HomeMy WebLinkAbout10198891 - PermitI
cify of santa Ana 20 civic center Plaza (M-19), santa Ana, cAg2702
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Building Permit #: 1O19889{
Pin #: 5O25O
Proiect Address: 1022 E Fourth St Unit:Bldg: Address Range:Suite Range:
Zoning: SD84Assessor's Parcel: 39847'l-02 Lot: NA Block: NA Tract NA Historic: No
Building Use: Commercial Occupancy: NrA 1st FLArea Patio:
Job Type: Demolition Constr Type: NrA 2nd FL Area T.t.Area:
Nature ofwork Demo Building Code: cBc 20'16 OtherAreas yards Reqd
Existing Bldg. & Use: Comme.ical Flood Zone: X-0802320276J
proposed use: # of storiesi Garage Area valuation: $'l'000 00
Total O
O6c.iption of Work Demolish all structurcs to facilitate new aesidential proi6ct. Founation and parking lot to remain. (lnclude6 addrrsaea 10211026,.
1028, and 1030 E 4th St.)AQMD on file. Bond posted on M-72052
***Storm Water Pollution Prevention Plan Reo'd**
Planning Conditions:Addresses need to be deactivated once demdlished.
it:..
irri
Owner:
Address:
Phone:
Tenant
Toms Truck Center
909 N Grand Ave
Santa Ana, CA 92701
(71415604145
Contractor: Tight Quarters lnc
Address: 2031 S Anne St
Santa Ana, CA92704
Phone: (714) 557-9701
State Lic #: 584915
Lic Type: C-61, C-21, C-12
Bus. Lic #: 133416
Workers' Compensation I nsurance:
Carrier: State Fund
Policy #: 9243055
Expires: 0'110'|.12020
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
No
No
No
No
Guevara,
Zuniga, Al
Jerry I
llirr"Y
Date: 01/10/2019
Date:
Date:01/10/2019
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
$160.25
$1.00
$22.08
$55.04
$238.37
$0.00
s238.37
Fire lnsp. Req'd:
Police lnsp. Req'd
No
No Account#Total
07716002 57607 Permit Fee
07776002 57672 Bldg. Stds. Revolving
07776002 57600 General Plan Update
07776002 57607 lssuance
Fee Total
Paid to Date:
Balance Due:
Flood Zone Cert. Req'd: No
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 ls suspended or abandoned for a period of 1 80 days after
the time the work is commenced.
01 1 16002 51600
01 1 16002 51601
01116002 5't612
$22.08
$215.29
$1.00
lnspector MID#: 2O19-1487OG
#
BU!LDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS oWNERBUILDERDELCARATION V
I hcrchy allirm undcr pcnalty ol pcrjury thilr I am cxcmpt lrrm thc Contrack)rs' [-iccnsc Law fi]r the ti)llowing rcason (Scc.7oll.i
Busincss and Prolcssi{)n Codc): Any City or County which requires a frcrmit to conslrucl, altcr, improvc, dcmolish or rcpuir any
structurc.prir)rk)ils issuancc.als()rcquircsthcnpplicantli)rsuchFrnlilk)fileasigncdstatcmnt lhalhcorshcislicensed Pursuanl.
b thc provisions ol'tlE Contract)r's Licenscd l-aw (Chaptcr 9. Comntcncing wilh Scction 7000 ot Division ,l of thc Bu\trtrs and
P()l'c$si(msCoJc)orthatheorshciscxemptth!-rcliomxndlhcbasislirrlheallcgcdc\cmption. AnyviolationolScclion?0-ll.5byany
appli(ant lilr a permit suhjccts lhc applicant k) a civil pcntlly of not nx)rc than fivc hundred dollars (S500)
_1. ns owncr of th!' p()[rcdy. or n1y empl()yccs wilh wJgcs rs thcir solc conrpcnsali()n. will do llE work drj lhc stnrcture is n{,1
inlcndcd oroflcrcdlbrsalc(Scc.l044.BusincssandProltrsionsCnlc:lhcContracklr'sLicensel,!wdoesnotapplyhMowncrof
thcp[)[Eny whohuildsorinrprovcslhcrq)n.ilrdwhod(Essuchworkhimscll'orherscl[orthroughhis()rherowncmpbyccs,
providcd rhnt such improvcmnts trc ft)t intcftlcd or ollcrcd li)r srle. If. howcvcr. lhc huildilg or imprlvcmnl is v)kl within otlc )td
ot comphlion. lhc Owncr Buikler will have tlrc hurdcn ol provinS lhat lE or shc did not huild or imp(tvc lhc ptuFf,{y tbr lhc purF)sc ol
sah).
_1. rs owncr of thc propcny, rm cxchsivcly conlraelirS with liecnsed contractors k) conslrucl thc p()jccl (Scc. 7044. Busntcs\
and l)tDli.ssirn(illc:'lhcConlrictor'sLiccnscl-awdot'sn(ildpnlytornowDcrol'prol{rlywh()huildsorimprovcslhcrcon.
and whr) contraclsli)rsuchpr)icctswilhaCo,ilraet)is)liccnscdprr\uantk)thc(:rtrilrxctor'sl-tccnsclrw).
_l nnr c\ctrrpl nrtrlcr Scct ll. & P.C. lbr thrs rcason.
IVO RK T]RS' COi\I PI]NSATIoN
I)ECLARATION
I hcrchy all irm undcr pcnalty ol pcrjury onc ol'lhc li)ll()wing dcclartli(usl
_lhavcandwill maintainaCc,tilicatcolConscnltlSclFlnsurcli)rworkcrs conlpcnsalion.as providcdli)rhyScction-17(X)ofthc
htx)r C(ilc, lbr lhc pcrtormancc ol thc work li,r which the pcrmit is i{sucd.
_l havc {nd will n[intain workcrs'conrpcnsali()n insuruncc. as hy
thc work ti)r which lhis is
Scct ion .17{X) of thc l-rh}r Codc. li)r lhc pcrli)rnuncc of
crfficr d]d F)licy numhcr trcl
i I 2-D zoPoliry
_l ccflily lha( in thc pcrlbrmrncc ol thc work l'(tr which thrs l--rnr( is issucd. I shall not cmploy nny pcrson rn nny nranncr
s() as k) hccomc suh.jcct k) lhc w(n'kcrs' c()nlpcnsation laws ol Crlifbrtria, rnd rgrcc thrl il I sh()uld hccomc suhjccl t) lhc
work!'r\'cr)mpcnsrtirrrpro!isi{)[\olSccti(r.]7{X)r)tlhcl.atxrrCrxlc.lshill.li)nhwilhcomplywilhlhoscp()visions.
IVARNIN(;| Failurr tr) sccurc workcrs'conrpcnsalion c()vcrigc is unlxwlul. and \hall suhjccl iD crnploycr lo cflminal Ftnxllics and
civil lint's up t) onc hutrilrcd thrNcand dollrrs (.$lm.Ux)). in addil(D to (hc of compcn\rtion. damnSes as providcd li)r the
Sccl()n C(trlc. trilcrcst rn(l
i ro
I hct!hy alljrm undcr pcnalty ol pcrjury that I am liccnsd undcr p()vision ol'Chaptcr 9 (commcncin8 with Scction 7U)0) of Division .l
ol' lhc Business and Prolcssions Codc. url my liccnse is itt lull lirrcc urd clltct.
l,iccnsc 'Nilrilhcr:
(
C]ONSTRUCTION LENDING AGENCY
I hcrchy aftirm undcr Fnalty of pcrjury that thcrc is a conslruclion lcnding agcncy fi)r thc Jrcrlbrmancc of thc work fi)r which lhis FErmit is
issucd (Scc. ,1097, Civ. C.).
[rndcr'r Namc:
I-cn(l.r'\ Arldf('\\:
APPLICANT DECI,ARATION
I lHrhy aliim undcr pcnalty ol pcrjury onc ol thc li)llowing dcclffationsi
Dcm)lit[)n Pcrnlils-Ashcsk)s Nolilicrtion Fedcral Reguhti0ns (Titlc 40. l'dn6)
_Rcqutrcd Lcltcr ()l Nolili.rlnnl
-l
c.rlily thrl lhc lcdcral rc!ulillions rcgiullitl[ ishcslos r('tiloval at(' rxil ilpPlicnhl(' lo lhis pft)jccl
|
-l
."nity rnar lhivc read lhis apnlrcation and slalc rhat thc {h)vc inlirrmali(}n is c()r.ct. I rgrcc lo (omply
I rcprcscnlatives ol lhi\ City
wilh !ll City and C(,unly
and C;()unly to cntcr !F)n thc()rdil)rn!c\ rnd Slrtc l-aws relating
ahovc orL'Dlirrrc(l l[opciy lbr
Applicanl or Ag€nt
Iterilrilee nrtrrr
rulhorizc
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsulation
Roof Sheathinq
Shear Wall
Framing
lnsulation/Eneroy
Drywall
Ext./lnt. Lath
Brown Coat
IMasonry
Pool Fence
T-Bar
Handicap Req
Deputv Final Report
Enqineer Final Report
Flood Zone Cerlif
/(\
FINAL 7-7-7A kWlr\\
Certificate of
Notes, Remarks, Etc
,.a-Lfro[ri-