HomeMy WebLinkAbout101104351 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
Permit Counter: (7'14) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Permit #: {O110435{
Pin #: 65498
Proiect Address: 801 W Civic Center Dr-a-
Assessor's Parcel. 005-1 4240 Lot: 1-8,'14-30110-16 Block: NA
Unit: 300 Bldg: Address Range:
Tract: WAKEHAM/KEESE'S ADD Historic: No
Suite Range:
Zoning: P
Building Use: Commercial Occupancy: B 1st FL Area
Job Type: Tenant lmprovement Constr Type: V B 2nd FL Area
Natureof Work: Tl Code: CBC 2019 OtherAreas
Existing Bldg. & Use: Commerical Flood Zone: X-0602320144J
Garage Area:
Proposed Use. # of Stories:
Total
Description of Work: New interior non-structural wall to create offices withing existing including new doors.
Planning Conditions: lnterior Tl only.
Patio:
T l.Area: 900
Yards Req'd
Valuation: $18,000.00
a Owner:
Address:
Phone:
Tenant
Cushman & Wakefield
2O2O Main St #360
lrvine, CA 92614
(7141 834-5843
Contractor: Coastline Development
Address: 13911 Enterprise Dr
Garden Grove, CA 92843
Phone: (7141 265-0250
State Lic #: 485187
Lic Type: B
Bus. Lic #: 161044
Workers' Compensation I nsurance:
Carrier. Benchmark lns Co
Policy #: CST5018184
Expires: 0 1lO1l2O21
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address.
Phone:
License #:
Fraser McClellan & Associates, lnc.
Fraser McClellan
8302 Madison Ave
Midway City, CA 92655
(7141 307-6883
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
Kelaher, Selena Date: 09/1 512020 Misc. Receipt:
, tl/ J Lee Engineering lnc Date: 09/1 412020 Misc. Receipt:
\qt Hernan dez, Kathy Date: Ogt24t2O2O Misc. Receipt:
No Subject to Field:
74657
Total
07776002
07776002
07776002
07776002
07776002
07776002
Permit Fee
Plan Check Fee
Microfilm Records
BIdg. Stds. Revolving
General Plan Update
lssuance
57607
s3600
57770
57672
57600
57607
Fee Totat
Paid to Date:
Balance Due:
$243.00
$478.68
$32 40
$1.00
$23.7e
$se 30
$838 1 7
$333 00
$505.17
PWA lnsp. Req'd: No Fire lnsp. Req'd: No
Planning lnsp. Req'd: No Police lnsp. Req'd: No
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
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.
Account#
01 1 16002 51600
01 1 16002 51601
01116002 51612
01 1 16002 s3600
01116002 57770
$23.79
$302.30
$1 00
$14s.68
$32 40
lnspector MID#: 2020-1 60902
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION
I hcrcby allrm undcr Fnally ot Frjury that I am cxcmpl fr()m tlE Conlraclos' Liccn* kw fbr thc tilllouing rcavtn (Scc.7031.5
Busirrcss anl Profcssion Colc): Any City or Coutrty which rcquircs a lsmil kt construct. altcr. improve, dcmrlish or rcpair any
struclurc, pri()r to its i$suatrcc, also rcquircs the applicant for such lrcrmil lo filc s signcd statcmnt that hc or slrc is liensd pursualt
l(, thc pruvisions of thc Contraclor's Liccnscd Lau (Chaptcr 9, Commcncing with Scction 7UX) of Division -l of thc Busincss and
Prctbssions Codc) or that hc or shc is excmpt thcrehom aftl thc hasis ftrr thc allcgcd crcmplion. Any violation of Scclion 70.1 1.5 by any
0pplicant tilr a Jrcmit subjets thc &pI,licatrt kr a civil pcnalty of not morc than livc huudrcd dollus ($500).
_1. as owner ol'thc propcrty, or my employccs with wages as thcir solc compcnsation, will do thc work atil ttrc structurc is not
intcndcd or otl'crcd lirr salc (Sec.7044, Busincss and Prot'cssiorts Crxle: Thc Contraclor's Liccnsc Law dtrcs not aPply to an owncr of
thc propcrty who buikls or impn)vcs thcrc()n. and who drrcs such work himscll'rlr hcrsclf or thrlugh his or hcr own cmployccs.
pnrvidcd that such improvcrncnts arc m)t intcftlcd or oll'crcd tilr salc. If, howcvcr, thc huikling or impnrvctrrcnt is sokl within onc yciu
ol'conrplction, thc Owncr Builder will havc thc burden ol'proving that hc or shc did not build or inrprove thc pruperty lirr thc puryx)st ol
salc).
_1. asowncrof the propcrty, amcxclusivclycontracting with liccnscd contractors to construct tlrc pnrjcct (Scc. 7(X4. Busincss
antl Profbssion C<ldc: 'Ihc Contractor's Liccnsc Law docs not apply to an owner o[property who builds or improvcs thcrctu't,
and who contracts tirr such prcjccts with a C<lntractor(s) liccnscd pursuant to thc Contractor's Liccnsc Law).
-IamexcmptunderScction-,B.&P.C.tbrthisrcastln.
IVO RKEI(S' (]ONT PF]NSATIO N
DI.]C]LARATION
I hcrcby all'irm undcr pcnalty of Jrcrjury onc of thc lirlklwing dcclarations:
_l have urd will maintain a Ccrtiticatc of Consent to Sclt'-lnsurc lilr workcrs' comJrcnsation, as pnrvidcd ltrr by Scctiott 37fi) of thc
Latxrr Codc, lilr thc Jrcrlilrmancc ol'thc work lilr which thc ;rcrmit is issuctl.
_l havc and will maintain workcrs' compcnsation insurancc, as rcquircrl by Scction -1700 ol'thc Labrtr Codc, tirr thc Jrcrlilrmancc of
thc wrlrk lilr which this pcrmit is issued. My workcrs' compcnsation insurancc carricr urd 1xllicy numbcr arc:
Policy Numbcr: Expires:
_l ccrtity that in thc Jrcrlilrnrancc of thc work tbr which this Jrcrmit is issucd, I shall mtt cnrpkry any lrcrson in any manncr
so as to hcconrc subject to thc workcrs' compcnsatiotr laws of Calitilrnia, and agrcc that if I should bccomc subject to tlrc
workcrs' comJrclrsation provisions ol'Scction -17(X) of thc Latxrr Crxlc, I shall. tbrthwith comply with thosc pnrvisions.
WARNING: Failurc to sccurc workcrs'compensation covcragc is unlawlul, and shall subjcct an cmpklycr to criminal pcnaltic* and
civil lincs up to onc hundrcd thousand dollars ($lU),000), in addition to thc cost of compcrtsation, damagcs as providcd tirr thc
all()rrrcy's
I hcrcby allirm undcr pcnalty of pcrjury thal I am liccnscd undcr pnrvision of Chapler 9 (commcncing with Scction 7UX)) of Division J
of thc Busincss and Pnrl'essions Codc, and my liccnsc is in tull ftrrcc and cll'cct.
Liccnse
G+'
W
I hcrcby aflirm undcr JEnalty of Jrcrjury that thqc is a constructbn lcndhg agcrey for thc lElbrmnce of lhc work for which lhis tsmit is
issucd (Se. .109?, Civ. C.).
lrndcr's Name:
[.cndcr's Addrcss:
APPLICANT DECLARATION
I lrrcby all-rrn undcr pcnalty of Jrerjury one of thc lbllowing dcclarations:
Dcmolition Pcrmits-Asbcstos Notification Federal Regulations (Title 40, Part6)
_Rcqu irctl l-cttcr of Notilicatkln
_l cerlily that the l'cdcralrcgulations rcgarding asbcstos rcn'xrvalarc n()l applicahlc to this pro.icct.
6rr'y that I havc rcatt this apptication antl with all City and County
and Courrty to enter uJxtn thcordinanccs and Statc Laws rclating to
atxrvc- mcntionc'd proFrcny lilr insJrcctiorr
Applicant or Agent
Penrrilee narne
thc ahrvc intirrnration
o*", ? -2/-2t?
Set Backs
Forms/Stee!/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVI n s u latio n
Roof Sheathing A
Shear Wall t\
Framing I -%-Zo Vilil'){,),
lnsu lation/Energy (//It
Drywall L an-4 X"Yh,L
Ext./lnt. Lath v \-/
Brown Coat
[\Iasonry 1
Pool Fence
T-Bar JgE fro\[ cu ]rL t0 --7-V)vJ{ou
Handicap Req L,AIJ) ,\, \-/
Deputv Final Report
Engineer Final Report
Flood Zone Certif
/
FINAL k"rtl: I
Certificate of I
Notes, Remarks, Etc.
--
BUILDING. INSPECTOR RECORD
Florr nP.-n79f}16
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