HomeMy WebLinkAbout101102599 - Permit\(
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City Of Santa .it ;:* ,-i) (jir ic Leii-,.' ,- rali, (:Vi.19), Santa Ar t, CA92't)2 Building
Permit Counter: (714) 647-5800 lnspection Requestr;: (714) 667-2738 lnspecto; Sei:iicn. (71q e4.7-5853
Permit #: {01102599
Pin #: 27227
Proiect Address: 1551 N Tustis"t Ave-a-
--t---t
Assessor's Parcel: 400-211-11 Lot: fJOR 5
Unir ?1iq; Bldg: ,ACCress Range: 1537-1551
Tract: FEL_lpE y(.RtsA Historic: NoBlock: t{A
Suite Range:
Zoning: P
Building Use: Commercia! Occupancy: B 1st FL Area
Job Type: Tenant lmprovernent Consti'Type: ll A, SPK 2nd FL Area
Natureof Work: Tl Code: CBC 2016 OtherAreas
Existing Bldg. & Use: coMMERctAL oFFlcE BLDG Flood Zone: x-0602320164J
Garage Area:
Proposed Use: Offices # of Stories: 10
Totat
Description of Work lnterior demolition & ncur !-.art!tion ivalls/ceilings to creato offices, copy room, & break room
Planning Conditions: !nterior work only. lrlc e,xterior alterations o; rnodifications.
Engineer:
Patio:
T.l.Area:
Yards Req'd
Valuation:
7536
0@0
$200,000.00
0
Owner:
Address:
Phone:
Tenant
Greenlaw Partners
1551 N Tustin Ave Ste #150
Santa Ana, CA 92705
(s4e) 331-1 313
Fidelity Bancorp Funding lnc
Contractor: simith and Severson Bullder
Address: 21072 Bake Parkway #106
Lake Forest, CA 92630
Phone: (949) 232-1222
State Lic #: 989943
Lic Type: B
Bus. Lic #: 351717
Workers' Compensation lnsurance:
CarriEr.. ZURICH A]I4ERICAN INSURANCE C
Policy #: WC456733000
Expires: 09/01 12020 '
Address:
Phone:
License #
Architect /
Designer:
Address:
Phone:
License #:
l'(1ll E.fl t.
t[r?[l
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
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: ilio 01116002 51600
011 r6002 51601
01116002 51612
01 1 i6002 57770
Graham, Jeffery
CSG Consulta
Zuniga, Allissa
Date. 0113012020
Date: 0112812020
Date: 0210312020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
$1,570.40
$2,500.80
$43 01
$8 00
$22.95
$s7 20
$4,202.36
$2,500.80
$1,701.56
r\ccount#
.,
73919
Total
0 77760Q2
077760 02
0 77760 0 2
077760 02
0777600 2
07776002
57607
s3600
57770
57572
57600
57607
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after ifs issua nce,or if the work authorizeo'
on the site by such permitis suspended or abandoned for a period of 360 dais after
the time the work is commenced.
$22 es
$1,627.60
$8 0c
$43 01 Fee Totat
Paid to Date:
Balance Due:
lnspector MID#: 2019-156342
I
Irtt tt
a
03 Design lntericr Plannning & Design
Sheila P Andelin :
#220
CA
BUILDING- INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
S u bfloor/Ve nU I ns u latio n
Roof Sheathing
Shear Wall
Framing
lnsulation/Energy l1 I r,
Drywall '^lqll'uln 'ti(ffi
Ext./lnt. Lath I I t
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
f,t
FINAL 5. 10'?070 0WAgtr
Certificate of Occupancy
AEtc.
lh/dcy IL 7 l
YIb/NfrO -,'
i her'eby affrrm undcr penalty cf perjury that I am exempt frorn the Contractors' License Law for the rottJ*ing rJi (Sec.703 1.5
Buins and Profcsion Codc): Any City or County which rcquirc a pamit to coEtruct, alta. improvq dmolish or rcpair m!
struciuq prior to its iss@cq also rcquirG thc applicmt for such pcrrnit to fil€ a sigocd statmqt that he or shc b licofied pmuanr
to thc provisiom of the Codrrcror's Licenscd Law (Chaptq 9, Corruncncing with Sation 7000 of Division 3 ofthc Businru ui
Prcfcsions Codc) or thst h€ or she is cxmpt thscfrom ild thc basis for thc allcted erflption. Any violation of Setion 7031.5 by my
applicmtforapcnnitsubjetsthc applicuttoacivilpcrultyofnotmorcthdfivehun&cddollm($500).
_1. c ovr,q of thc proptny, or my cmployc with wagc c ttcir mlc cornpcruaion. will do thc wort ad thc srnrtw b nol
intodcd or olfqcd for sle (Se.7044. Buine ud Profsioro Codc: Thc Contractor's Lic€re taw doB not apply to m omq of
the prcpqry who builds or improvs th@n. ed who dc such wtk himself or hmclf or lhrough his or ho om mdoye,
providcd that such impmvmmts e rct intqrdcd or oflsed for sle. lf, howwq, thc hrilding or imprcmt is sld wilhin onc y6
of complaioq thc Ovmq Buildq will havc the hrdo of poving that hc or she did mt build or imFovc lhc propqly for thc pruposof
el€).
_1. as owner of the prop€rty. arn exclusively contracting wrth liccrsed contractors to construcl the project (Sec. 7044. Buiness
and Pnofession Codc: The Contractor's License Law does not apply to an owner of propcrty who builds or improves thereon.
and who contracts for such projeos with a Contracto(s) licensed pursuant to the Contractor's License Law).
_l arn exempt under B. & P.C. for this reason.
Date:_-._owner'-
WORKERS' COMPENSATION
DECLARATIOh*
I hereby affrm under penalty of perjury one of the following declarations:
_l have and rvill maintain a Certificate of Consent to Self-lnsure for workers' compensation. as provided for by Section -1700 of the
Labor Code, for the performance of the work for which the pennit is issued.
and will maintain workers' compensation insurance. as required by Section 3700 of the Labor Code. fbr the performance of
issued.compensation insurance carrier and policy number are:
c ce
Policy q t-Ao
_l certify that in the performanc.e of the work for which this permit is issued, I shall not ernploy any person in any manncr
so as to become subject to the rvorkers'compensation laws of California. and agree that if I should becorne subject to thc
workcrs' compcnsation provisions of Section 3700 of the Labor Code. I shall. foirhwilh comply rvith those provisions.
WARNINC: Farlurc to secure workers' compensation coveragie s unlarvful. a.nd shall subject an onployer to crirninal poraraes and
civrl fines up to one hundred thousand dollars ($100.000). in to the compcnsation. damages as provided for the
attorney's
hereby affirm under penalty of pcrjury that I arn provision of Chapter 9 (cornmencing with Section 7000) of Division 3
the Business and Profc"ssions Code. and rny force and effect.
Number:
qqq7q3 €rebr
o
I hereby aflirm under penalty of perjury that thcrc is a
issued (Sec. 3097. Civ. C.).
agency tbr the pcrformance of the work for rvhich this perrnit is
Lender's Name:
[,cnder's Address:
APPLICANT DECLAITATION
I herd,)'ailfirm under penalty of perjury one of the following declarations:
l)ernolition Permits-Asbcstos Notification Fedcral Regulations (Tille 40, Part6)
-_
Required l-rtter of Notification
.- __l cotifr that the federal regulations regarding asbestos removal are not applicable to this project
Irernritcc nilrrle
a
t a
work for
t
_Expires:
Section
-'A-t,