HomeMy WebLinkAbout101102769 - PermitCity 0f Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702
Permtt Counter. (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Sectron: (714) 647-5853
Building Permit #:1O110.2769
Pin #: 464387
Project Address: 1901 E First St
Assessor's Parcel:400-081 -09 Lot: POR 15 Block NA
unit: 136 Bldg
Tract: MAYBURY
Address Range: 1901-1903
Historic: No
Suite Range:
Zoning: C5
Building Use: Mixed-Use Occupancy: M, R-2 1st FL Area:
Job Type: Tenant lmprovement Constr Type: lll A 2nd FL Area
Nature of Work: T.l. - Shelves/Refrigerators Code: CBC 2019 Other Areas.
Existing Bldg. & Use: Condos/Retail Flood Zone: X-0602320277J Garage Area:
Proposed Use: pre-packaged Food # of Stories:Total: ; :tc,.:ii'i9;:1,r1r1r-r.1 --
Description of Work: lnstall shelves (under 5'9" high) & reach-in refrigerators for an un-manned convenience E_tole:: , r i n
. I I.i: rr,.irlt,':itri','
Patio:
T.l.Area:
Yards Req'd:
Valuation:$18,000.00
i/2t/ )tiJ'lt-t I0: t1t-,iNr.DA
r'ntrns*: !/ I ctl ?F:efi: lrJtlu"//6?- l/i|/?ttur 1:JLl f'ri
Planning Conditions: lnterior work only -OnTG'.:ClOn l0[.Ol 66iii . l ?
Engineer:
Address:
Phone:
License #
Architect /
Desiqner:
Address:
Phone:
License #
r',i o95r!fii lnf,en t Clr
Owner:
Address:
Phone:
Tenant:
Cardigan 1901 First, LLC
440 W. First Street Suite 201
Tustin, CA 92780
(71415,444OOO
Quick Eats
Conlractor: Blossom lnterior
Address: 14462 Serenade Dr
Corona, CA 92880
Phone: (714125'14946
State Lic #: 934406
Lic Type: B
Bus. Lic #: 374818
Workers' Compensation lnsurance:
Carrier: Exempt
Policy #:
Expires:
Core Concepts
305 Union Street
FRANKLIN, MA 02038
(508) 528-0070
$??3.73
t1 , Urr
$166.5]
$43, trl
$63S, 1 ?
Planning Approval By
Plan Checked
Permit lssued
NPDES lnsp. I
By
PWA lnsp Req'd
Planning lnsp. Req'd:
Landscaping lnsp Req'd
Teri
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
ham,Dale: 0111312020
Date:
Dale: 0112112020
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Anson So
07776002
07775002
07776002
01775002
07776002
07716002
Permit Fee
Subject to Field
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
57507
53600
57770
57672
57600
57607
Fee Total:
Paid to Date:
Balance Due:
$166.53
$166.53
$43.01
$1.00
$22.95
$57.20
$457.22
$0 00
$457.22
No
No
No
Account#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 permit ls suspended o r abandoned for a period ol 360 days after
the time the work is commenced.
01'1't6002 51600
01 1 16002 51601
01 1 16002 51612
01 1 16002 53600
0't116002 57770
$22.95
$223.73
$1.00
$166 s3
$43.01
lnspector MID#: 2020-156931
BUILDING. INSPECTOR RECORD
t:lev 0B'()7-201 5
SITE.WORK DATE ID/SIG.COMMENTS OWNER BUII,DER ])I'I,CARA'I'ION
I hereby rfllrm under penolty of periury that I flm exempt fn)m the Contrack)rs License l-aw for the foll()wing rensn (Sec.7oll.5
Business antl l,rofcssion Corle)r Any City or County which requires a fErmii to (rnstruct. fllter. improve, demlish 0r reprir rny
structure. prirrr kr its issurncc. also rrquires the apllicrnt for such Frmi( k) file a qi8ncd stilemnt rhilr lE 'rr sb ir liceEe.-d pursuant
ro rhe pnrvrsnns of rhe Conrrilcr(tr s l.icen\ed Law {Chaprer 9. Commencing wirh Secrion Trxx) of Diririrr'ri.r r}rhe Bris)ne<s antl
Ptr)fessionsCode)ortharheorsh€isexempttherefiomandthebasisfortheallegcdexempli{)n. AnyviolationofSecliooT0lf.5hyany
applicflntforapermitsuhiectsthe applicanttrracivilpcnaltyofnotm)rethanfivehundre(ldollars($5(X)).
_1. as owner of lhe n()perty. or my empklyees with wages as their sole cornpensation. will (lo the Nork md the stNure is nor
inten(led oroffcre(lforsale(Sec.T0.l4.BusinessrndhofessionsCode:'[he(inlraclor'sLicenqeLawdoesnotapplytrranou'nerof
thepfi)peny whotiliklsorimpmvesthercon.an(lu'h)does\uchworkhinrselforhcrsclforthr()uShhisorherowncmpl()yee\.
provide(l that such inrprovetrrntq ile f,ot iilended or offrre(l f(x qlc. If. hrwever. the tuikling or irrrprrvermnt is sokl within one yerr
ofcompletion. the Ou'ner Buiklcr sill lulE the fuftlen of ptr)ving lhal he or she rlid not huikl or improvc the pn)lEf,y for the purFx)seof
vrle)
_1. as owner of the pft)peny, am exclusively conlrilcting with Iicensed contrnctors k) construct the pmiect (Sec. 7{).14. Business
arl PnrltssirnCode:'lheConlrachr'sLicensel-awdoesnotapplykranownerofpropertywhohuildsorimprovesthereon.
rnd who contracts for such projects with a (hntracktr(\) Iicensed pursuanl t) the Contrachr's License Lflw).
-IaDrexen]plUndersec(i()n-.B,&P'C,forthisreason'l)alr:
\YoRKIRS' COI\ITI,NSAI ION
DI,CI,ARA I'ION
I hrrehy nffirm un(ler nenxlty r)f periury r)ne of the folhwing dechrrtirrnr:
_l haveand*ill maintainaCenifrcaleofConsenlloSelf-lnsuref()rworker\'compensntion,as pmvidedforbySectionST(nofthe
L1h)r C(xle. f()r the p€rfonmnce ofthe work frrr which the permit is issued.
_lhaveandwillmnirtrainworkcrs cr)nrpensati()nin\urrnce,as requirc(lhySectir,n-17(X)ofthel-ahorCode.fortheperformanceof
the u)rk frrr which thi\ perrnit is issued. My wrtrkcrs conrpen\ation insurxnce crrier and F)licy nurnber xre:
Policy Number: Expires:
{ .cnrfy rfrrt rn tlr Jxrfirrnrnce '!fthe urrk fnr which thi\ ncrrir i\ rs.ucd. I .h:'ll nr{ crDlrloy any per{r)n in rny m:rnncr(r rs to hccore suhject rr! rhe sr)rlcrs comlpnsati(tn liws of(:alilbrnia. rnd rgrce thrt if l \hould hecome suhiect o the
worker\'conrpen\atir)nprovisi{)nsofSectionl?(X)ofthelihrrCode,l\hall.fo(hwithcornplywiththos.pfl)visions.
WARNING: Faifure h rcure workers'compensilti()n covernge is unlrwful, ind shall suhject an empk)yer h qiminal JEnalties rnd
civil finer up h one humlrctl thou\and (krlhr\ ($l(x).(xx)), in rtltlition to thc ro{ of damnges as provided for the
Sectiiln .1076 ilf thr l.ahtr (ixle. inrere\r and att'mv's feer:__--??
u"r", / -Li - ),o Apptr*nr: -4
o
I herehy affirm under pcnalty of periury that I am Iicensfll under provisirn of Chapter 9 (comnEncing wilh Section 7(XX)) of Division -l
of the Business an(l P()fessions (i)de, md my license is in full force and effect.
[-i.en\e NU 3 c
l)ate: /-)l - >-s (imtra(lor -2
I herehy rffirnr under lEnahy of periury thrt there is a construction bndinE ngency for the lErformance of lhe work for which this pcrfiit is
i\sued (Sec. .1(X)?. Civ. C.).
[-ender'\ Nnilrei
Lrn{irr'\ A(ltlrrs\:
APPLICAN'I' D1-CLARA'I'ION
I herehy afthrn unrler penalry of periury one of the folkrwing declarat ions:
Denxrlition Permits-Asltstr)s Notificfltion Federal Regulrtions {Title 40, Pa(6)
-Required
l.etler of N(nification
renrrvrl are not ilpnlic:rhle h lhis projecr.
rh)\e infi)nnnti(rr is corrcct. I lgree to conlrly wfh rll ('ity rn(l County
hcrthy repre\enlrtives of this ('ity nnd County (o enter ufx)n the
alx)ve,renti(ined pr)peny firr inspection purfx)se>
Appllcsnt or Agent Signelure: // //->/-
I'rmrilrr iliillr {prinO:H)n-tz;rr)
l)nlr >a)
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Vent/l nsu I ation
Roof Sheathinq
Shear Wall
Framinq
lnsu lation/Energy
Drywall
Ext./lnt. Lath
Brown Coat
lVlasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Engineer Final Report
Flood Zone Certif
FINAL 4tql%o nt \t*t,titt
Certificate of Occupancy U e
Notes, Remarks, Etc
I 'tz?)
Os ncr: