HomeMy WebLinkAbout10195564 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA e27C2 ' Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #: { O195564
Pin #: 72672
Proiect Address: 900 W Seventeenth Sta
Assessor's Parcel: 005-071-51 Lot: NA
Unit:Bldg:Address Range: 900-980 "
Historic: No
Suite Range:
Zoning: C5
,
Block: NA Tract: NA
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Commercial
Tenant lmprovement
Parking Lot Accessibility
Commercial/Offices
N/A
N/A
cBc 2016
x-0602320144J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
Patio:
T.l.Area:
Yards Req'd:
Valuation: $63,900.00
Occupancy:
Constr Type
Code:
Flood Zone:
# of Stories:
D.3cription of Work: Perking lot accosBibility upgrade6. AlteEtlons to exbling accessible ramF, (164 .xisliDg tIaU!).aa e ..auh total 6talta will bo
reduced by 4.
Planning Conditions tiLP I. i
Owner:
Address:
Phone:
Tenant:
Wellington Square
900 W. Seventeenth Street
Santa Ana, CA 92706
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
CEJ Engineers
15859 Edna Place Suite 10'l
Bellflower, CA 90706
Engineer
Address:
Phone:
License #
Architect /
Designer:
Address:
Phone:
License #:
70635 BuiIdin
u I I l6l:lt:t
CEJ Engineers
15859 Edna Place Suite 101
Bellflower, CA 90706
Planning Approval By: Guevara, Jerry
Plan Checked By: So, Anson
Permit lssued By: 7i X Amsden, Julie
NPDES lnsp. Req'dl ( ,o
PWA lnsp. Req'd: No Fire lnsp. Req'd:
Planning lnsp. Req'd: No Police lnsp. Req'd
Dale: 0211412018 Misc. Receipt: 70601
Date: 04/04/2018 Misc. ReceiPt:
Date: 04/i6/2018 Misc. Receipt:
Subject to Field:
No
No Account#
07776002
07776002
07776002
07776002
07775002
07776002
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57607
53600
57770
57672
57500
57607
Fee Total:
Paid to Date:
Balance Due:
$462.78
$641.58
$2s.34
$3.00
$21.25
$52.98
$1,206.93
$641.58
$565.35
Total
Landscaping lnsp. Req'd: No Flood Zone Cert. Req'd: No
Every permit issued shall become invalid unless lhe 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.
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01116002 57770
$21.25
$515.76
$3.00
$25.34
lnspector MID#: 2018-141480
BU!LDING. INSPECTOR RECORD
SITE.WORK DATE !D/S!G 'COMMENTS OWNER BUILDIiR DEI,CARA'TIoN II hcrcby aft'irtrr undcr pcnxlty ol pcrjury that I arn cxcrnpl lron! lhc (i)nlract)rs Liccnsc Law for thc l'()lk)wing rcn{(tn (Scc.7{ll/5
Busincss nnd Proltssi(t Codc): Any Cily or County which rcquircs n pcrnlil l() construct. rlter. imJrrovc. rlcnrrlish or rcp:rir {ry
slruclurc.prk)rloils issuancc.alsorcquircstheappticantforsuchltrnlitk)lllcil\igncdslatcrmnt lhalhc()rshcisliccnrcrl pursu\t
lo lhc provisbns of llE Conlrrclor's Liccnscd Law (Chuplcr 9. Comnrcncing silh Scclion 7Un of Division J of thc Busircsr ar&
ProlessionsCodc)orthalhcorshciscxcnrptlhcrcftomandthchosislirrthcallcgcdcxcmption. AnyviolalionolSccttrnT03l.5byany
applicctrlforapcrmilsuhjccl\lhc applicnnlloncivilpcncltyofnoltrr)rcthtnlivchundrcddollars($5fi))
_1. as orvncr of lhc l)r()[rcny. or rny cmnk)yccs wilh wn8cs ns lhcir solc comPcnsation. \'illdo lhe work atxl llrc (tnElurc is nol
iilcndcd oroffcrcdli)rslc(Sc-".T(}44.RusincssandhofcssionsCodcifhcContrilck)r'sLiccnscIjwdocsnotnpplykrnnowncrol
lhcpmFny whobuildrorimptr)vcslhcrqrl.Mdwhod(rcssuchworkhimrcl[orhcrsclforthroughhisorhcrowncnuk,ycc{.
providcdthatsuch improlrntnlsilrcnolinlcndcdoroflcRalkrrsalc.lf.hrrvcrcr.thehuildingorinprovcrrcntisy)ldwithiil(ntcJrir
ofcomphli()n. lIrc Owncr Buildcr * ill havc lhc hurden ofproving lhat hc or shc tlirl not hnikl or imrrcvc thc pmfrny li)r lhc purlxrsc of
t4 Pmfijssirr Codc: 'l hc Conlrrclor's l,iccnsc l,dw docs nol apl)ly to rn (,wncl'ol pr()pcrty uho huilds or inrprrvcs thcrcrrn.
ilnd wh() (onlrilclslirrsuchprrjcctswithaC'orilmclor(s)licl'Isc(ll)ur\lhrnl()lhc(i)nlrilcl(nisl-iccnscLnw).
_l nN cxcnrpl undcr Sccl & r,.(-. rbr
Po,,"' { , [[ -t1 X-,".[6(
DECI ARATTON
I hereby aflirrn undcr pcnalty of pcrjury onc ofthc following declaralions:
/ have :uxJ will nuirlain a Ccnificute ofConscnl lo Sclf-lnsurc for workcrs cornfcnsalion. as providcd for hy Scction .17{x) ofthc
Lrbor Codc. for thc pcrfornumcc of lhc work for which thc pcrmit is issucd.
-lhavcandwillnlrinlrinw()rkcrs'conrpcnsrlioninsurance.as
rcquirctlhyScction3T(X)oflhcLahorCodc.fi)rthcpcrli)rnlilnccof
thc work li)r which thi\ pcnnil i( is\ucd. My workers conycn\xlion insrrlncc caricr anrl lmlicy numhcr:rc:
Policy Numhcr: llxnircs:
-l
ccrtify lhal in thc ltrlirrmancc of thc work for which lhis pernlit is issucd. I shtrll nol cnlploy any person in any rranncr
so as lo bcconr suhjccl lo lhc u'orkcrs' conrpcnsalion laws of Calili)mit. rnd ilgrcc lhat if I should hecom subjcct b thc
workers'conrpcnsrli(ilprovisionsofScclionST0Oofthetntx)rCotlc.lshall.fonhwithconrplywiththosp()vist)ns.
WARNING: Failurc lo scurc workcrs'conrpcnsilhn covcragc is unldwlul. and shall subjccl an cillploycr to rrinlin{l lrnilltics tnd
civil fincs up lo onc hundrcd thousand dolLus (Sltn.0fi)). ir ilddit
p
lo lhc cost (,f compclsiltion. danugcs as providcd for lhc
Scction 1076 ol lhc Lrh)r (ixlc. irilcrcsl rnd attorrcy s
)o*",
{-1,UilX 'a.hl.-,l
of thc Busincss and Prrrltssir:ns Codc. and nry Iiccnsc is in lill li)rcc and cllcct.
Liccnsc Class:_l,iccnsc Nuillhr: _
Date: _._-_ Contrsclor:
CONSTRUCTI(IN LENDIN(; A(;ENCY
I hcrcby affirm u[dcr fEnally of Frjury lhal lhcre is a construction lcnding agcncy for lhc pcrformancc of thc work for which this Jrcrmit is
issucd (Scc. .1097. Civ. C. ).
Lcndcr's Nrnrc:
lxndcr's Addrcss:
APPLICANT DECLAIl1\'TION
I hmhy atlirnr undcr pcnrlty of pcrjury onc of lhc following dcclarilt ions:
DcmolitioI Pcrnlils-Ashcslos Nolilicnlion Federal Rcgulations ('l'illc 40. l,rrl6)
-Rcquircd
Lcltcr ol N(f ilicali(trr
\ rcSrrdiilg ashcslos rc'trx)vil ilc nr{ applicrhlc k, (his lrojcct.
i{)n and \lnlc lhrl thc rlxrrr- inkrrrrlion i\ c()rcct- I rgre lo comnly with all Cily rnd County
r rcprcscnlativcs ofthis City ancl County to cntcr uF)n llrcconstruclion. and hcrchy auth()rizc
Applicant or Agent f - | {,r-l(
Pemrilee ntrne ct I
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsulation
Roof Sheathinq
Shear Wall
Framinq
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
IMasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
I I
F!NAL lo g 4d \>fiwY 7
Certificate of Occupancy 7
Notes, Remarks , Etc