HomeMy WebLinkAbout101100907 - Permit@ CifV of Santa Ala 20 Civic Center Piaza (M-19), Santa Ana, CA 92702
PermitCounter. (714)647-580A lnspection Requests: ff14)667.2738 lnspectorSection (714)647-5853
Building Permit #:1O1{OO9O7
Pin #: {3545:J
Proiect Address: 300 W Fifth Sta
-
Assessor's Parcel: 398-255-30 Lot: POR 16
Unit:Bldg:
Tract: BIRCH ADD
Address Range: .420424 N
Brdwy/300, 310
Historic: Yes
Suite Range:
Zoning: SD84Block: NA
Building Use: Commercial Occupancy: A-2 1st FL Area:
Job Type: Tenant lmprovement Constr Type: V B 2nd FL Area:
Nature of Work: Tl Code: CBC 2016 Other Areas:
Existing Bldg. & Use: COMMERCIAL RESTAURANT Flood Zone: X-0602320276J Garage Area:
Proposed Use: # of Stories: Total: O
Description of Work: Tl includes the installation of a new bar. NOTE: Grease interceptor not req'd per PW memo on file.
Planning Conditions: lnterior work only. No exterior alteratons or modifications.
Patio.
T.l.Area:
Yards Req'd:
Valuation:
2500
0@0
$89,750.00
Owner:
Address:
Phone:
Tenant:
S & A Properties
300 w Fifth st
santa Ana, cA 927010000
(7141949-7227 ext.400
La Riconada Mexican Restaurant
Contractor: Athos Group lnc
Address: 10775 Business Center Dr #
Cypress, CA 90630
Phone: (7141713-6311
State Lic #: 997813
Lic Type: B
Bus. Lic #: 374686
Workers' Compensation lnsurance:
Carrier: National Liability and Fire lnsuran<
Policy #: V9WC052597
Expires: 1010812020
Engineer
Addi-ess:
Architect /
Desioner:
Address:
Phone:
License #:
IMP lnterior Material Planners
Bernard Martinez
7699 gth St #'t01
Buena Park, CA 90621
(7141519-8342
Planning Approval By
Plan Checked By:
Permit lssued By:
NPDES lnsp. Req'd:
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Gomez, Pedro
So, Anson
Hernandez, Kathy
Dale: 0712912019
Dale: 1210912019
Dale: 1212312019
Subject to Field:
Yes
Misc. Receipt:
Misc. Receipt:
Misc Receipt:
No
No
73253
Total
07776002
07776002
07116002
07L75002
01775002
0LL16C02
57607
s3500
5777 0
57672
s7600
57607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
$650.00
$900.00
$23.46
$4.00
$22.95
$57.20
$1,657.61
$900.00
$757.61
Fire lnsp. Req'd:
Police lnsp. Req'd No Account#No
Landscaping lnsp. Req'd: No 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 360 days after its issuance,or if the work authorized
on the site by such pe rmit is suspended o r abandoned for a pe riod of 360 i)ays after
the time the work is commenced.
01 1 16002 51600
011 16002 5160't
01116002 51612
01116002 57770
$22.95
$7A7.20
$4.00
$23 46
lnspector MID#: 2019-153236
a
Phone:
License #:
Fee Total:
Paid to Date:
Balance Due:
BUILDING. !NSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUII-DER I)ELCARATION r I
IhcrehyatlirmundcrpcnrltyofpcrjurythrtIamcxcmptlir)mlhcG)nlraclos LicenscLawforthclillk)win8rcason($c.70-11.5
Busincss arxl Proltssi()n C(xlc): Any City ()r County which rcquircs a l--rmil to conslrucl. allcr. improvc. dcm()lish ()r rcpair nny
stntcturc. prior k) ils irsuancc, also rcquircs thc applicant lbr such Frmit lo lilc a siSned statcn*nt that hc or shc is liccn*d pursuanl
k) thc pr)visions ol'thc Contrack)r's Liccnscd Law (Chaptcr 9. Conrmcncittg with Scctt)n 7fiX) of Division -l of thc Busincss and
Prol'cssionsCodc)orthithcorshciscxcmptthcrchomandlhchasistirrthcallcgctlcxemplt)n. AnyviolationofScctitrnT0,ll.5byany
applicanltrrapermilsuhjcclsthe apphcantklacivilpcnaltyolnotnurclhnnfivchumlrcddollars(S5(x)).
_1, rs owncr of thc profEdy. or my emf byccs wilh wages as thcir s)lc compcnsali{)n. will d(} thc w(rk and tlr sltutm is nol
intcndcd orollcrcdli)rsalc(S(.7(X4,BusinessandPnrlcssionsC(rlciTheContract)r'sLiccnscLawd(tcsnotapplyk)anowf,crof
thcpn)frcrty whohuildsorimprovcslhcBrn.andwl&)d(rssuehworthimsclforhctsclfortltroughhisorhcrowncnrpl()yces,
Irrovidcd that such improvcnrnts m ftil intcndcd orollbrcd ti)r salc. ll, lx)wcvcr. thc buikling or inrprovcmnt is sold wilhin onc )cr
ofcomphtr)n. tlrc Owncr Buildcr will hdve thc hurdcn ol proving thal hc or shc Jid fril huil.l {)r impr(rvc thc pmlErty lor thc puqrcsc of
$lc).
_1, as owncr of thc prolEf,y, am exchsivcly conlracltrg with liccnscd c(nnrne krN k) conslruct thc proicct (Scc. 7044, Busillcss
anrl PnrlbssinCode:'IhcContract(,r's[-iccnscl-awdocstrotxpplyloanownerofprolrcrtywhohuildsorimProvcslhcrcon,
and who contracls li)r such projccls with i Conlrackn(s) liccnscd put'suant k) lhc Conlraclor's l-iccnsc Lnw).
_l amcxcmpt undcr Ii. & I).(. ftrr lhi\ rcr\r)n.
Dste :-
UABKEBS:COIIIENS4IAN
DECLARATTON
I hcrcby affirm undcr pcnalty of Frcrjury onc of thc li)llowing dcclaralions:
_lhavedi-lwill maiilailaCenificatcofConscntklSel[lnsurcti)rworkcrs comlcnsalion,as providcdlbrhyScctiul.]70Oofthc
tih)r Codc. for thc Frldrmancc of thc work for which thc pcmit is issuc,l.
_lhavcandwillmaintainworkcrs'comJrensaliorinsurancc,ls rcquirctlbySection-1700ofthcLihorCorlc.li)rthe[rcrlbmanccof
llrc work for which thls pcrmit is issucd. My workcrs conlpcnstti()n insurancc cafticr and fxllicy numhcr ilc:
Policy Number: Expircs:
_l ccf,ity that in lhc pcrli)rmancc of thc work li)r which this pcrmit is issuerl. I shall not cnrpkry any 1rcrson in any nllnlcr
so rs b hccorc suhjc'ct k) thc workcrs'c()mfEnsation hws ol Calilbrniil. and a8rcc lhat il I should hcconrc suhjcct b thc
workcr'compcnsationprovisi()nsofScclion-lTUlollhcL{tx)rCodc.lshall.li)rlhwitheomplywiththoscprovisions.
WARNIN(;: Ftihtrc k) sccurc workcrs'compcnsali{)n covcragc is unlawlitl, and shtll subjcct an cmpk}ycr lo crimintl fEnaltEs nnd
civil tlncs up t) onc hundrcd thousand d()llars ($lu),ftD), in arldition lo Ihc cosl ol compcnsati()n, drnugcs as provilcd tilr lhe
Scction -1076 of thc [-ak)r Culc. iilcrcsl and altn'ncy s tccs.
,\pllit ant:
LICI'NS!]D CONTR,\CToR
I)ECLARATION
I hcrcby allirm undcr pcnrlty ol pcrjury that I anr lircnscd undcr p(x isiiD ol Chrplcr 9 (conrnEilcint with Scction 7Un) of Divis(i .1
ol' lhc Busincss and ['rolessrrns Corlc. iurtl nty liccnsc is n tull fi)rcc aild cllccl.
Liccnsc Ctass:-Li(cnsc Numltr:
W
I herchy atfirm undcr fEnalty of pcrjury that thcrc is a conslructirn lending agcncy lbr lhe pcrfbrmnce of lhc work tbr which lhis fErmit is
issucd (Scc. 1097, Civ. C.).
kn.lcr's Namc:
hndcr's Arldrcss:
APPLICANT DECLARATION
I lrcrthyallimrundcr pcnally oIpcrjury onc ol the lblk)wing dcelarations:
DcnDlilion P.rmils-Asheslos Notilicatirtn Fcdcral Rcgulttions ( l illc 40, Pffl(,
-Rcquircd
latlcr of Notilication
_l ccrtily (hrl thc tcdcral reSulatir)ns rc8trdrng l{bcslos rclnoval arc nol {ppllc{l}lc k) this projcct.
_l c(rtili lhnl I luve rcad this applicatt)n md statc that lhc ahlvc hlornulir)n is cotrccl. I aElre b cr)mply with all City and County
ordutance$ and Statc liwr rclating b huilding constructt)n. ild hcrchy aulhoriz-c rcprcscnlatives (!f this City md Counly lo cntcr uf(D thc
ala)vc mntiurcd pft)pcdy li)r inrpcction purFx)scs.
Applicant 0r Agcnt
I'oruitor nniltr'l
l)ale:_
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenVl nsu lation
Roof Sheathinq
Shear Wall
Framinq
lnsulationi Energy
Drywall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
{, r/
FINAL rt'tt'' lc'll U)fut"/i,Y o
Certificate of Occupancy
Etc.
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