HomeMy WebLinkAbout10190267 - Permit (2)I
Cify of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #z 1fJ19o.267.
Pin #: 13697'
Proiect Address: 611 E First Sta
-
Assessor's Parcel: 398.491-35
Unit:Bldg: Address Range: 607-61'l -
Tract: NOAH PALMER Historic: No
Suite Range:
Zoning: SD84Lot: 10 & 11 Block: C
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Commercial
Signs
Sign
Auto repair
N/A
N/A
cBc 2013
x-0602320276J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $2,500.00
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
Oosc.iption ofWork: lnstall('l) non-illuminated wallsign tor " "Fix Auto w/ Logo and Autobody & Paint", bonC,posted on M-68389. \elter of aulh on lile.
Planning Conditions:
Ac,:Li: Rel*: 1019r:rlr'7
F(ir,ti:1t1614i71 - 8/1112$t6 ?!14 i:'n
I I-Llil}Lr r:L I tl[l uL(lt DI rt-!.-Il.Lri]
Owner:
Address:
Phone:
Tenant:
Dean C Berto
521 TORREY PINE PL
Arroyo Grande, CA 934205000
(805) 489-8060
Fix Auto
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
Generul Flnn Updnte Fee
Ul 1 l6ilLr2- SlSLlLrLrrll:r-
["r-r,.idins
lJl I 161il:r2- i16t:rllrUr:r-
P.lclg 5tdE, ftr:vi:1v ins
r-r1 I 1,(rrir2- i16 12LrL[:l-
F/i: tui1dins
r-rl 1 lor-rr-r2- 536ttULt0tl-
I ( t- i:,i erir 1 I 396?
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Denrr i: il.er'lc
'i?0.56
$iltll,51
$1. ull
it iLr3.46
Slrr_r5t.Lt6
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp.
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Orozco, lvan
Amsden, Julie
Amsden, Julie
Dale 0712812016
Date: 08/03/2016
Date: 08/11/2016
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07776002
07776002
07775002
07776002
57607
s3600
57672
s7600
57607
Permit Fee
Plan Check Fee
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Total:
Paid to Date:
Balance Due:
$149.25
$103.46
$1.00
$20.56
$51.26
$325.53
$0.00
$325.53
No
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 1 16002 51600
0'l 1 1 6002 51 601
0't116002 51612
01 1 16002 53600
Account#Total
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 180 days after its issuance,or if the work authorized
on the site by such permit ls suspended or abandoned for a period of1 80 days after
the time the work is commenced.
$20.56
$200.51
$1.00
$103.46
lnspector MID#: 2016-130334
o\l'Nt R Dt[l,l)t.R l)]rL( ARA t ()N
to lhc fln\isions ofthc (.onlraclor's Licensed [-aN (('hapl$ 9. (bilrnreilcin8 \ith Scclion 7000 ofl)irisi()il 1 ofthe l]usiness and
.pplicant for a pcrilrit slbj{ts lhe afplicant to a cir il penalty ofnot rx)re lhan fi\'c huil(hcd (lollars ($50(l}
l.as orncrofthcproryny.ornryeilfkl)eesuilhsagcsaslhrirsolcconrpcnsaliur.sillrlothcrrorkaulthcstnrcllrcisn{)l
and $'ln) conlraclsforsuchpr()icctssilha(i)rnrnckn(s)liccnsc(lpursuailllollrc(oDtract(rr'sl-iccilsel-is')
rilder Sftti(nr
aso$ncrofthepropft.ame\clusi\elvconlraclin8\ilhliccnsc(lconlrrcloNlocorslrucllheprr)iect(Scc 701'l.l}isirrcss
l] & l'( lirrt
fru
DE('I,ARA'I'ION
I hoetry aflirrn under penaltl. ofpojurl one ofthe follon irrg delaratiors:
_lhavemdrill nraintaina('e(ificaleo[(i)nseillloSelf-lnsurefor\\l]rko's coirlensntbn..s pro\idc(l forlr)Sdlioil700ofthe
l-abor Corle. for the po fdrnance of Ihe rvork firr shich thc pornit is issuccl.
the trrrrk for uhich this permit is issucd. Nl! $orkqs c(nnfcnsali()n insurancc canicr antl Brlicr nunrbcr nrc:
(-an'icr
Nurnbcl
U-,lJL1
I:\pir cs:
cffify thal in lhe perfornlance ofthe s'ork for shich this ptrmit is issrc(|. I shnll not employ anl poson in anr rranncr
so as to become sul)iecl to lhe wd'ko s' conrpensation laws of Cali fomin. and agrce I hat i f I should bcconre sul)iecl lo I hc
workos' conrpensaltrn pr ovisions o I Setion -1 700 of lhe l -f,txn Code. l shal l. fonh\r it h cotrrpl\ u'it h t hosc pr ovisirrs
WARNINC: Faihre k) *cure workers'coilpensalion coYemse is unlarvful. antl shall subject an enrphvcr to oirni[.] lu]alti6 and
ciril fines up to oile hundted thousntl dollars (Sl{}0.000). in addition to lhe cosl ,cortprrsation. darraccs as pror irlccl for the
Secti([ 3076 olthe t.al\n'(\xle. inlcrsl {nd allor nc!-s
,",". tlr, I tta
DECT"\RA'I'ION
I hcreby aflir rn undo penahy ofperjury that I am licensd under p[)r isiol of( haptr 9 (conrnrcncirrg r ilh Secliotr ?0(x)) of l)irision -]
of the Business and Profesions Code. and nry license is in full forte ancl effccl
License Class:
Drte:
Liccnse Nurnlxr:
I colify lhat the fcderal regulal ions regruding aslstos rerno\.al ar e nol alplical)lc to this fro.isl
cgtifl that I har e rcad lhis applicati()n aild slale lhat thc nlx)\ c in li)l nlal ion is cor r ecl. I arrr! lo c(rillpl!
( 0n(raclor:
CONS'I'RUC'I ION LENDIN(; AGTNCI'
I herctry allirm under penahy ofperjury that thse is a con$ruclirrr lmdirrg agency for the pofonrancc oflhe rrork for \ hich lhis pefinit is
issued (Sec. -1097. Civ. C.).
Lcnder's Nnme:
I-endcr's Addrss:
APPLICANT DECLAR IION
I ho-cby allinn under penalty of perjury one oflhc folkrrving declarrtions:
Demolition Pqrnits-Astmtos Notification Federal RCEUlatioils ( I ille 4(). Pai6)
Required l,ctts of Notifi calion
ao(l Slalc I-aNs rrlalirg lo huikling cooslruction. antl hcrclrv arilhr)rizc reUcscntilliles oflllis ( ilv
\ ilh all City nil(i (i)unty
and (irunly lo ento upon th€
f,l l ltv
l'(rnl
AA&tlsr
QL+<y'
firr^r",
SITE-WORK DATE ID/SIG.COMMENTS
,Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/VenUl nsu lation
Roof Sheathinq
Shear Wall \
Framinq
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report \
Flood Zone Certif
i-rK*vlFINAL -)
Certificate of Occupancy Y V
Notes, Remarks, Etc
>
BU!LDING. INSPEGTOR RECORD
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