HomeMy WebLinkAbout101105019 - PermitProiect Address: 2600 S Harbor Blvd-a-
Assessor's Parcel: 415-012-08 Lot: 1, POR 1 Block: L & M
Unit:Btdg
Tract: 509/1 025
Address Range: 2600-2610
Historic: No
Suite Range:
Zoning: Ml
Cify of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O11O5O{9
Pin #: 94572
Building Use:
Job Type:
Nature of Work:
Existing Bldg & Use:
Proposed Use:
Planning Conditions:
Commercial
Miscellaneous
Temp Bracing
Commerical
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
B
VB
cBc 2019
x-0602320258J
1st FL Area
2nd FL Area
Other Areas:
Garage Area.
Total
Patio
T.l.Area:
Yards Req'd
Valuation: $400.00
Description of Work: Temporary bracing due to fire damage (Complete repair plans wil! be submitted under s,epepte permit)
Olf ice: (:TYH T
A--Llrilt-l- L I r
Rcpt+:Ll3ltggtteg
Phone:
Tenant
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
Contractor: SPSA lncorporated
Address. 1213 E Hunter Ave
Santa Ana, CA 92705
Phone: (7141 558-7772
State Lic #: 1037890
Lic Type: B
Bus. Lic #: 369176
Workers' Compensation I nsurance:
Carrier: Employee Service Group
Policy #: C66381006
Expires: 0110112021
Date: 1012112020
Date: 1012112020
Date: 1Ol21l2O2O
Subject to Field:
Engineer: Hansen Hokama
Address:
Hans Hansen
180 E. Main St., Suite 201
Tustin, CA 92780
(714l. 573-0073
Architect /
Desiqner:
Address.
Phone:
License #:
Total
En
Owner:
Address:
Harbor Limited
1420 E Pamona St
Santa Ana, CA 9270s
(7141 547-6363 Phone.
License #:2- 5 I |tll0ttt-tds Re*iolv in2- 51e l2ttt tt-t
ldins:
Lr?- lis{tJ(tt-r[rI
itm & [iocume
rJ? - 7-,7-l7LtlttilJ
07776002 s7607 Permit Fee
077L6002 53600 Plan Check Fee
07776002 57770 Microfilm Records
08907007 24000 SMIP - Category 2
07776002 57672 Bldg. Stds. Revolving
07776002 s7600 General Plan Update
07776002 57607 lssuance
Fee Total
Paid to Date:
Balance Due:
Graham,
Le, Tung
Zuniga, Allissa
Misc. Receipt
Misc. Receipt
Misc. Receipt
$172.64
$239 34
$4.0s
$0.s0
$1.00
$23 79
$5e 30
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Ffood Zone Cert. Req'd: No
Account#
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterits 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.
Inspector MID#: 2020-162289
01 1 16002 51600
01 1 16002 51601
01116002 51612
01 1 16002 53600
01 1 16002 57770
08901001 24000
$23.79
$231 .94
$1.00
$239.34
$4 05
$0.s0
$500.62
$0.00
$500.62
BUILDING. INSPECTOR RECORD
SITE-WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsu I atio n
Roof Sheathing
Shear Wall
Framing
lnsulation/Enerqy
Drvwall
Ext./lnt. Lath
Brown Coat
lt/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enoineer Final Report
Flood Zone Certif
A.
FINAL 11- 1L'7b1 1ul,x)
Certificate of Occupancv V \J
Notes, Remarks, Etc.\
OWNER BI.ILDER DELCARATION
I hcrcby affirrn undcr pcnalty of perjury that I am exenrpt from thc Contractors' Liccnse law for thc following reason (Scc.7031.5
Business and Profcssion Codc): Any City or County which rcquircs a prmit to construct. alter, improve, dcnrolish or rcpair any
structurc. prior to its issuance, also requires the applicant for such pcrmit to filc a signcd statcmcnt that hc or she ls liccnscd pursuant
to the provisions of thc Contractor's Licenscd Law (Chapter 9. Commencing with Sc"ction 7000 of Division 3 of the Business and
Profcssions Codc) or that hc or she is excmpt thcrefrorn and thc basis for thc allcged exemption. Any violation of Section 7031 .5 by any
applicant for a pcrmit subjccts the applicant to a civil penalty of not nrorc than fivc hundrcd dollars ($50O1.
_1. as owncr of thc propcrty, or nly cnrployccs with wagcs as thcir solc conrJrcnsation. will do thc work and the structurc is not
intcrxlcd or ofl'crcd for salc (Scr.7044. Busincss and Profcssions Code: Thc Contraclor's License [:w docs not apply to an owncr of
thc propcrty who builds or inrproves thercon and who does such work hirnself or hersclf or through his or her own crnployees.
providcd that such imglrovcnrcnts are not intcrxlcd or offercrl for salc. lf. howevcr. thc buikling or inqrrovcnEnt is mld within onc ycar
of comphtion, thc Owncr Builder will havc the burdcn of proving that hc or shc did not buiH or improvc thc proJrcrty for thc purposc of
salc).
_1. as owncr of thc proprty. anr cxclusivcly contracting with liccnscd conlractors to construct thc projc.ct 1Scc. 7G14, Business
and Profcssion Codc: Thc Contractor's License Law does not apply to an owner of propcrty who builds or improvcs thereon,
and who contracts for such projects with a Contractor(s) liccnsed pursuant to thc Contractor's Liccnsc [,aw).
_l am excmpl undcr Sect B. & P.C. for this rcason.
Date:_Owner:-
WORKER,S' COM PENSATION
DF'CLARAT']ON
I hcreby affirm under penalty of pcrjury one of tlrc following dcclarations:
_l havc and will maintain a Ccrtificate of Consent to Sclf-lnsurc for workcrs' compcnsation, as povided for by Secti<ln 37fi) of thc
Labor Code, for thc perfornunce of thc work for which thc permit is issued.
_lhavcandwill maintainworkcrs'colnpensationinsurancc.as requircdbySection3T00ofthcLaborCodc.forlhepcrformanceof
thc work for which this pcrmit is issucd. My workers' com[rcnsalion insurancc carricr
\
Policy
_l ccrtity that in thc Jrcrlbrrnarrcc of thc work for which this permit is issucd. I shall not enploy any Jrcrson in any nunner
so as to beconrc subict to thc workcrs'comgrcnsation laws of Calilbrnia. and agrcc that if I should bcconrc subict to thc
workcrs' compcnsation provisions of Scction 3700 of thc [:tnr Code. I shall. forthwith comply with thosc provisions.
WARNING: Failurc to sccurc workers' cotnpcnsation covcragc is unlawful. and shall subject an cmploycr to criminal penalties and
civil fincs up to onc hundred thousand dollurs ($100,ffn). in addition to thc cost of compcnsation. danuges as provided t'or thc
Section 3076 of the l-abor Code, intcresl and
I hcreby affirnr undcr pcnalty of prjury that I anr liccnsed under provision of Chaptcr 9 (comrncncing with Scction
of thc Busincss and hofessions Code. and rny license is in full forcc artd cft'ect.
.1
l,iccnsc Nurnbcr:ID 7 o
Il..r ,..
I hcrcby afftrm urdcr pcmlty of Frjury thil thcrc is a mnstructk n lcnding agcrcy for the JErforrc of the work for which this pcrmit ir
issucd (Sc. 3097, Civ. C.).
Lcndcr's Namc:
l-cnder's Address:
A PPLICA NT NT'CLA RA TION
I tucby affrm undcr pcnalty of pcrjury one of the following declarations:
Dcmolition Pcrrnits-Asbcstos Notification Fedcral Rcgulations (Title 40, Part6)
_Rcqu ired Lcttcr of Notification
_l ccrtify that thc lbdcralregulations rcgarding asbcstos rcnrovalarc nol applicablc to this projc"ct.
arul statc that thc atnve infornration is correct. I agrcrc to comply with all City and County
corrslruclion.and hercby authorize reprcsentat\f this City and County to enter upn the
abovc nrcntioncd proprty for
.{pplicant or Agent
Pernriter name
purF)scs.
holo / O ,- t-l ,-Lc, 2^r
Rev. 08-07-201 5
Date: