HomeMy WebLinkAbout101107017 - 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 #: {O11O7O17
Pin #: 18777
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Proiect Address: 3703 S Ocean Crest- -a-
Assessor's Parcel: 412-222-18 Lot. 90
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 7711 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Reroof
Reroof
Sfd w/att garage
Occupancy:
Constr Type:
Code.
Flood Zone'.
# of Stories:
R-3
VB
cBc 2019
x-06023202s9J
1st FL Area
2nd FL Area
Other Areas:
Garage Afreai * : o 1 r_n-ti
i$ f i r:e i i: I f t{IOtal rirr._t +:0
Patio:
T.l.Area:
Yards Req'd
Valuation:
Description of Work: Remove existing wood shake and replace with Saxony 600- Shale, 5.7 lb ESR 1647. (Roof sheathing required)
Planning Conditions: Repair and repaint any damage to window trim, fascia, rafterc as needed.
5
Owner:
Address:
Phone:
Jenant
Scott Campbell
3703 S OCEAN CRST
Santa Ana, CA 927047127
(7141 486454/
Contractor: Prestige Roofing
Address: 91 1 S Figueroa St
Santa Ana, CA 92704
Phone: (7141469-8795
State Lic #: 1059050
Lic Type: C-39
Bus. Lic #: 374213
Workers' Compensation lnsurance:
Carrier: State Compensation lnsurance Fur
Policy #: 9258598
Expires: 08l,0G12023
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
F,,
5t5ultlt:[:r-
Revolv i ns
535LtLl
& Do,:r
?_,777r_t
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
Enriquez, Gissel
Ahangian, Kathyi
Zuniga, Allissa
\
Date: 0512712021
Date: 1010412021
Date: 1010512021
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Kathy Ahangian
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
07776002
07776002
07776002
07776002
07776002
07776002
57607
s3600
57770
57672
57600
57607
$172 64
$239.34
$8.1 0
$1 00
$23 79
$5e 30
No
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Ced. Req'd. No 01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 53600
01 1 16002 57770
Account#Total
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days afterits issua nce,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
$239.34
$8.1 0
Fee Totat
Paid to Date:
Balance Due:
$504 1 7
$0 00
$504.17
lnspector MID#: 2021-166419
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BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG,COMMENTS OWNER BUIII)ER DELCARATION
I hqcby aflm undo penalty of pcrjury thst I m qmpt fiom thc Contrsctots' Liccre [rw for thc following ren (Se.7031.5
Bwine and Prcfcion Codc): Any City or County which rcquiro a pcmit to conslrucl, altq, improvc &nolish or rcpoir my
structurg prior to its iswcq also rcquirc thc applicut for such pcmit to filc a signcd statmot thst he or shc is licascd pw{l
to thc provisioc of thc Contretor's Liccnsed t:w (Chapt6 9, Comocing with Setion 7000 of Division 3 of thc BBirc md
Prcf*ioro Codc) or that hc or shc is qcmpt thqcfrom ad th€ basis for thc alleged umpion Any violation of S@tion 7031.5 by any
applicmtforapo'mhsubjetsrhc applicettoscivilpflaltyofnotmorethufivchundrcddollm($500).
_1, s om6 of thc popary. or my mplolB with wag6 s thcL $lc @mpcttsatioo, will do thc mrt md thc $tuctw b rct
intqdod or oflkcd for slc (Sc.7044. Buine ud Profsioro Codq Thc Cont actor's Liccre kw do6 not apply to e om6 of
thc propqty who builds or improrc ttu@n, srd who do6 och mil himsclf or hcclf or thrcugh his or ho om mploye,
prcvidcd thst such impowrrcnts rc mt intqrdcd or oIH for sh. If. hoP€E, ttE buiHiry or irprovqmt is oH withh onc )E
of ompftrb]L thc Oryna Buiklr will haw ttrc hr&r of poving 0u hc or shc dil mt bild or hprove thc popcty for thc prpo* of
elc).
_1, ils owncr of the property, arn cxclusively contracling with licensed contractom to construct thc project (Scc. 7044, Business
and Prcfession Code: The 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 Contractor(s) licaued pursuant to the Contractor's License l-aw).
-l
am exempt undcr Section-, B. & P.C. for this reason.
Dolo'
WORKERS' COMPENSATTON
DECI,ARATTON
I hereby alTirm under penalty of pcrjury one ofthe following declarations:
_l have and will maintain a Certificate of Consent to Sclf-lnsure for work6s' compensation, as provided for by Section 3700 of the
Labor Code. for the performance of the work for which the permit is issued.
-l
havc and will maintain workers' compcnsation insurance, as required by Scction 3700 of the Labor Codc, for the pcrformancc of
the work for which this permit is issuod My workcrs' comp€nsation insurance carria and policy numh arc:
9c t(
PolicyNr.b"r' -- q ZS f;5 qB Expires:on I oclzoAn
_l ccrlify that in the performance of the work for which this perrnit is issued, I shall not employ any person in any manner
so as to become subject to the workers'compcnsation laws of California, and agree that if I should become subject to the
workers' compansation provisions of Section 3700 of the Labor Code, I shall. forthwith comply with thosc provisions. -
WARNTNG: Failurc to secure workers' composation coverage is unlawful. and shall subject an onployer to crimind petnlties and
civil frnes up to onc hundred thousand dollars ($100.000). in addition to the cost of compensation. darnages as provided for the
Section 3076 of the t^abor Crde, interest and attorney's fecs.
\lna dLv LLto I cl+r D F-l
ta
Ilqto.
I hercby affirm under pcnalty of perjury that I arn licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code, and nry license is in full forcc and efkct.
License
,C-
Nurnber:1o5965cl,,,. - (olqlzt HTJ L
W
I hwby atfm undo p@alty of pcrjury thEt thc is a @ns(ruction lcnding agocy for thc pcfomcc of thc work for which this psrnit b
issucd (Se. 3097, Civ. C.).
Lender's Name:
I-ender's Addrcss:
APPLICANT NECI {RATION
I hercby affirm under penalty of perjury one of the following declarations:
Demolition Permits-Asbcstos Notifrcation Fcderal Regulations (Title 40, Part6)
-Requ
ired lrtter o f Notifi cation
_l ccrtify that the federal regulalions regarding asbestos removalare not applicable to this project.
_l certi& that I have read this with all City and County
and County to ent€r upon theordinances and State laws
above mentioned property for
Applicant or Agent Fr&\)Dete:_
Pemlteumc(pdnt)l
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloo r/Ve nUl ns u lation
Roof Sheathinq lu -O-Lt JL1r
Shear Wall
Framinq
Insulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
.^
FINAL lo-,-Ll tt-ur (1\',
Gertificate of Occupancy \.r7
Notes, Remarks, Etc.
Owner:_