HomeMy WebLinkAbout101103179 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests (714)667-2738 lnspector Sectlon (714)647-5853
Permit #: I Ol 1O3179
Pin #: 3O66-a\
Proiect Address: 1539 S Standard Ave Unit Bldg: Address Range Suite Range:
Zoning: MlAssessor's Parcel 014-321-14 Lot:16 Block: NA Tract: 5085 Historic: No
Owner:
Address:
Phone:
Tenant
Tesoro Refining and Marketing Cor Contractor: Allen lndustries
539 S Main St Address: 11351 49th St
FINDLAY, OH 45840 Clearwater, FL 33762
(210) 626-6000 Phone: (7271329-3406
State Lic #: '1009452
Lic Type: C-45
Bus. Lic #: 375157
Workers' Compensation lnsurance:
Carrier: American Zurich
Policy #: WC343290
Expires: 'lOlO1l2O2O
Engineer:
Address: 2840s
Canyon
A&SEnglneeringlnc.
Nader Ghaderi
Phone:
License #:
Architect /
Desioner:
Address:
Phone.
License #:
(818)
36475 Ii1(
ii I
n
rt11l6D02-
llicrofilrr
ll1 I 1.5t:tu2-
I (:l (:hecll
Road, Suite B
91387
Jfi(rri
Planning Approval By:Guevara, Jerry
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd
PWA lnsp Req'd
n, Julie
Amsden, Julie
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Fire lnsp. Req'd: No
Police lnsp Req'd. No
Flood Zone Cert. Req'd: No
Date: 01/16/2020
Dale. 0211912020
Dale 0211912020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
lVlisc. Receipt:
07776002
01"176002
07776002
0LL15002
0L715002
07776002
5L607
53600
57770
57672
57600
57607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Total:
Paid to Date:
Balance Due:
$166.53
$115.44
$93.84
$1.00
$22.95
$57.20
$456 96
$0 00
$455.96
No
No
No
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 the site by such permit rs suspended or abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 51600
0't116002 51601
01 1 16002 51612
01 1 16002 53600
01116002 57770
lnspector MID#: 2020-157154
$22 95
$223.73
$1.00
$11544
$93.84
Building Use Commercial Occupancy: N/A 'lst FL Area: Palio
Job Type: Signs Constr Type: N/A 2nd FL Area: T.l.Area:
Natureofwork Signs code cBc2019 otherAreasr yards Reqdl
Existing Bldg & User Seryice Station Flood Zone: X{602320276J
Garage Area Valuation: $15,000.00
Prooosed User # of Stories: Totat
Deacription of Work: Replace faces on existing pol. sign; change display to digital; badgo sign "S Express". , iBond peiC on M.74155.
Planning Condition6:
2- 5tt
(
BUILDING. INSPECTOR RECORD
Rev. 08-07-201 5
SITE.WORK DATE !D/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl 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
,tt I
'/l/lrt1 -rr*YJr:7tFINAL
Notes, Remarks, Etc.
IherehyallirmunderpenaltyofFrjurythatIanrexemptfronrlheContractoN Licenselawforthefollowi.Srcaen(Scc.7031.5
llusincss and Prolbssion Codc): Any City or County which rcquircs a lrcflnit to construct, alter, irnprovc. dcmlish or rcpair any
struclure. prirr to its issuance. also rcqrircs lhe applicant for such frrnil b filc a si8rcd slatenBnl that he or shc il licctoed pursant
lo lhc previsions of thc Contractor's l,icenscd [-aw (Chaptcr 9. Comrncncing with Scclion 7(XX) ol Division 3 o[ lhc Busincss and
ProtessionsCode)orrharheorrhcisexempttheretromaBlllEhasistbrrlEallegedexemilion. AnyviolariooofsectionT03l.5byany
applicrntforrpennirsubjeclslhc npplicanlroncivilpe0rllyolnolmorethatrlivehundreddollars($500).
_L as owncr o l'thc propeny. or my c.nployccs wilh wagcs as lheir sole cornpcnsation, will do thc work md thc structre is ml
inend*l or offcrcd for $le (S4.7O44. Busincss and Pmfcssk)[s Codc: Thc Conlraclor's Licensc ljw docs not apply to an owncr of
thepn)peny wlx)buildsoritrprovesthersLlrdwlhdoessuchworkhimselfothcrselforthroughhisorherownemployccs.
prorid('d that such impmvcrrcils are mr intcrylcd or ollcrcd for sah. ll. howcvcr. lhe h{ilding or improvctmnt is sold within onc }ril
ofcon{rletiur, the Owrrcr Buikler will ltsvc tlr burden of proving lld lr or shc did not boild or impmve thc prclrny for tlt purpose of
salc).
_1. {s owner of lhe propefly, rm cxclusively contracting with licenrd conlrsch)N to construct lhc pmjcct (Scc. 7(X4. Business
aill I'n)lLssiilCode:TheContrackrr'sLicenscLawdoesnotapplytoanowncrofpropenywhobuildsoritugroveslhereon.
and who contracts lor such projccts wilh n Contractor(s) liccnsd pursuant kr ttrc Coolraclor's License Law). '
-Ianlexemptundclsccli()n-'B.&P.C,li)rthisrcasotr'l)nlr:_
WORKI]RS' COMPI.:NSATION
DECLARATIoN
I hc'reby allirm undcr pemlty ofp..juryonc ofthc lbllowin8 declaralions:
_lhaveandwillminlainaCcniticateofcotlsenttoSelf-lnsureforworkcrs'comJrcnsation,as prcvidcdforbyScction3Tmofthc
Luttr Codc, for thc perforrunce ol'thc work lbr which lhc pcrmit is issucd.
\(haveandwillmaintainworkers compctrstioninsurance,!s requircdbyScclion3?00oflheLabo.Cod.,fortheperfomrccof
lhc\ork for which this pcrmit is issucd. My workfrs' comlrcnsrtion insurancc cffiicr anl fDlicy numho ue:
A rg D t)s
*,,,,n", lpe u q33zqo ,,.,r,,",, /e-of - z'o20
-I
ccf,ity that in the Jtrtornuncc of thc work for which this pcrnrit is issusl, I shall not cnrploy any 1rcrson in any manncr
s as lo hccorrc suhjcct to thc workers' conrpensation laws of Cnlilornia. ntrd agrcc that if I slnuld hccorrc subject to lhe
wodicrs conrpensatioD provisions of Section 3700 of thc trbor Code, I shlll, fo(hwi(h conrply with dDs prcvisions.
WARNINC: Failurc k) scurc workcrs'conrfcnsation covcBgc
civil lines up to one hundred thousand dollirs (Sl{)0,(IX)t. in r
Secti(,n J076 of lhe tilxrr C(xle, iilere$ and attoruy s fees.
is unlawltl. nn(l enrJrkrycr to qiminul Fmltics ud
lion. d{nulges N provided for lheaddilion ro rhd
t,,1" 'Z''11'?1)21)
I hcn'by al lirm undcr JX.nally ol pcrjury thnt I arn liccnscd undcr ol Chaprcr I (commncing with Scction 7000) of Division 3
of tlN Busincss snd Prcfcssions Codc. ard nry liccose is in lill fbrcc and clfect.
[-iccnsc a,".., G -4 f, Liccnse Numbcri z
CONSTRT'CTION I,I:NDlNG AGENCY
I herchy aflirm uuder lEilal(y of pcriury that thec is a coilslructiql leildirg a8ercy for rhe pcrfomance ofthe work for which this p€mit is
irsued (Scc. .1097, Civ. C.).
l,cndcr's NJnrc:
l-Ln(lcr's A(khos\:
APPLICANT DECLARATION
I hwby affm!nder pcnahy of perjury onc of the followirrg declarations:
Dcnplirion P€rmils-Asb.stos Norification Fcdcral RcSulations (Tirlc 40, Pan6)
-Rcquired
lf,ltcr of Notification
cenily thar rhe lideral reSulnriors regddinB rshestos rcnxrval arc not applirable k) this projed.
rhal I have r.nd rhis application ad stalc thrt lhc abov. info@lion is corcct. I agre to clmply
rcpresntatives of this City
wilh all City and County
and County to enter ulDn tlEand State Laws relatir)g t) huildiilg
atxrrc nrntionctl propeny f'()r inspccti()n puqnscs-
or A8cnt
rc-\
P(nililft natrre oile
Certificate of