HomeMy WebLinkAbout101107756 - Permit-l-City 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 #: {01107756
Pin #: 86354t
Project Address: 907 E Clemensen Ave
Assessor's Parcel: 396-41 1-24 Lot: 19
Unit:Bldg: Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 4226 Historic: No
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Single Family Dwelling
Solar
Solar
SFD w/ garage
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
R.3, U
VB
cBc 2019
AE-06023201 63J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area
Yards Req'd
Valuation:$2a000.00
Description of Work: lnstal! new rof mounted solar PV system. Per PV checklist.
Planning Conditions:
Batchi:6tt+.{5 8/24/2ttZI I0: oriloroleslI
0f'f ice: (:TYH Trgns*: 39 I of I
Acct* : Ref *: lrrl 1 117756
JU6l l M l+l L\tll rLl; Llv Hll
Owner:
Address.
Phone:
Tenant
Jeffrey Collins
907 CLEMENSEN AVE
Santa Ana, CA 927056714
(949) 682-6718
Contractor: Nerd Power CA
Address: 13614 Carolina Hill Ct
Draper, UT 84020
Phone: (602) 715-0407
State Lic #: 1019100
Lic Type: C-10
Bus. Lic #: 377230
Workers' Compensation I nsurance:
Carrier: WCF Mutual lns Co
Policy #: 3468038
Expires: 0612112022
Arashi tion lotni
143 Saint Thomas Drive
Oak Park, CA 91 377
s6285
t503,6i
$45tt, [t0
$1 . [t[t
$52.65
$:itts. 65
Authi:55 7723
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone.
License #:
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
Fire lnsp Req'd No
Police lnsp. Req'd: No
Ffood Zone Cert. Req'd: No
Zuniga O,,,rrM
Date:
Date:
Date: 0812412021
Subject to Field:
Misc Receipt:
Misc Receipt:
Misc Receipt:
07776002 57607 Permit Fee
07776002 57770 Microfilm Records
07776002 s7672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Totat
Paid to Date.
Balance Due:
$450 00
$s2 65
$1.00
$0 00
No
No
No
No
Account#Total
01116002 51601
01 1 16002 51612
01 1 16002 57770
$450 00
$1 00
$52 65Every 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 suspe nded or abandoned for a period of 360 days after
the time the work is commenced
$503 65
$0 00
$503.65
lnspector MID#: 2021-168350
BUILD!NG. INSPECTOR RECORD
S!TE.WORK DATE ID/SIG.COMMENTS OWNERBUILDERDEI,CARATION - 'I hmby affim undo pcaalty of pcrjury thst I an cxcmp ftom thc Contracto6' Liccrc Law for thc following tlen (SE.7CJI.5 iBuinas ard Profasion Codc): Atry City or Counly which requira a po'mit to coNtruct. alt(, improvq danolish or repair oy
structue prior to its issuocc. also rcquirc thc applicut for such pcmit to filc a signcd samot that hc or shc b lictred pwant
to thc provisioE of thc Contractor's Liccnscd l:w (Chapta 9. Commcncing with Sation 7000 of Division 3 of thc Busins md
Prcfe$ions Code) or that he or shc is cxempt thqefrom md the b6sis for the allegcd exmption. Any violstiotr of Setion 7031.5 by uy
applicatforapemitsubjetsthe applicanttoacivilpcnaltyofnotmorcthefivehundreddollas($500).
-1.
as owner of the prop€rty. or my employees with rvages as their sole compensation. will do thc work and the structure b not
intended or offered for sale (Sec.7044. Business and Professions Code: The Contractor's License larv does not apply to an owner of
the properry who builds or improves thereon, and who does such wort himself or herself or through his or her own employees,
provided that such irnprovanents are not intended or off€red for salc. l[. howerrer. the building or improvement is sold within one year
of cornpletion" the Orvner Builder will have the hrden of proving tha he or she did not build or improve the propoty for the purpose of
sale).
-1,
as owner of the propcrty, am exclusively contracting with licensed contractors to construct the project (Sec. 7M4, Business
and hof€ssion 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) licensed pursuant to the Contractor's License Law).
-l
am exempt undcr Section-. B. & P.C. for this reason.
WORKER.S' COM PENSATION
DECLARATION
I hereby affirm under penalty of po'jury one of the following declarations:
-l
have and witl maintain a Certificate of Consent to Self-lnsure for work€rs' compensation, as provided for by Section 3700 of the
L^abor Code. for the performance of the work for which the permit is issued.
-l have and will maintain workers' compensation insurance, as rcquired by Section 3700 of the l-abor Codc. for the performance of
the work for which this pcnnit is issued. My workcrs' compensation insurance carrier and policy number are:
\rJCf toS., ca nC<
poricy*,,*,- 34G<AO3( Expires: b lql l2o"-L
-l
certify that in the performance of the work fior which this permit is issued, I shall not employ any person in any manner
so as to become subject to the workers'compensation laws of California. and agree that if I should become subject to the
rvorkers' compensation provisions of Section 3700 of the labor Code, I shall. forthwilh comply wilh those provisions.
WARNTNG: Failure to secure workcrs'
civil fines up to one hundred thousand
Section 3076 of the Labor Code, interest
compensation is and
dollars ($100.000).the
fees.klh*r Iq^
I hereby affrm under pcnalty of perjury that I am licensed 9 (commencing with Section 7000) of Division 3
of the Business and Professions Code. and my license is in full force and effect.
t c=-lo I0tq (co
License Nurnber:
Ur
W
I hrcby affm undo pemhy of pcrjury that thsc is a construclbn krding agocy for the psfomcc of the work for which this pqmh b
issucd (Se. 3097, Civ. C.).
[:ndo's Nme:
Lcnder's Address:
APPLICANT DECLARATION
I horby aflinn under penalty of perjury one of the following declarations:
Demolition Pennits-Asbestos Notification Federal Regulations (Title 40. Parr6)
-Required
Letter of Notification
-l
certi& that the federal re{ns regarding asbestos rernovalare not applicable to this project.
_l certify that I have read this application and state that the above information is correct. I
ordinances and State Laws relating to building construction
above rnentioned property for
Applicrnt or Agent
Permitee
hereby althorize
2r(
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/VenUl ns u lation
Roof Sheathinq
Shear Wall
Framing
!nsu Iation/Enerqy
Drynruall
Ext./lnt. Lath
Brown Coat
Nlasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
rl ,t 0t
F!NAL la\u A D'tVV ,-l
Certificate of
Notes, Remarks, Etc.
l)alc:
,",", O8 l2t[/7o- I
Puw a
all City and County
of this and County to enter upon the
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