HomeMy WebLinkAbout101100903 - Permit (2)'r6L Cig of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA s2702 Building
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@ Permit Counter: (714) 047-s{oo tnspection Requests: (714) oo7-2738 lnspector Section: (714) o47-5853 .- -*'.--
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Permit #: { O{ 1OO9O3
Pin #: 130.23
Proiect Address: 1 E MacArthur Pl
Assessor's Parcel: 411-071-05 Lot 5
Unit Bldg:
Tract: 13802
Address Range:Suite Range:
Zoning: SD43Block: NA Historic: No
Buildrng Use:
Job Type
Nature of Work:
Existing Bldg & Use
Proposed Use:
Commercial
Tenant lmprovement
Lobby remodel
Commercial office bldg
Occupancy:
Constr Type
Code.
Flood Zone:
# of Stories:
B
I A, SPK
cBc 2016
x-0602320278J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total.
Patio:
T.f .Area: 2l4O
Yards Req'd
Valuation: $370,000.00
Description of Work: Lobby remodel - install new ceiling only
Planning Conditions:Eotch
tif'f i c
Owner:
Address:
Phone:
Tenant:
Ocean West Capital Partners
2101 Rosecrans Ave, Suite 3270
El Segundo, CA 90245
12131261-9422
Contractor: Coastline Development
Address: '139'l 'l Enterprise Dr
Garden Grove, CA 92843
Phone: (7141 265-0250
State Lic #: 485187
Lic Type. B
Bus. Lic #: 161044
Workers' Compensation lnsurance:
Carrier: Benchmark
Policy #: CST5014784
Expires: 0110112020
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Ware Malcomb
Lonnie R. Stephenson
10 Edelman
lrvine, CA 926'18
(s49) 660-9128
c-22710
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp
PWA lnsp. Req'd:
Planning lnsp Req'd:
Landscaping lnsp Req'd
McCann, Melanie
Anson
Dale. 0712912019
Date: 08/20/2019
Date: 10/30/2019
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
73252
Total
07716002
07776002
07776002
07776002
07776002
07776002
57607
s3600
57770
57672
s7600
51607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg Stds. Revolving
General Plan Update
lssuance
Fee Total:
Paid to Date:
Balance Due
$712.40
$986.40
$66.47
$15 00
$22.95
$57.20
$1,860 42
$986 40
$874.02
No
-No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert Req'd: No 01 1 16002 51600
0'1116002 51601
0'1 't '1 6002 51 61 2
01116002 57770
Account#
Every permit issued shall become invalid unless lhe 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
$769 60
$15.00
$66 47
lnspector MtD#. 2019-1s3222
Amsden, Julie
BUILDING. INSPECTOR RECORD
ID/SIG COMMENTSDATESITE.WORK
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/VenUl nsulation
Roof Sheathinq
,AShear Wall vdlu\Framinq i-tz-V
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
7o
Rema Etc.
FINAL
Certificate of Occu
I colify thal in the perfonrance ofthe Nork for Nhich
w as tr beconre subjal to the workes'compenstion larvs
fo lkrwing (Sec.70.1 ,5
this pemit is issued. I shall not mploy my pe6on in any milnq
ofCalifomia. and agrc lhat ifl should b€come subj(t to the
()\\ N I t()N
lhalrrjury e\cnlPl frorn lhe ConlracloB'-tcense Ias for lhehsebyalTirrnunderpenahy
Businss md Profsion Code): Any ('ity or Couily shich requirG a p€nnil to conslrucl. altd. improve. donolish or repoir any
struoure. prior ro its isumce. also rcquire the applicant for such pennit to filc a signed slarmmt thal hc or she is licf,sed pmu'int
to the provisioro of the Contractor's Licensed Law (Chaplq 9. Commencing N ilh S(lion 7000 of Division J of the Busines and
profcssionsCode)orthatheorsheiseremptthBefiomandlhebsisfortheallegedcxmption. AnyviolaltrnofSationT03l.5byany
applicantforapmitsubjststhe applicanttoacivilpenaltyofnotmorethanfivehundrcddollds($500)
_1. o owns of the pnopeny, or my employec wilh wag6 6 their mle cornposalion. sill do the work dd the slruclue is not
intodsl or offqed for sle (56.7M4. Busins ild Prof6siom Code: The Contraclor's Licmse Law doe not apply to d out6 of
the pmtEly rvho buil& or improvs lhqon. od rvho doe srch $ort himself or h6elf or thrcugh his or ho orvn employec.
provided lhat such imptrovflols ilc nol intoded oroffaed for sle. lf. horvo'o, the building or improvmol is oH rvilhin one )q
ofcomplaion. the O*oq Builclq *,ill have the htrdo ofproving thd he or she did not build or improve the gopqly for the purpos of
sle).
l. m owner oIlhe propoty. an exclusivcly contracting wilh licensed contractoB to construcl the preject (Str. 7044. B6ins
and PmfesionCode: TheContractor'sLiccnseLawdoesnotapplylomownaofpropenyN'hobuildsorilnprovesthqq)n.
and who conlmcls lor such Fojects with a Contmcto(s) Iicmsed pumudl to lhe Conlractor's Licmsc Lau').
I dn exempl unds Setion --. B. & P.C. for this reoon.
of
Loder's Addrsr
Owner:l)rlel
WORKERS' COMPENSA'IION
DDCLARATION
I hereby affirm undq poalty ofpojury one ofthe following declarations:
_l havc od will maintain a Cc(ificate of Const to Self-lnsure for rvorkm' contpcnsstion. 6 provided for by Sstion 3700 of thc
Iabor Code. for thc psfonnmce o f the u'otk for lvhich the pqmh is i$ued.
I have and will maintain rvorkos' compemation insurancc. 6 required by Setion -1700 of th€ tabor Code. for the [sfommce of
the work for which this pmil is isued. My workas' compesation insuroce cmia ed policy numbq se:
BArzf +,rrqrz,<
Policy
--Expn""'
/'/- 2o2 o
workss' cornpenelion provisiof,s ofsection 1700 ofthe t-atnr (bde. I shall. fodh$'ilh comply with those provisions.
WARNIN(i: Irailure lo sdure works's'compffiation coverage is unlarvful. and shall subject an onployer to oiminal pmaltiB and
civil finesuptoonehundredthousanddollas($100.000),inadditiontolhecoslofconlpensation.donagesoprovidedforthe
Section 1076 ofthe Labor ('ode. inlerGt and atlomey s fccs.
l,t( ENSED ( ON] R"\( 1()R
t)t:( t,ARAl loN
I hoeby affirrn undo poalty of p€rjury lhat I m licmsed undr provision ofChapts 9 (commocing rvith Scclion 7000) of Division 3
of the []usinas and Profssions Code. od my license is in full force md effct.
ct*'B 'l-iccnsc Nunlber:/ts / ?7
'O -3o1?conrracror: C D T
CONSl RU('1 ION LENDING ACEN('Y
I hereby aflirrn undo penally ofperiury th.t llrse is a conslnrction lcnding agency f()r lhe pofonnmce oflhe rvork for which lhis ftrnil is
issued (scc. 3097. Civ. C.).
Lendcr's Name:
APPI,I(]AN'T DECLARATION
I tertry allim under poralty of pcrjury one ofthe following dcclilalions:
Dmlolition Pqmits-Asbdtos Notification Fedoal Regulations (Title 40, Part6)
-Required
Ldltr of Notificalion
-l
cgliry lhd the fedsal regulatiom rcgading Gb6tos ranoval tre not spplicable to this prcjct.
I cfitify lhal I have read this application ild state lhat the ahrve inftrnnation is const. I agrc to cotnply lvith all Cily and County
ordinancG and Srate Laws relating to building conslruction. md hocby authorDe rcpr6mtaliv6 ofthis Cily and County to mld upon the
above iltenlioncd prope(y for inspection
or,\grtrl on",/a - 3o '/ 7
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