HomeMy WebLinkAbout101102971 - PermitCity of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Building
Permit Counter: (714) 647-5800 lnspection Requests: (714) 667-2738 lnspector Section. (714) 647-5853
Proiect Address:2107 E Seventeenth St Bldg: Address Range:
Tract: A.B. CHAPMAN
Unit
Historic: No
Suite Range:
Zoning: C1Assessor's Parcel:396-321 -04 Lot: NA Block: A
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Commercial
Demolition & Clear Lot
Demo & Clear Lot
Commercial Bldg
Occupancy.
Constr Type.
Code:
Flood Zone
# of Storres:
A-2
VA
cBc 2019
x-0602320164J
1st FL Area:
2nd FL Area:
Other Areas:
Garage Area:
Total.
Patio:
T.l.Area
Yards Req'd
Valuation:$40,000.00
Description of Work: Demolish commercial building & clear lot. Bond paid on M- 1qql!-)
Planning Conditions:
/'o
Owner:
Address:
Phone:
Tenant:
Baja Fish Taco lnc
3674 S Bristo! St
Santa Ana, CA 92704
(714)486-6904
Contractor: G A Demolition
Address: 13603 KINGS CANYON CT
Fontana, CA 92336
Phone: (909) 343-9634
State Lic #: 1025003
Lic Type: C-2'l
Bus. Lic #: 374970
Workers' Compensation lnsurance:
Carrier: State Comp
Policy #: 9205835
Expires: O3l20l2O2O
Engineer:
Address:
Phone:
License #:
Architect /
Desiqner:
Address:
Phone:
License #:
Planning Approval By:Khang, Kathy
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: No
Police lnsp. Req'd: No
Flood Zone Cert. Req'd: No
Amsden, Julie
Dale: 0112912020
Date:
Dale: 01l29l2O2O
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
07776002
07775002
07775002
07776002
07776002
57607
5777 0
57672
57600
57607
Permit Fee
Microfilm Records
Bldg. Stds. Revolving
General Plan Update
lssuance
Fee Total
Paid to Date:
Balance Due:
$166.53
$3.91
$2.00
$22.95
$57.20
$252.59
$0 00
$252.59
No
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 afrer lts lssuance,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.
01 1 16002 51600
01 1 16002 51601
01 1 16002 51612
01116002 51770
$22.95
$223.73
$2.00
$3 91
t
lnspector MID#: 2020-157417
Permit #:1lJ11o2971
Pin #: 97043
I
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG.COMMENTS OWNER BTJILI)I]R DEI,CARATION
I hcrchy alfirnr ntrdcr pentlty of pcrjury lhill I am excrnpt lioilr lhc (inilrack)rs Liccnsc Larv for thc folk:wing rcrson (Scc.70-31.5
Buciilc\s tnd Proli'(sion Code)i Any City or County which rcquires il FrDril lo con\lrucl. allcr. ilu'ovc. dcnDlish or rcflir any
lo thc l)trvisions ol thc Contrnck)r's Liccnscd l;rw (Chaptcr 9. Conlrcrcing with Seclion 7(X)0 ol Division.l oflhc Busincss and
Prolt\\ionsCode)orlhatlEorshciscxcmilthcrclromandlhehxsi\fortht'allcgcdcxcrtption. AtryviolalionolSecltttrT0.ll.5hyaiy
applictnlli,rrpcrnritsubjcctsthc rpplicilnlhacivilpcnrllyof[olnx)rcthanl'ivchun(lrcd&)llrrs($5(x)).
_1. ils oNncr of lhc profrf,y. or trly cmpk)yccs silh wagc\ as tlNir solc c(nnlEnsxlion. willdo lhc work ilnd thc slftturc is not
intcntlcd oroflcrcdlirrsalc(Src.7(Il4.BusincssandProltssions(l{lc:'lhcConlruclor'sl,iccnsclnwdocsnotapplytoxnowrcrof
thc pn)lrcf,y who tililds or inpro\c\ thcctrl. and who dms ruch work hinr\cll or hcr\ell or lhrou8h his or hcr own cnrpk)yccs.
provi(lcdthtlsuch inlprovcilrntsdrcnotinlcndcdorofltrctlfirrsalc.lf.hrtwcvcr.lhchuildingorhrrprovcnrcntiss()ldwilhinoncyctr
ofcomflcli(nr. thc Osncr Buildcr will ha\r thc burdcn ofproving thal lrc or shc ditl Dol buikl or imlxrw lhe prcpcdy for tlt puqx)$ of
salc)-
_1. rs ou'ncr of lhc propcrty. am cxclu\ivclv conlrnctilrg wilh liccn\cd conlrrclors lo coil\lrucl lhc projccl (Scc. 7(H4. Bu\incs\
and PnrtLssinCodc:'lhcContrxctor'sLiccnsc[-awdocsnolapplytoilnowncrofpropcrlyshohuikls()rinrplovcslhcrcon.
and sho c(nilrrcls lbr such pr(iccls wilh a Corilrackn(s) liccnscd pursurnt lo lhc CoDlrxcbr's l-icensc Law).
lrilrc\rlrl)tlrtr(lcrSe.liorr .li&l'(.1()rllli\rcist)rr
l)nle ()$nrr:
WORKFRS' CONIPI'NSA'I'ION
DECLARATION
l hcrchy allirnlun(lcr pcnallyoIpcriuryonc of thc lolk)wirtg declnralion\:
_lhavcuxlwillnrninluiililCcrriljcatcofConscntk)Sclf-lnsurclirrw()rkcrs'coilrpcnsalion.as providcdforhyScclion.lT(X)oflhc
Labor Codc. for the pcrfortrrancc of lhc work for which thc pcrtnil is issuc(|.
fllhrvcanrlwillnainlainworkcrs'conrpcn\arioninsurrncc,as rcquircdhyScctt)n.17(x)oflhclnborCodc.li)rrhepcrlbrnrilnccof
lhc work for which lhis pcnril is issrcd. My workcrs' cotrrpcnsalion irsurancc carricr atr(l policy rlumher nrc:
vl
e.ri.yNu,.t",,4205935 -I4 e,pi,".,<,t zl ?l;2 6
_l ccllity rhtl in rhc lrcrli)rnuncc r)l thc Nork for shich lhis pcrnlit i\ issucd. I shall nol cnlpk)y any pcrson in any rtanncr
so ilstotEconrcsubjccllothcworkcrs'cotrlpcnsrli(mlcwsolCalili)rnia.ilil(lagrcclhaliflshouklhecontsubjcctlolhc
workcrs'coillpcn$tionprovisionsol'ScclionlT(X)ofthcl-ahrrCotlc.lshall.fitrlhNithconrplywilhlhoscprovirions-
WARNIN(;: I:ailurc to $'curc workers'conrlrnsation covcraSc is unlawlirl. an(l shall suh.iccl in cnrpk)ycr k) criminal fEnallic\ !n(l
Scction -1076 o[ thc [;rtr)r (l)dc. inlcrcst rn(l rthnty s lccs.
oare:!-'2-:?t. lZatc, nrr,,."*' Q&qrl--(e
LICENSED (ONTRAC'I'OR
IIECI.ABAIIQN
I hcrchy flllirnr uDdcr pcnalty of pcrjury thnt I am liccnsd undcr provision of Chrptcr 9 (conrmncing wilh Scclion 70(X)) of Division 3
of thc Bnsincss rnd Profcssions Codc. ilnd rny liccnsc i\ in full litrcc akl cfltcl.
l.irettsc Nurrl)cr:IozsocJ
Dare: t hq I -Lo Lo Conlrnclor:G-t+ Qer-s>\b<>vr
CONSTRUCTION LENDINC ACENCY
issucd (Scc. l{)97. Civ. C. ).
l.cnJcr's Nrrrrc:
-
L-cndcr's n(l(lrcss:
APPLICANT DECLARATION
I trrcby allirm undcr pcnahy o, pcrjury onc of thc lollowing dcchriltions:
Dcrrxrlirion Pcrmits'Ashcslos Nolilicalion ftdcral Rcgulalions ('l'itlc 40, Pafl 6)
_Rcquircd Lcllcr of N(ililicati(rr
-l
cc!1ily thrt thc fcdcral rcguliltions rc8ilrdinE! asbcsk)s rclnoval are not applicablc 10 lhis Projcct.
tlQt ccniiy rhur I hilvc rcad this application trnd stalc thrt thc at$vc inlbrmrlion is corccl. I aSre k) colrply wilh nll City and County
ordiDxnc€s ilnd Statc l-uws rclating lo building conslruclion, and hcrcby aulhorizc rclrcscntalives ol lhis Cily and (l)unly lo cilcr upon thc
ahovc nEnlt)ncd propcny for inslrcction purFnses.
Al,plirilnl (il-,\grnl Signillilrc
ItcrnrilN nilnrr (pritrl):.r", cg\( 5
o"r" \ lzqf?ozo
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Su bf loor/Vent/l nsu lation
Roof Sheathinq
Shear Wall
Framino
lnsulation/Enerqy
Drywall
Ext./lnt. Lath
Brown Coat
Jt/lasonry
Pool Fence
T-Bar
Handicap Req.
Deputy Final Report
Enoineer Final Report
Flood Zone Certif
//,l/
F!NAL blD/z{n @/.U,f ,Y
Certificate of Occupancy
Notes, Remarks, Etc