcnrpt thsclioin and thc bnsis for lhc allegcd crcmption. Any violalion of Smtion ?03 1.5 by anf
applicant for a pcrmit subjccts thc applicant Io a civil penally of not mrc th.n fivc hundrcd dolles (5500).
-1.
as owncr of thc proJEf,y. or my emplo)rccs with wagcs as lhcil slc comlrcnsalion. willdo thc work ild thc slnnm is mt ?
inlcndcd or ofibrcd for selc (Se.?(X4, Busircss and Profcssions Codci Thc Contr{ctor's Liccns law docs not apply to an owncr of ,
lhc pmFny wlb huilds or irrpmvcs thcB)n. arf,, wlD d(rcs s$h mrk himsclf or hcr*lf or thmugh his or hcr own cmployccs.
providcd that such imprcrcmnts rc rel inlendc{ orofFcrc{ for eh. lf, howcrcr, the htilding or inrpmrcilrnt is sH wilhin onc )rce
ofcoil{,htion. thc Owncr BuiHcr will haw lhc burdcn ofpmving that hc or shc did not build or impmrc tlrc pDlrcrty for thc puryprc of
slc).
-1.
as owncr of thc propcrty. am cxclusivcly conlracting with liccnsed contraclors to construct thc projcct (Scc. 7W. Busincss
and Profbsskrn Codc: Thc Contractor's Licensc Law does not apply lo an owner of property who builds or improves thcreon.
and wh<l conlracts f'or such projccts with a Contractor(s) liccnsed pursuant to lhc Contraclor's Liccnsc Law).
_l arn cxcrnpt utrdcr B. & P.C. for this rcason.
WORKERS' COMPENSATION
DT'CLARATION
I hcrcby affirrn undcr pcnalty of pcrjury one of thc following dcclarations:
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have and will maintain a Ccrtificate of Conscnt to Self-lnsurc for workcrs' compensation, as provided for by Scction 3700 of thc
I-;rbor Code. for thc pcrfonnancc of the work for which thc pcrnrit is issued.
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have and will maintain workcrs'compcnsation insurance. as rcquircd by Scction 3700 of thc l-abor Code, for thc pcrfornrance of
thc work for which this prrnit is issued. My workers' compcnsation insurance carrier and plicy numbcr are:
Date: Owner:_
Policv Numbcr: Exoires:
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ccrtify that in thc performancc of thc work for which this pcrmit is issucd. I shull not crnploy any pcrson in any manner
so as to bcconrc subjcct to the workcrs' cornpensation laws of California. and agrec lhat if I should bccomc subject to thc
workcrs' compcnsation provisions of Scction 3700 of thc t-abor Code, I shall. forthwith comply with thosc provisions.
WARNING: Failurc to sccure workers' compcnsation coveragc is unlawful. and shall subjcct an cmployer to criminal penaltics and
civil fines up to onc hundrcd thousand dollars ($100.000). in addition to lhc cost of conlpcnsation. damagcs as provided for the
Section 3076 of thc Labor Codc. inlercst and altorney's fccs.
Date:
a
DECII\RATIQN
I hcrcby all-rrrn undcr penalty of pcrjury that I anr licenscd undcr provision of Chrptcr 9 (conrmencing with Scction 7000) of Division 3
of thc Busincss and Profcssions Code. and my liccnsc is in full forcc and cffcct.
Licensc Class:_
Date:
Nurnhcr:
CoNSTRUCTION LENDIN(: AGENCY
I hcrcby allirtn undcr lrcnulty of pcrjury thal lhcrc is a construction lcnding agcncy for thc Frformncc of thc work for which this Ismil is
issucd (Scc. 3097. Civ. C.).
Lcndcr's Nanrc:
Lcndcr's Addrcss:
APPLICANT DBCI ARTilTION
I hcrcby affrnn under pnalty of pcrjury onc of thc lbllowing dcclarations:
Dcmolition Permits-Asbcstos Notification Fedcral Rcgulations (Title 40. Part6)
-Rcquircd
lrttcr of Notification
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ccnifi that thc fcderol rcgulutions rcgading &sbcstos rcmval arc not applicablc to this pmjct.
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ccrtify that I havc rcad lhis applictrtion urd st{tc thsl thc obovc inforrolion is corcct. I agre lo comply with all Cilyand County
ordinanccs snd SIate kws rclating to building construction. ard hcrcby authorizc rcprcsntatircs ofthis City ad County lo cnter ulDn thc
abovc rcntioncd prcpcny for inslEction purlDrcs.
Applicunt or Agent
I'ernrilee nanre
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SITE.WORK DATE ID/SIG.\
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Ve nt/l ns u I atio n
Roof Sheathinq
Shear Wall
Framinq 7-l{-Z t rE<rrrl 4t
lnsu lation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Jt/asonrv
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
FINAL
Certificate of Occupancy
Notes, Remarks, Etc.
Applicant:
Signature: Date:_