HomeMy WebLinkAbout101101770 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Building
PermitCounter. (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-58 'fiJ
Permit #z 1O11O177O
Pin #: 43373
Proiect Address: 400 S Grand Ave Unit Bldg: Address Range:Suite Range:
Zoning: SD16Assessor's Parcel: 01 1-313-02 Lot: NA Block: NA Tract: NA Historic: No
Owner:
Address:
Phone:
Tenant
Public Storage
71 Western Avenue
Glendale, CA 91201
(818) 2/14-8080
Public Storage
Contractor: lconldentitySolutions
Address: 1418 Elmhurst Road
ELK GROVE VILLAGE, IL 6(
Phone: (847) 631-3207
State Lic #: 796721
Lic Type: C45
Bus. Lic #: 365906
Workers' Compensation lnsurance:
Carrier: Nat'l Fire lns Co of Hartford
Policy #: 605742861
Expires: O3l28l2O2O
Engineer
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Graham, Jeffery
Amsden, Julie
Hernandez, Kathy
Date:10/03/2019
Date:10/09/2019
Dale: 1012312019
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002
07776002
07775002
07775002
07775002
07L76002
57607
53600
57770
57612
57600
57607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg Stds. Revolving
General Plan Update
lssuance
Fee Totat
Paid to Date:
Balance Due:
$166.53
$1 15.44
$39.1 0
$1.00
$22.95
$s7 20
$4O2.22
$0.00
$402.22
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't116002 51601
01 'l 't6002 516'12
01 I 16002 53600
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 the site by such permit ls suspended or abandoned for a period of360 days after
the time the work is commenced.
$22.95
$223.73
$1.00
$1 15.44
$39.1 0
lnspector MID#: 2019-154875
Building Use: Othor Occupancy: NrA 'lst FL Area Patio:
Job Type: Sign. Constr Type: NrA 2nd FL Area T.l.Area:
Nature of Work: Sign.illuminated Code: CBC2016 OtherAreas yards Reqd
Existing Bldg. & Use: Public Storag6 Flood Zone: X-0602320276J
proposed use: # of stories: Garage A'ea valuation: $4'300 00
Total 0
De6cdptlon of Work In6tall (1) led-illumineted ch.nnel lott6. wall sign & (2) non-illuminatod Blgn6 fo, "Public Sto,rgd:, Dond porbd on tl-7Ell69
Planning Conditions:
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenUl nsu lation
Roof Sheathing
Shear Wall
Framing
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enoineer Final Report
Flood Zone Certif
/.\
3-31JoF!NAL V.il-tcl\
Certificate of Occu
Notes, Remarks, Etc.
OWNT:R BU II,DER DIiI,(]ARATIoN
IherebyalfirmunderpenaltyofperiurflhatIaneremptfromtheConlrack,n Licmsel.arvforthefollosingre6on(S(.7(ll.5
Business and l'rofession Cocle): Any Cily or ('ounty rvhich requir$ a pqnit to conslnrct. alts. improve. demolish or repair hny
slruclue. prior lo ils issuance. also requirs the applicant for such fmDit lo file a signcd statmmr thal he or sh€ is licmserJ pursufnt
to lhe provisions of the ('ontractor's Licensed l,arv (Chapter 9. (innrncncing with Scction 7000 of Division .l of the lJusiness and
Profcssions Codc) or that he or she is exentpl lhoefion and lhe b6is for lhe allescd exernption. Any tiolation ofS(tioil 70.1 1.5 by .ny
applicant for a pennit subjects thc applicant to a civil penally ofnot more lhan five hundred dollars ($500).
1.6 orvneroflheproFErly.ornlyemployeBrvilhrvagsaslheirsolecornpensation,willdolheworkaildthcslnKtueisnot
intorded oroffcredforsle(Sc!.T044.BusinmandProlessirrnsCode:IheConlrackrr'sLicmse[-asdo6notapplytoano$'nsof
thepropdy rvhobuildsorirrprovathqqrn.odrvhodoesuchwofthimselforherselforlhroughhisorherorvnemployes.
provided that such irnprovenenls ue not intmdcd crroffsed for slc. lf. howq,6. lhe trrilding or tnprorerDmt is $ld wilhirr oile yw
ofconrplelion, the Clrvncr Buildq u'ill have lhe burdo ofproving that he or she did not build or inrprovc the pmpoty for the puryrs of
slc).
_ I.morvnerofthepropfly.ancrclusivclyconlractingwithliccnsedcontrackJrstoconstnrcltheprojecl(Sec.7044.UusinNs
md ltofushn Code: l he Conlraclor's License l,a$ dos nol apply lo an owner ofprolEny \r'ho builds or improve therann.
and who conlrads for silch pro.jects rvith a Contraclor(s) licmsed pursuant k) lhe (l)ntraclor's l.icense l,arv).
-
I dn exempl under Secttrr-_
Dnte:()il trer:
WORXERS' CO[IPENSAllON
DECLARATION
I hoeby allinn unde penalty of gmjury one of thc follorving clelaratiom: ,
-_ I have md will rnainlain a Ce(ificate ofcoLsent to Self-lnsure for works's compensation. o provided for by Setion 3700 oflhe
Latxrr Code. for thc petfonnance ofthe rvork for rvhich the pmnit is issued.
-lhaveandrvillmaintainrvorkss'cornpensalioninsurance.6
requiredbySstion3T00oftheLaborCode,forthepsfonnanceof
lhe work for which lhis pennit is Lssued. My rvorkos' composation insurance catq ild policy numbq ile:
('miq:
Policy Numbqi -,Expires: .-
I cenify that in the perforrunce ofthc work for which this prmit is issued. I shall not onploy any poson in any manner
m astobecomcsubjellothervorkos'compensalionlawsofCalifomia.andagrethatiflshouldbecomesubj(ltolhc
rvorkm'composationprovisionsofSection3T00oftheLah)rCode, lshall.fonhwithcomplyrviththosprovisions.
WARNINC: Iailure to sure workers'compensalion colsa8e is unlarvful. ald shall subjrt m mployu to qfuninal poatiG and
cilil finesuploonehundrcdlhousanddollm($100.000),inadditiontothccoslofcompensation.danagescprovidedforthe
S(lion 1076 of the tabor Cod€. inlo6l and attomey s le6.
,^r., /o - ?3- Lotg oppr"^nr, I C - ----
r-r
DECLARATION
I hrcby affirm unde pmalty of pqjury that I an licmsed undo provision ofChapts 9 (commencing wilh Sction 7000) ofl)ivision l
of the lJusiness and Profssiom Code. md mv license is in full force anl elfecl
[J. & l'.C. for lhis reasotr.
Liccnsc ('lass:
l-crrdcr's Adtficss:
l.icensc Numtrcr:
oate, /o' 23' ?2L1 .on,."uo.,(a a
lhcrebyal1.irmunrJopmul.,ofo".i.,o,ho.,hffiq-firnnanceofthcwor.kforwhichlhisporilitis
issued (Se. 1097. Civ. C.).
Lenrler's Narne: _
APPLICANT DtrCLAIIA'I'ION
I horrry- aflinn under penally oI pejury onc of the follorving delarations:
Dernolition Permils-Asbestos Nolificatbn F'ederal Rcgulalt)ns ( l itlc 40, Pat6)
, Requiredl-dtqofNotification
I ccl1il-y thnl lhc lt(lcral rcgulalions rcgruding ashcstos rcrrrrval rrc nol .pplicnl)lc lo lhis proiect.
atrevc nrentioncd propmy lor irrspection puqress.
ApplicsntorAgentsignarure: L
2 -
OL,'s-ku\
oare: lo Z3'Zotl
l'ernritce tramc (pritrl):