HomeMy WebLinkAbout10199592 - Permitciff of Santa Ana 20 civic center Plaza (M-19), Santa Ana, cA 92702
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647
Bu ing Permit #: { O{ 99592
Pin #: E755O
Proiect Address: 4501 3/4 W MacArthur Blvda
Assessor's Parcel:41 5-031 -31 Lot: POR 1 Block: NA
unit:WCC01 Blds:
Tract: NA
Address Range:Suite Range:
Zoning: M2Historic: No
Building Use: Other Occupancy: lJ 'lst FL Area: Palio:
Job Type: Miscoll.neous Constr Type: NrA 2nd FL Area: T-l.Area:
Nature ofwork: cellsite code: cBc2ol6 olherAreas: yards Reqd:
Existing Bldg. & Use: Celt site Flood Zone: x..0602320258J
prcposed use: # of stories: Garage Area: valuatlon: $25'000'00
Total:
Do.cription of wo.k: lnstall(12) dlplexers on tower, roplaco (3) dual mounts, install (9) RRU'B on tower, instell (1) raycap in oqulpment, lnBtall (l) hybrld
cable/contract price
Planning Conditions:
Entch*:5436ti - ?/12/21-t2t-t JD: crmoroler;lEnlf ire: (:TYH Trnnsi: 6? I tif LA,:*Li: Ref *: lt:tt??:j??
PSAC Development PArtners LP
701 eastern Ave 1st Floor
Santa Ana, CA 92704
(818) 244-8080 ext. 1350
Verizon
Contractor: Alamon Telco lnc
Address: 3'15 West ldaho St
KALISPELL, MT 59901
Phone: (406) 531-2187
State Lic #: 652774
Lic Type: B, C-61, C-7, D-31
Bus. Lic #: 342171
Workers' Compensation lnsurance:
Carrier: Zurich American lnsurance Comp:
Policy #: WC0230054
Expires: 1213112019
J5 lnfrastructure
Jose Carlos Faz
2030 Main Str€€t, Suite 200
lrvine, CA 92614
s 5ss0
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
i76(r.ilt)
Owner:
Address:
Phone:
Tenant:
$7?3.3:|
Planning Approval By:
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd: No
PWA lnsp. Req'd: No
Planning lnsp. Req'd: No
Landscaping lnsp. Req'd: No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Fregoso, Vince
So, Anson
Chavez, O.u"5Z?
Date: 03/01/2019
Date: 05/30/2019
Dale: 0211212020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
o, n 6 [ff2 i lit h. d6ll{{ld'Pts $666.1 2
07776002 i53€eoi8bB..GhcdrrEee ;ir;_ii; , :,, $23QiE7
07776002 57770 Microfilm Records $3.91
08907007 24000 SMIP - Category 2 $Z.OO
07776002 57672 Bldg. Stds. Revolving $1.00
07775002 57600 General Plan Update $22.95
07776002 57607 lssuance $57.20Account#
72377
Total
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 360 days after its issuance,or if the work authorized
on the site by such pe rmit rs suspended o r abandoned for a period of 360 days after
the time the work is commenced.
01 1 16002 s1600
01 1 16002 51601
01116002 51612
01 1 16002 53600
01116002 57770
08901001 24000
$22.9s
$723.32
$1.00
$8.71
$3.91
$7.00
Fee Total:
Paid to Date:
Balance Due:
$989.05
$222.16
$766.89
lnspector MID#: 2019-149802
Srf r I
BUILDING. INSPECTOR RECORD
Rev.08-07-2015
SITE.WORK DATE ID/SIG.COMMENTS owNI.tR lrtIl,t)t:R Dt]t,c,tRATIoN
I hcreby rffirm under penalty of pcrjury that I m cxenrpt fronr lhe Contractos' LiceDsc law for the following rcason (Scc.7031.5
lJusincss rnd Prol'cssi()n Codc)r Any Cily or County which rcquires a Jtrrnit to conslrucl, altcr, irnprovc, demolish or rcpair any
slnrclure.priortoils issuance.alsorcqilircslheapplicliltfi)rsuchpernritl(]tileasignedstatemenl lhatlEorshcislicensed pursuant
ro thc f,mvisions ol rhc Cohlraclor's l.iccnrcd [nw (Chapter 9. Commcncin8 wilh Section 7(XX) of l)ivision 3 ol lhe Business and
P(rtssionsCode)orrharheorsheiscrempltherehonrarrlthcbasisti)rlltallegedexemprion. AnyviolariulofSeclionT0Sl.5byany
rpplicrnt Ibr r pennit subjects the npplicant to r civil pcnihy of not rmre lhiln five hundred dollars ($5{X)).
_1, as owncr ol'thc propcfly, or rny crnpbyccs wilh wagcs as thcir solc cornpr:nsation, will do thc work and lhc stnlcturc is not
iilcilded orofferedforule(5*.7044.BusircssandPmfessionsCode:TheConlriclor'sLiaenscliwdoesnotapplytoanownerof
thcpn)Fny wlx)huildsorimprovesthcrdn,arlwlbd(Essuchworkhin)selforhcrselfortfuouthhisorhcrowtremployees.
pro\ idcd lhat such improvcrEnts &c Rn intcrdcd or ollcrcd lbr slc. Il. howcvcr. rhc tf,riHiog or irprovemnl is soU within orc ycar
ofconq:lctirrl the Owrrr Builder will lutvc thc burden ofproving lhd lE or shc did il{ buill or inrpruve the profrcny for tlE pu(ns of
salc).
_1, as owner of the propcfly, am exclusively conlractinS wilh licensd conlraclors to construcl lhc prc.iect (Scc. ?(X4. Business
arxl PnrllssirrC<xlerTheConlractor'sLicenseLawd(Es0ollJrplybanownerofpropcnywhobuildsorinrprovesthereon.
and who contractsforsuchprojcclswithaConlmcb(s)licen*dpur\uadtotheCootractor'sLicenscbw).
-IlnrexemPtnnderseclion-,R,&P,C-tilrthisreasou,l)alr:_
woRKt:tts' coMP!:NsA'fl oN
DECLARATI0N
I hcrchy amrm undcr pcnalry ofperjury onc ofrhc followin8 dccleations:
_lhaveardwill MintainaCeflit'icatcofConsentloSclFlnsurcforworlcrs'compensation,as prcvidedforbyScctionJT00ofthe
\Ftrrr Gxlc, tor thc pcrlorlr1mc of rhc work lor which ttr. lErmil i\ is\ucd.t-
{hor.ondwillnHintrinworkeB compc[salioninsurance,as requircdbyScclion3T0OofthetlborCode,forthelErfomrccof
thc wi,rk lilr which this pcrnrit is iosurilncc ca[icr ifrl lxrlicy nunrtrr nrc:
- .Zuric*t lN Sl/trcrttf e
Policy Nu
a tl'rt )r)
_l ccnity that in thc Nrlirrnuncc ol'tlrc work for which this pcrmit is issucd, I shall not cmploy nny Jrcrson in any manncr
so ss lo hccorrc subjcct h lhc workcrs' conrpcnsatior laws ol'Cali fornia, aDd sgrce thal it I stnuld becorre subjcct to lhc
worlers conrlrcnsatioD pruvisions ofSectiotr 1700 ofthc l-attr C'ode, I shall, fonhwith rnnrply with thow pruvisions.
WARNING: Failure k) scure workcrs'compcnsalt)n covcrugc is unlawful. and shall subjcct an eDployer to oiminal pmltics and
civil lines up to one hundrcd thousand dollnrs ($l(X).(xx)), in addilior lo lhe cost ofcoillpensation, darrurgcs ns provided for thc
Sectior 1076 oflhc lrtDa C(xle, interesl and atkrrrey s feer.(
f
I hcreby allirm undcr pcnahy oIperjury rhal I am licen$d Chaptcr 9 (cornrrcncing wilh Scclion 7mO) ol l)ivision l
of tlr llusiness and l'roli'ssirrns Cotlc. md nry liccn\c is in fill li)rcc ril(l ('icct.
Liccnsc Nurnla'r:6bA 774
-|2D
CONSTRTJC'TION I,I:NT)INC AGI.:NCY
I hcrcby allirn under Jenalty of periury thal there is a con\lnlcti(nr leildilS agerEy tor rhe fErfrrrmance of the work fbr which th$ fEmit is
issucd (Scc. :1097, Civ. C.).
ktrdcr's Name:
[-cn(lcr's A(klrcss:
APPLICANT DECLARATION
I lHeby rffmr under pcnalty of perjury onc of the followirrg declarations:
DenDlirion Pernrits-Asbestos Notification Federal ReSulatiotrs (Title 40, Pnrt6)
-Retluired
trtter of Notification
\ Ilcaily rha( rhe federal relulrrioDs reStrding rsbesbs renxrval ure not applicable b rhi\ pr().icd.
ffi*n* ,'nnt traue rcr.l rtris a-pplication and slale lhat lhe nbovc irfornidtion is corecl. I ngre to conrply wirh all City anrl County
;;;-:,-:,ffii""i-"'W- ^," - 2-tv'ao
Pcmritee name (prinl r,
U
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsu lation
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
lt/asonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enoineer Final Report
Flood Zone Certif
I t^
FINAL
Certificate of Occu
Notes Remarks Etc.
-
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