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City of Santa Ana <br />Permit Counter: (714) 647-5800 <br />20 Civic Center Plaza (M-19), Santa Ana, CA 92702 <br />!nspection Requests: (71 667-2738 lnspector Section: (714) 647-5853 <br />t(Building Permit #: {O{96E9O <br />Pin #: 34177 <br />Project Address: 1105 S Oak St <br />Assessor's Parcel: 011 -074-10 Lot. 10 <br />Unit:Bldg: Address Range:Suite Range: <br />Zoning: RlBlock: D Tract: 466 Historic: No <br />Building Use: Singlo Family Dvrelling Occupancyt R3 1st FL Area Patio: <br />Job Type: Ahsration Conatr Type: vB 2nd FLArea: T.l.Area: <br />Nature of Work ssi8mic Rs&ofrt code: cBc 2016 ohe.Arqgsl ,. . yardqmu ig@p. <br />::"r'lnil:"u '*' sFo w'DEr GAR I'lfflll x{802s20276J <br />:::* {ii: : . v"riiritiqh;ii, rp,egpoo <br />Total: i O. " ""'' <br />,1.,i,, <br />De.crlption of Work: Volunl.ry 3.l3mlc retrcflt to sfd only. lnBtall (t) pu6h pler6 & polyurethane foam bslow siab <br />"nd <br />f.ornd"tiol;,.r, ,, ,. , , <br />Planning Conditions: No exterior alterations or modifications Genennl F lnn Updqte Feefll I 1 AftftT- I I r,rifrfrfrfr-$??.IJB <br />Owner: <br />Address: <br />Phone: <br />Tenant: <br />Mr Jorgensen <br />1 105 S Oak Street <br />Santa Ana, CA 92701 <br />(909) 957-9192 <br />Contractor: A-1 Concrete & Constructiot <br />Address: 781 N Loren Avenue <br />Azusa, CA 91702 <br />Phone: (626) 523-5222 <br />State Lic #: 972625 <br />Lic Type: B, C-8 <br />Bus. Lic #: 370992 <br />Workers' Compensation lnsurance: <br />Carrier: Everest Nat'l lns Co <br />Policy #. 7600018129181 <br />Expires: 0912112019 <br />tHelfrich ASsociatbs <br />Steven C }lelfrich <br />30640 XrlSUn Court <br />Redlands, CA 92373 <br />(sos) 38917326 <br />Engineer: <br />Address: <br />Phone: <br />License #: <br />Architect / <br />Desiqner. <br />Address: <br />Phone: <br />License #: <br />rrit 1r-rr-rU- <br />voJ v ins <br />,i I ?t-tlJU-- <br />$215.29 <br />t I. . tttl <br />$,1 . .itj <br />6[.tt-tt-ttl[t <br />040046 : <br />I <br />i <br />Planning Approval By: <br />Plan Checked By: <br />Permit lssued By: <br />NPDES lnsp. Req'd <br />PWA lnsp. Req'd: <br />Planning lnsp. Req'd: <br />Landscaping lnsp. Req'd <br />Fire lnsp. Req'd: No <br />Police Insp. Req'd: No <br />Flood Zone Cert. Req'd: No <br />No <br />No <br />No <br />No <br />Escamilla, Manny <br />Chehade, Nabil <br />Amsden, Julie <br />Date: 0612812018 <br />Date: 1012212018 <br />Date: 1110512018 <br />Subject to Field: <br />Misc. Receipt: <br />Misc. Receipt: <br />Misc. Receipt: <br />07776002 <br />01776002 <br />07776002 <br />08907007 <br />07776002 <br />07776002 <br />07776002 <br />Permit Fee <br />Plan Check Fee <br />Microfilm Records <br />SMIP - Category 1 <br />Bldg. Stds. Revolving <br />General Plan Update <br />lssuanceAccount# <br />71 188 <br />Total <br />57607 <br />s3600 <br />57770 <br />24000 <br />57672 <br />s7600 <br />57607 <br />Fee Total: <br />Paid to Date: <br />Balance Due: <br />$160.25 <br />$222.16 <br />$15.04 <br />$2.34 <br />$1 .00 <br />$22.08 <br />$5s.04 <br />$477.91 <br />$213.86 <br />$264.05 <br />Every permit rssued shall become invalid unless the work on the site authorized by <br />such permit is commenced within 180 days afterifs issuance,or if the work authorized <br />on the site by such permitis suspended or abandoned for a period of 180 days after <br />the time the work is commenced. <br />01 1 16002 51600 <br />01 1 16002 51601 <br />01 1 16002 51612 <br />01 1 16002 53600 <br />01 1 16002 57770 <br />08901001 2400a <br />$22.08 <br />$215.29 <br />$1 .00 <br />$8.30 <br />$15 04 <br />$2 34 <br />lnspector MID#: 2018-144349