HomeMy WebLinkAbout101108273 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O11o,8273
Pin #: 15342
Proiect Address: 2734 S Rene Dra
Assessor's Parcel: 140-281-03 Lot: 3
Unit:Bldg. Address Range:Suite Range:
Zoning: RlBlock: NA Tract: 5580 Historic: No
Building Use: Single F.mily Owelling Occupancy: R.3, U lst FL Area: Patio:
Job Type: Reroof Constr Type: V B 2nd FL Areat T.l.Area:
Nature ofwork R.roof code: cBc 2019 other Areas: yads Reqd:
Existing Bldg. & use: sFD wr.tt G.r.go Flood zone: x.0602320259J Garage Area: v.tu.tion: glo,ooo.oo
Propo8ed U9e: # of Stories:
Total:
Daacaiption of Work Toar ofi sxlatlng roof matorial and instrll naw oomp rhingla rool matarial. Owen! Coming ayrten. Handout glven.
Planning Conditions:
Engineer:
Owner:
Address:
Phone:
Tenant:
Hazel Brown
2734 S. Rene
Santa Ana, CA 92704
(7141 466-0s72
Contractor. Heriberto Alcantar Roofing
Address: 1926 S Main St
Santa Ana, CA 92707
Phone: (7141 858-9225
State Lic #: 1030621
Lic Type: C-39
Bus. Lic #: 367186
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #. 9244082
Expires: 0111112022
Address:
Phone:
License #.
Architect /
Designer:
Address:
Phone:
License #:
$
t.
q
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
Chavez, Datgr, ?,
Machado, Miriam Date: 1011312021
Date:
Date: 1011312021
Subject to Field.
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
!ssuance
-:..
$34s.28
$4.05
$1 .00
$23.7e
$5e 30
$433.42
$0 00
$433.42
Misc. Receipt
Misc. Receipt
Misc. Receipt
07775002
07776002
07775002
07776002
07776002
57507
57770
57672
s7600
57607
Fire Insp. Req'd:
Police Insp. Req'd:
No
No Account#Total
Flood Zone Cert. Req'd: No
Every permit rssued 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 daysafter
the time the work is commenced.
01 1 16002 51600
01 1 16002 s1601
01116002 51612
01116002 57770
$23.79
$404.s8
$1.00
$4 05 Fee Total:
Paid to Date.
Balance Due:
!nspector MID#: 2021-169439
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BUTLDER DEI,CARATION
I hacb, affrm undo penalty of per;jury that I m qmpt from the ContBctoE' Liccrc t w for the followitrg t@$n (Se.7031.5
Buine and Prcfsion Codc): Atry City or County which rcquirc a pomh to coEtruct. a.lto. improvc, damlish or rcpgir uy
structrc. lrior to its issuucc. also rcquic thc applicot for such pcnnil to fil€ 8 signcd starmat thal hc or slE b licqE€d pdsart
to thc Fovisiom of thc Contrutor's Licascd taw (Chaptq 9, Commcncing with Setion 7000 of Division 3 of thc Bwins md
PrcfsionsCodc)orthathcorshcisexmptth@ftomudthcbcisforthcalhgcdcxmption. AtryviolationofSetionT0ll.5byily
applicut for a pcnnit subjcts thc spplicilt to I civil pcmlty ofnot morc thao fivc hundrcd dollus ($500).
-1.
as owner of the property. or my employees with wagcs as thcir sole compensation, will do thc work and the stnrctue is not
intended or oflered for salc (Sec.7044, Business and Profcssions Code: The Contraclor's License Law does not apply to an owner of
the property who builds or improves theron and who does such wort hirnself or herself or through his or her own employecs.
provided that such improvoncnts arc not intended or offered for sale. I(, however. thc building or improvernent is sold within one )€ar
of complaion" the Orvner Buildcr will havc the btuden of proving thd hc or she did not build or improve the proprty for the purpose of
sale).
-1,
as owner ofthe propcfly, am exclusively contracting with licenscd contraclors to cons,truct the projec-t (Sec. 7044. Buiness
and Pnoftssion Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a Contracto(s) licerued pursuant to the Contractor's Liccnse l-aw).
-l
arn exempt under Section-, B. & P.C. for this reason.
l)qto'
WO RKER.S' COTT{PENSATION
DECLARATION
I hoeby affrrm under penalty of perjury one ofthe following declarations:
_l have and will maintain a Certificatc of Conscnt to Self-lnsure for workers' compensation. as provided for by Section 3700 of thc
Labor Codc, for the performance of the work for which the pennit is issucd.
!t nuu" and will maintain workers' compcnsation insurance, as by Section 3700 of the l-abor Codc, for the pcrformance of
and policy numbcr are:the u'ork for pcrmil is issued. My workers' compensalion
L
Policy
_l certi$ that in the perfonnance of the work for which this permit is issued. I shall not employ any pcrson in any manner
so as to become subject to the workers' compensation laws of California, and agree that if I should become subjcct to the
rvorkers' compensation provisions of Scction 3700 of the Labor Code, I shall. forthwith cornply with thosc provisions.
WARNING: Failure to sccure work€rs' compensation coverage is unlawful, and shall :rn and
civil fines to one hundred thousand dollars ($100.000), in addition to the cost the
Section Labor Code, intercst and attorney's fees.
o 3 -R
DECI.AEAIION
t hwby affrm undc p@lty of p6juy that I m [msod undr povision of Chapta 9 (om6cing with Sdlioo ?000) of Division 3
of thc Buiae md Prcfsiom Codc, ud my licw is in full forcc and cffet.
a c3 Number:
b 0 6 I
W
I hmby alfnn undo pqalty of pqjury th8t thrc is 8 @Ntruclion l€nding ag@cy for thc pqfotlmcc of thc worl for which this pqmh is
issucd (Sa. 3097, Civ. C.).
Lcnder's Name:
knder's Address:
APPI TCANT DECI.ARATION
I hoeby affirm under penalty of perjury one of the following declarations:
Dernolition Pcrmits-Asbcstos Notification Federal Regulations (Title 40, Pafl6)
-Required
Lrtter of Notification
_l ceni& that thc
Hfr"*rrthat I have
federal regulations regarding asbestos removal are not applicable to this project.
read this application and state that the above information is correct. I agree to comply with all City and County
ordinances and State laws relating to building constructioru and representatives of this City and County to eflter upon the
abovc mentioned property for inspccrion purposes.
Applicartt or Agertl
Pcrnritee namc
- lo-
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloo r/VenUI n su latio n I e,.
Roof Sheathinq lol I ,vl7l
Shear Wall
Framinq
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Jtlasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
.1
FINAL t9 VLWL )VV O I
Certificate of Occupancy
Notes, Remarks, Etc.
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