HomeMy WebLinkAbout101104899 - PermitProiect Address: 400 N Tustin Avea
Assessor's Parcel: 400-043-09 Lot. POR 6 Block: NA
Unit: 240 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
Permit Counter: (714) 647-5800 lnspection Requests: (714)667-2738 lnspector Section: (714)647-5853
Permit #: {01104899
Pin #: 49352
Building Ljse: Cotnlneici.l Occupancy: B lsl FL Area: Palio:
Job Type: Rovlalon Con8tr Type: ll A 2nd FL Area: T.l.Area:
Nature ofwoft: Revlalon code: cBc 2019 oher Areas: yards Reqd:
Exisling Bldg. & Use: Comm.rclal Flood Zone x-0602320277J
proposed use: # of stories: Garage Area: Vtlu'tion:
Total 0
D6cdption of Work Roylslon to PrC# 101103668-69. Ch.ng.3 in int.riorw.ll locationa Add (l) doorto corrido.. Atfoctcd shoeta AD-100, A-100, A-101,
a-102, A601.
Planning Conditions: !nterior ti only. No exterior alterations or modifications
Owner:
Address:
Phone:
Tenant:
PARKCENTER 4OO LLC
PO BOX 1108
Tustin, CA 927811108
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 Nationa! lns Co
Policy #: AMX0820021001
Expires: 0211212021
Elliott Associates
Bert Michael Elliott
16421 Wimbledon Lane
Huntington Beach, CA 92649
(7141 840-s488
E!!iott Associates
Bert Michael Elliott
16421 Wimbledon Lane
Huntington Beach, CA 92649
(7141 840-5488
c8623
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address.
Phone:
License #:
I
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES Insp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd. No
Landscaping !nsp. Req'd: No
Soto, Ricardo
Le, Tung
Amsden, Julie
Date: 1010812020
Date: 1011412020
Date: 1012812020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
74831
07776002 57770 Microfilm Records
07776002 53600 Revision
07776002 57600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
$28.35 -
$9s7.36
$0.00
$98s.71
$478.68
$507.03
Fire lnsp. Req'd:
Police lnsp. Req'd:
No
No Account#Total
Flood Zone Cert. Req'd: No 01 1 16002 53600 {OS?t36. I
01116002 57770 $28 35
qs*
Every permit issued 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#: 2020-158657
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loo r/VenUl ns u I atio n
Roof Sheathino
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
lMasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
FINAL ll-2f,20 e I)eL;fz QZ)
Gertificate of Occupancy
Notes, Remarks, Etc.
OWNER BUILDER DELCARATION D
I hcrchy affirm undcr pcnalty of pcrJury that I am cxcmpt from thc Contractors' Liccnsc Law for rhe following reason (Sdc.7031.5
Busincss and Profcssion Code): Any City or Ccunty which rcquircs a pcrmit lo conslnrct. altcr. improvc. demoli.sh or repair any
structurc. prior to its issuance, also rcquircs the applicant for such pcrmit to ['ilc a signcd statcrncnt that hc or she is licenscd pursuant
to the provisions of thc Contractor's Licenscd Law (Chapter 9. Commencing with Section 7000 of Division 3 of the Business and
Prol'cssions Codc) or that he or shc is cxcmpt theretiom and thc basis for thc allcged excmption. Any violation of Scction 7031 .5 by any
applicant for a pcrmit subjccts thc applicant to a civil penalty of not morc than five hundred dollars (5500).
__1, as owncr of thc property. or my employccs with wages as thcir sole contJrcnsation. will do thc work and thc stnrcturc is rnt
intendcd or otTered for salc (Sec.7044. Busincss and Professions Code: Thc Contractor's Liccnsc law does not apply to an owncr of
the prcpcrty who builds or improves thcrcon. and who does such work himself or herself or through his or hcr own employccs.
providcd that such improvenrcnts arc not intcrdcd oroflered for sale. If, howc'rcr, thc building or inprovcnrcnt is sold within one )rar
of conphtiou thc Owncr Buildcr will have thc burdcn of proving that hc or shc did not buiH or improve thc propcrty for thc purynsc of
sale).
l. asowncr of thc pmperty. anrcxclusivcly contracting with liccrrscd conlraclors to construct thc project (Scc. 7044, Busincss
and Professbn Codc: 'I'hc Contractor's Licensc Law docs not upply to an owncr of progrcrty who builds or improves thcrcon,
and who contracts for such p<rjccts with a Contracto(s) liccnscd pursuant to the Contraclor's Licensc hw).
-l
arn cxctnpt under Scction-, B. & P.C. for this rcason.
Dale:Owner:
womrns'co
DECLARATION
I hercby affirm under penalty of Jrcrjury one of the following dcclarations:
_l havc and will maintain a Ccrtificatc of Conscnt to Self-lnsure for workers' comgrcnsalion, as povidcd for by Section 3700 of thc
I-abor Code. for the pcrfornunce of the work for which the permit ls issued.
_l have and will rnaintain workers' compensation insurance. as required by Section 3700 of thc Labor Codc, for the pcrformance of
the work for which this pcrmit is issucd. My workers' compensation insurance carricr and plicy numbcr arc:
_l cerrify that in thc pcrformarrcc of the work for which this pcrmit is issucd, I shall not cmploy any pcrson in any trurnncr
so as to bccome subjcct to the workcrs'conqrcnsation laws of Califomia. and agrcc that if I should bcconr subjcct to thc
workers' compensation provisions of Scction 3700 of the L:bor Codc. I shall, forthwith comply with thosc provisions.
WARNING: Failurc to securc workcrs' compcnsation covcragc is unlawf'ul. and shall subjcct an entploycr to criminal pcnaltics and
civil fincs up to onc hundred thousand dollars ($100,000). in addition lo thc cost of cortqrcnsation. damagcs as providcd for thc
Scction 3076 of thc [:tnr C-ode. intcrcst and attorncy's fees.
Date: Applicant
LICBNSED CONTRACTOR
DECI ARATION
I hcrcby atfrm undcr pcnalty of perjury that I am licenscd under provision of Chapter 9 (comnrncing with Scction 7000) of Division 3
of the Business and hofessions Code. ard my liccnse is in full force ard effc.ct.
Liccnsc
Date:
Nurnbcr:
Contraclor:_
Policv Nurnbcr: Exoires:
lrndcr's Address:
W
I lEreby .ffrm urdcr JEnalty of lErjury that ttm is a consruction lcnding 8gcrcy for the pcrformc of thc mrk for uhich lhis tEmit is
issed (Ss.3097. Civ. C.).
Lrrrdcr's Nanrc:
A PPLICA NT NF'CLAIIA TION
I hcrcby aflirm undcr pcnalty of pcrjury one of thc following dcclarations:
Dcmolition Permits-Asbcstos Notification Federal Regulations (Titlc 40. Part6)
-Rcquircd
lrttcr of Notification
_l certify that thc f'cdcralrcgulations regarding asbcstos rcnxrvalarc not applicablc to this projcct.
_l ccrtify that I havc read this application arxl slale that the atnvc information
and hcrcby authorize
is corrcct. I agrcc to comply
,representativcs of this City
with all City and County
and cntcr upon thcordinanccs and State [:ws rclating to
abovc nrclttioncd
.rpplicant or r\genl
Permiler nnnre
Rev. 08-07-2015