HomeMy WebLinkAbout10196186 - Permit (2)I
City of Santa Ana 20 Civic Csnfr:r Piaza (M-19), Sanla Ana CA gt!702 Building
PermitCounter: (714)647-5SA0 lnspr:ction Requests (714)6;87-2738 Inspector Section. (714)647-5853 <.]
Permit #: 10196186
Pin #: 86{29
Proiect Address: 1666 N Main St
Assessor's Parcel: 005-153-19 Lot: NA
Unit:Bldg: Address Range:Suite Range:
Zoning: SP3Block: NA Tract: NA Historic: No
Building Use.
Job Type.
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Multi-Family (5 or more units)
Revision
Revision
Commercial
Residential
Occupancy:
Constr Type
Code
Flood Zone:
# of Stories
A-3, B, R-2, S-2
IA,VB,SPK
cBc 2016
x-06023201 63J
5
1st F l- Area.
2nd FL Area
Other Areas:
Garage Area:
Total: 0
Patio:
T l.Area:
Yards Req'd:
Valuation:
Description of Work: Revision to 10191745. Structural seismic retrofit revisions
Planning Conditions:
Owner:
Address:
Phone:
Tenant
Santa Ana Arts Collective LP
1640 S. Sepulveda Suite 425
Los Angeles, CA 90025
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Contractor: WestportConstructionlnc.
Address: 125 W.Maple Avenue
Monrovia, CA 91016
Phone: (6251 447-2448
State Lic #: 712732
Lic Type: B
Bus. Lic #: 12345
Workers' Compensation lnsurance:
Carrier: Everest National lnsurance Co.
Policy #: 7600015708171
Expires: 1110112018
DCA Structural Engineering
David Choi
1327 Lima Avenue
Long Beach, CA 90804
(562) 382-8040
4784
Studio One Eleven
Michael P. Bohn
245 E. Third Street
Long Beach, CA 90802
(562) 901-1500
c21695
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner.
Address:
Phone.
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Pezeshkpour, Ali
Heidari, Fred
Hernandez, Kathy
Date: 05/29/20'18
Dale: 0512412018
Date: 05/29/20'16
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Flood Zone Cert. Req'd: No -O+1{.600tS3500_ {fr+S7€?
07776002 5i600 Revision
07776002 57600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
70862
$1,497.02
$0.00
Fire lnsp. Req'd:
Police lnsp. Req'd:
Yes
No Account#
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 authonzed
on the site by such permit rs suspended or abandoned for a perroc.l of 180 days afler
the time the work is commenced.
$1,497 .02
$855.44
$541.58
lnspector MID#: 2O16-133i'04
o lrlQPeSTLou t 6ctl €y
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS
Set Backs ZN> Flsq- /1E!-
Forms/Steel/Holdowns ffi 6_2f.6 /zr-?)
Erection Pads \-Z
UFER Ground
SLAB Floor
Subf loor/VenUlnsu lation
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enoineer Final Report
Flood Zone Certif
A-+ti-79F!NAL LL l9 Pe /?D:>*'2u'J
Certificate of Occupancv
Notes, Remarks, Etc.n
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4-z
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OWN I:R BUILI)I.]R I)tiLCARATI()N
I hcreby allirrr undcr pcnrlly of pcriury th{l I trnr cxctrrpt lionr thc Conlractu's' I"icensc [,aw li)r thc tolkrwing reason (9cc.7031.5
Busincs\ rn(l Profcssi()n Codc): Any City or County which rcquircs a pcrnlit to conslrucl. altcr. intprovc. dcnr:lish or rcpair any
D .t*,.trr". prior to ls issurncc. il\o rcquircs lhc ilpplicrnl lor such Frnril lo filc a signed strtctrrnt lhal lt (I shc is liccnscd pursuanl -
/ tothcprrrvirirrnso,'thcCorlrnck)r'sLiccnscdLaw(Chxptcrg.CorrncncingwithScctiorT(XX)ofDivistr;n-lofthcBusincssantl'
l'roltssiolsC(xle)orlhlthcorshcisexctrptlhcrclronrrndlhehisislirrlhcallcgcdcxcirplion. Anyvkrtti(,nofS(tion7(].1l.5hyxny
npplicanllbrnpcnDilsubjcclslhe 0pplicrnlloacivilnctraltyofnoln()rcthnnl'ivchundrcddollrrs($5(X)) o
-1.
as owncr of thc prolEll y. or il1y cnrpkryccs w il h wagcs as thcir solc conrpcnsrtirrn. \'ill do tlrc work and llE stMlurc i\ un
iilcndfrl 0roflcrcdforsnlc(Scc.7(N,l.BusirrcssandProlcssionsC({lci'lheCofltrrck)r'sLiccnscl-ilwdocsnolxpplytoanowncrof
thc pn)pcrly who builds or inrl)roves thcrmn. and who (l(,cs such work hiillsclf or hcrsclfor through his or hcr own cmployccs.
providcdlhalsuch improvctrEnlstrcnolinlcndcdorolltrcdlbr$llc.ll.howcvcr.lhcbuildingorimprovcrmnlirsoldwithiD('ncvcitr
ol cotrrplcli(trr. lhc Owncr Buildcr will hatc Ih( burdcn ol proving lhnt hc or shc dil Dol huild or imprcrc lhc pnrFny lor lhe purfx)s of
srh).
_1. as owncr of lhc pn)pcrly, ilm cxclusivcly contracl ing wilh Iiccnsc(l contraclors t) conslrucl (hc projccl (Sec. 7(144. Busincss
and l'rrrft'ssirt Codc: Thc Conlraclor's l.iccnsc Law rlocs not aplly lo an owmr ol propcrty who huilds or inlpr)vcs lhcrcon.
and sln) conlracts li)r such projccl\ wilh a Conlraclo(\) liccnsc(l pursuxnl lo lhc Contrilctrr's Liccnsc [n!v].
_l atrr cxcrnpl undcr Scctio[_ . It. & P.('. li)r this rclson
Dale:Owner:
1\'ORKERS' CoI\IPENSA'TI(IN
DECLARA'IION
lhcrchyilllirnrun(lcrpcnaltyolperjuryoncol'thcli)lk,iviilgdcchrxti(,ns:
-l
hurc or)d will DEinlrin r Ccnificrlc ol'Coilscnt k) SclLlnsurc lur workcrs conrlrcnsalion. ns providcd l'()r by Scction -17(x) of thc
litDr Codc. li)r thc pcrforiluncc oflhc work lbr which lhc pcrnrit is i\\ucd.
lhc wn'k liil' which lhis l)crnil i\ issuctl. My workcrs' conrPcnsation insurrncc crrricr nn(l policy runrhcr arc:
(
l\)licy ir cs:
-l
ccnit.y lhat in the perli)rmaocc of lhc work for which this lcrrlit i\ issucd. I shnll nol cnukry any pcrson in any nrilnncr
so ns k, lEco[rc suhjcct t) thc workcrs' coilrlrcnsal kxt laws of Califonr ia, nnd xgrcc I hat if I sh()uld hccorrc suhjcct to thc
workcrs' conrpcDsalion provisions oI Scction -]70O of thc l-atnr Corlc. I shrll, li)nhwith cotrlply wilh thosc prrvisions.
WARNIN(,: l;ailure kr sccurc workcrs'conrfcnsxli()D covcragc is unlawful. and shilll subjccl rn crnploycr lo crirninnl pcnillics a0d
civil lincs up lo onc hundrc(l lhousand dollars ($l(X).(Xn). in arldition lo lhc c{)sl o[compcnsalion. dxtrugcs as provi(lcd li)r lhe
Scction 3076 o, thc Lrtnr (ixlc. inlcrcsl nnd alhrNy s lL'cs.
I)ate: - Applicant:
LICENSED CONTRACTOR
DECLARATION
I hcrcby affirm undcr frcnahy of pcrjury that I am liccns{ undcr p()vision of Chnf,lcr 9 (comnrencing with Scction 7fi)0) of Division 3
of thc Busincss and Profcssions Codc. and my liccnsc is in full li)rcc and cffcct.
I-iccnsc Cld\s:_Liccnsc Nunlbcr:
Drte: Conlraclor:
CONS'IRUCTION I I.:NDINC A(;I'NCY
lhcrcbyallirnrundcrptrnllyofpcrjurylhnl lhcreisacon\tructifilcndingagcncylirrthepcrfornunceoflhcworklbr*'hichlhirJnrmitis
Civ. C.).
Lcndcr's Arldrc\s:
)APPLICANT DECI.ARA'IION
I lrrchy allinr undcr pcnrlly of pcrjtx y onc of Ihe lirlkrwing dcclamtirrrs:
@mdition Pcrmits Asbcstos Notificalion Fcdcral Rcgulations (Tille 40. Pan6).Z
-Requircd
lrtlcr of Ndilicalion
_l ccnily lhat thc fcdcral rcgulations rcguding asbcsk)s rcmoval arc nol applicablc lo lhis pro.iccl.
-l
ccnify thlt I havc rcad;|is agpJication ud stalc lhal lhc ah)vc infonnntion is corccl. I agre to comply with all City and Counly
:ffJ#}ic|ff:ilffrfl#d,H'iiiH::lstruction. and hcrcbv authorizr rcprcscntarivcs orthis cirv nnd countvro cnrcr upon thc
2pplicanl
or Agent Signalure - _
Permitee nome (prinl):
!-,W fu**f
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