HomeMy WebLinkAbout102107937 - 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 #: 10.2107937
Pin #: ,rfrf
Project Address: 1603 W Ninth St
Assessor's Parcel: 405-1 4141 Lot. 9
Unit.Bldg: Address Range:Suite Range:
Zoning: R1Block: A Tract: 687 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Miscellaneous
Nru-Window
SFD w/ garrage
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
R-3
VB
cBc 2019
x-0602320144J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuationr $t,000.00
Description of Work: Legalize window change out in kitchen. Auth on file.$r.t$?
rt 3rr [t7 [t? 3
r::t ion Totnl
I / lt-r/?tt21
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Planning Conditions:
Owner:
Address:
Phone:
Tenant
GLORIA TORRES
1603 W gTH ST
Santa Ana, CA 927032935
(7141 785-3980
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone.
License #:
6eriernJ. l-'Jnn ilpdttt.tr: Fee
r-r t I l,{t-ttt?- Ii 1,5t-ttJtltltl-
P,uiId irrg
r-rl I 16r-rrlt- 5 16tl lUl:llJ-
P,lds Stds F:e'rnlvins
01 I l6ulJ2- 516 1 ?t-tt.ttl-
ll icr'iililro & DgcurrtenLs
01 t I 6t.rt-t?- 1777[tt-tt]t-t-
lln gt er i:crr d
(:C* : r *** r * **** t(*/r 8?Lt Au L h'i
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
Pezeshkpour, Ali
Zuniga, All
Date: 09/1 012021
Date:
Date. 09/1 012021
Subject to Field:
Account#Total
Misc. Receipt
Misc. Receipt
Misc. Receipt
0777600 2
07776002
07776002
07776002
07776002
07775002
07176002
57507
57770
57607
57607
57672
57600
57607
Permit Fee
Microfilm Records
lnvestigation
Penalty
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Totat
Paid to Date:
Balance Due:
$172.64
$4 05
$1 04 26
$261 96
$1 .00
$23.79
$se 30
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01116002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 57770
$23 79
$598 16
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.
$1 00
$4 0s $627 00
$0 00
$627.00
lnspector MID#: 2021-168728
ID
1 :3i
{627 .
BUILDING- INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby aflirm undcr lEnalty of pcrjury that I u crcmpt fmm thc ContractoB' Liccnsc Law for thc following rcaon (Sa.7031.5
Business uld Profcssion Codc): Any City or County which rcquircs a lErmit to construct. ahcr, imprcvc, dcmlish or rcpair my
structurc, prior to its issuarcc. also rcquircs thc applicant for such lrcmit to filc a sigrcd statcmnt that hc or she h licenrcd puNilt
lo thc prcvisions of the Contractor's Liccn*d Law (Chapter 9. Comcncing with Sfftion 7000 of Division 3 of thc Busincss and
PrcfcssionsCodc)orthatheorshciscxemptthcrcfromsndthcb&sisforthcallcgcdcxcmption. AnyviolationofsctionT0Sl.5byany
opplicont for a lEnnit subjccts thc applicanl to a civil pcnalty of not rcrc thu fivc hundrcd dolltrs (9500).
-1.
as owncr of thc propcrty. or my cmpk)yecs with wages as thcir sole compcnsation. willdo thc work and thc stnrcturc is not
intcndcd or offered for sale (Sc.c.7M4. Busincss and Profcssions Code: The Contractor's Liccnse [:w does not apply lo an owner o[
thc proJrcrty who builds or inlprovcs thercon. and who docs such work himsclf or hcrsclf or through his or hcr own employces.
providcd that such improvenrcnts arc not intcndcd or offcrcd for sah. lf, howcvcr, thc building or improvcnrcnt is sold within onc )rcsr
of cornplction. thc Owncr Builder will have thc burdcn of proving that hc or shc did not build or improvc thc propcrty for the pur;nse of
sah).
-1.
as owncr of thc proprty. anr exclusivcly contracting with liccnscd contractors lo conslruct thc projcct (Scc. 7W. Busincss
and hotbssion Codc: Thc Contractor's License Law docs not apply to an owncr of property who builds or improves thereon,
and who contracls for such projccts with a Contructo(s) liccnscd pursuant to thc Contraclor's Liccnsc l-aw).
B. & P.C. for
?-
I)IiCLA ItA'I'I()N
I hcrcby aftjrm undcr pcnalty of perjury one of thc following dcclarations:
-l
have and will maintain a Ccrtificatc of Conscnt to Self-lnsure for workcrs' compensation, as providcd for by Section 3700 of thc
Labor Codc. for lhc pertbrrnancc of thc work for which thc pcrrnit is issucd.
-l
havc and will rnaintain workcrs' compensation insurancc. as requircd by Scction 3700 of thc Labor Code, for the perfornuncc of
the work for which this pcrmit is issued. My workcrs' compcnsation insurancc carrier arxl policy number are:
Carricr:-
Policv Numbcr: Exoires:
-l
ccrtify thal in lhc Jrcrfornunce of the work for which this pcrmit is issucd. I shall not cnrploy any lrcrson in any manncr
so as lo bccomc subjcct to thc workers'comlrcnsation laws of California, and agrce that if I should bcconrc subject to the
workcrs' comJrensation provisions of Scction 3700 of thc L-atnr Codc. I shall, forthwilh comply with thosr provisions.
WARNING: Failure to sccurc workcrs' compensation coverage is unlawful. and shall subjcct an cmploycr lo crinrinal pcnaltics and
civil lincs up to onc hundred thousand dollars (S1ffi.000). in to thc cost of cornpensation. damagcs as providcd for the
Scction 3076 of Codc. intcrest and attorrcy's [ces.
c.'
DECI ARATION
I hcrcby atlirrn undcr pcnalty of perjury that I anr licenscd undcr provision of Chapter 9 (conuncncing with Scction 7000) of Division 3
of thc Busincss and Profcssions Code. arxl my liccnsc is in full forcc and cffect.
Liccnsc Class: Liccnse Numbcr:
W
I hcrcby aflirm undcr pcnultyof lErjury that thsc is a @nstruction bnding agcrcy for thc Frforroncc of thc work for which this Ismit is
issucd (Scc. 3097. Civ. C.).
lxndcr's Nam:
Lcndcr's Addrcss:
APPLICANT DECLARATION
I hcrcby affinn undcr pnalty of perjury onc of thc following declarations:
Dcrnolition Pcrmits-Asbcstos Notification Fcdcral Regulations (Titlc 40, Part6)
-Rcquircd
lrttcr of Notification
-l
ccrtily thal thc fcdcral rcgulati<lns regarding asbcstos rcnmvalarc not applicablc lo this projcct.
-l
ccrtify that I havc rcad this application and stale that thc atnve information is corrcct. I agrcc to corrtply
, rcprescntativcs of this City
wrth all City and County
ordinanccs and Statc Laws rclating to building ufnn thc
above nrcntioncd proprty for
Applicant or Agent
I'ernrilee name
l^
and hereby authorize and
/n
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bf loor/Vent/l n s u I atio n
Roof Sheathinq
Shear Wall
Framing ?-l)-2 t D--€Ir-
lnsulation/Energy
Drywall
Ext./!nt. Lath
Brown Coat
[\Iasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
FINAL VID-71 g-{-9,2-
Certificate of Occupancy
Notes, Remarks, Etc.
/
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