HomeMy WebLinkAbout10193410 - Permitcity of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Building Permit#:101934{O
Pin #: 29241PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Project Address: 1666 N Main St Unit Bldg: Address Range:
Assessor's Parcel: 005-153-19 Lot: NA Block: NA Tract: NA Historic: No
Suite Range:
Zoning: SP3
Building Use: Multi-Family (5 or more units)
Job Type: Alter Materials/Methods
Nature of Work: Alternate methods and materials
Existing Bldg. & Use: Commercial
Proposed Use: Residential
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
A-3, B, R-2, S-2
ilA
cBc 2016
x-06023201 63J
5
Patio:
T.l.Area:
Yards Req'd:
Valuation:
Description of Work: Alternate methods and materials-Door arrangement
F
Planning Conditions:
Owner:
Address:
Phone:
Tenant:
Santa Ana Arts Colective LP
1640 S. Sepulveda Blvd. Suite 425
Los Angeles, CA 90025
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation I nsurance:
Carrier:
Policy #:
Expires:
Engineer
Address:
Phone:
License #:
Architect /
Desioner:
Address:
Phone:
License #:
$
Studio One Eleven
Michael P. Bohn
245 E. Third Street
Long Beach, CA 90802
(562) 901-1s00
c21695
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:
Fire lnsp. Req'd:
Police lnsp. Req'd
Date: Misc. Receipt
Dale'. 0712412017 Misc. ReceiPt
Date: 12t1912017 Misc. Receipt
Subject to Field:
07776002 s3600 Alter MaUMethods - S
07776002 57600 General Plan Update
Fee Total:
Paid to Date:
Balance Due:
69800
Total
$853.39
$0.00
, Gerald
k, Patricia
Account#No
No Flood Zone Cert. Req'd: No N/A _ No Balance
No
No
Every permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 180 days after ifs lssuance,o r if the work authorized
on the site by such permit rs suspended o r abandoned for a period of 180 days after
the time the work is commenced.
$853.39
$853.39
$o.oo
lnspector MID#: 2016-133704
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total:
.No
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATTON
I hocby a[firrn under poalty of perjury thal I m exempt from thc ContractoE' License Law for the following .".rnn (S*.zO] I.5
Businas md Profesion Code)r Any City or County which require a pmit to conslruct. alt6. improve. dmolish or repair any.
structure. prior to ils issumce. also requirs the applicant for such pmit to file a signed statmot lhd h@r she is licmsed pursuant
lo thc ptrovisioN of lhe Contractor's Licensed law (Chaplfi 9. Cornrnencing Nith Section 7000 of Division J of the Busins and
Professions Codc) or lhat hc or she is exempt thBcfrom and the b6is for the alleged cxonption. Any violation ofs(tion 70.1 1.5 by any
applicantforapcnnilsubjeclsthc applicanttoacivilpcnaltyofnotmorclhanfivehundreddollas($500).
l. o orvncr oflhe property. or my employG with wage c their rele composalion. will do the work md the strucl@ is not
inloded or offoed for ele (Se.7044. Busines md Prcfsions Code: The Conlractor's l,icrue las dos not apply to an orra of
(he prop€fly who boilds or improve th66tr md who do6 such work himself or hmclf or through his or h6 om employce.
provided that such improvmots ae nol inladed oroffced for glc. l[ howws, the building or im;rovmot is rcld within one ;a
ofcompletion, the Ormq Buildq rvill have the bud6 ofproving that he or she did not build or improve thc prcpsty lor lhe purposeof
sale).
-1,
c owno of the gopoly. m cxclusively contracting u ith licflsed contradoElo construcl the pmjd (Sc. 7044. Busins
and ProftsionCode:ThcContractor'sLicenseLawdo6nolapplytoanownsofpropffywhobuildsorimprovesth6@n.
and who conlracls for such projets with a Contracto(s) licosed puBumt lo lhe Contractor's Licose Larv).
I am exempl unds Section,B. & l'.( . for lhis reason.
X" I )'lg .toi:./hq( r qr ,.
DECI,ARi\ I'I()N
I hereby affirm unrler penalty ofpojury one ofthe follorving declaations:
-l
have md rvill rnaintain a Cffificale of Consml to Self-lnsure for rvorkm' compmsation. 6 provided for by Sstion 3700 of the
hbor Code. for the pcrfommce of the rvork for which the pqrnil is i$ued.
Ihaveandrvillmaintainrvorkos'compensationinsurance.N rcquiredbySection.3T00ofthel.aborCode,forlhepsfomanceof
thc work for rvhich lhis pemit is issued. My workos' cotnpensattrn insurance canio md Jnlicy nurnber ue:
Policy Number lixpires:
I certify thal in lhc perforrnance oflhe work for which this pernit is issued. I shall not mploy any psson in any manns
so ro to becorne subj*l to the workos' compensalion laws of Califomia. and agre thal if I should becotne subj(l lo lhe
rvorkss' cornpensation provisions ofSttion 3700 oflhe tabor Code. I shall. fonhwilh comply with thos provisions.
WARNINC: l:ailurc to sure rvorkm'compensation cormge is unlawful. ild shall subj(t m mploy,o to oiminal poaltie and
civil finesuploonehundredlhousanddollaB($100.000).inadditionlothecostofcompenstion.damagesasprovidedforthe
Section ,1076 of lhe l,abor Code. inlerdl dd atlomw's [6.
lld c,Yq
DECLARATION
I hocby affirrn unda penalty of pqjury thal I m licmsed undo prcvision ofChaptq 9 (commocing with Section 7000) of Division 3
ruf the Busincs md Professions Code, ad my licose is in full force md effst.
License Clas:Number:
)e,,",a -F -?o/-l lw
CONSTRUCTION LENDING AGENCY
I hoeby aflirm undr penalty of pqjury that thqe is a comtruaion lcnding agocy for the pofomocc of rhe work for which rhis pqnit is
issued (S<. 3097. Civ. C.).
Lendq's Namc;
l,cnds's Addras:
APPLICANT DECLARATION
I haeby affirm unds penalty otpojury one of the followinS d(ltrations:
I)ernolition Permils-Asbdtos Nolification Fedtral Rcgulations (Title 40. Paa6)
R€quired lrltd of Notifi calion
_l cftify thal lhe fedgal regulatioE regading 6b6tos rmovAlee not applicable to this prcjet
I cenify thal I have read this applicalion ild slalc lhal lhe ab()ve infotrnalion is corrcct. I agrtr to cornply wilh all Cily and (-ounty
authorize reprGmtalive of this City md Counly to 616 upon lheordinailcB and Stale l.aws relaling to
@ I l\t 00t t if4-
i)-/9-20/?
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/VenUl nsu lation
Roof Sheathing
Shear Wall
Framing
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 (" 'LY 4)(-L t9 N" lO YU-ZD
Certificate of Occupancy
Notes, Remarks, Etc
Canis:
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