HomeMy WebLinkAbout101108130 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, cA92702
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Building Permit #: tot{oEt3o
Pin #: 1O2A
Project Address: 1521 W Carriaqe Dr
Assessor's Parcel:412{11-18 Lot: 45 Block: NA Tract: 6036 Historic: No
Suite Range:
Zoning: Rl
Unit:Bldg. Address Range
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Single Family Dwelling
Reroof
Reroof
Occupancy:
Constr Type
Code
Flood Zone'.
# of Stories:
R-3
VB
cBc 2019
x-06023202s9J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd.
Valuation: $283.00
Description of Work: Tear off existing, resheath, and install I squares of comp roofing
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
Matt Tulve
1521 W Carriage Dr
Santa Ana, CA 92704
(808) 271-5885
Contractor: RH Roofing, lnc.
Address'. 702 S. Mohawk Dr.
Santa Ana, CA 92704
Phone: 17141 381 -1 870
State Lic #. 1007845
Lic Type' C-39
Bus. Lic #: 352077
Workers' Compensation lnsurance :
Carrier: Zurch-American
Policy #. WCl40631701
Expires: 0610112022
Engineer:
Address:
Phone:
License #:
Architect /
Desioner'
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd.
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscapang lnsp. Req'd:
web userwsu-us'+,O'
Date:
Date:
Date'. 10101/,2021
Subject to Field:
Misc. Receipt.
Misc. Receipt:
Misc. Receipt:
0 7776002
07776002
07776002
07776002
0 777 6002
57607
57770
57 672
s7 600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving Fu
General Plan Update
lssuance
$345.28
$4.05
$1 .00
$23.79
$s9.30No
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Account#Total
N/A - No Balance
N/A - No Balance
N/A - No BalanceEvery permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 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.
Fee Total:
Paid to Date:
Balance Due:
$433.42
$433.42
$0.00
Inspector MtD#' 2021-169194
I
INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Reroof
Roof (Diaphragm Sheathing/Frame)
Structural Final IOlZSlLI DITtr s2
Plumbing I
Under Floor I Under SIab
Rough
Shower Pan / Tub Test
Water Service
Sewer / Sewer Cap
Gas Air Pressure Test
Plumbing Final
Electrica!
Service (Meter I Panel)
Grounding / Bonding
Rough
Electrical Final
Mechanical
Gas Air Pressure Test
Rough
Piping (HW, CW, etc.)
Exhaust Ducts
Mechanical Final
Notes, Remarks, Etc
OWNTR BUILNER DELCARATION
lherebyaffinrrunderpenaltvofperlurvthatlanrexenrptfornrtheContractors'Lrcensel-au'forthefollowrngreason(Sec.70.ll 5Bustness
and Professron Code) Any Crty or ('ounty which requtres a pernut to construct. alter. rnrprove. denrolish or repatr any structure. prtor to tls
issuance. also requires the applrcant f<rr such pernrrt to file a srgned statement that he or she is licensed pursuanl to the provtsions of the
Contractor's l.icensed l,aw (Chapter 9. Conrnrencing wrth Section 7000 of Drvision 3 of the Business and Professions Code) or tltat he or
shetse\enlpttherefi'onrandthehasisfortheallegedexenrptron AnyvrolationofsectionT03l 5byanyapplicanlforapernttlsub.lectsthe
applicant to a crvil penaltv of not more than five hundred dollars ($5001
[1. ". o\ nerof rhe property. or my enrployees r+rth wages as therr sole conrpensalron. wrlldo ther.r,ork and fre structure rs not tnlended
or offered for sale (Sec 7044, Brsrness and Professrons ('ode The Contraclor's License Larv does not appll' to an o\\ner of the propcrty
wtro burlds or improves thereon. and rvtro does such rr,ork himself or herself or through hrs or her own employees, provrded that such
tmprovemenE are not rntended or offered for sale If. houever, tre btuldrng or rmprovement rs sold wrtrin one vear of completron. dre
Ouner Burlder rvrll have the burden of provrng that he or she drd not burld or improve dre properw for dre purpose of sale)
I$. ,r owner of the property. am exctusively contracting wrth lrcensed contractors to construcl the pro.lecl (Sec 7044. Busrness and
Profession Code The ('ontractor's l.icense Larv does not apply to an o\rner of property who builds or rnrproves thereon. and
who contracts for such projects rvrth a Contractor(s) licensed pursuant to the C'ontraclor's Lrcense Law)
No I ., exempt untler Sectron . B & P (' for this reason
WORKE' RS' COMPENSATION DECLAITATION
I hereby affirnr under penalty of perlury one of the followrng declarafions:
\l h.r. and will marntarn a Certificate of ('onsent to SelGlnsure for u,orkers' conrpensalron, as provided for by Sectton 3700 of the
l.abor Code. for the perfornrance of the work for which the pernut rs issued.
YES
_l have and will marntain workers' conrpensation rnsurance. as requrred by Section 3700 of the l,abor Code. for the perforntance of the
work for r,r'lrrch this permrt rs rssued. My uorkers' conrpensalton rnsurance carner and polrcy number are
FrmkCrum('arrrer
urc14ac-317{1
Polrcy Number. Exprres
NO
06t01t2022
_l certifv that rn the perlirrnrance of the work for whrch thrs pernut rs rssued. I shall not enrploy any person rn any manner so
as to lrecorrre sub,;ect to the workers'compensation laws of ('alifornra. and agree that if I should lrecortre subject tothe workers'
compensatron provisrorrsof Sectron.lT00of tlre l,nbor Code. I shall. forthwrth conrply with those provrsrons
WARNING Farlure to secure workers' conrpensatton coverage rs unlarvful, and shall subject an enrplover to crrnrinal penaltres and cn'il
fines up to one hundred thousand dollars ($100.000). rn addrtron to the cost of compensatton. damages as provided for the Sectron 3076
of the Labor Code. rnterest and attome'/'s fees
LICENSED CONTRAC:TOR DECLARATION
I hereby affirnt under penalty of perlury that I anr ltcensed under provlsion of Chapter 9 (conrnrencrng wrth Section 7000) of l)rvtsron.] of
the Busrness and Pro{bssrons ('ode. and nry license rs rn full force and effect
c39
l-rcense ('lass 1007E46
l,rcense Nunrber
(.ONSTRU('TION LENDING AG ENCY
I herebv affirnr under penalty of per1ury that there ts a construction lending agency for the performance of the work for whrch thts pernril ts
issued (Sec .3097. Crv C )
[.ender's Nanre
l,ender's Address
APPLICANT DECI.I\RATTON
I herebry affimr under penalty of per1ury one of the followrng declarations
Denrolrtion Pernrrts-Asbestos Notrfication Federal Regulafions (Trtle 40. Part6)
rc Requrred Lener of Notrficauon
YEg f cerrrfu that the federal regularions regarding ashestos removal are not applicable ro this proJect
I I cenrfu that I have read thrs apphcatron and state that the atnve rnformation is correct t agree to conrply with all City and C'otnty
ordinances and State Laws relatrng to burlding constructton. and hereby authorize represenlatrves of this Citv and County to enler upon the
above nrenlioned propertv for rnspeclron purposes
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