HomeMy WebLinkAbout101104319 - PermitProiect Address: 800 N Tustin Avea
Assessor's Parcel. 400-202-03 Lot: POR 5
Unit: A Bldg: Address Range:
Tract: 678Block: NA Historic: No
Suite Range.
Zoning: P
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 #: {O11O43{9
Pin #: 49127
Building Use: Commercial Occupancy: N/A 1st FL Area:
Job Type: Signs Constr Type: N/A 2nd FL Area:
Nature of Work: Signs Code: CBC 2019 Other Areas:
Existing Bldg. & Use: Commercia! Flood Zone: X-0602320164J Garage Area:
Proposed Use: # of Stories:
Total:
Description of Work: lnstall (2) non-illuminated foam letter wall signs for "Concentra Urgent Care", bond included.
Patio:
T.l.Area.
Yards Req'd.
Valuation: $2,540.00
0
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
S and A Management LLC
129 w Wilson St, Suite 100
Costa Mesa, CA 92627
(949) 722-7400
Concentra urgent Care
Contractor: Trulite Signs lnc
Address: 232 N Sherman Ave, F
Corona, CA 92882
Phone: (951) 735-5525
State Lic #: 846189
Lic Type: C45
Bus. Lic #: 375049
Workers' Compensation I nsurance:
Carrier: State Fund
Policy #: 9222821-2020
Expires: 0810212021
Engineer
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Enriquez, Gissel
Amsden, Julie
Amsden, Julie
Date: 08/1 3l2O2O
Date: 08/1 412020
Date: 08/1 8l2O2O
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
07776002
07776002
07776002
07776002
07776002
07776002
05376002
57607
s3600
57770
57672
57600
s7607
s3636
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Bond
$172.64
$1 19.67
$44.55
$1.00
$23 79
$5e 30
$200.00
NPDES Insp. Req'dv
PWA Insp. Req'd:No
No Account#Planning lnsp. Req'd:
Landscaping lnsp. Req'd:Flood Zone Cert. Req'd: No 01116002 51600
Every permitissued 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 permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
lnspector MID#: 2020-160402
No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd:
01 1 16002 51601
01116002 s1612
01 1 16002 s3600
01 1 16002 57770
05316002 53636
$23 79
$231 .e4
$1.00
$t t 9.67
$44.55
$200.00
Fee Total:
Paid to Date:
Balance Due:
$620.9s
$0 00
$620.95
BUILDING- INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS 0WNI'R B U I I,I)I.]R I)I.]I,CA RA'I'ION
I hereby affirm under penalty of perjury that I am exempt from the Contractoni' License Law for the following reason (Sec.7031.5
Business and Prol'cssion Code): Any City or County which requires a permit to construcl, alter. irnprove, demolish or rcpair any
structure. prior to its issuance. also requires the applicant tbr such pcrnrit to file a signed staternenl that lre or she is licensed pursuanl
to the pmvisions of thc Contractor's Liccnsed law (Chaptcr 9, Comrnencing with Section 7000 of Division 3 of the Business and
Professions Code) or that he or she is exentpt thereltom and the basis lbr the alleged exenrption. Any violation of Section 703 1.5 by any
applicant for a pcnnit subjects thc applicant to a civil penirlty of not more than five hundrcd dollars ($Sfn).
_1, as owncr ol'thc property. or my employees with wages as their solc compcnsation, will do thc work and thc slructure is not
interxlcd or offeretl for sale (Soc'.7&+. Business and Profcssiorrs Ccxle: The Contractor's Licensc Law docs not apply to an owner o[
thc property who builds or improves thereon, arxl who does such work hinrself or lrerself or through his or her owrt employees.
provided that such improvemcnts are not intendcd or ol'fercd lirr salc. Il, howcvcr, thc building or improvcment is sold within one year
of conrpletkrn. the Owner Buikler will havc the burtlen of pmving tlut hc or shc did not build or improve tlrc poopctty for lhc purposc of
yab).
-1,
as owner of thc propcrtyt am exclusively contracting with licenscd contraclors to conslruct the project (Sec. 7044, Busincss
and hotbssbn Code: The Contractor's License Law does not apply to an owner of property who builds or improves lhereon.
and who conlracts for such projects with a Contracto(s) licensed pursuant to lhe Contractor's License l-aw).
_I am cxcmpt under Section_, B. & P.C. tirr this reason.
Date:
WORKI.:RS' COM PI.:NSATION
DECLARATION
I hereby aftirm undcr pnalty of grcrjury one of the following declaration.s:
/ lLn^ve and wilt maintain a Certifrcatc of Consent to Sctf:-lnsure for workers' compensation, as pruvided for by Section 3700 of the
l-abor Codc, for lhe Jrerforrnance of the work for which the permit is issued.
_I Seclion 3700 of the Labor Code, for the performance of
sarricr anl Jnlicy numhcr are:thc
-cn, '1P?l'1r0
that in thc prcrlbrnuncc of thc work frrr which this pcrmit is issucd, I shall not cnrploy any pcrson in uny manncr
so a.s to bccornc subject to thc workers' conrlrcn.sation laws of Califonria, and agrce that if I should bccorrc subject to the
wodters' compensation provisions of Section 3700 of the Labor Cotle, I shall, forthwith comply with thosc provisions.
WARNING: Failurc to securc workcrs' compcnsation covcrugc
civil lines up to one hundrcd thousand dollars ($100.fiD). in
is unlawful, and shall subjcct an enrployer to criminal Jrcnalties and
to the cost of conlpcnsation. damages as provided for the
Seclion 3076 of the Code, interest and attorney's
DECLARATION
I hereby al-lirm under penalty of perjury that I am licensed under provision of Chaptcr 9 (cornmcncing with Section 7000) ol'Division 3
of thc Business and Professions Codc, arxl my license is in full forcc and etfect.
c15 rb$q
s (Ji
CONSTRT.'CTION I,T:NDING AGT:NCY
I hereby atl-rm under Jrnalty <lf 5rcrjury that there is a construction hnrling agency fbr the Srerformarrce of the work tbr which this perntil is
issued (.Scc. 3097, Civ. C.).
kndcr's Name:
lrnder's Address:
APPLTCANT DECLARATION
I hercby affrnr under pnalty of perjury one of the following declarations:
Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6)
_Requ ired lrtter of Notification
with all City and County
and county to enter upon thc
atxrvc rncnti()ncd propcrry tbr
Applicant or Agent
\Permitee nnme
*,",s/tb/4D
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Ve nUI n su I atio n
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Enerqy
Drywal!
Ext./lnt. Lath
Brown Coat
Jt/asonrv
Pool Fence (
T-Bar
Handicap Req
Deputy Fina! Report
Engineer Final Report
Flood Zone Certif
i n\
FINAL l)-Z-fl)x I T
Certificate of Occupancv \
Notes, Remarks, Etc.\-/
Rev. 08-07-2015
a a
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