HomeMy WebLinkAbout101101772 - Permit (2)city of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA 92702
Permit Counter: (714)647-580C lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Building Permit #:1fJ11fJ1772
Pin #: 28198#
Proiect Address: 3759 S Plaza Dra
Assessor's Parcel: 412-131-12 Lot: NA
Unit Bldg Address Range: 3701-3795
Historic: No
Suite Range:
Zoning: CRBlock: NA Tract: NA
Building Use: Commercial Occupancy: N/A 1st FL Area.
Job Type: Signs Constr Type: N/A 2nd FL Area:
Nature of Work: Sign Code: cBc 2016 Other Areas:
Existing Bldg. & Use: Commercial Flood Zone: X-0602320259J Garage Area:
Proposed Use: # of Stories.
Total:
Description of Work: lnstall (1) non-illuminaterl channel letter wall sign for "Winding Road Racing", bond poBted tln M-73611
Patio:
T.l.Area:
Yards Req'd:
Valuation:
0@0
$3,775.00
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
Metro Towne Square
3694 S Bristol Street
Santa Ana, CA 92704
(714) s46-28s6
Winding Road Racing
Contractor: America's lnstant Signs dba
Address: 1265 Manassero Street
Anaheim, CA 92807
Phone: (714) 693-2989
State Lic #: 1023555
Lic Type: C.45
Bus. Lic #: 365933
Workers' Compensation lnsurance:
Carrier: State Compensation lnsurance Fur
Policy #: 9231694
Expires: OSl15l202O
Engineer:
Address:
Phone.
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Planning Ap ! Bv:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
, Verny
en, Julie
Brodowski, Teri
Date: 10/08/2019
Date: '10/09/2019
Date:10/10/2019
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002
07776002
07776002
07776002
07776002
o7776002
57607
53600
57770
57672
57600
57607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$166.s3
$1 15.44
$19.ss
$1.00
$22.95
$57.20
No
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 1 16002 51600
01116002 51601
01116002 51612
01116002 s3600
01116002 57770
Account#Total
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after its issuance,or if the work authorized
on fhe site by such permit ls suspended o r abandoned for a period of 360 days after
the time the work is commenced.
$22.95
$223.73
$1.00
$1 15.44
$19.s5
Fee Total:
Paid to Date:
Balance Due
$382.67
$0.00
$382.67
lnspector MID#: 2019-154963
Generol PIqn Updste Fee
Lrl I 16trlr2- 516t:r0cr0tr*
Buildins
Lr1 I 160(12- 516(110Lr0-
Blds S[ds Revolvins
Lrl 1160tr2- 516l2olrlr-
P/C Eu i ld ing
Lr 1 1 16(t02- 536t-r00ltu -llicrofilr & Oocunents
rrl 1 16U02- 5777r:r0Lrlr-
ICL Chectr LrLr691+
BUILDING. INSPECTOR RECORD
SITE.WORK rD/stG.COMMENTS OWNER BUILDER DT'LCARATION
I h6cby amrm undcr poally of perjury that I m exempt fiom the Conlraclos License Larv for lhc followinS reen (Se.70,3 1.5
[]usincs and l'rofssion Code): Any City or County which requir6 a pqmil to constmcl. aho. improve. dcmolish or rcpair any
structu'e. pior to its issuance. also requirG the applicant for such pennil lo file a signed statenol thal he or she is licmsed pureuant
lo thc pro\isions ofthe Conlractor's Licensed larv (Chapts 9. Cornrnencing \ith Setion 7000 ofDivision.l ofthe Businss md
I'rofcssionsCode)orthatheorsheiseremptthfiefiomandtheb6isfortheallegcdexernplion. AnyviolationofSectionT0,ll.5byany
applicanl for a pennit subiects the applicant to a civil penalty o f not nrore than five hundred dollms ( $500 )
[. c orvnv o f the pnrfErty. or my employeG rvith rvags as their sole cornpcnsat ion. $,ill do thc work md lhe strudue is nol
intmdc{ orolloedforsle(Se.T044,BusinssandProfssionsCode:'lheContrnckrr'sl-icenscl-arvdo6nolapplyhanownqof
lhcpropqty rvhotnildsorirnprovsthson,mdrvhodossuchr\od(hintselIorhcrsclforlhroughhisorheorvncmployees.
providedthalsuch imprcvsnenlstrenolintmdedoroffqedforsle. Il.hou'eve.thcbuildirrgoritnprovqncnlissoldvithinoney6
ofconplclion. the Oyner Buildq will have the burdm ofproving that he or she did not build or imprtxe the propGly for the purfise of
salc).
I.asorvncrofllrepropcrly.anrexclusivelycontacting$ilhliccnsc(lcoDlrilclomlo!onslNctlhcpr()icct(Scc 70.l4.llusincss
and l\ulhsior(ixle: lhc(\)ntr0ctor's[-icense[,a\\,docsnolapplytoanoNilcrolp(]pcrlylvhobui[lsorinrprovesthcrcon.
a0d rlo conlractsforsuchprcjectsrvilhaConlmcl(il1s)licerse(lpursuatillothc(inilractor'sl.iccnscl.aw).
I dn crenlpl under Selion B. & P.C. for lhis renson-
Date: owner:
WORKERS' ('OI\IPENSAI'ION
DECI,ARA'I'ION
I hereby affirm undr penalty oflnjury one oflhe follorving dmlarations:
IharemduillnraintainaCffificateofconsmltoSelf-lnsureforrvorkus compcnsattm.m prolidedforbySfftion.1700oflhe
[rk)r ('odc. for lhe psfomarce of the s'ork for which lhe polnil is i$ued.
I have aild Nill rnaiiltain rvorkers cornpensation insurance. m rcquircd by Sectitm 3700 ofthe l.abor (hdc. for the ptrfonnance of
thcrrcrkforshichlhispcnnitisissued.Myworkss cornlnrsalioninsrrancccanicranr! Jxrlicy_numbcroc:
('an icr:
Policy Numtrcr:l:\pilcs.
I cciify that in lhe perforrnance oflhe rvork lor rvhich this permit is issued. I shall not enrploy any psson in any mlnner
so as to lsonre subj<l to the wofkm' conlptrsation laws of California. and agree that if I should lBome subie-t to thc
rvorlus' cornpensation provisions ofSetion 3700 oflhe t,abor Code. I shall. fonhuith comply rvith tho$ provisions.
WARNING: faihre to sure rvorkers'compensation coiqage is unla$'ful. and shall subjst .n qnplo)'er lo qiminal Frnaltis and
civil llnes up o one hun<Ired thousand dollos 100.000). in addilion b the cost of compens.tion. dalnaSes as pror.ided for the
Seclion .1076 ol the Lalr)r (-ode. inlerest les.
t)l.t( l,AR.A I toN
I hcrcbyaflirrn undcr pnallyoIpcrirry I an licensed undcr provision of( hrptu 1) (cornillencing $ ilh Scction 7000) of I)i!ision -'1
ol lhc llusincss and l\rrfrssions (irdc. trd nry license is in full &rrcc url clfcct
l.iecnsc ( lass Liccnsc Nurnbcr:
l)xlr 1o (/to U1
I hcrcby allirnr unda ;rnaltyof psjurylhat
issucd (Scc. ,10S7. Civ. C.).
l-endq's Name:
ion lcnding agerrcy lirr thc ptr lirrnrancc ol lhc \1r k for \\ hich lhis per ilril is
Lcndcr's Arkltss:
APPLICANT DECLARATION
I hrttr)'affinn under poalty of prjury one ofthe follos'ing delaations:
[)enrrlition Ptrmils-Asbestos Notification Fedqal Regulations (Thle 40. Pan6]
Rcquircd Ldtq of Notification
Nith all City and Count)
and Counly lo flltr upon lhe
I corifv tlylhc fcdcral regulations regrding asbestos remoralarc not applicatrlc to lhis projcrr.
t .or\tf l"r" ,."d this application md state that the atx)\e inft)nnalion is corccl. I agrcE k) comply
rrdinonccs af(,State l-ass rclating to building conslruclion, md hereby authorize reprscnlali\$ oflhis ('it)
ah're nrcntFnell frrtrncrty frrr inslmtirrn puryxrsq.
nppricanr/orngcnrsrrrr* % l)rre:
Pcrtr,ircetr5y'_ frlr*fo &W*l
/o/ra1/?
Set Backs
FormsiSteel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bfloor/VenUl nsulation
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
I
FINAL 1///z.to -ffi h
Certificate of Occupancy '/'U
Notes, Remarks, Etc
DATE
r>*", (o1/o I lQ