HomeMy WebLinkAbout101103669 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: {01103669
Pin #: 35445
Project Address: 400 N Tustin Ave
Assessor's Parcel: 400-043-09 Lot: POR 6 Block: NA
Unit: 225 Blds:
Tract: 678
Address Range:Suite Range:
Zoning: PHistoric: No
Building Use: Commercial
Job Type: Tenant lmprovement
Nature of Work. Tl
Existing Bldg. & Use: Commercial/Offices
Proposed Use:
Occupancy.
Constr Type:
Code:
Flood Zone'.
# of Stories:
B
II A, SPK
cBc 2019
x-0602320277J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total: 0
Patio:
T.l.Area:
Yards Req'd:
Valuation, $t,000.00
Description of llVork: Relocate (e) demising wall to reduce suite 225 by 972 SF
Planning Conditions:
Owner:
Address:
PARKCENTER 4OO LLC
PO BOX 1108
Tustin, CA 927811 108
Contractor: Service First Contractors Ne
Address: 2510 N Grand , #110
Santa Ana, CA 92705
Phone: (7141 573-2200
State Lic #: 556812
Lic Type: C-36, B, ASBS, C-61 , C-2, C-l0, C-:
Bus. Lic #: 141280
Workers' Compensation I nsurance:
Carrier: State National lns Co
Policy #: AMX0820021001
Expires: 0211212021
Elliott Associates
Bert Michael Elliott
16421 Wimbledon Lane
Huntington Beach, CA 92649
(7141 840-s488
c8623
Engineer:
Address.
Phone:
License #:
Architect /
Desiqner.
Address:
Phone.
License #.
a
Phone:
Tenant: NUMA Network
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd.
PWA lnsp. Req'd:
Planning lnsp. Req'd
Soto, Ricardo
Le, Tung
Amsden, Julie
07776002
07776002
07776002
08907007
07776002
07776002
07775002
Permit Fee
Plan Check Fee
Microfilm Records
SMIP - Category 2
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Tota!:
Paid to Date:
Balance Due:
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
Date: 08/1 312020 Misc. Receipt: T4SIO
Date. 08/1 912020 Misc. ReceiPt:
Date: Og/Og/2 O2O Misc. Receipt:
Subject to Field:
No
Yes Account#Total
57607
s3 600
57770
24000
57672
s7600
57607
$172.64
$239.34
$44.55
$0.50
$1.00
$23.79
$5e.30
Landscaping lnsp. Req'd. No Flood Zone Cert. Req'd: No
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within360 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.
01 1 16002 51600
01116002 51601
01116002 51612
01 1 16002 53600
01 1 16002 57770
08901001 24000
$23 79
$231 .94
$1 .00
$8.47
$44.55
$0.50
$541 .12
$230.87
$3t 0.25
lnspector MID#: 2O2O-1 58659
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf I oor/VenUI n s u Iatio n
Roof Sheathinq
Shear Wall
Framing
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
[\Iasonry
Pool Fence
T-Bar
Handicap Req
Deputv Final Report
Enqineer Fina! Report
Flood Zone Certif .
,-
FINAL lk^gnh JaL 3o bpq
Certificate of Occupancv
Notes, Remarks, Etc.
OWNER B UILI)IiR l)I.lLCA RA'I'I()N
I hcreby affirm under pcnalty of perjury that I am exempl from the Cbntractors' Licensc [-aw for the following rcason (Scc.7031.5
Business and Prolbssion Codc): Any City or Countv which requires a Jrrmit to construct, alter. irnprove. dcmolish or repair any
structure. prior to ils Lssuancc. also requires the applicant for such prmit to file a signed staternenl that hc or she is licenscd pursuanl
to thc. pmvisions of thc Contraclor's Licen.sed law (Chapter 9, Comrnencing with Section 7000 of l)ivision 3 o[ the Business and
Prot'essions Code) or that hc or she is exempl therefrom and tlrc basis tbr the alleged exemption. Any violation of Section 7031.5 by any
applicnnt for a 1rcnnit subjects the applicant to a civil pcnllty of not more than five hundred dollars ($5tXl1.
_1. as owncr ol'the properly, or lny employces with wages as thcir solc compcnsation, willdo the work and thc structurc is not
intended or offered for sale (Scc'.7(X4, Business and Professions CtxJc: The Contractor's License Law docs not apply to an owncr of
the property who builds or improves thereon, and who does such work himself or herself or through his or her own employees,
providcd that such imprrvernents are nol intended or olTered lbr sab. ll. howcver. thc buiHing or irprovennnt Ls sold within one ),ear
of conrpletion, thc Owner Buildcr will havc the burden of provirrg that lrc or she did not buikl or improvc thc propaty for tlrc purposc of
sah).
_1, as owner of thc propcrty. am exclusively contracting with licensctl conlractors to construct thc proFct (Scc. 7044, Business
and Prrolbssbn Code: The Contractor's License Law dtxs not apply to an owner of property who builds or improves thereon.
and who contracrs for such projects with a Contracto(s) licen.sed pursuanl to thc Contractor's Liccnse L:w).
_l am exempt under B. & P.C. ltrr this reason.
I t., r^.
W() R K I{) RS' COM I'I.INSATION
DECLARATION
I hcreby allirm undcr penalty of pcrjury one of the tbllowing dcclarat ions:
_I have and will maintain a Certilicate of Consent to Self-lnsure for workers' comyrn-sation, as provided for by Section 3700 of the
Lahor Code, for the Jrerformance of thc work for which thc Jrrmit is issucd.
_l have and as requircd by Section 3700 of thc l-abor Code, for lhe perforrnance of
thc work tbr insurance carrier ard policy number are:
Policy o 0t
_t certi$ that in thc Jrcrformancc of thc work for which this pcrmit is issucd, I shall not employ any person in any manncr
so as to becorne subjcct to thc workers' compensation laws of California. and agree that if I stnuld bccorne subject to the
worliers' comlrcnsation provisions of Section 3700 of the labor Code. I shall, forthwith cromply with tlrosc provisions.
WARNING: Failure to sccurc workers'compensation covcnrgc is unlawful. and shall subject an cmploycr to criminal pcnahies and
civil fines up to one hundrcd thousand dollars (Slm.(XX)). in addition lo lhe cost of comlrcnsalion. damages as provided for the
Section 3076 of the l-abor C'ode. interest and attorney's fees.
,,",", S(f!f 2o2r)
I-ICENSED CONTRA(:TOR
DECI,ARATION
I hereby alfirm undcr penalty oI perjury that I am licensed undcr provision of Chapter 9 (cornmencing with Section 70m) of Division 3
of the Busincss and Profcssions Code, and my liccnse is in full lbrcc and cllbct.
License tL
CONSTRT.'CTION I,I.:NI)ING AGENCY
I hercby affrm under pcnalty of perjury that there is a construction lending agency fbr the perfonnarce of thc work for which this pcrmit is
issucd (Sec. 3097. Civ. C.).
Lrnder's Nanre:
l,cnder's Addrcss:
APPLICANT DECLARATION
I hercby affrm under penalty of perjury onc of the f<rllowing declaratiorts:
Demolition Permils-Asbstos Notification Federal Regulations (Title 40, Part6)
_Required lrtter of Notification
_l certify that thc fedcral regulatioru regarding asbcslos removal are not applicable to this proirl.
_l certify that I havc rcad this application and state that the abovc information is correct. I agroc to comply with all City and County
onlinances and State Laws relating to building construction anl hereby authorize rcprcsentatives of this City and County to enter upon the
alxrve mentioned propcrty lbr inspcction purposes.
Applicant or Agcnt r,.,"S rrffit%2l)
at
Bev. 08-07-201
Pcnnitee