HomeMy WebLinkAbout101105401 - PermitProiect Address: 515 E Dver Rd
Assessor's Parcel: 411-052-26 Lot: NA
Unit:Bldg: Address Range:Suite Range:
Zoning: MlBlock: NA Tract: 43 Historic: No
City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: {O11O54O{
Pin #: 660{9
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use.
Proposed Use:
Commercia!
Revision
OT lnspection
Commercia!
Occupancy:
Constr Type:
Code:
Flood Zone'.
# of Stories:
N/A
N/A
cBc 2019
x-0602320278J
1st FL Area: Patio:
2nd FL Area: T.l.Area:
Other Areas: Yards Req'd:
Garage Area. Valuation:
Total:
lnspector is David Appel,714-240-3583; contact is AlexDescription of Work: Overtime inspection for Saturday, 1211912020 - permit 'l 01 1 03329, code 34.
Rodriguez, 562-25+14/;2. OK per John Pham.
Planning Gonditions:
Owner:
Address:
Phone:
Tenant:
MDD PARTNERS
17111 RED HILL AVE
lrvine, CA 926145607
Contractor: Oltmans Construction Co.
Address: 10005 Mission Mill Rd
Whittier, CA 906080985
Phone: (562) 9484242
State Lic #: 86393
Lic Type: B, A
Bus. Lic #: 175797
Workers' Compensation I nsurance:
Carrier: Travelers Property Casualty Co
Policy #: UBlN1629892025
Expires: 0710112021
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
Planning Approval By:
Plan Checked By:
Permit lssued By.
NPDES lnsp. Req'd:
PWA Insp. Req'd:
Planning lnsp. Req'd:
Amsden, Julie
Date:
Date:
Date: 1211012020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002 57770 Microfilm Records
07776002 57607 O/T lnspection
07776002 57600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
$4.05
$6e0.56
$0.00
No
No
No
Fire Insp. Req'd:
Police lnsp. Req'd
No
No Account#Total
Landscaping lnsp. Req'd:Flood Zone Cert. Req'd: No 01 1 16002 51601
Every permitissued shall become invalid unless the work on the site authorized by
such permit is commenced within360 days afterifs issuance,or if the work authorized
on the site by such permit is suspe nded or abandoned for a period of 360 days after
the time the work is commenced.
lnspector MID#: 2020-1 5821 1
01 1 16002 57770
$690.56
$4.0s
$694.61
$0 00
$694.61
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl ns u Iation
Roof Sheathinq
Shear Wall
Framinq
lnsu lation/Enerqy
Drvwall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
I /t l;.
FINAL iLlt?-'k r d)f '4Y6-l
Certificate of Occupancy I
Notes, Remarks, Etc.
OWNER BUILDER DELCARATION
I hcrchy attirm undcr pcnalty of Frjury that I am cxcmpt hom lhc Conlracbrs' Liccnsc kw li)r lhc litlktwing rcasrn (Ss.7031.5
Busincss atrd Profcssior Colc): Any City or Coutrty which rcquircs a Jrrmil to conslruct. altcr. impnrvc. dcmolish or rcpair any
stmcturc, prior b its issuancc, also rcquircs lhc applicant lirr such Frmil lo I'llc a signed slatemnl that hc or shc is liccnkd lrursuant
to thc pnrvisi()ns of thc Contractor's Liccnscd Law (Chaptcr 9, Commcncing with Scction 7U)O of Division .l of lhc Busitrcss and
P(rlbssrcns Codc) (rr thal hc or shc is cxemlt thercfi()m and thc basis fbr thc allcScd cxcmption. Any vi(tlation of Setittn 703 I .5 by any
applicant Ibr a Frmit subjccls th€ applicatrl k) a civil pcnalty of not morc lhan fivc hundrcd dollars ($500).
_1. as owncr of thc property. or my cmployccs with wagcs as thcir solc comJrcnsalion, will do thc work and lhc structure is nol
intcndcd oroll'crcd lirr sale (Scc.7044, Busincss and Prol'cssions Crxlc: Thc Contractor's Liccnsc Law dtrcs not apply lo an owncr o[
thc pnrpcrty who builds or improvcs thcrcun. aml who drrcs such work himsclf or hcrsclf or through his or hcr own cmployccs,
prlvidcd that such improvcnrcnts arc mrt intcndcd or ollbrcd lirr salc. If, ltowcvcr, thc buikling or improvcrncnt is sokl within onc year
of complction, thc Owncr Buildcr will havc thc burdcn o[pnlving that hc or shc did not build rlr improvc thc propcrty lirr thc purJxrrc ol'
sah).
_1. as owncr ol thc propcfly, am cxclusivcly contracting with liccnscd contractrtrs to conslruct thc pnljcct (Sec. 7044, Busincss
and Pnttbssion Codc: Thc Contractor's Liccnsc Law tklcs not apply to an ()wncr of proJrcrty who builds or improvcs thcretln.
and who contracts lirr such pro.iccts with a Contractor(s) liccnscd pursuant to thc Cuttlractor's Liccnsc Law).
_l am cxcmpt undcr B. & P.C. lirr this rcason.
Date:0wner:
wonrcns'coltrums
DECLARATION
I hcrcby all'irm untlcr pnalty ol'Jrcr.iury onc of thc lirlkrwing dcclarations:
_lhavcanrlwill maintainaCcrtiticatcofConscnttoSclt-lrrsurctirrwrtrkcrs'conrJrcnsation,as provirlcdtitrhyScctittn3T00ofthc
Latxrr Crxlc', Iilr thc Jrcrlilrmance of thc work tirr which thc prmit is issucd.
kr havc and Scction 3700 of thc Lahor Code, lilr thc lrcrfirrmancc of
arxl Jxrlicy numbcr are:wrlrk lirr
l'olicy
_l ccrtify that in thc Jrcrlilrmance ol'the wrlrk tbr which this pcrmit is issucd, I shall not cmploy any lrcrs()n in any manncr
so as to bcconrc subject to thc workcrs' compcnsation laws of Calililrnia, and agrce that if I stnuld bccomc subjcct to thc
workcrs' comJrcnsation provisions of Scctkrn 37ffi of the Lahlr Codc, I shall. filrthwith c<lmply with thos:c pnrvisions.
WARNTNG: I;ailurc to scurc workcrs'comgrcnsation covcragc is unlawlul, and shall suhjecl an employer to criminal Srcrraltics and
civil lincs up lo onc huntlrcd thrtusand dollars in addition to thc c<tst of comJrcnsalittn,as pnrvidcd tirr thc
Scction -]076 ol'thc Latxlr Ctxlc. irttcrcst and atkrrncy's
DECLARATION
I hercby aflrm undcr pcnalty o[ Jrcrjury that I am liccnscd undcr provision of Chaptcr 9 (commcncing with Scction 7U[) of Division 3
of thc Busincss and Prol'cssions Code, arxl my liccnsc is in ttll lirrcc arxl ctl'cct.
Liccrrsc Nurnbcr:<-
CONSTRUCTION LENDING AGENCY
I hcrcby atftrm undcr lEnalty of lErjury that therc is s coNtruclion lcnding ogcrey tbr thc [rcrlbmcc of lhc uork for which lhis lEmit is
issucd (Se. 3097, Civ. C.).
l-cnrlcr's Namc:
[-cndcr's Address:
APPLICANT DECLARATION
I lrcrcby atlirm undcr pcnalty of prjury one of thc lblkrwing declaralions:
Dcmolition Permits-Asbcstos Notil'ication Fcdcral Rcgulations (Titlc 40, Part6)
-Rcquirctl
l,cttcr of Notilication
_l ccrrily that thc t'cdcralrcgulations rcgarding ashcstos rcmoval arc nol applicablc to this pnrjcct.
statc that thc abovc intirrmation is corrcct. I agrc.c to comply with all City and Cttuttty
hcrchy authorizc rcprcscntativcs of this City and County lo cntcr uJxln thc
atxrvc mcntioncd pnlpcrty for
Applicant or Agent
Pennitce n&nlc
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