HomeMy WebLinkAbout10114978 - PermitPROJECT
AOORESS:508 N. BRISTOI, STCity of Santa Ana
SUITE '
SU TE
RANGE JOB TYPE RF:S /NE
NA
AOORESS
RANGE]BUILO NG 'CLEAR I.OT
NATURE
LEGAL
DESCRIPTION: Lotl LO Bl@k: NA SFD ANN GAPA(IE
NO, OF Ei(STING
AUILDINGS & USE
rhclr 1152 VN
TYPE OF
CONSTRUCTION:R3./tr1
OCCUPANCY
GROUP:
lh.6by.ftm und.r p.n.rv ol pc'uryth.l l.h.x6mpr lrom lh..onlEctors'lic.ns.l.w lor th6 loll@i.q G.$.
_ S.clron 7044A, I, as M.r ol lh. pmp.ny or my .mploy.6s wilh wages .s
!h.t .ol. comp.ns.tio., will do th6 wlk, .nd th. stuctrr. is nol inl$d.d ot
_ S.cton 70taB l, .. osd o, th. prcpcrty .h .rcusEly @.lr.ctng wnh
lic.nE d @ntr.cto6 !o consirud th. prci.ct.
405 -07 3- L7ASSESSOR'S
(
'TENANT IMPROVEMENT
ANO / OR REMODEL AREA x-oFLOOD
lzoNE
OWNER: CTTY OT SANTA ANA o @
oNEW/ADOL,20 CIVIC CENTER PZAOORESS o2nd FLR SO. FT
zoNrNG sP-1 (O/CSANTA ANA, CA r,/SuAnoN 6500 . OO
ATTN: BOB HAUFFM.AI tsrorue 71{/555-4008 JRPLANNING OATE oe/23/e7
coNrRAcroR: AII{ERICAN CONCRETE CUTTING BLOG, SAFETY
PLAN CHEC( BY.DATE
,KU"ISSUED BY
520 POINSETTIA STAOORESS OATE.oe /2t/ s7
rMPRovEyd(Jrs NREOU REO NLANOSCAPING
REOUIREO
SANTA ANA, C^ 927@L
3907s
k-o
ENGINEERYARCHITECT:
ryPESTATE
LICENSE 3
BUSINESS LICENSE *
I h.Gby.fiim undr p.nafiy ot p.ryry on. ol tn6 iollolei.g D.cl.rrlion!:
l neE .nd will maintain a C.tiric.l. Ot Cons.nt io S.lf-lns'r€ tor Wo 66'
66p.n..lion, es provid.d ior by S.ction 37@ o, th. L.bor Cod., ior th.p.dmancc oi th. rc.t lo. whrch th8 P.mn is Bso.d.
_.lzahav. and willm.inLi. wo.k B comp.nsaton lnrur.ic., .. r.qur.d by
Seno. 37m ol th. trbo, Cod., lor th. p..lona.c. ol th. rcrk lor which this
pofinn i6 issu.d. My Work.ls' Comp6ns:tio. lnsuran.. c.ri.r.nd policy numb€.
Policy Numb.r_
$is;6ctDn.@@
Wo.k.6' Comp..salDn prdisDns d SaclDn
WARNING F.'lur.lo !€cur. Wo,k.rs' Co+p€nsal'on c@rage 's unlawlul .nd
sr.! sub.cl an.Fployer to cnF n.lpenart.s aad c'rll.n.s uDtoon. hLnoredlioG.nd doll.6 (!100,0OO), ih addtion tolh€cosiol comp.nsnon, damages as
prdid.d tor i. Soction 3706 ol th. LaborCod.. rnt 16(.nd ano.n.y's l4s
lc.ft'fv thai in lh. oedorma.c. ol
iFa_ll nor rri'ptoy any pcrcn rn any ma
Comp.nsi@n LaE ol Caliomia, a.d I
the rc.k lo. Ftich this p6.mt is rssu.d I
si,bj@t io th6 wodeE'
ld beom. sublecl to lh6
)T f'a.n a\
ADDRESS:
PHONE
L]CENSE '
I he..by.tn.m under pc.alty or peru.ylhatl.m lE6nsd und6. p@ieons ol
Chaplet9 (comm.n.ins wilh Seclion 7000) o, Oivision 3 ol the gosi.ess and
Prol.ssiona Cod., .nd hy lic.nse is in lulltorco and
+t,5{
PEII{O SFR AND GARAGE AND CLEARLgT / CTTY PROJECT*92A7 ,76A3.7626.1440w.Q.* 48657 , ACC* 325s16631.
( urD BRISTOL')
JOS OESCRIPTION
p 11')t 7
CL
0q
206 W. 4th. Street
2nd Floor
(7 14) 647 -s800
City of Santa Ana
Building Safety Div. M-19
P.O. Box l9EE
Santa Ana, Ca.92701
OTY
1
1
1
AI,IOUNTLts.OO
20.o@
FEE115.O0
FEES:
PERI,IIT FEEI SSUANCECITY JOB
o.ooo.@oo,oorEE TOTALPAID TO DATE
20
8
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:88
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l h.r.by.tfrm dnd.r p...lryol p€lurythat$.r. rs..omltucnon l.nd,rt.s.ncy
tor th. p.rlom.nc. ol d'. e,k lor wnrch tnrs pcrmn 15 is3u.d Se 3097. Cd C )
O.molilio. P.,mits-Asb.stos Notific.tion F6d.6l R.golalioni Oitl. zO P.n 8)
.rLa*rot .*, ,
"rr-oon_l c.tit that h. H.El .c!ul.non3 Elerding .3b..!o3 r.movel ar. nol
.pplic.bl. to this prol.ct
,,ry'
L
-r..r l.9r..lo
Pcnin.. nemc (print)
_l c.rt, th.l I h.6 ,..d this a znd stat. thal th. abd. i.lomatron rs
Couovodin.nc6 and st t l.s
r.pr6e.LtiEs ol lhis Cfy
OWNER-BUILDER DECLARATION
WORKERS COMPENSATIO]'I DECLARATIOT.I
LICENSED CONTRACTORS DECLARATION
CONSTRUCTION LENOING AGENCY
Mailing Addrcss Puhlic Count€r
This p€rmil shalle4rre by limilation and become nulland void iflhewo* ardh.izdd
by lhis permil is nol commenc€d wilhin 180 days lrom lhe dale of lhis perm'l. or if lhe
wort aulho.ized by lhis p€rmil is suspend€d or abandoned for 1 80 days, al any trme
afler \ rort was commencsd. ln such case a new p€rmit shall lirsl b€ oblained before
such v,Jorl can be recommenced.
BUILDING PERMIT PERMIT NO. LoL!4sza
Account No.011-01-5911 - Pafinit Validatioa Cs-ms
- INSPECTOR COPY _
NEW/AOOL.
15i FLR SO FT:
NEW/AOOL.
OTHER SO ET,:
tr a qll
APPLICANTS DECL,ARATION
#r57
Address UniUSuite:
BUILDING ... INSPECTI ON RECORD
Site Work Remarks Date Signature t.D.
Setbacks
Forms/Steel/Holdowns
UFER Ground
Slab Floor
Steel
Pool Fence
Masonry
Notes, Remarks, etc.:
OWNER-BUILDER DECLARATION
I heroby affirm under p€nally ol p€rjury thal lam exompl |rom lhe Conlraclors Law for lhe follo\ ring rsason
(Sec. 7031.5 Busin66s and Protassions Cods): Any City or County which r€quiGs e pormil lo conslrucl, all6r,
improva. d€molish, or r€pair any slructur€, prior lo ils issuanco. also roquirs€ lh€ spplicafll for Buch pormit tofll6 a
signsd slalemsnl thal h6 or she is lic6ns6d puBuanl lo lh6 provisions of lh6 Contractors' Licons€ Law (Chapler 9,
commgncing wilh Seclion 7000 of Oivision 3 ol lho Eusin€ss and ProlsssioB Code) or lhat he or sh€ is sxempl
thororlom and lh6 basi6 for lh8 allgg€d exomplion. Any violalion of S6c,llon 7G,1.5 by any applicanl for a pormil
subjscls lho applicrnt lo a civil p6nal9 o{ nol mor6 than li\,€ hundrod dollars (isfl)).
_1, as ovrnor or lh€ property. or rrly omployses wilh u€06s .s lhok sole comp6nsalion. will do lho rvort, and the
slruc'lurs is ltol iol6nd6d or ofsr.d for selo (S6c. 7(X4, Busin€s6 and Pml63sion6 Cod6: Th€ Conlractora Lic€ns€
La doos nol apply lo an own6r of lho pmporly who builds or improv€G lhor6on, and who doos such $torl himsoll or
hsrs€I or through hb or hd own omploy6€. providod thal such lmprovomonb aro nol lntended or ofr€rod for 6816. f,
hoylrovor, th6 building or impror€m€nl is sold within on6 Far ol complstion, th€ O/vn6r-&rildor will her€ lh€ burdoo
ol proving that ho or sho did not build or amprov6 fo. the purpoco of sslo).
_1. es ov\,ior of lhe proP€rly, am oxclusiwv conlracling wilh llcsnssd conlraclors to conslruot th6 proi6cl (S€c.
7M!. Busino6s and Prof66sions Cod6: Th€ Contractors Lic€ffi€ Law doaa nol epply lo an ownor of prop€rly who
buiid6 or improvo5 th€r6on, and wlto cor{racls for such proj€cls with a ConlEc{o(s) lic6ns€d pursuent to tho
Contraclori' Liconso Law.).
-l
am ox6mpl undsr S*'lion:
Building Remarks Date Signature t.D.
Under Pinninq (floor ioistl
Foundatlon Ventilation
Roof Sheath
lnsulation / Energy
Exterior Lath
T+lar
FRAMING
AFINAL (shell only)
FINAL (Tenant lmDrovementl U4q-11 LUJ.*1a
Dal€:
Erown Coat
Ory Wall
Handicap Requilemerfs
B. & P.C. for this raason.