HomeMy WebLinkAbout101103028 - Permit@ City of Santa Ana 20 civic center Plaza (M-19), santa Ana, cA 92702 Building
PermitCounter: (714)647-5800 lnspection Requests: (714)667-2738 lnspectorSection: (714)647-5853
Permit #:1O1{O3O28
Pin #: 65{(\
Proiect Address:- 208 N Harbor Blvd
Assessor's Parcel: 198-061-17 Lot: NA
Unit:Brdg Address Range: 100-230.
Historic: No
Suite Range:
Zoning: SP2Block: NA Tract: NA
Planning Conditions:E0tchi rri4267 - ?./ $/2t12
Fngineer
Owner: Me onecrelr Management Cont.actor: San Pedro Sign co , i ;:1 . ,, rl'L
Address 2i791 LrIe Forest Dr, Suite 203 Address: 701 Lekme av Address:
Lake Forest, cA 92630 Wilmington, CA 90744 ,., '
Phone: (949) 305.4199 Phone: (3',10)s494661 ext. 105 Phone
renanr wsssho* :[f#- ::l']:,".,. :fl::l r,i':,,,, i,
Bus.Lict 67M Desiqner: :'ri ,"
workers Compensalion lnsurance: Address:CaTieI: STATECOMPENSATIONINSURAN
Polrcy #: 9051294 Phone: : i:..|
Expires: 04/01/2020 Licensef: ]il'.it':: rr' 'lrlrJ'llr '
0,,,,fi'l)t $t[i[ FZ;/dHlii,
Planning Approval By
Plan Checked By:
Permit lssued By:
NPDES lnsp
PWA lnsp. Req'd:
Planning lnsp. Req'd:
Landscaping lnsp. Req'd
t'GL"r"rr. Jer*
\kgfr,"
\Broddwski, Teri
Dale: O1l31l2O2O
Date. 0210512020
Date: 02/06/2020
Subject to Field:
Plan Check Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07175002
07776002
07776002
07776002
07775002
s3600
57770
57672
57600
57607
$166.53
$11544
$31.28
$1 00
$22.95
$57 20
No
No
No
No
Fire lnsp. Req'd: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No 01 '1 16002 51600
0'1116002 51601
01 1 16002 51612
01 1 16002 53600
01116002 57770
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 or abandoned for a period of360 days after
the time the work is commenced.
Fee Total:
Paid to Date:
Balance Due:
$394 40
$0.00
$394.40
lnspector tvllD#: 2020-157322
$22.95
$223.73
$1.00
$1 15.44
$31.28
Building [rse: Commercial Occupancy: N/A 1st FL Area: Patio:
Job Type: Signs Consh Type: N/A 2nd FL Area: T.t.Area:
Nalure ofwork Signs Code: cBc 2019 OtherAreas: yards Req,d:
Existing Bldg. & Use: comm.rci.l Flood Zone: x.0602320256J
proposed user # of slories: Garage Area valuation: $9'800 00
Total: 0
Description ofWolk: Install(3) lg4illuminated chennel letter w.ll signs & (5) non-illuminated channel letter shoe b,and 6igns to,"WSS, Shoes. Style.
Selection.", bond paid on M-74108.
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BUII,DER DELCARA'TION
I hqeby affirm undq penalty of perjury that I an exernpt liom the Contracto6' Licqse Law for lhe lbllowinS reen (Se.7031.5
Businss and Profcssion Code): Any City or County which rcquira a po'mit to construcl. aho. irnprove, dmolish or repair oy
structure, prior to ils issuance, also requirs the applicant ftrr such pennit to file a signed statemot that hc or shs is licmsed pumuanl
Io lhe Eovisions of the Contractor's Licensed Law (Chapt6 g. Comrnencing with Selion TOOO of Division-3 of the Business mri
ProfessionsCode)orlhatheorsheisexemplthqefiommdtheb6isfortheallegedexanption. AnyviolationofseclionT03i.5byany
applicant for a penuit subjets the applicant to a civil penalty of not morc th6 five hundred dollus ($500).
l. as oNmer oithe pnrfErty. or m) employs with wags 6 their sole compcnsation. will do the work md thc slrudue is not
iilorded oroffcredfor*le(Se.TC44.BusinasmdProfqsionsCode:TheContraclor'sl.icmscLawdo6notapplytooownqof
theprcperty whohuildsorimptovsthqmn,mdwhodo6suchworkhirnselforhersclforthroughhisorhtrowncmployees,
provided that such inprovonents ae not intmded oroffoed for slc. l[ howwo. the building ot irnprovqnent is mld within one yo
ofcompldion. the Olvner tluilds will have the budm ofproving that he or she did nol build or improve the prcpaty for the purpor of
slc'.
_1. a ouno ofthc ;rolEly. m exclusively contracting lvith liccnscd contractoG to construct the prcject (Ss. 7044, BNin6s
ed Prof6sonCodc:TheContractor'sLicenseLawdo6notapplytomown6ofpropertywhobuildsorimprovesthtr@n.
and who conlracts for such projEts with a Contracto(s) licensed pursumt to the Contrack)r's Licens€ Law).
I m exempt unds Seclion-, B. & P.C. forthis r6on.
Date:_ Owner:
WORXERS'COMPENSATION
DECLARATTON
I hecby affrrm undo pmalty of perjury onc of the following dcleatiom:
I have md will maintain a Certificatc ofConsent to Self-lnsure for workqs'compensalion, m provided for by Section 3?00 ofthc
LahoTCode. for the pafommce of the uork for which lhe pmrit is issued.
t2(haveanduillrnaintainworkes'compensationinsurance,6 requiredbySection-lT00oftheLaborCode.forthepafommceof
thc work for rvhich this permit is issued. My workqs' compensalion insurmce cmir ad policy numbe ue:
c*;,d<sie Atrytwttot lf-ll:,.. ; totae FJrKJ
Iblicy Nunrber:Expires:
_l certiry lhat in the perforrnance oflhe work for u'hich lhis pornit is rssued. I shall not ernploy any person in any manna
* o to lxcome sulrjet to the work6' compcNalion lass of Califomia. md agree that if I should become subj(t to the
rvorkm' ccmpensaltrn provisions ofSetion 1700 oflhe tabr Code. I shall. fodhrvnh comply rvith thos provisions.
WARNING: t-ailure to *cue workss'compcDsation covemge is unlaq'fuI. md shall subjet m mployr to oiminal p€naltiG md
civil fines up to one hundred thcusand dollars ($100.000), in addition to the cosl compensation. danagcs o provided for thc
Secticm 1076 ofthe Latnr Code. inlerest fcs.
D,k, I -ia)-')L)){)
t)[( 1.,1&\l loN
I htrby alfinn und6 penahy ofpsjury thal I an licoseJ undo provision ofChapto 9 (commocing with Section 7000) of Division 3
of the Businss and Prof€ssioru Code. md my licmse is in full force md e ffect.
l-icense ?Numher ?T>i{U-lcl
-y/*",6an Perlfo 9gn Cornf-qry
CONSTRUCTION LENDINC ACENCY
I heeby aflinn undo pcrralty of psjury that thfic is a coNtruction lending agmcy for the psfommce of the work for rvhich this pennit is
issued (Sec. 3097, Civ. C.).
t-ender's Addrss:
APPLICANT DECLAR,TTTON
I lucty affinn undcr penalty of pojury onc oflhe follorving declaralions:
Dcmolition Perrnits-Asbcstos Notification F-ederal Regulations (Tille 40, Ptrt6)
Required Lelter
_l regulatiore rcgading Gbetos rqnovalae not applicable lo this prcjst.
lhal I hil'e read lhis md stale that thc atxrve infonnation is con ect. I agrtr to comply
ivs ofthis City
with all City and Counly
md Counly lo flld upon lheconstruction, md hseby authorize reprsmtat
l'ermite naile
' rura Nowrro Zfr-?p2t)
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/VenUl nsu lation
Roof Sheathinq
Shear Wall
Framing
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
lVlasonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
/rr\
FINAL '1'24-7.t)V-{Lic)\
Certificate of
Notes, Remarks, Etc
I
vl\-/
Lcndcr's Nanrc.