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HomeMy WebLinkAbout10196857 - Permit (2)City of Santa Ana 20 civic center Plaza (M-19), santa Ana, cAg27o2 Building Permit Counter: (714\ 647-5800 lnspection Requesls: (714) 667-2738 lnspector Section: (714\ 647-5853 q Proiect Address: 3779 S Plaza Dr Lot Block: NA Tract NA Historic No Suite Range Zoning Unit Bldg: Address Range: M V B, SPK cBc 20'16 x-0602320259J 1st FL Area 2nd FL Area Other Areas: Patio: T.l.Area: Yards Req'd 700 Description of Work: T.l. - Demo partition walls and install new walls to create restroom. Planning Conditions: Garage Area: Valuation: S25,130.00 Totat Botch?r{5ofi? - 7lfitzola I0: cct.lEl'LAR'''"' il;ie;;'ciii rrsnsf : {t 4 -el c XIL{;;- -"' R!r+: 1ote68s7fliiiiuar+tn - Tnfrtmts lt:15 Arlii-oiiiliii'i'iitot tlr6e3'2tt BSG West Bristol LLC 5 Park Plaza lrvine, CA 926'14 Phone: Tenant \ li-)- \t Contractor: GoldlineConstruction Address: 3004 Gainsborough Dr Pasadena, CA 91107 Phone: (6261222-6174 .- State Lic #: 994034.) Lic Type: B Bus. Lic #: 370OO2 Workers' Compensation lnsurance: Caffier State Compensation lnsurance Fur Policy #: 91343'l l Expires; 06/03/20'19 Crenerol PIon uPdote Fee o1l16092- 516m000- 8ui ld ineolrl6ffn- 5l60lm0- Bldg Stds Revolvin! 01,16(tr2- s1612000- ""n,."'ffiffii&moo-vrncenr l{flrrof lh f, 0ocurents 132a2 H{tllg r- 5?77!000- Garden quuecftkl2B44 Og:2O7, (714) 7194558 Engineer t22.08 t230.0{ t2.00 t7.00 t30. u8 t I r 693.20 Phone: License # Phone: License # ,,,",,"n1t{oi..Ilr%Ll Plan Checked By: Permit lssued By; NPDES lnsp. Req'd: PWA lnsp Req'd: Planning lnsp. Req'd: Landscaping lnsp. Req'd v\7 - Soto. Rrcardo Chehade, Nabi Zuniga, Allissa No No No No Date: 06/14/2018 Dale.0712612018 Dale: 07/30/2018 Subject to Field: 71171 07776002 07775002 07776002 0 77760 0 2 07776002 0 77760 0 2 57607 5i600 57770 5 7672 5760 0 5760 7 $175.00 $245.00 $30.08 $2.00 $22.08 $55.04 Permit Fee Plan Check Fee Microfilm Records Bldg. Stds. Revolving General Plan Update lssuanceFire lnsp. Req'd. Police lnsp. Req'd No No Account# Flood Zone Cert. Req'd: No Every permit issued shall become invalid unless the work on the site aulhoized by such peftnit is commanced within180 days aftet its issuance.or il the wo* authorized on the site by such permit is suspended or abandoned fot a peiod o1180 days after the tine lhe wotu is comnenced $529.20 $238.00 $291.20 lnspector l\AlD#. 2018-144079 01 1 16002 01 1 16002 01 1 16002 01 1 16002 01 1 16002 51600 51601 516't2 53600 57770 $22.08 $230.04 $2.00 $7.00 $30.08 Permit #: {O{96857 Pin #: 53461 Assessor's Parcel: 412-131-12 Building Use: Commercial Job Type: Tenant lmprovement Nature of Work: T.l. Existing Bldg. & Use: gepmsTcialoff ices Proposed Use: Occupancy: Constr Type: Code: Flood Zone: # of Stories: Owner: Address:Address: Architect / Desiqner: Address: Fee Total Paid to Date: Balance Due: Misc. Receipt: Misc. Receipt: Misc. Receipt; Total BUILDING- INSPECTOR RECORD SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILlIER TIEI,CARAT'ION I h.rcby il6nn rndcr Fnahy of Frjury rhd I un cichpr lmnr rh. (inr.lctri l-iccik Llw f.r ih. f.ll.wng rds (Scc.7o.ll5 trusincss {.d ProLsion Codc)r A.y Cny or Counrt which mqrn.s , pcnni o .onslru.l, ,llcr. improvc. demolhh or rcnrn ony struclurc. t orlo ns issuarcc- oho rcquncs thc optlicMi for su.h F mi Io lilc r si8rcd slalcmnl thlt h€or shc is lianrcd pu.suanr , k, rhc lftvhiont orrh. Conractor's Liccn$d tf,w (chnprer L Conm.ftinS wirh S..rion Tom o{ Divisidr 3 ofrhc Businc$ onJ Pml.sionr Codc) or thal tu or slE is excmpl rh.rciromu lhcbusniorlhcollc3cdcxcnprion.Anyviol.rionolserionToal5hyrny {tlicanr for a prrn: cur,jek rbc drpliGnr tu d civil pcoalr, of nor 'mrc rMn fi!. hunddl d.lltus lS50O). l. is ovncrof(hc pbFny. or my cnrrlorcs *ilh s.!.s,! rh.n $h conFns.rion, will do rwoltandlhcnulN is mr inrcB.tn or oficrcd lor slc (Sa.70.U. lrusircs rnd Profcsions Cftic: l hc Conhdols Liccnsc L3w docs ool arpl, ro m owrcr or rhc F)r.ny wh. briHs d imptuEs rhtdn. dd qb dcs soch rork hinsdror h.rs.ltoi rhou$ his.r h.r owncmployccs. povidcd rhrr such impmrmnk m ton intnbl or ollarei litr $b li ho$(r.ln. tuikling or inpmk!ftnt Ls $k wnhilr on! Jrd ot o.llllclhn. thc Owncr Buiuq will h(rc Ihc ttrdcn ol I'$vir8 lh.r h. or shc di.1 mt tlild or in{or lh. rreFr, t, rrf, purFl{ or l.r\osmrollhepr)pdy.merciu\irclyconta.ri'rgsilhli.cn\.dcotrtrcttr\k,con{turrrh.!n,j.cr(Sc.70,lJ,Bu{trc\l rDd Pnnar\in Codcr'lh. Cotrrr..ra s Li.ctr* Lnv do.r iorxtDlyk) dtrotrrcr.l nn,nc ywho huilds or nnnn)vcs rhcr.on. rn *ho contrc(ftn \u.h t,.Jcrr\ wirhrco trrr{i\) li.c,Nd pursurtrr t,(lrcco er.ntr's Li.ctr{ tr$) -l u'ncrcnrpl undqSccrio.-.B.&P.C. lorlhiieo$n Drt. o*n.. ultBtr[Be.l;! trlNraftgN DliCIrlS IjQN I hcrch,r,finutrdcrlcuhyofpcrjuryon olrhcnnb*i',8dcclarrrn,n\: -l h0vc and willnuinllina Ccrl ilrcarc of Consnt ro Scll-lnsurcforsorlqicotrlpcn\ari.n-,s pdviddd roi hyssrDn:1?(x)orrhr L{bor Codc. lor lhc t rfmmmc oflhe work lor whah lhc r.mil is issucn. l hrec and *rlln,ainrrin workErr ronrt isri,,n_rn\ursmc. a\ rcqut d tt Ser bn :lTm of rh. bbor Cod., for rhc pcrionmncc of rhc ux,k hn $hf,hthn mrm B b\dd Mv$' lrr nimFn\ahun 'n\u,ra.c.m.r afi]!.1'c) numbcrm: ...-, -510L €;) *'",""-*, -?/ 7 72/ /a/;//a I.cdrlirhrrrnrhcp.rfoflmftcofrhc*.rkr(rwhrhrhxlt nir N ls$nl.I shlllnor cnrployan] pcson iruny mrnn.r $ r ro 6cconc subFcr ro rnc $orkcB compcnsation Usr o, Crlilbrni!. rnd r3rcc rhrr ill sh.ulJ tf,rotu \rbj.{r ro rh (or(cr\.ompcnqiionprevkionsotSccrion.lTO0olrhcl.otnrOnlc.l\tu'lltunhwiihcon,rlywirhth,*poviln,ns I{ARNING Fdlurc ro $curc workcr\ conrpcn$ri.r ..ttrigc i( trnhslul. rnd shrll \uhtcd rn cmtloF. ro cnn dal p.nrlri\ rnd civil fiEs u,r Io otrc hundr& Ihousrnd dolh (Sl(x).(D. in addnion ro thc co$ ofconrp.nsrlion. dnm,ses $ prcvidcd tur rht Scclion :1076 ofrhc Lahor Codc. inlcrc{ rtrd dlortrcy s -Z4O:6 lJ.!Lll!!U!)\ n tu ttxli,rcs md Pot$ninsCodc. ifrlrnv li.cns n in rrllrad v""ry? 03/ 3o-;4eA I h.r.hy xlllr unncrpcnrlryoi0cturyrhxrrh.rclsr.on{ru.lit)nLndirErgctr.yturrhcr.rlnnnrmcofrt*orknt*h.hrhnNdirn k\ucd iscc :109'7 Civ C I A.TIUIANI.D&CLAIAIIQN I tf,rhy urtim undcr p.nrhy of pcrjury om ofth. rollowirS dccltrrlions t)crmlirion P.irnils-Asb.sios N.rilicarnr Fcd.ril Rc8uhrbns (l'klc 40. Pd6) -Rcqutcd L.rtcr of Notift otion oftlinrncr\ md SIrrr lf,ws rc .or{'x.ri()n. rRl h.r.hy rfl l$'ilc 'aprc\rnrdirc\ ofrhis ciry Md Cl)u0r) b cnrs, uor rhr l,or. trknri,!r.d J,ro|tny lni i 7se:lf Forms/Steel/Holdowns Erection Pads SLAB Floor Sublloor/Vent/l nsulation Roof Sheathing Shear Wall Framing lnsulationi Eneroy Drywall Ext./lnt. Lath Brown Coat Ir/asonry T-Bar Handicap Req. Deputy Final Report Engineer Final Report FINAL Certificate ol Occu pancy Notes Remarks, Etc Set Backs UFER Ground Pool Fence Flood Zone Certil. nAl -l ccniiyrh{rthc fcdcrrlE8uhrions EEmlirE ashcsros rcnn,vtrl drc ml nftli.lhlc rorhh froicr & -T------