HomeMy WebLinkAbout10191771 - 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
Permit #:10191771
Pin #:7641({
Proiect Address: 2603 S Main St
Assessor's Parcel: 016-052-08 Lot: 5-12, PORS 4 & lBlock: NA
Unit Bldg Address Range: 2601 -2607
Historic: No
Suite Range:
Zoning: C2Tract: 159
Building Use:
Job Type:
Nature of Work:
Existing Bldg. & Use:
Proposed Use:
Commercial
New
Carwash
Commercial
Occupancy:
Constr Type:
Code:
Flood Zone:
# of Stories:
B
VB
cBc 2013
x-0602320278J
1st FL Area: 2300
2nd FL Area:
Other Areas.
Garage Area:
Total: 2300
Patio.
T.l.Area:
Yards Req'd:
Valuation: $200,000.00
Description of Work: Carwash tunnel w/att. equipt room/SAUSD #3848/fee pd on M-70226
Planning Conditions
Owner:
Address:
Phone:
Tenant:
Gardena Group Holdings LLC
10240 Geary Ave
Santa Fe Springs, CA 90670
(s62) 699-8611
Contractor: T L M Petro Labor Force lnc
Address: 909 N Alameda St
Compton, CA 90220
Phone: (3101 639-2227
State Lic #: 761755
Lic Type: B, A, HAZ, C-10
Bus. Lic #: 364698
Workers' Compensation lnsurance:
Carrier: State Fund
Policy #: 1541150
Expires: 0110112018
Engineer:
Address:
Phone:
License #:
Architect /
Designer:
Address:
Phone:
License #:
PA!D
Nt]\/ 01 201/
o
City of $:rnta Ana
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:
Orozco, lvan
So, Anson
Hernandez, Kathy
Dale: 0612312017
Date: 05/30/2017
Dale: '1110112017
Subject to Field:
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:\t
No
6901 4
Total
07776002
0L776002
0890700 7
07776002
07776002
07776002
s7607
53600
24000
57672
s7600
57607
Permit Fee
Plan Check Fee
SMIP - Category 2
Bldg. Stds. Revolving
General Plan Update
lssuance/New Structu
$598.00
$2,208.00
$56.00
$8.00
$21.25
$141.32Yes
Yes
No
Fire lnsp. Req'd:
Police lnsp. Req'd:
Flood Zone Cert. Req'd: No
Noyes Account#
N/A - No
N/A - No
N/A - No
Balance
Balance
BalanceEvery permit issued shall become invalid unless the work on the site authorized by
such permit is commenced within 180 days after its issuance,or if the work authorized
on the site by such permit ls suspended or abandoned for a period of1 80 days after
the time the work is commenced.
Fee Total:
Paid to Date:
Balance Due:
$3,032.57
$3,032.57
$0.00
lnspector MID#: 2015-119845
BUILDING. INSPECTOR RECORD
SITE.WORK DATE ID/SIG COMMENTS OWNER BUILDER DEL(:ARATION
I hoeby affirm under pmalty of psjury thal I m excnrpl from the Contracto6' License Law for the follorving reason (Sec.70Jl.5
Businas md Prcfssion Code): Any ('ily or County which raluire a ponil to conslnrcl. alts. improve. denolish or repair aly
slructure. prior to its issuace. also requirs the applicant for such pemit to file a signed statmmt that he or she is licmsed pursuant
to the provisions ofthe Contractor's Licensed Law (Chapt6 9. Commencing $ilh Section 7000 ofDivision I ofthe Business and
I'rofessionsCode)orthathcorsheisexernptthoehomandthebmisfortheallege<lexemption. AnyviolationofsetionT0-ll.5byany
applicantforapmilsubjetsthe applicanttoacivilpef,alyofnotmorelhanfivehundreddollds($500).
I. 6 owner ofthc proFEny. or my employffi with !vag6 6 their sole composation. rvill do the work ed the slnrclm is not
intmdeti oroffqe<lforsle(Se.TM4.BusinqsmdProfessionsCodc:TheCof,lractor'sLicenseLawdoesnotapplytoanownqof
thepnrpny whotrildsorimprov6th6@n.mdwhodo6suchrvorkhirnselforherselforthroughhisorhsownemployes.
providcd that such improvmots rc not intmded oroffqed for slc. lf. hoN66. the boilding or improlonflt is mld *'ilhin onc 1w
ofcompletion. the Orvns Builds rvill harc the hrrdo ofproving thal he or she did nol tuild or irnprove the prepqty for the puryr* of
sale).
I. d oN'nq oflhe propfiy, m cxclusivcly conlracting with licensed conlracloG lo construct lhe projd (Ss. 7M4. Buins
and ProfssionCode:ThcConlraclor'sLicenseLarvdoenotapplylomorvnsofprop€rtyrvhobuildsorimprovGthssn.
and who contracts for such prejsts with a Contractor(s) licssed pursuant lo the Contractor's License [aw).
I arn ercnrpl undfr S(lion B. & P.C. for this re6on.
Dste: Owner:_
WORKERS' CONIPENSA'I'ION
DECLARATION
I hereby amm unds poalty ofperjury one ofthe following drlaralions:
_l havc md *ill mainlain a Ceflificate of Commt lo Self-ltrure for workqs comptrsatioo. 6 lrovided for by Section 1700 of lhe
kbor Code. for the perfommce of lhe rvork for which lhe pfinil is isued.
I have and will rnainlain workm compcnsation insurance. as rquired by Scction 3700 oflhe t,abor Code, for lhc psfomance of
the rvork for rvhich lhis pennil is issued. My rvorkes compensalion insurance canier md Jxrlicy numbo oe:
Caricn
Policy Number:_Expircs:
_ I cffify thal in the psfonnance ofthc rvork for rvhich lhis ponril is issued. I shall not ernploy any pmon in any manner
so as to betome subjccl to lhe workm'cornpnsation larvs ofCalifornia. and agre that ifl should beconle subjffl to the
workss'compmsalionprovisionsofSeclionST00oflhel.aborCodc.lshall.forthwithconrplywiththo*provisions.
WARNING: Failurc to sure rvorkm'composlion cov@ge is unlarvful. and shall subiet m anploy,o to oirninal lFnahis and
civil llnes up to onc huf,dred thouund dollm ($l in addition to of compenstion.as provided fur the
Seclion.t076 Codc. int16l and allomey's
DECLARATION
I heeby a{Iirm undo pmalty ofpsjury lhal I m licm*d undq provision ofChaptr 9 (commencing rvith Setion 7000) of Division 3
of thc Busines md Profsions Code. md mv licse is in full force md effccl
l-iceilsc Number;
Ihdebyaffmund6penun,o,-,,o.n"',nffi*o.n*o,,,,*,,o,*"-fomilceoflheworkforwhichthistEmit6
issued (Sc. -1097, Civ. C.).
Lender's N8E+
"U,Kru.
APPLICANT DI'CLARATION
I hoeby allm undo poalty ofpsjury one oflhe following dsltrations:
Demolition Pmits-AsbGtos Notification Fcdsal Rcgulalions (Tille 40, Paa6)
-Required
Lelts of Notificalion
I ccfliry lhat the fed6al regulations rcguding asbestos rmoval are not applicable to this prejet.
I cdify that I havc read this application md state lhat the above infrrnnation is cor6l. I agre to conrply rvith all ('ity and County
ordinancs md SIate [,arvs rclating to building of this ('ity and Counly to mts ufFn lhe
above mmtioned propay for
Appliceill or Agent Signature:
I'ermilcc n{me (print)r
md herebv aulhorize
,,,"rdt fI?
Set Backs
Forms/Steel/Holdowns
Erection Pads
UFER Ground
SLAB Floor
Subfloor/VenUl nsu lation
Roof Sheathing
Shear Wall
Framing
lnsulation/Energy
Dnnryall
Ext./lnt. Lath
Brown Coat
Masonry
Pool Fence
T-Bar
Handicap Req
Deputy Final Report
Enqineer Final Report
Flood Zone Certif
I N
FINAL -?t -ta u+&
Certificate of Occupancy
Notes, Remarks, Etc.
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