HomeMy WebLinkAbout105108189 - Permit)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 #: 105{08{89
Pin #: 228{3
Ln^I
Proiect Address: 802 E Seventeenth St-a- -
Assessor's Parcel: 398-161 -04 Lot: 6
Unit:Bldg:Address Range: 802-808
Historic: No
Suite Range:
Zoning: C5Block: NA Tract: 1459
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use
Proposed Use:
Fourplex
Alteration
Legalize Window Change Out
4 Unit Apartment
Occupancy:
Constr Type:
Code:
Flood Zone'
# of Stories:
R-1
VB
cBc 2019
x-06023201 63J
1st FL Area
Znd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation:$11,500.00
Description of Work: Legalize window change out for 4 unit apt
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Alejandro Ruiz
3604 W Roberts Dr
Santa Ana, CA 927042333
(7141 788-3ee7
Contractor: Owner-Builder
Address:
Phone:
State Lic #.
Lic Type:
Bus. Lic #.
Workers' Compensation I nsurance:
Carrier.
Policy #:
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
Off i ce: CTYH Trnns*: 27 I of 1Acct*: Ref*: 1115108189
Rcpt*:1t34311Ztr lit/ 6/2tr21 113 49 Ail
Tronsoct i on Totol i799 .64
Aleiondro Ru i z
Gener nI Flan Updqte Fee $?3 .7!
Lrl I l6trr-r2- 51611000tJ-
Bu i ld i ns {771t, g[l
'11
I 16002- 516Lr10trtr-
Blds Stds Revolvins $l.[r[t
rll I 161102- 516120til1-
NOTICE oF vlolAtloN
Expires: License f:
Martin, Eric
.r:_o77767;o2=:p!ggt ppJlnrt_Egei j ^, .,,tL.t.i; f.*ttl**t**tf i-i i;.j ijijr-.lrt.i07776002 57770 Microfilm Records
07776002 57507 lnvestigation
07776002 57607 Penalty
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
07776002 57607 lssuance
Hernan dez, Kathy
Total
Flood Zone Cert. Req'd: No
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days after lfs 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
Date. 1010612021 Misc. Receipt:
Date: Misc. Receipt:
Date: 1010612021 Misc. Receipt:
Subject to Field:
No
No Account#
01 1 16002 51600
01 1 16002 51601
01116002 51612
01 1 16002 57770
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA Insp. Req'd: No
Planning lnsp Req'd: No
Landscaping lnsp. Req'd: No
Fire lnsp. Req'd.
Police lnsp. Req'd
$345.28
. :. r
$4 0s
$1 04 26
$261 96
$1 00
$23 79
$59 30
$23 7e
$770 80
$1 00
$4 0s Fee Totat
Paid to Date:
Balance Due:
$799 64
$0 00
$799.64
lnspector MID#' 2021-169283
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNERBUILDERDELCARATION . T
I hocby affrm unda poalty of pcrjury that I m qcmpt fiom thc Contraclom' Licffi kw for thc following r@n (Sc.7031.5
Bwincs and Profeion Codc): Any City or County which rcquirc a po'mit to @mtruct, alta, improvg dmolish or rcpair uy
structuc, prior to its issuece, also requirG thc applicut for such pdrnit to filc s signed stalm@t that hc or $c b licqEd plmilt
ro thc prcvisioru of the Cotrtretor's Licgscd L:w (Chapts 9, Commcing with Sctioo 7000 of Division 3 of thc Buine ud
Prcfsions Codc) or that hc or shc is exanpt ths.from ud thc basis for thc allcgcd cxmpion. Any violation of Selbn 7031.5 by 8ny
applicanl for a permit subjets thc applicut to a civil pcmlty ofnot more the livc hundred dollas ($500).
_1. as owner ofthe prope(y, or my employees with wages as their sole compensation. will do thc work and thc structue is not
intendod or offered for sale (Sec.7044, Business and Professions Code: The Contractor's Licerse law does not apply to an owner of
the propo'ty who builds or improves thereon. and who does such work himself or hcrself or through his or her own employees,
provided that such improvonents are not intcndcd or offered for sale. I[, hower/cr. thc building or imp,rovan€nt is sold within onc ]ear
of complaion, the Orvner Builder will have the burden of proving tha he or she did not build or improve the property for the purposc of
sale).
-1.
as owner ofthe property, am exclusively contracting with licensed contracloni to construcl thc project (Sec. 7044, Business
and hoftssion 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 Contracto(s) licanscd pursuant to the Contractor's Licanse l-aw).
_l an exempt undcr B. & P.C. for
orru,l0 - Q*2F71
I hereby alfirm under pcnalty of perjury one of the following
-l
havc and will maintain a Certificate of Consent to Self-lnsure for workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which the permit is issued.
-l
have and rvill maintain workers' compcnsation irsurancc, as required by Section 3700 of thc l-abor Code. for thc pcrformance of
the work for which this pcrmit is issued. My workers' compensation insurance carricr and policy numbcr are:
Carrier:
Policy
_l certi& that in thc pcrformance of thc work for rvhich this permit is issued. I shall not employ any person in any manner
so as to become subject
workers' compensation
to thc work€rs'com[rcnsation laws of California, and agree that if I should become subject to thc
provisions of Section 3700 of the Labor Code, I shall,forthwith cornply with those provisions. .
and shall subject an onployer to crirninal penalties andWARNING: Failure to secure workers' compensation coverage
civil fines up to one hundred thousand dollars ($100,000), in
Section 3076 of the Labor Code, interest and attorney's fees.
is unlawful.
addition to thc cost of compensation l4mages as provided for the
o*",10 -'0f - 202,u_z
I hercby affrm under penalty of perjury that I am licensod 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
License Nurnbcr:
f):r I r.'
W
I heby affm unda pcoalty of pojury thal thqc is a congruction loding agocy for the pqfonMcc of thc wrt for which this pqmil b
issucd (Sc. 3097, Civ. C.).
Lender's Name:
Lender's Address:
APPI.I('A N'I' DT.]C LAITA'I'ION
I horby affinn under penalty of perjury one of the following declarations:
Demolition Permils-Asbcstos Notification Federal Regulations (Title 40, Pan6)
-
Required Lrtter o f Notification
-l
coti$r that the federal regulations regarding asbcstos removal are not applicable to this project.
_l cenify that I have read this application and state that the above
ordinances and State [arvs relating to building construction and
above mefltioned propcrty for inspcction purposcs.
Applicnnt or
Permitee nnme
orr", l0 - ol-P2(
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloo r/Ve nUI n s u latio n
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./!nt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif.
A I I ,/
FINAL lrl u>l ul ff|ff,>/
Certificate of Occupancy
Notes, Remarks, Etc.
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