HomeMy WebLinkAbout10188564 - Permit (2)q
Project Address: 106 W Fourth St
Lot: POR 8, POR 9 Block: 'l l
Suite Range:
Zoning: SD84
-/ff
kv city of santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA\27O2 Building
Permit Counter: (714\ 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714), 647-5853
Permit #: {O188564
Pin #: 8{4{9
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use
Proposed Use:
Commercial
Tenant lmprovement
Bathroom upgrade
CommercialrOffices
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Description of Work: Upgrade existing Bathroom to accessible bathroom. Shell only, Tenant improvement under separate permit.
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
B
III B, SPK
cBc 2013
x-o60232027 6J
Patio:
T.l.Area:
Yards Req'd:
Valuation: $9,500.00
0
Botch+:35994 - It7/26/2tlir i0r NGAri(.IA
Illiii' "t* '"on'*r,.|,, ,*,*&.i 'Engineer: Ecptitr:r16,c1i36 -- 10/26/2115 S"/\4 ::tr,
Owner: Ted Tapfer, VP (Miller, Burg, DuPor Contractor: Owner-Builder TronscLt ion ToLol $7\? .27
Address: 105 W. Fourth St. Suite #211 Address: Address:
santaAna, cA 92701 Ted Ttpfer': uF iflillerr Furgr
Phone: (949) 244-9040 Phone: Phone: flicrofilnr & 0o,:u6en[s $]i.3,
Tenant: State Lic#: License #: 11116r-r,,12 1771(r0r:rl:r-
Lic rype: Architecl / cr"is s.ltfiLrl]fifibt", rnJli't'[1487 $]1).:11
Bus. Lic #: Desiqner: Craio Smith
Workers' Compensation lnsurance: Address: l04l W. 'l6th St. #A-208Carrier: Costa Mesa, CA 92627
Poliry #: Phone: (949) 764-0010
Expires: License #: C20154
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA Insp. Req'd: No
Planning lnsp. Req'd: No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#
Aguilar, Jessica
Ahangian, Kathy
Chavez. Dave9v
No
Date; 03/14/2016
Date; 09/1212016
Date: 10/26/2016
Subject to Field:
Misc. Receipl
Misc. Receipl
Misc. Receipt
0 7776002
07116002
07176002
07116002
07776002
07716002
57607
53600
57770
57672
57600
57607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$'149.25
$413.82
$17 .5O /
$,t.oo /
$zo.sa /
$s1.26
67443
67445
Total
Landscaping lnsp. Req'd: No Flood Zone Ce(. Req'd: No
Every pemit issued shall become invalid unless the wo* on the site authoized by
such p6mit is connenced wilhin 180 days after its issuance,ot if th6 wo* authoized
on the site by such pemit is suspended ot abandoned lor a peiod ot 180 days aftet
the time the wo* is commenced.
lnspector MID#: 2016-127430
oltt LooZ gTr7o 13.3? >r.
Fee Tolal:
Paid to Date:
Balance Due:
01116002 51600
01116002 5'1612
01116002 57770
56
50
0$2
$
$653.39
$640.00
$13.39
Assessor's Parcel: 398-264-07
Unit: 600 Bldg: Address Range: 102-106
Tract: TOWN OF SANTA ANA Historic: Yes
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS OWNER BUI LDER DEt,('ARATION
I hocby rflirm utuld FDlty oirojury rhar I m cx.dfl nDm rhc Conha.roE Licm li\r lor rh. lollorinr r.etr (Ss 701r.5
alsin6s .nd Prol6sion Cod.)r Ant City or Coudy $hich r.qun6 o p6mil lo conslnrct. alt6. improve, dsnolish or tpair dy
srtudrq rior lo irs isuuc.. sl$ r.quiB rh€ qlpli.d for su.h !.mil ro 6lc a sisned statmml lhal h€ or shc 6 li.ors.d poNafl
ro rhc provisions ofthc Conrdcrois t,i.c.*d L.rv ((haplr 9. Co'n,ncn ing $nh s.dion 7000 of Divisioo I ollhc Rusins &d
Prefsi.ns (ode)orrnar h.orsnc b.r.nDr tho.lrornandrh.hsk aorlh.allcS.d cro.plion AnyvioldionofsdhnT0.ll5byey
applica for a pmil subjdl3 th. applic.nl lo rcivilp.nrhyofnor morelhe liv. hundr.d doll.6 ($500].
I. 6 owncrollh.I,oFry. or my dnployB silh salsa lhcir sl. comp€Mlion. rvilldo Ihc trork and rhe ntodu. G ml
intd(H o, orr.d for slc(56.7044. Ausin6 rnd holsioN Codc: Th. Coitadr\ Li.@ Lr$ do6 nor.ppltro.tr 0\16 oa
E pNp.dy who h & or imprcvB $60., aftl who do6 such *o,{ hins.llor hdsclf orlhrr]u'8h his or her o\yn cmployeB.
prolid.d thd such inpdcn nt e nor i ad.d .r ollddi tr)r sL ll howdd. rhe hriL.liru or nnprovdn€rn is $kl *irhi'r otr€ yw
ofcomplelioo, thc OM6 Srildd will ha\r tlE hrr&n of poi.s lhd hc or sh. dd nol build 6r iqrcrc rh. prrFry for fi. purpoF ol
El. * o" n.. o r rr,. p-p<y. - Bclstr ely (nnra(r! s'ilh liccs.d co radon tu .oBrtu( rh. prujd (s(. 70.1.1. Busins
and PJlcssi.h Cod.r Th. conta.rois Lic.ns. Law dos nor apply'o an oNn6 oaprop€ny (ho buil& o. nnprove rhaon.
a.d *ho co !a.ts lor such projc$ $ilh a Co r.cl.(s) liccnscd pusodr totn. (bnlrnclois Licen* Lav)
_l@cicmpru n S(l'o._ ,B &PC I^r rhi{ r.asaa ,- !
,.," . t[lr-UlaolL -".,,). "Xryo Z ddl!oatrEa5i!r!t[!.la.Ua! |-DE(IAIAIII'! I
I hdcby amrm ufldq p.nllly ol lqjury on€ oflhc followins d<ldalio6:
I halc d Nillmainrain a c6lific0t.otConscnt lo Self-lnsurc tor Norksi conDcnsalioi, as poided Lrbtsdior 1700of lh.
Lrbor Co!c, fo. rh. p6fom&cc olthc worl lor *hich rhc pamir i! iisucd
I h.vc af,d *ill mainl.in *ork6 comp€ns.t ion isu,onc.. s .eqtrned by Sd tuo 1700 ol rh€ lrhor Cod.. tor the lB nrmec. of
Itc work lor whi.h lhie p6mil is isucd My workdi onrp$srion insuBncc cri6 dd poli.y numbd &.:
E\ cenr$ rnar in ltrc psromwcc olthc \orl lor trhi(h $is psnril is issued, I shallnor dnpl.y a.r t6on in otry mntrre!
s 6to beod. subjsr lo rhc $0116 .omposarion la$ ofC6lifomia..nd +E thit ifI snouH bccor.. subjal lo lh.
(0r[6.o,nprsarionpmvtionsofsdion:J700ofih.Lah.rcod.,I3haU.fonhwithcomplywill,lh.spnvnions.
ltAliNlNC F ilur. to Kuc "orkm ompds.lion covelas. is unla*ful. ed shdll subjd d dplo}cr ro oihiml tEali6 md
civil fin6 up to on. hnndrcd lhouend dolltrs ($100.000). in addilion lo th€ cosl ofcofrp€.strion, danaBs as Oolided aor lh.
s(rion r0ro ofrhe L.bor Codc. inrsqi
,,,,", , lo lzil 2ol(
DECI,AAAII!]ts
I n@by anim undq poally of pqjury lhar I m licdsd u.d.r a,ovision olChaprd I (co,nmncing snh Se.liotr 70Ct)olDirisior l
or lh. Bnsin6s ed ProadioN Code, md my lic.e n in tull 4o... dd .rd.
qaNlrauc.ullrL[rDlNclcENcr
I h.Eby amm und6 pcrahy of psrury lhal lh6. b a cotrrruclioo Lndins asdcy for rh. poaomdc. 6a$. \ ort for \rhich lhis pq.n b
isstr.d (Sd. 109?. Civ. C.).
atauc .NfD[qdaalt()N
Ihaebyamnn undcr pcnally ofpqjuryonc olthc lollosins decl.ralions:
D.molnio. P.mtu Asb<sros Norifi.arion F.ddal R.guhbns (lnk40, Fan6)
Requircd L.ucr olNolinc.liotr
I cdin rhd rhc f.ddalraLlarioN Rddin( 6besro, rerno\il .ro!appl'c.hlcror\irrajd..1{
tsI (d'fy !ha' I h!!c rsd rhB EDI'c,r'.n dJ !a'c'h,rrh. ahov. inlonn.rnrn i.oftdt IaSrd(ocomtlywirhsllCilya.d(ouly
orlinaoc6 ed Sralc rrws Elatinr ro blildins co.srtodioa &d h6.by auhorn.r.pr6nl.liva ofrnis ( ily.nd Counl, to sl6 upon th.. lo)-L6lLQil
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loorfuenUlnsulation
Roof Sheathing
Shear Wall
Framing
ln s u lation/Energ y
D rywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
l
FINAL 8/74ry /M4 )
Certificate of Occu nc L
Notes Remarks
-
Set Backs
, Etc.
aboLc nrelr(.n.d pmndy f.r iNedon p5:)F c -l t
Appricnnr orAEm, siqnr,ure >1 J'//{\- C^ dodlf\
ronrrenrnerprino, !( [.y4f,]q$f '
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