HomeMy WebLinkAbout10197328 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA927O2 Building
PermitCounter: (714)647-5800 lnspection Requests (714)667-2738 lnspectorSection: (714)647-5853
Permit #:1O197328
Pin #: 14067
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Proiect Addressi 2274 E Seventeenth St-a- -Unit Bldg:
Tract: MAYBURY
Address Range: 2000-2278
Historic: No
Suite Range: 2262-2278
Zoning: ClAssessor's Parcel-400-121-01 Lot: 1 Block: NA
Building Use:
Job Type:
Nature of Work
Existing Bldg. & Use:
Proposed Use:
Commercial
Demolition
Demo
Commercial
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
A-2
V B, SPK
cBc 2016
x-0602320164J
,l
1st FL Area
2nd FL Area
Other Areas
Garage Area:
Totat
Patio.
T lArea
Yards Req'd
Valuation:
0@0
$1,500.00
Description of Work: Demo only- Tl under seperate permit (ref#l016906)
Planning Conditions:
Owner:
Address:
Phone:
Tenant
lCl Development, Mick Meldrum
2222 E Seventeenth Street,
Santa Ana, CA 92705
17141541-1200
Mediterranean Guy lnc
Contractor: BZConstructionlncorporal
Address: 25561 ADRTANA STREET
Mission Viejo, CA 92691
Phone: (949) 3384529
State Lic #: 836849
Lic Type: B
Bus. Lic #: 349173
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 9161554
Expires: 0612512019
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01116002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 53600
01116002 57770
Mar, Escarlet
Kwak, Jason
Zuniga, Allissa
Date:08/13/2018
Date: 08/13/2018
Date:08/13/2018
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07716002
07776002
07776002
07776002
07776002
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57607
53600
57770
57672
s7600
57607
$160.25
$222.16
$15.04
$1.00
$22.08
$55.04
No
No
No
No
Account#Total
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 180 days after its issuance,or if the work authorized
on the site by such permit is suspended or abandoned for a period of1 80 days after
the time the work is commenced.
$22.08
$2',t5.29
$1.00
$222.16
$15.04
Fee Totat
Paid to Date:
Balance Due:
$475.57
$0.00
$475.s7
Permitee MID#: 2018-144389
BUILDING- !NSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNI'R IIUILDER DEI-CARATION
I hcrcby illlirm undcr pcnnlly ol pcrjury lhal I anl cxcnrpl fft)trr lhc Onilraclors' l.iccn\c Law frrr thc fblkrwing rcasirn (Scc.7031.5
llusincss lnd I'rolcrsion Codc): ADy Cily or Counly which rcquircs r Ernrit to conslrucl. ollcr. infrovc. dcnx)lish or rcpair ilily
slruclurc. prior Io its issuailcc. illso rcquires thc applictrnl for such lrcrnrit to lilc a signcd statcilrcnt thrl hc or shc is liccnscd pursuilnl
lo thc provisbns ol-lhc Contrrcbr's Liccnscd hw (Chaptcr 9. Conrnrcncing wilh Scclion ?(Xlo oi Division 3 of thc Busincss and
I'ro[cssionsCodc)orlhalhcorshciscxeDlJillhcrcfromflndlhchrsisli,rlhcxllcgc(lcxcnll)lioil. Atryviol{tionoiScclionT0.]l.5bytny
rpplicnntli)rapcrnlitsubjcctslhc ilpplicantk)acivilpcnaltyolnotmorcthnnlivchundrcddollars(S5(n).
-1.
as owncr of lhc propcrly. or my cmployccs wilh wcgcs ns thcir \olc coilipcnsal i()n, will do thc work und thc structure is not
inlen(lcd or ofltrcd lbr qlc (Scc.70.l.l. Business and l'rofcssions C]odc: The Contrack)r's I-icensc Law docs nol upply h xn owncr of
lhcpropcrly whohuildsorinlx)v€slhcrcoil.ilxlwhod()cssuchworkhinrsclfr)rhcrsclforlhroughhisorhcrowncntphyccs.
l)rovi(lcd lhrl such irilprolcnttrls arc nol irilcfilcd orollcred for sah. ll. hoscvcr. lh( huiklirrg or improvenrnt is \oH wilhin (ntc )ril
srlc ).
-1.
as owncr ol thc Propcrly. rnr cxclusivcly c(nilracting wilh liccnsc(l conlrackrrs lo construct lhc p()iecl (Scc. 70l.l. Busirrcss
oM Pn)fcssi)n Codc: l hc Conlrnclor's l-iccnsc Lnw doc\ trol rpply lo an ()wncr ofprrrpcrly who buildr or inrproves thcrcon.
rnd who conlrilcl\ tbr such projcct\ wilh a Corilrnctor(s) liccnsed l)ursurnt lo lhc (i)nlrirck)r's Liccnsc l,ilw)-
_l ilrn cxcmpl undcr Scclion_. ll. & P.C. li,r this tcrsoo.
Dale:_ __ ownerl
lVO RK E RS' C( II\I PENSA TION
NECLARATI(IN
l hcrchy allirnr undcr pcnaltyol pcrjuryonc of lhe lblk)wilg dc.lilrations:
-l
have and will ilrriiltuin a Ccdificillc of Cotr\cnl lo Scll:lnsurc f()r workcrs coilrl)cnsation. as providcd Ii)r hy Scction l7U) of thc
hkr Codc. for the pcrli)rtruncc oflhc work tbr which lhc pcrnrit is is\ucd.
-lhavcandwillnrainlxiDworkcrs'cofllpcnsalioninsurancc.x(
rcquirc(lhySccti()nJ7(X)ollhct,ahorCode.li)rlhcpcrlirrtnnccol
lhc work lin which thir pcrnrit is issu(I. My workeN coilll)crlsiltioD insurrncc canicr antl 1x)licy nuillhcr luc:
l'olicy Nu
I ccnily that in thc Jrrl(,rmrilcc olthc work l'or $hich rhis fcrnril is issucd. I shrll not cnlploy rny Nrson in any manncr
so as lo bcc()illc subjcct t) lhc workcrs'cotrrl)cnsation Iaws ol Crlilbillia. rnd dgrcc lhal il I should bccomc subjcct k) thc
st)rk('r\' conllcilulion provisions ol Scclion -17(I) ol lhc [-rtnr C{xlc. l shrll. lorthwith conrPly wirh tho(c pft)!i\ions.
WARNINC: Ftrilurc lo sccurc workcrs'conrpcnsalir)n coveragc is unlawlul. nnd shrll suhFcl nn cillpk)ycr lo crirninal Jrnilllics nnd
Sccli(n .1076 of lhc l-ak)r (-odc. irilcrcst and atk)rncy \ l-ccs.
l)rlr:
--
Appliont:
t,ICI!NSED CONTRACl'()R
DECLARATION
I hcrchy alllrm under l)cnally ol pcrjury lhat I anr liccn*d undcr provisio0 of Chilpler 9 (conrnrcncing with Scclion 7(X)0) ol Divisior 3
of lhc Busincss and Prclcssi()ns Codc. an(l mv Iiccilsc is in full lorcc {nd cffcct.
l-iceilsc
Dale:
-iccnsc Nunlhcr:
C0Dlra(krr:
CONSTRUCTION LITNDING AGENCY
I hcrchy aflirm under lttrtlty of pcrjury lhrl lhcrc is il conslrucli(nr lcnding nScncy li)r lhc pcr[orn]nncc o[ thc work for *hich this Jrrmit is
issued (Scc. .1097. Civ. C.).
I rndcr'\ A(ldrc\\
APPLICAN'I DECLARATION
I hcruhy allinn umlcr pcnalty of Ircrjury onc of lhc folhwing dccltrrtrtions:
DcmolitioI Pcrntits-Asbcstos Notillcxtion l:cdcrnl Rcguhlions ('l'itlc 40. I,iln6)
_Rcquircd Lcttcr of Notilicxtion
_l ccaily thill Ihc lcdcrnl rcgulillioils rcgilrding rstrsk)s rcrnoval rrc n(x npplicahlc to lhis proicct
-l
cctrify lhal I hnvc rcild lhis ilpplicalion ilnd sltlc thnt lhc akrvc inlirrnut ion is corrcct. I igrcc to cotnply with illl City and Counly
ordinnilccs ilDd Slrlc [ilws rclatirrg to building conslrucli()n. ud hcrchy authorizc rcprcscnlnlivcs oflhis Cily lnd County to cntcr upoD tlrc
abovc n)cnlioncd propciy li)r iDspcction purposcs.
Apl,licilill or Agcnl SigDalrrrc:
Prnrilce naDe (prinl):
Ih(r:
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Vent/l nsu lation
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
[/lasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL /-/f-t? ,J)e{d-(9
Certificate ol Occupancy
Notes, Remarks, Etc
(:uri.r
lrndcr's Namc: