HomeMy WebLinkAbout101104752 - PermitProject Address: 1055 N Main St
Assessor's Parcel: 398-023-01 Lot:
Unit: 600 Bldg: Address Range.
Tract: WITMER/SMITHBlock: NA Historic: No
Suite Range:
Zoning: SP3
city of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA927o2 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: 1O1104752
Pin #: 79{OO
Building Use: Commercial
Job Type: Tenant lmprovement
Nature of Work: T.l.
Existing Bldg & Use: Commercial/Offices
Proposed Use:
Description of Work: T.l. to remodel breakroom
Planning Conditions:
Occupancy:
Constr Type:
Code:
Ffood Zone'.
# of Storres:
B
I A, SPK
cBc 2019
x-06023201 63J
1st FL Area
2nd FL Area
Other Areas:
Garage Area:
Totat
Patio:
T.l.Area:
Yards Req'd
Valuation:
300
$45,000.00
0
Owner:
Address:
SIC 1015 Santa Ana LLC
PO BOX 17777
Beverly Hills, CA 902093777
Phone:
Tenant County of Orange lT Department
Contractor: Savant Construction
Address: 13830 Mountain Ave
Chino, CA 91710
Phone: (909) 614-4300
State Lic #. 596646
Lic Type: B, C-6
Bus. Lic #: 0196439
Workers' Compensation I nsurance:
Carrier. lnsurance Company of the West
Policy #. WSD505269100
Expires 0110112021
Engineer:
Address:
Phone:
License #.
Architect /
Desiqner:
Address:
Phone:
License #.
DLR Group
Christopher V Ward
117 E Colorado Blvd., #500
Pasadena, CA 91 105
(310) 488-1 071
c-21640
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
Arabe, Jill
So, Anson
Hernan dez, Kathy
Date: 09/1 ,,112020
Date: 10l,14/2020
Date: 1011512020
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002
07776002
07716002
0 7776002
07776002
077760 02
57607
s3600
57770
57672
5760 0
5760 7
74775
Total
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
9172 64
$478 68
$32 40
$2 00
$23 79
$5e 30Fire lnsp. Req'd.
Polrce lnsp. Req'd Account#
No
No
Flood Zone Cert. Req'd: No 01 1 16002 51600
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after its issua nce,or if the work authorized
on the site by such permitis suspended or abandoned for a period of 360 days after
the time the work is commenced.
lnspector MID# 2020-1 61442
01 1 16002 51601
01116002 51612
01 1 16002 53600
01116002 57770
$23 79
$23 1 94
$2.00
$239.34
$32 40
Fee Total
Paid to Date:
Balance Due:
$768 81
$239 34
$529.47
I
BUILDING. INSPECTOR RECORD
SITE-WORK DATE !D/SIG COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsu latio n
Roof Sheathino
Shear Wall
Framinq lo'L,tr,7n bktr61
lnsulation/Energy
Drywall LI 1/)hktrtr 7
Ext./lnt. Lath t
Brown Coat
[t/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enoineer Final Report
Flood Zone Certif
1 A ,\-? /^
FINAL Ir lv 'l/)I>kq'r
Certificate of Occupancy -
Notes, Remarks, Etc. .c.-
lol ? 71 7d. f o .l- --\fr#m
t I \)
OWNER BT'ILDER DELCARATION
I hcrcby affrm under Fndty of lErjury that i m cxerpt frcm the ContBcloN' Liccnse l:w for thc following rBsn (Ss.7031.5
Busincss and Prcfcssion Codc): Any City or County uhich rcquircs a pcmit to @nstnrct. altq. imprcve, &mlish or rcpair uy'
structurc, frior lo its issuance, also rcquircs thc applicant for such Jrcrmit to filc o signcd ststcmnt tha] hc or she is licensd pursumt
to thc Jrevisions of the Contractor's Liccnsd Law (Chaptcr 9, Comrcing with Sction 7000 of Division 3 of the Busircss md
PrcfcssionsCodc)orthatheorslrciscxcmpttlmfromardthcb&sisforthcallcgcdcxcmption. AtryviolationofscctionT03l.5bysny
applicant for a Jrmit subjats thc applicant to a civil pcmlty of nol mrc the fivc hurdrcd dollus ($5fi)).
_1. as owtrcr of thc property. or my crnployccs with wagcs as their solc compcnsation. will do thc work and thc stnrcture Ls rrrt
intcndcd or olTercd for sale (Sec.7014. Busincss and hofessions Codc: Thc Contractor's Liccnse law docs not apply to an owner of
thc propcrty who builds or improvcs thcrcon, and who docs such work hirnsclf or hcrsclf or through his or hcr own employees,
providcd that such improvcnrnts arc not intcndcd or offercd for salc. lf, howcvcr. thc building or improvctrrcnt is sold within onc ycar
of complction. thc Owncr Builder will havc thc burdcn of proving that he or she did not buikl or improvc thc propcrty for the purpsc of
sab).
_1. as owncr of thc propcrty. am exclusively contracting with liccnscd contraclom lo construct thc pnl.icrt (Scc. 7W. Busincss
and Prrofcsskrn Codc: Thc Contraclor's Liccnse Law docs nol apply lo an owncr of propcrty who builds or improves thercon.
and who contracls for such projccts with a Contracto(s) licenscd pursuant to thc Contractor's Liccnsc L:w).
-l
arn cxcnlpl undcr Scction-. B. & P.C. for thls rcason.
Date:___( )rr lter.
WORKERS' COMPM{SATION
DT'CLARATION
I hercby affirrn undcr penalty of pcrjury onc of thc following dc'clarations:
_l havc and will maintain a Ccrrilicatc of Consent to Scll'-lnsurc for workcrs'compcnsation. as provided for bySection 37fi) of the
Labor Code, for lhc pcformancc of thc work for which thc pcrnrit is issucd.
_l have and will rnaintain workers' compcnsation insurarrcc. as by Scction 370O of the l-abor Code, for the performancc of
carricr ard plicy number arc:thc work lbr which this permit is issucd. My workers'
t .J \tv )
Policy s lr /ror,l
_l certify that in the pcrfornrancc of the work for which this pcrrnit is issucd, I shall not employ any pcrson in any numncr
so as to bcconrc subjcct to thc workers' compcnsation laws of California. and agrcc thal if I should bcconrc subjecl to tlrc
workcrs' con{rcnsation provisions of Section 3700 of the L,:rtnr Code, I slrall. forthwith comply with thosc provisions.
WARNING: Failure to sccurc workcrs' compcnsation coveruge is unlawful. arxl shall subjcct an employcr to criminal pcnaltics and
t
civil fin('s up to onc hundrcd thousand dollars (S100.000).
Scction 307(r of thc Latnr Codc. intcrcst and attorncy's fces.
in addition to thc cosl of comfrcnsation. danutges lirr lhc
Dalc: \.sl ts l:o g r,t
I hcrcby allirrn undcr pcnalty of pcrjury that I am liccnscd 9 (comnrcncing with Scttion 7000) of Division 3
of thc Busincss and hofcssions Code. and my liccrse is in full force ard cffcrct.
B q(l
Liccnse Nurnbcr:
W
t hercby aflirm undcr Fnalty of IErjury th.t th@ is a conslruction lending agcrcy for thc Frformcc of thc work for which lhis Imil is
issucd (Scc. 309?. Civ. C.).
lrnder's Namc:
lrndcr's Acldrcss:
APPI ICANT DECLARATION
I tracby aflirnr undcr pcnalty of Jrcrjury onc of thc following dcclarations:
Dcmolition Pcrnrits-Asbestos Notification Fcdcral Rcgulations (Title 40, Pan6)
-Rcqu
ircd [-cttcr of Notification
_l certily that thc federal rcgulations rcgarding asbcstos rcnxlvalare not applicable to this prolt'ct.
_l ccrtify that I havc rcad this application and state that thc atnvc infornvation is to comply with all City and County
ordinanccs and Statc [:ws rclating to building of this City and County lo entcr upon the
abovc rrntioncd property for
Applicant or Agent
Pernriler-. ntnrt
constructioru hcreby
o** to I tS/OO
Rev. 08-07 -201 5
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6vl
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Applicnnt: