HomeMy WebLinkAbout10198138 - Permitcity of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 tR Building Permit #: 10198138
Pin #: 94652Permit Counter: (714)647-5800 I Requests. (7 1 4) 667 -27 38 I nspector Section: (7 1 4) 647 -5853
Proiect Address: ffi E Seventeenth Sta
2
Assessor's Parcel:400-231-02
Unit:Bldg: Address Range:Suite Range:
Zoning: C4Lot: NA Block: NA Tract: NA Historic: No
Building Use: Commercial Occupancy: M 1st FL Area:
Job Type: Revision Constr Type. V B, SPK 2nd FL Area:
Nature of Work: Revision Code: CBC 2016 Other Areas:
Existing Bldg. & Use. Commercial Bldg Flood Zone: x-0602320163J
Garage Area.
Proposed Use: # of Stories: , ,o,r,,
Description of Work: Revision to 10186458 - relocate (1) roof mtd unit. No mechanical revision required per Anson So
Planning Conditions: Existing parapet screens
Patio:
T.l.Area:
Yards Req'd:
Valuation: $0.01
Owner:
Address:
Phone:
Tenant:
Venture Point lnc
4685 MacArthur Ct #375
Newport Beach, CA 92660
(949) 676-4660
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Engineer:
Address:
Architect /
Desiqner:
Address:
Phone:
License #:
Greenberg Farrow
Rod G New
19000 MacArthur Blvd, Suite 250
lrvine, CA 92612
(949) 296-0450
3419
Greenberg Farrow
Douglas Cooper
1430 W Peachtree St NW
Atlanta, GA 30309
(404)6014000
c-25874
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
Arabe, Jill
So, Anson
Amsden, Julie
Dale: 1012512018
Dale. 1012512018
Dale: '1012512018
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Flood Zone Cert. Req'd: No 01fi6002 53600 $222.16
07776002 53600 Revision
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
$222.16
$0.00
$0.00
$222.16
$0.00
$222.16
No
No
No
No
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 1 80 days after its issuance,or if the work authorized
on the site by such permit ls suspended o r abandoned for a period of 1 80 days after
the time the work is commenced.
lnspector MtD#. 2014-118337
Phone:
License #:
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS owNuR l|U[.t)Ett I)Iil,( Al{A'IloN
IhercbyaflirmunderpcnaltyofperjurythatImexemptfromthcContractors License[-awforthefollorvingrmon(Se.7031.5
Businss md Profcsion Code): Any City or County which requira a pcmit lo construct. allo. improve, detnolish or repair any
slruclure. Frior to ils isumce. also requirG the applicant for such pmnit to file a signed statemenl that he or she is licensed puEuilt
to lhc provisions ofthe Contraclor's Licensed law (Chaptq I, Cormencing with Seclion 7000 ofDivision 3 ofthe Busincss md
l,rofe$ions Code) or lhat he or shc is exempt thdefiom Md the b6is for the alleged crmplion. Any violation ots6tion 70,11.5 by any
applicanlforapmnitsubjcctsthe applicanttoacivilpenaltyofnotmorclhanfivehundreddollus($500).
_1, o orvno of the prorErly. or my employs wilh wag6 6 their sle conrpflsalion. will do thc work ud the structue is not
intmdql or offsed for ste (Se.7044, Businas ad Profesions Codc: 'Ihe Contrsclor's l,icnse taw do6 nol spply to d oMs of
the preFrty who builds or improra thoon. md who doc such ro* himself or hmelf or through his or ho om entployee.
provided that such improvflmts de not intmded oroffoed for sle. If, howwq. the building or improvonent is sold within one )s
ofcompletion, the Grner Buildq will have the btudm ofproving that he or she did not build or improve the propsty for the purpos of
sale).
_1. N owns of the prcpqty. an exclusively contracting wilh licensed contractoE to comtruct the prei6t (Se. 7044, Busins
and ProfqsionCode:TheContractor'sLiccnscLawdo6nolapplytomownsofpropertywhobuildsorfunprovslhs@n.
and who contracls for such projms with a Contrado(s) licmed purs@t to lhe Conlraclor's Licme [aw).
I an cxernpl unds Section-. B. & P.C. for this r6on.
l)ate ()sncrl
I hreby affirm undo penalty ofpqjury one ofthe following
_l have md will mainlain a Cffificate of Co$mt to Self-l$ure for workcrs' conrpensation, 6 Fovided for by Sstion 3700 of the
kbor Code. for the pqfomoce of the work for which the pennit is issued.
-l
havc and will maintain workers compensalion insurance. as rcquircd by I
the *ork for which this pmnit is isued. My workers' compmsation iuuruce
Sslion 3700 ofthe Labor Codc. for lhe psfonnmce of
cmier md policy number ue:
Policv Numbs: Expires:
-
_l cenify lhat in the psformance of the work for which this pennil is issued. I shall not employ any person in any marnq
rc otobecomesubjrttothework6s'compesdionlawsofCalifomia.ildagtwthatiflshouldbecome subjecttothe
workq-s'composatiooprovisionsofSection-lT00ofthetaborCodelshall,fonhwithcomplywiththosprovisions.
WARNTNG: Failure to sue workm' compmation covmge is unlarvful. and shall subjat m onploye to qiminal petElli6 ild
civil fine up to one hund,ed lhouwd dollm ($100.000). in addition to the cosl of compensalion. danages o provided for the
Section 1076 ofthe Labor Code. inttrBt md altorney's fees.
Dxte:-_- Appliqnl:
LICENSED CON'TRAC'I'OR
DECI.ASAIION
I hoeby allmr undo pmahy ofpsjury lhal I m licorul undo provision ofchaplq 9 (commencing with Section 7000) of Division 3
of the Busins and Professiom Code. od my liceme is in full force md effel.
Licemc Class:-Liceme Numbq:
Da(e: Cotr(rac(or:
CONSTRUCTION LT'NDING ACFN('Y
I hreby affrrn undo penally of pqjury that thqe is a co[slrlclion loding agency for lhe psfonnoce ofthe work for which this psmit is
issued (Sec. 3097, Civ. C.).
Lendrr's Narne
Lender's Ad&s:
ATILICANLDECI.ABAIIAN
I hqtby amm undq penalty of pqjury one ofthe follorving drlaations:
Demolition Psrnits-Asbeslos Notification Fcderal Regulations ('l itle 40. Pa16)
-Required
Lelter of Nolification
-l
cdiry that lhe federal regulatioN regdding abestos rernoval oe nol applicable to lhis project.
I cenify thal I have rcad this application md slate that the abovc infomation is corffl. I agre lo conrply
f this City
u ith all City and County
and ('ounty to entq u[x)n theordirancB ild Stalc LnNs relating to
above nlentioned property for
ffnnti""ut o. ag"nr
L,
l- Pemitce nNmc (print):
conslruclion. ild hereby authorizc reprsentatives o
l)rlc:'./4/L
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/VenUl nsu lation
Roof Sheathinq
Shear Wall
Framinq fflp/rq .CGil,)
lnsulation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL 6l{l r1 ,..ra / rt,
Certificate of Occupancy
Notes, Remarks, Etc.
f
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