HomeMy WebLinkAbout101103356 - PermitProiect Address: 400 N Tustin Avea
Assessor's Parcel: 400-043-09 Lot: POR 6 Block: NA
Unit: 401 Blds
Tract: 678
Address Range:Suite Range:
Zoning: PHistoric: No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {01103356
Pin #: 8t 122
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use.
Commercial
Tenant lmprovement
TI
Commercial
B
II A, SPK
cBc 2019
x-0602320277J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T l Area: B1s
Yards Req'd:
Valuation: $100,000.00
Occupancy.
Constr Type
Code.
Flood Zone'.
# of Stories:
Description of Work: Demo/new non-bearing partition walls & doors. New door into rated corridor
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
PARK CENTER 4OO LLC
400 N Tustin Avenue, #260
Santa Ana, CA 92705
(7141 667-0602
Fitzgerald Campbell
Contractor: Service First Contractors Ne
Address: 2510 N Grand, #1 10
Santa Ana, CA 92705
Phone: (7141 573-2200
State Lic #: 556812
Lic Type: C-36, B, ASBS, C-61 , C-2, C-10, C-:
Bus. Lic #: 141280
Workers' Compensation I nsurance:
Carrier: State National Ins Co
Policy #: AMX0820021001
Expires: 0211212021
Engineer:
Address:
Phone.
License #:
Architect /
Designer:
Address:
Phone:
License #:
Elliott Associates
Bert Michael Elliott
16421 Wimbledon Lane
Huntington Beach, CA 92649
(7141 840-5488
c8623
Planning Approval By:
Plan Checked By:
Permit lssued
NPDES !nsp.
Guevara, Jerry
J Lee Engineering lnc
Amsden, Julie
Date: 06/1 612020
Date: 0312312020
Date. 09/09/2020
Subject to Field:
Misc. Receipt
Misc. Receipt
Misc. Receipt
07776002
07776002
07776002
07776002
07776002
07776002
57607
s3600
57770
57672
57600
57607
74239
Total
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
I ssuance
Fee Total:
Paid to Date:
Balance Due:
$220 05
$301 s5
$44.ss
$4.00
$23 79
$5e 30
$653 24
$293.40
$359.84
PWA lnsp. Req'd:Noyes Account#Planning lnsp. Req'd:
Landscaping lnsp. Req'd: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 afterifs issuance,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#: 2020-158213
No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd:
01 1 16002 51601
01116002 51612
01 1 16002 53600
01 1 16002 57770
$23.79
$279.35
$4 00
$8 1s
$44.s5
BUILDING. INSPECTOR RECORD
!
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Ve nVl nsu latio n
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Enerqy
Drvwall
Ext./lnt. Lath
Brown Coat
Jt/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
^ z*l
FINAL J)rt\,,V4t ' I I 'l/)'tuv
Certificate of Occupancy
Notes, Remarks, Etc.
?d/<4
U
/
OWNIER B UII,I)IiR DIiI,CA RATTON
I hereby affirm under penalty of perjury that I am exempt fronr the Contraclors' License Law for the following reason (Sec.7031.5
Business ard Profession Code): Any City or County which requires a permit to conslruct, alter. irnprove, dcmolish or rcpair any
structure, prior to its issuancc. also requircs the applicarrt for such prermit to filc a signed staternent that hc or she is licensed pursuanl
to the pmvisions of the Contractor's [.icensed law (Chapter 9. Commcncing with Section 7000 ol'Division 3 of the Business and
Professions Code) or that hc or she is exempt therefuom arxl the basis tbr the alleged exemptiorr. Any violation of Section 7031.5 by any
applicant for a grcnnit subjects the applicant to a civil penalty of not nrore than five hundred dollars ($5001.
_1. as owner ol'the propcrty, or my employees with wagcs as their solc compcnsation, will do thc work and the structure is not
interxlal or offcred for sale (Scc.7OCa, Business and Pmfessions Code: The Contractor's Liccnse [:w docs not apply to an owner of
the proJrerty who builds or improrrcs thereon, and who does such work himself or hcrself or through his or her own employees,
provided that such improvenrnts are rnt intcnded orollercd for sale. Il, howevcr. the buiHing or improvennnt is soH within one year
of complction, thc Owrrcr BuikJer will hnve thc burdcn of proving that hc or she did not buikl or improvc thc propcrty for the puqposc of
sale).
_1, as owner of thc property, am cxclusively contracting with liccnrcd conlractors to conslruct the project (Scc, 7044, Business
arxl Prrollssbn Code: The Contractor's License Law does not apply to an owner of progrerty who builds or improves thcreon.
and who conlracts for such projects with a Contractor(s) licensed pursuant to thc Contractor's License Law).
_l anr exempt under R. & P.C. ltrr this reason.
I)ale: Owner:
WORKI.:RS' COM PI.INSATION
DECLARATION
I hereby affirm under Jrcnahy of perjury onc of the following declarations:
_[ have and will maintain a Certificate of Consent to Self-Insure for workers' compensation, as pmvided for by Section 3700 of thc
Labor Code, for the perlormance o[ the work for which thc permit is issucd.
_l have and
thc work ttlr
will maintain workers' compensation insurance, as by Section 3700 of the [:bor Code, for lhe performarrce of
thi.s pcrnrit is issuctl. My carricr un<l prclicy number are:
)<2os aS
6 2-
'""s?*?)t:)
Policy
_I ccrtify that in thc prtbrmancc of the work for which this Jrcrmit is issued, I shall not employ any person in any manner
so aslohccomcsubjecttothcworkers'cornpcnsationlawsofCalifomia.andagrccthatiflshouldbccorrcsubjecttothc
worliers' comlrcnsation provisions of Section 3700 of the labor C'ode, I shall, forthwith conrply with thosc provisions.
WARNING: Failure to secure workcrs'compensation covemgc is unlawful, and shall subjcct an cmployer to criminal penalties and
civil fines up to one hundred thousand dollars (SIOO.UXD, in addition to thc cost of conrlrcn.sation. damages as provided for thc
attorney's fees.
I hcreby allirm under pnalty of perjury that I am liccnsed under provision ol'Chapter 9 (cornmencing with Scction 7000) of Division 3
of thc Busincss and Professions Code, arxl my license is in futl tbrce aml cffect.
Licensc
CONSTRI.'CTION I,I.:NDING AG}:NCY
I hcrcby aflirnr under penalty of per.iury that there is a construction lending agency for the performance of the work tbr which this permit ls
issucd (.Sec. 3097, Civ. C.).
lrnder's Name:
lrnder's Addrcss:
APPLICANT DECLARATION
I hcreby affrm under penalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Rcgulations (Title 40, Part6)
_Requ ired lrtter of Notification
_l certify that the federal regulations regarding asbestos renroval are not applicable to this project.
_l certify that I havc rcad this application and statc that thc above infornration is corrccl. I agrec to comply with all City and County
onlinances and State [:ws relating to building constructior\ and hereby authorize reprcscntatives of this City and County to enter upon the
abovc mcntionctl propcrty lbr inspcctir)n purp()scs.
Applicant or Agcnt
Permitee name
0B-07-2015
I
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