HomeMy WebLinkAbout101101844 - PermitPermit #:1O1101844City of Santa Ana 20 Civic Center Plaza (M-'19), Santa Ana, C.i92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section: (714) 647-5853
Proiect Address i 2709 W Westminster Avea Unit: B Brdg
Pin #: 12
Assessor's Parcel:101-131-36 Lot: NA Block: NA Tract: NA
Address Range: 2709-2727
Historic: No
Suite Range:
Zoning: C1
Building Use. Commercial Occupancy: B 'lst FL Area
Job Type: Tenant lmprovement Constr Type: V B 2nd FL Area
Nature of Work: lnterior Tl Code: CBC 2016 Other Areas:
Existing Bldg & Use: Retail sales/grocery store Flood Zone: X-0602320144J
Garage Area:
Proposed Use: Grocery Store # of Stories:
Totat
Description of Work: lnterior Tl to remove an existing non-load bearing wall between units B&C. Auth on file.
Planning Conditions:
Patio.
T.l.Area:
Yards Req'd
Valuation:
578
0@0
$5,000.00
0
c0 f
Owner:
Address:
Phone;
Tenant
Chom Chong
3844 E lnoodbine Rd
Orange, CA 92867
(7141772-3906
La Rancherita Bakery
Contractor:
Address:
Owner-Builder
Phone:
State Lic #:
Lic Type:
Bus. Lic #:
Workers' Compensation lnsurance:
Carrier:
Policy #:
Expires:
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
Graham, Jeffery
So, Anson
Zuniga, Allissa
Date:10/15/2019
Dale'. 0111612020
Dale: 011271202O
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
73836
Total
07776002
07776002
07776002
07776002
07776002
07776002
57507
53600
57770
57672
57600
57607
Permit Fee
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Totat
Paid to Date;
Balance Due:
$150.28
$41 6.1 6
$15.64
$1.00
$22.95
$57.20
$663.23
$147.50
$515.73
No
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 I 16002 51600
01116002 5160'l
01 1 16002 51612
01 1 't6002 53600
01116002 57770
Account#
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 rs suspended or abandoned for a period of360 days after
the time the work is commenced.
$22.95
$207.48
$1.00
$268.66
$15.64
lnspector MID#: 2019-155135
ID/S!G.COMMENTSSITE-WORK DATE
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subf loor/VenVl nsu lation
Roof Sheathing
Shear Wall
Z'zi/zo .tZ e rs^,*r,ZO< 2)Framinq
lnsulation/Enerqy
Drywall )a 7r-2,/D
Ext./lnt. Lath
Brown Coat
lVasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif.
FINAL 9./s./t,t /Z( " s,,/r./U\ ){h
Certificate of Occupancy / t
Notes, Remarks, Etc.
r\,o bvre-La-
C'. 37.2?7*:-56
r J//D
I hereby affirnl uDder penalty of perjury that I m exenpt from the Contraclos' License Law for lhe following reason (5@.7031.5
Busincss and Prolession Code): Any Cily or Counly which rcquires a pcrrnit 10 conslruct, ahcr, irnprove. demolish or repair any
structure, prior to its issuance. aLlo rcquires the applicant tbr such pernit to file a sigDed statement that lrc or she is licensd putsuant
to lhe provisions of lhc Conlractor's l-ic€nscd Law (Chapter 9, Commencing wilh Section 7000 ol'Division 3 ol-thc Business and
PrctessionsCode)orlhatheorsheisexemptthereliomandthcbasisfbrtheallcgedexenrpti<rr. AnyviolationofscclionT03l.5byany
applicantforapermitsubjeclsthe npplicanttoacivilpenxltyofnotmorelhatrfivehundreddollars($5(x)).
J41. n*n". nf,h" proFE(y, or rny employees wilh wages as their sole compensation, will do the work and the structurc is nol
iitcnded or offered for sale (Se.7(H4, Business and Prrfesshns Code: The Contraolor's Licensc Law does nol apply lo an owner of
theprcpcfly wlDbuildsorimprovesthermn,andwhodoessuchworkhimselforherselforthroughhisorherownemploy*s,
provided that such improverrcnts are not itrcnded or ollcrcd for salc. Il, howevcr, the building or improvcmnt is sold within one yea(
ofcompletion, the Owner Builder will have the burden ofprcvin! that he or she did not build or improve the prclEfly for the purlre of
sale).
f". o*n", uIthe propeny, am exclusively conlracting wilh licensed conlraclors lo conslruct lhe poject (Sec. 7044, Business
and holLssioDCodc:TheContracbr'sLicenseLawdoesnotapplybanownerofpropenywhohuildsorinrprovesthercon.
and who conu'acts for such proiects wilh a Contractor(s) licensed pursuml lo thc Contraclor's Liccnse Law).
-IanrexenptUndefSection-,B,&P,C,lirrthisrcasrrrr,
"".,71?p/b,>W0RK!]RS' C0MPT]NSA'I'ION
DECI-ARATIoN
tblhwing (lecllrations:I hcrcby allirm u ndcr pcnAhy of pcrjury onc of t he
_l have ud will nraiilain a Ceililicate of Consent to Self:Insure for workers' compensation, as prcvided for hy Section 3700 of the
Labor Codc, for thc performancc o[rhc work lbr which lhc permil is issued.
_l have and will maintain workers compensation iDsurance, as required by Section 3700 ot' the Labor Code, for the perfomrance of
(hc work ti)r which this pcrmit is issucd. My workcrs' compcnsalion insurnncc cafiicr ffil Imlicy numh(r uc:
Policy Nurnher: Expires: _
_l cctrify tlrat in thc perfbrnunce of the tr,ork for which this pcrmit is issucd, I shall not enrploy uny pcrson in any manncr
so a\ 1o bccorrc subjcct to lhc workcrs' cotrrpensation laws of Calilor0ia, and agrce lhat iI I slnuld bccorrc subjcct lo the
workers' conrlrcnsation provisions of Section 3700 of the Labor Code, I shall, fonhwith comply with thos provisions.
WARNINC: Failure k) securc workers'compcnsation covcmgc is unlawful, and slrall subjcct an cmploycr to criminal pcnaltics anrl
civil fiilcs up to one hundred thousand dollars ($100,fi)0), in addilion to the cosl olconrpensation, darnages ns provided for lhe
Section -'1076 ofthe Lak)r Cbde, interest and ailorney's fees.
LICENSED CONTR CToR
DECLARATION
I hereby al-lirm undcr penalty ol pcrjury that I arn licenscd under provision ol ChAptcr 9 (cornmcncing with Scclion 7000) of I)ivision I
of rhc Busincss and P()fessions Codc. md nrv liccnsc is in full lorcc :nd cfTcct.
License Clnssr_Liccnsc Number:
CONSTRT]CTION I,ENDING AGT]NCY
I heEby aflirm under lEnalty of perjury that there is a constnrctioil leildilrg agency for the performance ofthe work fbr which this pernrit is
issued (Scc.3097, Civ. C.).
lf,nder's Nanrc:
I-cn(lcr's Addrcss:
,\PI't,t('''\N'r t)u('t,Att,\'iloN
I hercby aflrnlunder penalty ofperjury one ofthe followinS declarations:
Denrclition Permits-Asb€stos Notification Federal Regulations (Title.l0, Pan6)
_Required btler of Notification
_t certify that the fideral regulati()ns regdding asbesk)s removal are Dot upplicable to lhis project.
_l ce(ify that I have read this applicalion and state that lhe above infornration is conect. I agree 1o conrply with all City and County
atx)!e nlcnli()nr(l propc(y li)r inspcction e ^2- z7-Appli(ant or Agcnt I
Prrmilec narne (prlnl):
BTIILDI}}G. INSPECTOR RECORD
08-07-201 5
o